August 3, 2023 / Pediatrics

The Internet and Your Kids: 8 Tips for Keeping Safe Online

Talk with your kids about online risks, and consider monitoring their activity  

Internet Safety for Kids: Online Safety Tips – Cleveland Clinic

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When you think back to your childhood, it’s easy to see how parents’ concerns have changed.

They probably taught you safety lessons like looking both ways before crossing the street. To stop-drop-and-roll if you ever caught on fire. To wear a helmet while riding your bike. 

But they probably never sat you down and talked about cyberbullying and keeping your passwords secure. They didn’t have to worry about whether your username gave away too much information about you. Or whether creeps would watch your dance videos on YouTube. 

Now that you’re the parent, though, you see potential threats to your kids not only in the physical world, but also in the online world.  

It can be scary to think about the complicated ways the internet affects your kids’ lives and their well-being. It’s also normal to not know what to do about it. After all, these weren’t the safety lessons you grew up with. 

So, we talked with child psychologist Kate Eshleman, PsyD, about internet safety and kids — how to talk about it and where to draw lines. 

Tips for internet safety 

In the spring of 2023, the U.S. Surgeon General issued an advisory about the risks of social media on children and teens. The report provided advice about the “growing evidence that social media use is associated with harm to young people’s mental health.” That includes things like setting unrealistic expectations, increased depression and anxiety, and impacts on sleep.  

But it’s not just social media that can affect your children’s physical and mental health online. The internet as a whole is a portal to the best and worst that society has to offer. And it’s changing every day. 

“As parents, part of our job is to educate ourselves about what’s out there and what’s available to our kids,” Dr. Eshleman notes. “But kids are very smart. Their brains are wired to learn quickly. It’s hard to keep up with technology and content that evolves daily.” 

So, how do you help your children respect the opportunities and dangers of the internet? And to what extent should you monitor their activity? Dr. Eshleman offers advice. 

1. Talk about the risks of internet access 

Access to people and information at all times is a given in your kids’ lives. They don’t know a world where that wasn’t an option. But that access comes with responsibilities that they likely won’t understand without some coaching. 

“Kids are being exposed to ideas and information on the internet all the time, but they may not appreciate that they’re not necessarily always getting truthful, safe or age-appropriate content,” Dr. Eshleman explains. 

Parents and caregivers can help set expectations with their kids to help them sort out the good and bad of internet access. Yes, the internet can help them learn about science or new cultures or current events. And, yes, cat memes can be a welcome distraction on a stressful day. But the internet can also be a hotbed of hateful commentary, illegal activity and false information. And kids should be aware of the dangers — in an age-appropriate way. 

“You don’t necessarily need to talk about human trafficking, with your 9-year-old child, but it is appropriate to say something along the lines of, ‘There are people out there who use the internet to do bad things,’” Dr. Eshleman says. “Explain steps you’re taking as their parent to keep them safe online. And let them know that they can talk with you about anything they have questions about.” 

Some topics of conversation might include: 

• The importance of keeping personal information private. That includes things like their name, school, photos and passwords. 
• How to think critically about what they see and read. That means understanding which sources are more likely to give reliable information and how photo- and video-editing can manipulate the truth. 
• The dangers of clicking on suspicious links or downloading unknown files. 
• The risks of trying certain social media challenges. 
• The addictive nature of the internet and the importance of disconnecting. 
• What they should do if they’re worried, upset or scared about what they see or hear online. 

2. Keep tabs on their activity — and tell them so 

Every family is going to have a different level of comfort about what their kids should and shouldn’t do online. And how involved you are in knowing about your child’s online presence is a matter of your comfort level.

Dr. Eshleman says that parents should feel empowered to have some oversight of what their kids are doing online if that feels right for their family. But transparency is critical.  

“If you are going to monitor your child online, it’s important to make sure they know that you’ll be doing that and to set expectations of what they should and shouldn’t do on their devices,” Dr. Eshleman advises. “Secretly following their internet activity will diminish their trust. And building and maintaining a trusting relationship between parents and children is important to raising healthy kids.” 

There’s no shortage of apps and programs available to monitor your child’s online activity, each with different features, options and price points. If you don’t know where to start, it can be helpful to ask other parents for advice and about their experience.

