Ninth Annual MediaWise Video Game Report Card

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David Walsh, Ph.D.; Douglas Gentile, Ph.D.; Jeremy Gieske; Monica Walsh; Emily Chasco
National Institute on Media and the Family
November 23, 2004

This MediaWise Video Game Report Card is the ninth issued by the National Institute on Media and the Family, an independent, non-partisan, non-sectarian, non-profit organization. The Report Card provides a snapshot of the interactive gaming industry with a focus on issues related to the welfare of children and teens.

Double Messages Lead to Double Trouble

Parents get a constant stream of mixed messages about video games. On the one hand they are told by the industry to pay attention to the ratings. On the other hand the industry denies that any of these games are harmful. So what parents hear is "Pay attention to the ratings, but it really doesn't matter if you do."

The praise being heaped on the latest blockbuster game Grand Theft Auto: San Andreas is another example of the double messages parents receive. Reviewers across the country are hailing this game as one of the greatest ever. Reviewers are lauding the game for its technical qualities while barely mentioning the game's immoral story line. "A game with everything but morals," is the equivalent of a four star restaurant review praising the eatery's ambience and service but then adding as an afterthought the fact that the food is laced with salmonella.

It is no wonder that so many parents are confused about what to do about video games. It is for this reason that we are launching a new public service announcement along with this year's report card. We hope that media outlets will air the PSA during this shopping season to help parents get the straight message to "watch what their kids watch."

Why Do They Act That Way?

Advances in brain science show that children's experiences during their brain's growth spurts have a greater impact on their brain's wiring than at any other time of their lives. The groundbreaking discoveries about the teenage brain reveal that the growth spurts continue throughout adolescence, making teens more impressionable than we thought. Teenagers are wiring the circuits for self control, responsibility and relationships they will carry with them into adulthood. The latest brain research shows that violent games activate the anger center of the teenage brain while dampening the brain's "conscience."

It's not that every teen who plays an ultra violent game is going to go out and pick up an Uzi. The real impact is more subtle. The worst effect of M-rated games is the culture of disrespect they create. Whoever tells the stories defines the culture. What do we think the effect is when our kids' storytellers are violence simulators that glorify gang culture, celebrate brutality, lionize crudeness, and trivialize violence toward women.

The U.S. Army now uses video games as recruiting tools because the games capture the interest of teens, shape their attitudes and influence their behavior. Evidence grows that games teach skills and affect behavior. The important thing to remember, therefore, is that video and computer games are powerful-for good and for bad.

Video Game Violence and Youth

For the past eight years, we have consistently expressed concern about a subset of ultra-violent games that are very popular with preteen and teenage boys. 87% of boys play M-rated games and 78% list an M-rated game among their favorites. Parents report they are now being barraged with requests from their kids for Grand Theft Auto: San Andreas. We know there will be more "killographic" and sexually explicit games each year. Therefore our focus has always been on restricting youth access to these games. That is why we have called for more accurate ratings, more responsible marketing and advertising, greater accountability at the retail level, and greater education for parents about the games and their impact on youth.

Video Games, the Obesity Epidemic, and Babies

Content aside, the amount of time kids spend playing games, even the good ones, is contributing to the obesity epidemic among American youth. For too many kids, the only parts of their body they are exercising are their thumbs. We are particularly concerned, therefore, about the launch of games this year aimed at children as young as two. We know that the industry wants to expand its customer base and that it is in their economic interest to hook babies on games. This trend, however, raises serious implications for our children's health.

Areas Covered in the 2004 Report Card

  • Ratings
  • Ratings education.
  • Retailer surveys.
  • Retailer enforcement.
  • Research update.
  • List of recommended games and games to avoid.


We believe The Entertainment Software Rating Board (ESRB) game ratings set the current standard for media ratings. We recommend that parents use them as a guide while seeking additional independent reviews like those found on our Web site We do continue to have concerns, however, about the reluctance of the ESRB to use the AO (adults only) rating. According to the ESRB, the AO rating is used when games "include graphic depictions of sex and/or violence." Games like The Guy Game, Leisure Suit Larry and Grand Theft Auto: San Andreas would certainly fit that description and yet they are rated M. In addition, the distinction between AO as not appropriate for persons under 18 and M as not appropriate for persons under 17 is impossible to decipher. This is not a trivial issue, because most major retailers will not sell AO games. Publishers therefore manipulate the criteria to avoid the dreaded AO rating. The result is that very few games receive a final rating of AO.

Ratings Accuracy………………………………………………………B-

The ratings are a very important tool for parents. However, a Kaiser Family Foundation study showed that only 52% of parents used ratings to guide game purchases. Therefore education about the ratings is important. Knowing about the ratings, however, is not enough if parents do not understand the need to observe the ratings. Parent education about the ratings needs to include the answer to the question "Why do you need to pay attention."

The ESRB "OK to Play" education campaign is not working. In our retailer survey, we found that 78% of the clerks surveyed did not know about the campaign. We call upon the ESRB, therefore, to improve its efforts to educate parents about the ratings and to tell parents why it is important to pay attention to ratings.

