ABSTRACT. This statement describes the possible negative health effects of television viewing on children and adolescents, such as violent or aggressive behavior, substance use, sexual activity, obesity, poor body image, and decreased school performance. In addition to the television ratings system and the v-chip (electronic device to block programming), media education is an effective approach to mitigating these potential problems. The American Academy of Pediatrics offers a list of recommendations on this issue for pediatricians and for parents, the federal government, and the entertainment industry.

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In September 1977, the Academy published a statement calling for a ban on the use of trampolines in schools because of the high number of quadriplegic injuries caused by this apparatus.1 A considerable amount of thought and action resulted. The Academy does not endorse trampoline use, but a revision of the Academy's position to allow for a trial period of limited and controlled use by schools seems appropriate. However, careful assessment of the incidence and severity of injury must continue during this trial period. The trampoline is a potentially dangerous apparatus, and its use demands the following precautions: 1. The trampoline should not be a part of routine physical education classes. 2. The trampoline has no place in competitive sports. 3. The trampoline should never be used in home or recreational settings. 4. Highly trained personnel who have been instructed in all aspects of trampoline safety must be present, when the apparatus is used. 5. Maneuvers, especially the somersault, that have a high potential for serious injury should be attempted only by those qualified to become skilled performers. 6. The trampoline must be secured when not in use, and it must be well maintained. 7. Only schools or sports activities complying with the foregoing recommendations should have trampolines.

The aspiration of a foreign body is a common hazard and the second greatest cause of home accidental death in children less than 5 years old.1 The National Safety Council reported more than 450 childhood deaths in 1978 caused by the accidental ingestion or inhalation of objects or foods resulting in the obstruction of respiratory passages. Pediatricians must emphasize the dangers of this emergency situation and teach first aid measures essential for proper evaluation and treatment. Much existing data on treating the choking child are anecdotal. Review of the available literature suggests that the following approach be adopted. Any foreign body in the upper airway is an immediate threat to life and requires urgent removal. If the child can speak or breathe and is coughing, any maneuvers are dangerous and unnecessary. If the choking child is unable to breathe or make a sound, turn the child's head, place the child face down over your knees, and forcefully give four back blows. If this procedure fails to propel the object from the windpipe deliver four chest thrusts rapidly. Repeat these procedures as necessary if there is no response. Finger probing of the mouth should be attempted only if the foreign body is visualized. If the victim is an infant, place him over your forearm for the maneuvers. Older children can be placed on the rescuer's lap or on the floor. Pediatricians should familiarize themselves with recommended methods of cardiopulmonary resuscitation (CPR) for the various age groups.2 Remember, if the child is able to breathe and make sounds, and is coughing, these maneuvers are not needed.

When the 55 mph national speed limit became a law in 1973, the first significant reduction in the number of highway deaths in this country occurred. When this speed limit has been maintained, the number of automobile accident fatalities and injuries has continued to decrease. However, recent statistics1 indicate that the legal speed limit is again being exceeded, and the number of automobile accidents are again beginning to rise.2-4 The United States is in the midst of a worse energy crisis than the one which prompted the enactment of the 55 mph speed limit in 1973, and we should be more aware of attempts to save energy as well as save lives. The Committee published comments on the incidence of mortality and morbidity in automobile accidents and the speed limit in its 1975 and 1976- 1977 newsletters.5,6 Because of recent statistics, the Committee wishes to reemphasize its previous statements. The Committee strongly endorses the national, maximum speed limit of 55 mph as an effective method of lowering the incidence of automobile accidents, injuries, and fatalities. Pediatricians should make every effort to reinforce this form of accident prevention by personal example and by education of pediatric patients and their parents.

The Consumer Products Safety Commission issued a report on baby-walker related injuries at approximately the same time that an article on the same subject was accepted for publication in Pediatrics.1 The latter study of the risks and problems of baby walkers as seen in a private practice accurately expresses the problem as most practicing pediatricians see it. However, only a portion of users who are sufficiently injured to require treatment will be observed or treated by pediatricians. Thus, the CPSC report of 23,900 walker injuries requiring treatment in one year, 1980, indicates a much greater problem than might be inferred from the experience of a single pediatric practice.

As many as half of routine ill-patient visits in pediatrics practice involve respiratory symptoms. It is not surprising that we see so much coughing and wheezing when we consider that children are still developing immunologically and are, therefore, more susceptible to infection. In early life, most of these infectious diseases occur in the respiratory and gastrointestinal tracts. In addition, the gradual exposure of the constitutionally allergic child to environmental allergens pre-disposes to the development of respiratory symptoms. Childhood is also a time for congenital defects of the cardiopulmonary system to become apparent. A sometimes overlooked cause of respiratory symptoms in infants and young children—and one that can become rapidly and severely complicated if misdiagnosed—is the aspiration of foreign bodies. Aspiration or ingestion of foreign bodies remains a significant cause of morbidity and mortality in the pediatric population. Children between 8 months and 4 years of age are at highest risk. Not all cases of aspiration are of the acute, obstructive variety, and pediatricians should consider a foreign body as a possible cause of coughing and wheezing even when no definite history of aspiration is obtained. Children of course are curious and their natural tendency is to reach out and explore new objects. Bringing objects to their mouths to taste and to test textures is common.