3. Consider the impact of their online activity 

A lot of people will ask how much time is OK for kids to spend online? It’s a legitimate question. But the American Academy of Pediatrics says there isn’t enough evidence to set guidelines on a quantity of time that’s healthy for kids to spend online. Instead, consider the quality of their internet use and what effects it has on them. 

Dr. Eshleman explains, “Rather than focusing on how much time your child spends online, consider the impact of that time, and how it fits into their life and the family’s lives.” 

For example, is your child doing online research for a school project? Are they having meaningful and healthy interactions with friends from school virtually? Probably OK. 

On the other hand, internet use shouldn’t keep them from participating in other aspects of their life. 

• Are they watching videos or playing video games online long after bedtime?  
• Are they avoiding spending time with friends in real life?  
• Are they scrolling through social media instead of doing their chores, practicing sports or musical instruments, or spending time with the family?  

“Kids can have a hard time transitioning away from their devices. It’s fun. It’s immediate feedback. But we need to look at how that fits into the family’s life,” Dr. Eshleman states. “We know, too, that there’s an impact of too much screen time on mood and behavior. So, talk with them if you notice any changes to find out what’s driving that. Maybe it’s related to their online life, and maybe it’s not. But it should be addressed in any case.”  

4. Set rules (and stick to them) 

Setting clear boundaries is important to establishing a healthy online presence for your child.  

There aren’t necessarily “right” or “wrong” answers. Just like other rules in your house, your comfort with certain activities may be different from other parents’. Just like you’re a stickler for eating only at the table, but their friend’s family eats on the couch. Different strokes for different folks.  

That’s OK. 

Your family’s internet guidelines will depend on your preferences, as well as factors like your child’s age and maturity level. The important thing is that you set some ground rules (whatever they may be) ahead of time and are consistent in enforcing them. 

Some things to consider: 

• What times of the day are your kids allowed to be on their devices? When should devices be put away? 
• Will you set a number of hours per day they’re allowed online? 
• Are they allowed on their devices in their bedroom?  
• Are there people they may and may not associate with online? (For example, are you OK with them talking with family members and school friends but not with people they don’t know in real life?) 
• Are there sites or apps your kids aren’t allowed to access?    
• What are the consequences of breaking the rules? 

5. Model healthy online behavior 

How you interact with your phone, tablet, computer and other online devices makes an impression — whether you realize it or not. 

“If a parent has a screen at the dinner table, or when they’re riding in the car, but telling the child to put their tablet away, they’re not going to understand why,” Dr. Eshleman points out. “They should see you disconnecting from the online world, too; see you interacting with people in real life. Modeling that behavior is very important.” 

That whole “Do as I say, not as I do” thing? That’s a hard sell. And in reality, taking some downtime from the online world can do your mental health a world of good, too. 

6. Keep the lines of communication open 

Dr. Eshleman recommends setting aside certain times when your child knows that you’ll check in with them. Maybe it’s in the car ride home from school. Or during dinner. Or at bedtime. Whatever time works for you and your family is fine. 

The important thing is creating space and time where your child can expect you’ll ask about how they’re doing.  

“It always comes back to communication,” Dr. Eshleman says. “Hopefully, most of the time, nothing’s going on. But then, if something major might happen online or at school or wherever, they know they’ll have a space to talk about it.” 

7. Talk with others 

You’re far from alone in wondering how to talk with your kids about internet safety and what steps are appropriate. It’s a question parents everywhere are asking.  

Dr. Eshleman says talking with other parents, healthcare providers, teachers and others can help you get new insights and ideas.  

Ask about: 

• How or if they’re restricting certain sites. 
• Do they institute certain times of the day as “internet-free”? 
• What are the latest trends and apps that their kids are into? What worries do they have about them? 
• How did they decide when it was time for their child to have their own phone? 

That’s not to say that other parents’ rules and strategies have to be yours, too. But gathering some information about what works well in others’ families can help you determine what you’re comfortable with — and what you’re not. 

8. Give yourself some grace 

Let’s face it. The internet is big. It’s unwieldy. Complicated. And changing all the time. Chances are you’re not going to think of everything and shield your child 100%. 

Might your child accidentally watch a news report that scares them? Yes.  

Could they friend a stranger on a gaming platform? Possibly. 

Might they try out a new social media app that you had no idea even existed? Sure. 

