1. Reduce overall exposure to computers. Do not purchase video games, which encourage relentless intensive use, for your child. Instead of sending e-mail, children can talk on the telephone or socialize with friends in person. Have them look something up in a book instead of searching the Web. Let them explore Nature and create their own games to play.
   
   
2. While the minimum threshold of time spent at the computer before injury occurs is not known, severe injury has occurred with as little as two hours of computer use a day. It would therefore seem prudent to limit your child to twenty minutes or so a few times a week. If your child uses the computer longer than that, insist that he or she take a 5-to-10 minute break every twenty minutes or less. Tell your child to get up from the chair and stretch during this break. Be aware that it is very difficult to set limits on such a time-consuming and engrossing activity. To ensure that regular breaks are taken, you may need to be present while your child uses the computer.



3. Teach your children the warning signs of RSI, which include tingling, heaviness or soreness. Symptoms can appear in the neck, shoulders, upper back, upper arm, elbows, forearms, wrists thumbs or fingers. Tell children to report any signs to you immediately. Children may not complain of pain or other symptoms of RSI, so parents should be alert to non-verbal warning signs. Your child might get headaches from looking up at the monitor. Children might massage their necks, forearms or wrists, drop things repeatedly, avoid playing sports they used to enjoy, or use their non-dominant hand for tasks they used to perform with the dominant hand, such as eating or dialing a phone number. Discontinue computer use immediately if warning signs of injury appear and see paragraph 10.



4. Children need child-sized workstations and proper chairs. Do not accept makeshift solutions such as lumbar supports made of rolled-up towels (they will slip out of place the moment the child moves forward) or using telephone books to raise the seat level (the sharp edges will impair blood circulation in the leg). The backrest of your child's chair must be locked in an upright position for computing. Place the monitor directly in front of your child, with the top of the screen at eye level. The keyboard and mouse should be slightly below elbow height with neck, shoulders and arms completely relaxed. Do not let your child use an improperly adjusted workstation because "this will just take ten minutes." People spend far longer at the computer than they realize because they lose their sense of the passage of time. You wouldn't let your children go for a car ride around the block without wearing a seatbelt; by the same token, the workstation needs to be adjusted properly every time they use it.



5. Laptop computers present a two-fold risk. They cannot be adjusted, so the hands, neck and head cannot be properly placed. Do not allow your child to use a laptop unless it had a separate monitor or keyboard so that it can be set up properly. In addition to ergonomic hazards, doctors have also reported an upsurge of children reporting back pain from carrying laptops, which are proportionally heavier for smaller people to carry. Children may also be lugging books and other gear at the same time. Wheel the laptop instead of carrying it.



6. See that your child receives plenty of regular exercise. The U. S. Surgeon General recommends at least 30-60 minutes of physical activity all or most days of the week for elementary school children.



7. Teach your child to maintain good posture.



8. Teach your children proper technique: never allow them to rest their wrists on the desk, wrist pad or armrests while typing or using a mouse or trackball.



9. Avoid using the mouse, trackball or joystick whenever possible. Use keystrokes instead. Do not allow your children to play with handheld video games.



10. If your child experiences pain, fatigue or soreness or any other warning signs of RSI, do not allow your child to continue using the computer. See a doctor who is competent to diagnose and treat RSI immediately. Read about treatments such as splinting, cortisone injections and nonsteroidal anti-inflammatory drugs before you agree to let your child use them. For more information on these treatments and coping with and preventing RSI, see The Repetitive Strain Injury Recovery Book, by Deborah Quilter (Walker, New York 1998). For an excellent examination of the issue of children and computers, read The Child and the Machine: How Computers Put Our Children's Education at Risk by Alison Armstrong and Charles Casement (Robins Lane Press, Beltsville MD 2000).

Given the inherent dangers of computer use – and the arduous, consistent effort required to reduce the risk factors for repetitive strain injury (RSI) – the best way to prevent computer-related injuries in children is not to allow them use computers at all.

Remember what is at stake. Repetitive strain injury can be permanently disabling. Many people lose the ability to work, engage in normal activities or care for themselves. RSI is the leading occupational injury in the United States among adults. More and more college students are swelling the ranks of the injured. Surely you do not want your child to join them.

Our society must demand safer tools and technologies -- and emphasize more active lifestyles and regular physical fitness conditioning -- so that our children do not eventually develop devastating injuries from using computers.