We are convinced that repeated exposure to entertainment violence in all its forms has significant public health implications," APA President Daniel B. Borenstein M.D., told senators on Capitol Hill last month. Borenstein testified before a hearing called by the Senate Committee on Commerce to review the Federal Trade Commission’s (FTC) report on the media industry’s marketing practices. The report, which was released last month amid much media hoopla, accused entertainment industry executives of specifically targeting 10- to 12-year-old children in focus groups to market materials labeled by the industry itself as not suitable for children under 17.

"As a nation, we are awash in a tidal wave of electronic violence," Borenstein told the committee, testifying on behalf of both APA and the American Academy of Child and Adolescent Psychiatry (AACAP). Parents have a right to know what is in the television, film, music, and videogame products their children are exposed to in the same way they know what is in the cereal their children eat for breakfast, Borenstein said. He called for clear labeling of media to guide parents, declaring that "what goes into a child’s brain is just as important as what goes into his stomach."

Borenstein’s appearance before the committee was in response to a request to APA, AACAP, and the American Academy of Pediatrics by the committee chair, Sen. John McCain (R-Ariz.), to provide evidence of the impact of exposure to violence in the media on children. The hearing garnered intense publicity due to the ever-sensitive connection between the appearance of media censorship and protection of First Amendment rights. The list of witnesses also drew much attention to the hearing, with testimony from Democratic vice-presidential candidate Sen. Joseph Lieberman (D-Conn.) and Lynne Cheney, wife of Republican vice-presidential candidate Richard Cheney.

The report was in response to calls from President Clinton and Congress following the Columbine tragedy to determine whether the entertainment industry intentionally promotes to children and teenagers products that the industry itself acknowledges warrant parental caution.

"For all three segments of the entertainment industry [movies, music, and computer and video games]," the report concludes, "the answers are plainly yes."

The FTC found that of 44 movies rated R for their violent content, 35 were specifically targeted by industry marketing executives to children under 17. Of 55 music recordings with warning labels for explicit content reviewed by the FTC, marketing plans for 15 of them identified teenagers as part of the target audience. Of the 118 computer and video games with a Mature rating for explicit violence, reviewed by the FTC, 83 were targeted to children under 17.

The FTC report noted that in the year and a half since the President requested the report, the three segments of the industry reviewed have made progress in addressing the concerns about marketing practices. However, the FTC called on industry leaders to take additional actions. Specifically, the report recommended that each segment of the entertainment industry establish or expand self-regulatory codes that prohibit marketing of violent media to children and impose sanctions for violations. In addition, the FTC called on the industry to increase parental understanding of the ratings and labeling, as well as increase compliance at the retail level, thereby reducing sales to inappropriate customers.

APA, AACAP, and the American Academy of Pediatrics testified in support of the report’s conclusions and recommendations. "We continue to strive for a much stronger and clearer media rating system," Borenstein said. "An effective media rating system should describe content as to language, sex, and/or violence. An informative, uniform guideline system will help parents decide what is appropriate for their children."

Borenstein cautioned that guidelines should not assume that children are incapable of understanding double entendres or assume that this type of exposure is not harmful simply because of the child’s chronological age. Borenstein reiterated APA’s offer to work with the entertainment industry and other organizations to strengthen the rating system.

Donald Cook, M.D., president of the American Academy of Pediatrics, testified that since the 1950s, nearly 3,500 studies have examined whether there is an association between media violence and violent behavior. "All but 18 of those studies," Cook confirmed, "have shown a positive correlation." Cook said that media violence is not the only, nor the strongest, predictor of violent behavior in children; however, "the media have great potential for shaping the hearts, minds, and behaviors of America’s young people, and we all need to understand and accept this potential as a very serious effect."

Borenstein told senators, "APA and AACAP are not suggesting that entertainment violence is the sole, or even the most important, factor contributing to youth aggression, antisocial attitudes, and violence. Family breakdown, peer influences, the availability of weapons, and numerous other factors all contribute to these problems. A public dialogue, parental involvement, and clear information about media content through an effective rating system are key to enhancing the health and well-being of America’s children."

Senators from both sides of the aisle expressed disgust with the industry practices described in the FTC report. Sen. Slade Gorton (R-Wash.) noted, "We should be able to entertain our adults without harming our children." Several senators were particularly annoyed by the failure of any movie company executives to appear before the committee. "I can only conclude," said McCain, "that the industry was too ashamed to show up."

Jack Valenti, president of the Motion Picture Association of America (MPAA), appeared before the committee on behalf of the movie industry executives. Valenti acknowledged the conclusions of the report, calling it "fair, objective, and strident," and pledged to meet immediately with movie industry executives to discuss how they can implement the report’s recommendations.

Committee members questioned Valenti vigorously, so much so that at one point he acknowledged Borenstein, who was seated at the witness table nearby. "I’m glad Dr. Borenstein is here," Valenti said, "because as soon as this hearing is over, I’m going to seek him out for professional counseling."

On a more serious note, Valenti acknowledged that using 10- to 12-year-olds in a marketing focus group is "wrong, unassailably wrong, and there’s no excuse to sustain it." However, Valenti defended the movie industry’s current rating system, citing a study that "81 percent of parents today understand the system and say that it is fairly or highly useful."

"It is important to note," McCain scolded Valenti, "that the presidents of APA, the American Academy of Pediatrics, and representatives of the American Psychological Association are all in agreement that the present rating system is both inadequate and doesn’t provide sufficient information to parents. That, Mr. Valenti, is a pretty strong indictment of the present system, in my view. I think the respect with which these professionals are held by the American people might be instructive to your industry."

In a written statement expressing harsh criticism of the entertainment industry, Clarice Kestenbaum, M.D., AACAP president, compared the marketing practices with the media executives to those of the tobacco industry.

"Parallel to the tobacco companies’ admission of marketing deadly tobacco products to children," said Kestenbaum, "is the revelation that the movie and video [companies] set promotional goals for exposing children under 17 to R-rated movies and videos. This is an unconscionable invasion of the development process that influences millions of youngsters in the worst way."

Borenstein noted in his testimony that in 1996 APA and AACAP declined to endorse the MPAA rating system it was developing for television, concerned that it did not provide sufficient information to parents. "Regrettably, we are here again today because the media industry has not taken comprehensive, responsible steps to consistently and accurately identify violent content in its products and continues to market violence as entertainment to children," Borenstein told the committee.

"We many times have special interests represented before this committee," McCain told Borenstein. "But you, Dr. Borenstein, represent, I think, the kind of special interest that has the most credibility in your testimony, and we thank you for your time and your service to our nation’s children."

Following the hearing, Valenti returned to California where he met with representatives from the Directors’ Guild of America, who joined the call for an overhaul of the movie rating system. The guild vowed to lead an effort to "give parents more information so that they can choose films suitable for their children," according to movie director Rob Reiner.

McCain had scheduled a second hearing at press time, giving movie company executives another chance to appear before the committee. Valenti vowed, "I will produce them, Mr. Chairman."