It happens. Try to give yourself some leeway. 

“Parents are more stressed than ever,” Dr. Eshleman recognizes. “Sometimes, things seem pretty simple, but in reality, they’re not easy. These are goals. Be kind to yourself and try your best. That’s all we can ever do.”  

Exodus 20:8 “Remember the sabbath day, to keep it holy” (Weekly Sabbath: Friday sundown to Saturday Sundown) High Holy Days: Leviticus 23; Deuteronomy 16:16 New Moon Sabbaths: Psalms 81: 3-4; Numbers 10:10 Dietary Laws: Leviticus 11

 

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The Disproportionate Impact of Covid-19 on Black Health Care Workers in the U.S.

by 
• Adia Harvey Wingfield

May 14, 2020

Grieving families, social distancing, economic disruption: In many respects, coronavirus has changed the world. But it also has exposed the startlingly consistent toll that catastrophe exacts from black communities. The old adage that “when white America catches a cold, black America gets pneumonia” has become a chilling reality.

Recent data coming out of New York, Chicago, and Louisiana indicate that deaths from Covid-19 are disproportionately high among communities of color — black and Latino patients in particular. Though blacks are only 22% of New York City’s population, as of mid-April they constituted 28% of fatalities from the virus. In Chicago, where blacks are 30% of the population, they comprise 70% of those killed by Covid-19. In the state of Louisiana, blacks are 32% of the population but 70% of those dead from the disease.

As some states move to reopen against the advice of public health professionals, these numbers are likely to get even worse. As we prepare for this, we should also begin asking another, interrelated question: What impact will this growing death toll have on black health care providers, particularly black doctors and nurses?

As a sociologist who studies the experiences of black health care workers, I fear that one unanticipated consequence of the coronavirus might be a setback of the modest advances the medical industry has made towards improving racial diversity among practitioners. Currently, despite being approximately 13% of the U.S. population, blacks constitute only 5% of all doctors and 10% of nurses. Both professions have come to realize that more racial and gender diversity is essential for providing care for a multiracial society — especially given data indicating black patients’ health outcomes improve when matched with a same-race provider. But conversations with black health care workers about their daily experiences exposes the possibility that Covid-19 could be a breaking point, both physically and mentally.

The Physical Dangers Black Health Care Workers Face

In a recent study, I investigated the choices that black practitioners made about where they wanted to work and what specialty of medicine they wanted to pursue. The 60 respondents in my study hailed from a range of specialties including ob-gyns, geneticists, and anesthesiologists. Across specialties, I found that many were motivated to go into health care by a desire to help those who were least likely to access high-quality, compassionate care. For instance, Annette, a geneticist, told me that she wanted to use her skills and training to help black populations who might not otherwise have access to genetic testing. Jackson, a physician assistant, described being motivated early on to pursue a career in health care so that he could give back to poor black communities like the one in which he was raised. Specifically, they wanted to provide respectful, effective health care to black populations for whom this is rarely the norm. (All names used here are pseudonyms.)

This commitment led many of my respondents to seek out employment at facilities in urban areas where most patients were black, Latinx, and often low income and/or uninsured. As Mindy, a nurse I spoke with for my research, told me, “Blacks are culturally a higher percentage of the poor, and so I just feel I take personal responsibility in making a difference. I’m really focusing on the culture who needs it the most and figuring out ways to reach them.” For health care workers like Mindy, this choice means being on the front lines for patients who can’t afford primary care physicians, use the emergency room for medical care, and often have extensive pre-existing conditions.

The data about who is most affected by the coronavirus is still coming out, but the kind of patients Mindy went into nursing to treat are likely those who are the hardest hit by Covid-19. This makes black health care workers’ intentional decisions to go where they saw the most need fraught with frightening implications.

Respondents in my study told me that the hospitals where they worked were frequently understaffed and under-resourced, and in the best of times often lacked equipment and personnel. Joel, an emergency medicine doctor in a public hospital, told me, “There are places where private emergency departments can get MRIs that aren’t for emergency reasons…We can get other scans involved, but if this hospital had the resources like [other private facilities], we could get more staff support, CAT scans, etc. We could better serve patients. [We’re] city funded, so we feel the effects.” If coping with a lack of staffing and resources was the norm during before the pandemic, it’s not hard to imagine how devastated many of these facilities — and the hospital staff who work in them — must be now, given the widespread shortage of masks, gowns, and other protective gear.

