Trouble for texting teens?: Constant text-messaging concerns doctors

They do it late at night when their parents are asleep. They do it in restaurants and while crossing busy streets. They do it in the classroom with their hands behind their back. They do it so much their thumbs hurt.

Spurred by unlimited texting plans offered by carriers such as AT&T Mobility and Verizon Wireless, U.S. teenagers sent and received an average of 2,272 text messages a month in the fourth quarter of 2008, according to the Nielsen Co., almost 80 messages a day, more than double the average of a year earlier.

The phenomenon is beginning to worry physicians and psychologists who say it is leading to anxiety, distraction in school, falling grades, repetitive stress injury and sleep deprivation.

Dr. Martin Joffe, a pediatrician in Greenbrae, Calif., recently surveyed students at two high schools and said he found many were routinely sending hundreds of texts every day.

"That's one every few minutes," he said. "Then you hear that these kids are responding to texts late at night. That's going to cause sleep issues in an age group that's already plagued with sleep issues."

Keeping parents close

The rise in texting is too recent to have produced conclusive data on health effects. But Sherry Turkle, a psychologist who is director of the Initiative on Technology and Self at the Massachusetts Institute of Technology and who has studied texting among teenagers in the Boston area for three years, said it might be causing a shift in the way adolescents develop.

"Among the jobs of adolescence are to separate from your parents, and to find the peace and quiet to become the person you decide you want to be," she said. "Texting hits directly at both those jobs."

Psychologists expect to see teenagers break free from their parents as they grow into autonomous adults, Turkle added, "but if technology makes something like staying in touch very, very easy, that's harder to do; now you have adolescents who are texting their mothers 15 times a day, asking things like, 'Should I get the red shoes or the blue shoes?' "

As for peace and quiet, she said, "it makes it very difficult to be in that state of mind."

"If you're being deluged by constant communication," she added, "the pressure to answer immediately is quite high. So if you're in the middle of a thought, forget it."

Michael Hausauer, a psychotherapist in Oakland, Calif., said teens have a "terrific interest in knowing what's going on in the lives of their peers, coupled with a terrific anxiety about being out of the loop."

For that reason, he said, the rapid rise in texting has potential for great benefit — and great harm.

"Texting can be an enormous tool," he said. "It offers companionship and the promise of connectedness. At the same time, texting can make a youngster feel frightened and overly exposed."

Thumbs take thumping

Texting also may be taking a toll on teenagers' thumbs. Annie Wagner, 15, a ninth-grade honor student in Bethesda, Md., used to text on her tiny LG phone as fast as she typed on a regular keyboard. She noticed a painful cramping in her thumbs a few months ago. (Lately, she has been using the iPhone she received for her 15th birthday, and she says texting is slower and less painful.)

Peter Johnson, an associate professor of environmental and occupational health sciences at the University of Washington, said it was too early to tell whether this kind of stress is damaging. But, he added, "based on our experiences with computer users, we know intensive repetitive use of the upper extremities can lead to musculoskeletal disorders, so we have some reason to be concerned that too much texting could lead to temporary or permanent damage to the thumbs."

Wagner said that although her school, like most, forbids cellphone use in class, with the LG phone she could text by putting it under her coat or desk. "You pretend you're getting something out of your backpack," her classmate Ari Kapner said.

Teachers often are oblivious.

"It's a huge issue, and it's rampant," said Deborah Yager, a high-school chemistry teacher in Castro Valley, Calif. Yager recently gave an anonymous survey to 50 students; most said they texted during class.

"I can't tell when it's happening, and there's nothing we can do about it," she said. "And I'm not going to take the time every day to try to police it."

Parents don't notice

Joffe said parents tend to be far less aware of texting than of, say, video-game-playing or general computer use, and the unlimited plans often mean parents stop paying attention to billing details. "I talk to parents in the office now," he said. "I'm quizzing them, and no one is thinking about this."

Some parents are starting to take measures. Greg Hardesty, a reporter in Lake Forest, Calif., said his daughter, Reina, 13, racked up 14,528 texts in one month late last year. She would keep the phone on after going to bed, switching it to vibrate and waiting for it to light up and signal an incoming message.

Hardesty wrote a column about her texting in his newspaper, The Orange County Register, and her volume quickly soared to about 24,000 messages. When her grades fell precipitously, her parents confiscated the phone.

Her grades have improved, and the phone is back in her hands, but her text messages are limited to 5,000 a month, and none between 9 p.m. and 6 a.m. weekdays.