Cyber Safety: A Pragmatic Prescription

As if pediatricians didn’t have enough on their plates caring for their young patients and trying to guide parents in their efforts to keep their kids healthy and safe, now they have social media and digital technology to contend with. The Digital Age has brought with it a variety of social contagions, online addictions and emotional pathogens that present new challenges to young users and the adults whose job it is to help them deal with the problems and threats that are part of growing up.

Gwenn Schurgin O’Keeffe, M.D., F.A.A.P. is one of a handful of “celebrity” pediatricians who makes the rounds on television, radio, conferences and online offering advice to fellow physicians and parents alike. She appears regularly on programs such as CNN’s Issues with Jane Velez-Mitchell, Nancy Grace, the Today Show and Good Morning America. In addition to being adept with a sound bite, O’Keeffe is known for doling out advice that is founded on common sense as well as medical knowledge.

One of the few pediatricians with a publicist, O’Keeffe is CEO of Pediatrics Now, an online health and communications company. Through Pediatrics Now and her nationally syndicated blog, she addresses issues ranging from general health to those concerning the intersection of health care and social media. She is on Symantec’s Family Norton Online Advisory Council, the speaker’s bureau for the National Partnership for Safe Computing and is a Fellow and National Spokeswoman of the American Academy of Pediatrics. She serves on the Executive Committee of the Council on Communications and Media.

O’Keeffe is the author of CyberSafe, which helps parents, kids and teens understand how the digital world works and how to navigate it. She recently co-authored a clinical report from the American Academy of Pediatrics (AAP) titled The Impact of Social Media Use on Children, Adolescents and Families.” The report presents a research-supported picture of the opportunities and dangers facing young children and adolescents online and offline. Intended as information and advice for pediatricians, the report is valuable reading for parents or anyone who has a stake in kid safety and well being, which is to say everyone. [see Literacy 2.0 3/30/2011]

Literacy 2.0 spoke with Dr. O’Keeffe in between media appearances about the range of new literacies that pediatricians must understand and incorporate into their caregiving. Her advice is nothing to sneeze at.

How is the job of the family pediatrician changing as a result of new digital tools and services, such as social networking?

The job is still the same. Pediatricians are responsible for keeping kids healthy and keeping families informed on the issues that are needed to keep kids healthy. But the Digital Age has added a layer of new stuff that pediatricians are not trained in and that they never had to deal with before.

As you look around at others in your profession, what is the current digital literacy status among pediatricians?

It’s all over the place. There is a small informed subset of pediatricians, many of them younger, who are familiar with the issues because they are on Twitter and have a Facebook account and are texting actively. The challenge they face is how to bring digital issues into clinical practice–what to do when they have a patient in front of them.

For pediatricians who didn’t grow up digital, it depends to some degree on where they are practicing. If they are practicing in an underserved area, or serving ethnic populations where there is low technology adoption, you can have a double digital literacy gap because the pediatricians’ digital literacy might reflect the populations they serve.

How does the new clinical report from the AAP try to close the gaps?

We are trying to help pediatricians realize that in one way this stuff is new but in another way they are really just asking about the same social history and family history they have always been asking about. The difference is now they are trying to find out how the digital stuff is impacting the kids. Our goal is to try to get them to ask a few simple questions to find out if their families are using this social media and if there are any problems.

What sort of questions?

Are kids getting bullied online? Are relationships being expressed more openly online? Are kids having trouble with that? Maybe this technological layer is causing trouble for the kids they care for and maybe not.

These new literacies are as novel for the pediatricians as they are for families. How do pediatricians go about becoming more digitally literate?

They have to make the effort to learn. There are a lot more articles being written in the major medical journals, if they choose to read them. The conferences are starting to add digital technology issues. There are a lot of Web 2.0 events that have a health track now. What I suggest is just start using the stuff. Get a Facebook account. Follow some people on Twitter. Learn about texting by texting people.

What can pediatricians do to help parents get closer to their kids in their digital realm?

The first thing pediatricians have to do is help parents realize that we live in one world. It’s not an online and offline world. The quicker they get to that notion the easier it will be. I tell pediatricians to figure out where kids are getting their information. That’s where you want to be. Join the conversation.

Are there certain steps parents should take?

They have to stop thinking about computers and cell phones and all of these technologies as different than anything else in life. It’s there. It’s part of everyday life. We have them like we have stoves or cars or coffeemakers.

Getting online has to be thought of as the same safety process as anything else in life. There is a process you go through. We would never let our kids cook in the kitchen without first teaching them the basics of how to make Jell-O or pudding and basic kitchen safety. It’s the same with crossing the street or riding a bike. The example I like best is driver’s education. You don’t just hand your teenagers the keys and say “bye.”

Parents should have discussions with their kids early and routinely. That’s how they will figure out where their deficits are and what their kids need to know. The key is to raise kids with those skills instead of waiting until the kids are all of a sudden wanting to be more independent and they join Facebook and do something foolish and a crisis develops, which is what is happening currently.

In some families it’s the parents who don’t have a clue about the technology. How do the kids teach the parents what they need to know?

That’s the new paradigm. If I’m a kid, I can’t tell mom or dad how to drive a car or make them better at it. But when it comes to digital literacy exercises, I might be half the lesson.