We do not yet have precise data reflecting how many of the health care professionals infected with coronavirus are black, but it’s possible that these practitioners are at risk of repeated exposure to this virus. It’s also likely that the dangers don’t stop at contracting the disease.

The Mental Health Dangers Black Health Care Workers Face

My research indicates that the conditions under which many black health care providers are working produces a specific kind of burnout, stress, and exhaustion. Frequently, this happens not only because many are working in under-resourced public facilities, but because they are also dealing with the racial implications of their work — caring for low-income patients of color whom even many of their white colleagues view through a racially stereotyped lens as drug abusers, noncompliant patients, or irresponsible parents. As Eric, an anesthesiologist, told me with visible frustration, “There were many times I saw patients shunned simply because of their skin color and problems they presented with that may or may not be present in our community…There’s all sorts of anecdotal conversation [from white doctors] about, ‘I know how those people are when you give them medication,’ or ‘I see that all the time with this population.’”

Repeatedly hearing these accounts from colleagues presents a special challenge to these black health care professionals: In addition to providing care to vulnerable populations, they are also put in a position of defending them from often unfounded stereotypes.

Further, black patients reminded the black practitioners in my study of their friends, family members, and sometimes themselves. In some cases, these patients were actually neighbors and community members — people with whom black doctors and nurses shared a connection. Hearing white colleagues label and prejudge these patients creates stresses, but many black health care workers conceal their resulting frustration to avoid being seen as “complainers” or “troublemakers.”

As Suzanne, a cardiologist, described race-related stress associated with her work, “I’ve become more jaded…I used to be very, incredibly open, and now I’m just a lot more guarded.” Suzanne told me that her response to overhearing or confronting racial biases from colleagues was starting to leave her numb and disengaged, stating, “It’s not even [that my feelings are] hurt, it’s just that you tend to become apathetic about it.” Being the only black woman in her workspace often meant bottling up feelings of frustration and anger in response to repeated racial incidents, a process that researchers suggest heightens stress and diminishes well-being.

How to Support Black Health Care Workers

These comments suggest that, at best, being a black health care worker comes with specific difficulties that can easily go unnoticed. In a pandemic where black populations are among the hardest hit, these difficulties are likely being magnified exponentially. Health care systems are undoubtedly taxed, but in the interest of their workers, they should consider ways they can support black health care providers to offset the kinds of burnout and stresses research indicates they are likely experiencing right now. These efforts need to go beyond the basics of providing personal protective equipment (PPE), though that’s certainly a necessary start. In this national emergency, health care systems may need to think past providing health care just for patients and consider the health of their workers, perhaps through counseling and support groups, heeding employees’ suggestions for how systems can be improved, and partnering with other institutions when helpful.

Additionally, it’s essential not to forget the needs of black nurses, technicians, and other staff who are a key part of the health care infrastructure. These workers are often similarly motivated to work with underserved patients, but with less power and visibility than doctors. The emotional, financial, and physical strains they face can go overlooked. And finally, wealthy donors who want to support health care systems should consider donating their resources to the facilities that serve patients — and the providers — who have long been overlooked.

Over the long term, medicine needs to accelerate its diversity efforts. Currently these efforts include — but are not limited to — fellowships and training programs, organizations’ and professional associations’ formal commitment to increasing racial diversity and cultural competence, and “pipeline programs” that are intended to attract underrepresented minority students into medicine.

Programs like these will become all the more crucial if black doctors and nurses are hit as hard by coronavirus as many of the patients they treat. But hospital administrators should also consider other ways to address the issues that adversely affect black health care practitioners’ work — the routine gender discrimination black women doctors face, for example, and the unevenly implemented and enforced diversity policies. Medical schools should push back against pressures to cease using race as a factor in admissions so they can ensure a racially diverse student body of future doctors. Hiring committees must re-think the weight they place on professional connections and networks in deciding who to hire, particularly since this method can perpetuate hiring discrimination.

