Reviews of pediatric research

December 1, 2007

E-mail communication * Language development * Alcohol initiation ... and more

• E-mail pleases families and physicians

According to a study conducted in an academic pediatric rheumatology practice, parents who communicate with their child's doctor by e-mail think that, compared with phone contact, using e-mail increases access to their child's physician and improves quality of care.

During a six-month period in the two-year study, investigators measured the time required for the physician to answer questions via telephone compared with e-mail. Time recorded for each e-mail encounter included time spent reading the e-mail, and typing and sending a response. Time recorded for each telephone encounter included time spent dialing the number and completing the call. The time spent on calls where no one answered also was measured.

The families enrolled in the e-mail program were sent a 12-question survey one year after the program had been in place; questions related primarily to physician access, understanding of medical tests, and overall satisfaction with the e-mail service. Parents did not believe that e-mail distanced them from their child's doctor (Rosen P, et al: Pediatrics 2007;120:701).

Commentary:

I guess e-mail communication with patients and parents is on the way. But, on balance, it may not be a good thing. E-mail offers improved documentation, asynchronous communication that might decrease interruptions during patient care, and, at least in this study, more efficient responses. But there is a downside. Without visual or auditory cues, this communication may be more inexact than in-person or phone contact. And while this rheumatology practice generated few e-mails per day, a general pediatrician could be swamped with messages, all requiring responses that, for now, are provided without payment.

• DVD/video viewing slows infants' vocabulary growth

Investigators measured the association of early viewing of TV and DVDs/videos with language development. They interviewed by telephone more than 1,000 parents of children from 2 to 24 months of age in Washington state and Minnesota about their child's viewing of TV or DVDs/videos, along with child and parent demographics, and how often they engaged in several types of parent/child interactions.

Parents who indicated that their infants watched TV or DVDs/videos were asked to report the amount of time the infant typically spent viewing each of six types of content: children's educational programs on TV, children's educational programs on DVD/video, noneducational children's TV shows, children's movies, baby DVDs/videos, and adult television. Investigators also asked parents to complete the short form of the MacArthur-Bates Communicative Development Inventory (CDI). They then evaluated associations between the norm for CDI scores by age and gender and media exposure, controlling for demographics and reported parent-child interactions, such as watching media together, listening to music together, or reading a story together.

Among infants 8 to 16 months old, each hour per day spent viewing baby DVDs/videos was associated with a significant decrease in CDI score-in a dose-related manner. The effect was specific to baby DVDs/videos, however, not to the other five content types. Among children from 17 to 24 months old, no significant associations were seen between any category of TV or DVDs/videos and CDI scores. How much viewing was done in the company of the parent did not affect CDI scores in either infants or toddlers.