This new reality requires parents to realize that the kids know a thing or two about their own lives. Parents that listen to their kids will do better with digital literacy if they really listen when their kid says, “No, mom and dad, it is not like that online.” Parents have to get rid of their preconceived notions in order to get something out of the new paradigm. The same is true for physicians, educators or any other adults.

But just because a child knows how to do something digitally, that doesn’t mean they know how to do it wisely.

That’s right. The problem is the kids sometimes think they know when they really don’t. They don’t always understand about privacy settings or how to post properly or how to friend appropriately. Those are things that have to be taught. It is a balance between listening to kids and learning what their experiences are like and making sure they understand some fundamental skills so they don’t get into dangerous situations.

What, in your opinion, is the biggest threat to kids online right now?

The biggest risks are peer-to-peer threats, threats from each other. That is very different than what some parents want to believe.

Then what about child predation? The AAP clinical report did not even mention it.

Predation is not a big deal. It is there in some settings, but overall predation is not a big problem in the social media setting. Overblown fears of child predation have been debunked by numerous studies. As pediatricians we don’t worry about that too much. That is not where the emphasis needs to be.

What are the most serious peer-to-peer threats?

Mostly, it’s the mean kid thing, what we call cyberbulling, and not respecting each others’ privacy. Sexting is also a major concern.

Are those threats getting worse?

Not necessarily getting worse. The situation just needs to get better.

What do kids need to know and do to be safer online?

Kids need to understand the rules of social networking: How to post appropriately, how to use privacy settings and how to friend appropriately. But basically they need to learn to be good citizens.

Good old fashioned human decency?

Yes, but that can be hard for kids to develop, especially when their learning environments are stressful. A lot of high school settings are not very positive. It might be hard to be a good citizen in some negative situations. If kids don’t feel good about themselves in the offline world, they won’t in the online world either. We have to help make it easier to be good online by teaching them how to be good people–online and offline. It’s very basic.

Then the big picture solution is not so much fixing problems as preventing them?

A lot of people live by the risks as opposed to living by what good the online world can do while maintaining a healthy respect for the risks.

Some people get caught up in the risk labels and don’t understand that what creates those risks is sometimes not having a philosophy of how to move forward in a positive way. If you help kids become good people and live an ethical life and have manners and all that good stuff, you don’t become focused on the risks and the risks don’t become self-fulfilling prophecies.

If you teach kids how to live in this environment in a healthy way you minimize the risks.

How so?

It’s no different than anything in health. You teach your kids what do if symptoms of a disease emerge. You teach them what to do if any of the threats come up and how not to freak if they do. I believe all these problems happen because we put the kids online without knowing the rules, without knowing what the social world is all about and what to do when bad things happen.

Your work focuses heavily on prevention and on viewing cyber safety through the lens of normative child and teen behavior. Why is that so important?

Look at the history of digital media. Out of the blue, along comes social media and broadband and nobody really knows how to behave. So we get things like cyberbulling and sexting. But you can’t blame the kids. They are just being themselves. They don’t know what they should or shouldn’t be doing in this environment. They are just being kids. They are just expressing their normal temperament with technology added to the mix. To say it is their fault is like blaming them for running out of gas without telling them they have to fill up the tank.

Now that we have some experience with digital environments, we know what the dangers are and what it takes to make it safer and more civil. We can tap the good instincts in kids to make the online world a better place. I believe kids want to do good. Kids don’t want to be treated badly and don’t want to treat other kids that way.

Um, all kids?

Okay, there are always going to be mean kids. You can’t fix everybody.

What is your social media philosophy?

I hate quoting Oprah, but Oprah says live your best life. If you embrace that philosophy in what you do with or without technology it works. If you take that approach with teenagers it is going to help them. It is not going to help them all the time, because they can be a droopy bunch and they sometimes shoot from the hip and their brains aren’t always functional because of hormones.

We are always going to have a certain amount of what looks like cyberbullying and some of this sexting stuff because they are teenagers and they like to look at naked pictures and sometimes they say mean things to each other. We have to be very situational and look at what is happening around an incident and see if it is what it looks like or if it is just teens being dumb teens.

Are online resources helping kids manage and maintain their own health?

For kids it’s a qualified benefit. For them to get good health information online and know it’s good they have to understand how to do a search online and know that the site they are looking at is reliable. That is true for everybody, but particularly true for kids.

It is a benefit in that you can get some fabulous information online and teens do have a lot of health questions. But they need a lot of guidance in how to do an internet search and how to find those reliable sites.

Is that happening?

I’m not sure they are always getting that. I think it needs to be added to their education. It is not necessarily something parents can help with. The kids need to get it from a medical librarian, or health education teacher or somebody who can show them how to get the information and how to assess it. That is something that needs to be addressed.

You are saying that at some point we need experts.

That’s why the clinical report was written. Social media really is a health issue, and if parents aren’t aware of what these issues are, the good and the bad, then they won’t know how to best empower their kids so that they can be healthy and safe when they are using it. They don’t know what to look out for if things are going wrong. With a pediatrician guiding them they will know how to do that and when to call for help.

Who is ultimately responsible for the teaching and training of all these literacies, for advising parents to get engaged and advising the kids themselves?

It is a community effort. Everybody involved with kids today has a stake in it. It’s the it-takes-a-village philosophy. All we are doing in the report is laying out the pediatricians’ stake in it. Other people have to look at their stake. Everybody in society has a stake in helping kids be better citizens and today that involves technology. That’s just the way it is.



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