Finally, some health care policymakers have argued for shifting to a value-based care model that accounts for social factors. This model would reward doctors by assessing patient outcomes, but could also consider the efforts involved in improving outcomes for patients whose social and economic circumstances can make medical care that much more challenging. By recognizing the additional challenges that social conditions create in attaining good health, medical systems could shift to reward health care workers who make sure the most underserved patients, who are usually black, don’t slip through the cracks. These changes could help offset the burdens black doctors and nurses shoulder in normal times, and could draw future black health care workers into the field in the future.

Describing the downside of being a black woman doctor in a public facility that served mostly low-income patients of color, a surgeon named Jenna told me, “funding gets cut, we don’t have the things we need, but [administrators] know we’ll still come in and work to get our patients what they need…It makes me feel exploited. It makes me feel like Mammy, honestly. Because we empathize — no one has more empathy than black women. But that’s not rewarded in the structure of how medicine works. So we just keep on working and working with less and less.”

Jenna’s comments describe a reality that isn’t a model for building a sustainable base of black health care providers over the long-term. And with the coronavirus pandemic taxing these health care workers on the front lines, her words should be an urgent call to future action.

Pregnant Chicago woman slain, baby cut from her womb

By CARYN ROUSSEAU and DON BABWINMay 16, 2019

CHICAGO (AP) — A Chicago woman who sold baby clothes to a pregnant woman and lured her back to her house with an offer of more clothing has been charged with murder after allegedly strangling the woman with a cord and cutting the infant from her womb, police said Thursday.

Clarisa Figueroa, 46, apparently wanted to raise another child two years after her adult son died of natural causes, investigators said.

“Words cannot express how disgusting and thoroughly disturbing these allegations are,” Police Superintendent Eddie Johnson told reporters at a news conference to announce the murder charges against Figueroa and her 24-year-old daughter, Desiree Figueroa. The mother’s boyfriend, 40-year-old Piotr Bobak, was charged with concealment of a homicide.

The charges come three weeks after 19-year-old Marlen Ochoa-Lopez disappeared and a day after her body was discovered in a garbage can in the backyard of Figueroa’s home on the city’s Southwest Side, about 4 miles from her own home.

According to police, the young woman drove from her high school to Figueroa’s home in response to an offer of free clothes that Figueroa had posted on Facebook. When she arrived, police said, she was strangled and the baby cut from her body.

A few hours later, Figueroa frantically called 911, claiming that her newborn baby was not breathing. When first responders arrived, the child was blue. They tried to resuscitate the infant and transported the boy to a nearby hospital, where police said he remained in grave condition and was not expected to survive.

https://apnews.com/article/d952ed4e6bed481a8f827313e6072f79 

Police did not connect the woman’s disappearance and the 911 call about the baby until May 7, when friends of Ochoa-Lopez directed detectives to her social media account, which showed she had communicated with Figueroa in a Facebook group for expectant mothers.

At the same time, Clarisa Figueroa had started a GoFundMe campaign for the funeral of what she said was her dying baby, said Sara Walker, a spokeswoman for Ochoa-Lopez’s family.

Police then conducted DNA tests, which showed that Ochoa-Lopez and her husband, Yiovanni Lopez, were actually his parents, Walker said.

When police arrived to question Figueroa, her daughter told them that her mother was in the hospital with some kind of leg injury, before adding that she had just delivered a baby, said Brendan Deenihan, deputy chief of detectives.

“She told an extremely odd story,” and officers “kind of knew where this is headed,” Deenihan said.

Police then searched the neighborhood and found Ochoa-Lopez’s car a few blocks away. On Tuesday, they returned with a search warrant, finding cleaning supplies as well as evidence of blood in the hallway and in the bathroom. They later found the body in a trash can behind the house and recovered surveillance video that showed Ochoa-Lopez’s vehicle driving through the neighborhood on the day they believed she was killed, authorities said.

Ochoa-Lopez’s family had been looking for her since her disappearance on April 23, organizing search parties and holding news conferences as they pushed police for updates in the investigation.

Her father, Arnulfo Ochoa, said relatives were grateful to have found her. Now they want justice. The family was also bracing for the baby’s death, while still hoping for a miracle.

“We plead to God that he gives us our child because that is a blessing that my wife left for us,” Yiovanni Lopez told reporters through a Spanish interpreter outside the county morgue where his wife’s body was taken.

The three suspects were scheduled to appear Friday in bond court.

Associated Press video journalist Noreen Nasir contributed to this report.

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