CASE: Max is a 3-year-old healthy boy who was brought to the pediatrician's office by his mother for frequent temper tantrums at home. His teachers at the Montessori school are concerned about his communication skills. He is very talkative with his peers, but he constantly speaks about Thomas the Tank Engine. His peers seem to be uninterested in his repetitive stories. His teachers believe that Max has difficulty separating fantasy and reality.
At home, his mother describes Max as “difficult to control.” When placed in time-out, he hits, kicks and scratches his mother. He has a large vocabulary, but mostly speaks in phrases directly from cartoons. For example, he repeats a particular phrase from a program in which the main character grows in size with fury every time he gets angry and says, “I hate it, leave me alone.” Before this exposure, the mother reports that her son had never used the word “hate.”
Max watches 5 hours of children's programs on television every day; he is not exposed to any news programs. Frequently, he watches the same episode of a program many times. Max's mother believes that he can watch as much TV as he wants as long as it is “good programming,” so he only watches PBS kids shows and the Disney channel.
Wendy L.M. Hunter, MD, Pediatric Resident, University of California San Diego, San Diego, CA.
Victor C. Strasburger, MD, Professor of Pediatrics, Professor of Family & Community Medicine, Chief, Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico, Albuquerque, NM.
David M. Snyder, MD, Medical Director, Child Development Services, Exceptional Parents Unlimited, Fresno, California Clinical Associate Professor, Department of Pediatrics, CSF School of Medicine, Fresno, CA.
Martin T. Stein, MD, Professor of Pediatrics, University of California San Diego, Children's Hospital San Diego, San Diego, CA.