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Practitioners should be alert to internet pitfalls for the young

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By Dr Choong-Siew Yong

During the recent meeting of the AMA’s Public Health and Child & Youth Health Committee, members considered children and young people’s use of the internet.  Today’s children and young people are growing up with unprecedented internet access and reliance on social networking and, while there are likely to be many benefits, there are also likely to be potential problems.

Concerns range from internet and gaming addiction to increased access and exposure to websites that promote unhealthy thinking and behaviours, such as websites that promote bullying, self-harm and eating disorders.

Last year, the AMA produced two resources on childhood bullying (one for doctors and another for consumers), both of which highlight the pervasive nature of cyber bullying. The longer term effects of cyber bullying may be more serious than other forms of bullying, with a potentially increased risk of suicidal thoughts and behaviours. Children and young people also report a reluctance to disclose that they are experiencing cyber bullying due to fear that they may be banned from, or have restricted access to, their mobile phones or computers.

There is also a wide range of internet content that is not appropriate for children and young people.

An emerging area of interest is the growth in websites that focus on self-harm and body image.  ‘Thinspo’ or ‘thinspiration’ websites often include detailed information about dangerous eating and exercise habits, as well as advice on how to hide these behaviours. Most sites also include extensive photo galleries of extremely thin fashion models and celebrities.

Many websites allow users to post material anonymously that may be appealing for those experiencing psychological distress.  Excessive exposure to these websites may normalise harmful thinking patterns and behaviours.

There are also groups of children and young people who spend excessive amounts of time on the internet (including online gaming). While there was some debate about the inclusion of “internet use disorder” in the latest version of the Diagnostic and Statistical Manual of Mental Disorders, it is clear that this is another area that requires further research.  Overseas experience shows that, left unattended, internet and gaming addictions can have very serious consequences.

While clinical guidance is emerging, it is important that medical practitioners with younger patients are aware of these issues.

Not all online activity will pose harm, but it may be an avenue of inquiry when speaking with younger patients.

There are a small number of organisations undertaking research and advocacy in this area in Australia, such as the Young and Well Cooperative Research Centre and the Network for Internet Investigation and Research Australia (NiRA).  The NiRA website has information for both the public and health professionals (http://www.niira.org.au).

 This is an area the Committee will continue to monitor.