Ratings Education……………………………………………………………..C-


There has been a great deal of attention paid to retailers in recent report cards because secret shopper studies have shown that children as young as seven have been able to purchase M-rated games three out of four times. At last year's report card release, the Interactive Entertainment Merchants Association announced that by this shopping season they would enforce policies restricting youth access to M-rated games without parental permission. This year's report card, therefore, focuses on change in retailer practices. We surveyed retailers three ways.

  1. We sent opinion surveys to the thirty-four CEOs of the companies who are members of the IEMA.
  2. We did a phone survey of clerks at forty-six stores in 12 states.
  3. We conducted a secret shopper survey to test enforcement.

CEO Survey
We sent surveys to the thirty-four CEOs of the major game retailers seeking their opinions about the games they sell. Follow-up phone calls were made as well. Only two executives responded. In addition, we received one letter explaining that time did not permit them to complete the survey although we estimate that it took longer to write the letter than it would have taken to complete our one-page survey. One of the respondents agreed that video games can have positive influence on children but had no opinion about whether games can be harmful. The other respondent thought that games had neither a positive nor negative effect on youth.

More significant than the responses is the fact that 31 out of 34 ignored the survey. Why won't retail leaders answer questions about the games they sell?

Retailer Phone Survey
Only 76% of respondents say they understand the ratings they are supposed to enforce. This is actually down from 85% last year. Only half of the stores train employees in the use of the ratings. In many of the stores that reported they have training, further questioning revealed the "training" only amounted to the cash register prompts being installed in many stores.

The significant improvement this year is that 89% of the stores surveyed said they now had policies restricting the sale of M-rated games to those under seventeen. This is up from 70% two years ago, and reflects the commitment the retailers made last December. In light of that commitment, it is clear that more needs to be done to educate the clerks selling the games about policy enforcement.

As noted earlier, the industry effort to educate the public about ratings, the "OK to Play" campaign is not penetrating the stores. Only one out of five respondents had heard of the campaign.

Retailer Training of Employees…………………………………………..B

Retailer Enforcement
In light of the retailers' commitment made at last year's report card announcement, we were particularly interested in the results of this year's secret shopper survey. This fall, 12 children between the ages of seven and 14 attempted to purchase M-rated games in thirty-five stores in Wisconsin, Minnesota, Maryland, and Florida. There were 35 attempts made and 34% were successful. This is an improvement from 55% last year and reflects the progress that retailers are making on their commitment. However, in analyzing the results we discovered a disturbing trend. While the overall purchase rate was 34%, boys as young as seven were able to buy M-rated games 50% of the time, whereas girls were only able to purchase games 8% of the time. So while there has been significant progress is not selling games to girls, boys just have to try twice to get any M-rated game they want.

Retailer Enforcement………………………………………………………….D


  1. Eliminate double messages to parents and educate them about why it is important to monitor game play and observe the ratings. The reasons should be based on scientific evidence about both the potential benefits of positive games and the potential harm of violent, antisocial games.
  2. Many advertisements for games in Sunday newspaper inserts are so small that the rating is not legible. Game ratings should be visible.
  3. Retailers should add a statement in their ads and post a policy in their stores that says, "Our store adheres to the policy of not selling M-rated video games to minors younger than 17 without parental approval."
  4. Retailers should fulfill their commitment to restrict the sale of M-rated games to those 17 and older.
  5. Retailers should enforce their restriction policies with both boys and girls.
  6. The ESRB should apply the AO rating in accordance with its own guidelines.
MediaWise Video Game Report Card
ESRB Ratings Accuracy B-
Ratings Education C-
Retailers' Policy and Employee Training B
Retailers' Enforcement D
Screen time related to overweight F

Research Update 2004

For the past eight years, we have provided an update about the newest research on the positive and negative effects of video games. We thought that it might be time to review the collected research rather than simply continuing to report on individual studies.

Video games are natural teachers. Children find them highly motivating; by virtue of their interactive nature, children are actively engaged with them; they provide repeated practice; and they include rewards for skillful play. These facts make it likely that video games could have large effects, some of which are intended by game designers, and some of which may not be intended. Recently, the Wall Street Journal reported that several companies are now designing video game consoles for preschoolers (Kim, 2004). Given the potential video games have to influence, we should pay attention to the fact that children are spending increasing amounts of time with them at younger and younger ages.

Video games have been shown to teach children healthy skills for the self-care of asthma and diabetes, and have been successful at imparting the attitudes, skills, and behaviors that they were designed to teach (Lieberman, 1997; 2001). In a study with college students, playing a golf video game improved students' actual control of force when putting, even though the video game gave no bodily feedback on actual putting movement or force (Fery & Ponserre, 2001). There have even been studies with adults showing that experience with video games is related to better surgical skills (e.g., Pearson, Gallagher, Rosser, & Satava, 2002; Rosser et al., 2004; Tsai & Heinrichs, 1994). Research also suggests that people can learn iconic, spatial, and visual attention skills from video games (De Lisi & Wolford, 2002; Dorval & Pepin, 1986; Green & Bavelier, 2003; Greenfield, deWinstanley, Kilpatrick, & Kaye, 1994; Griffith, Volschin, Gibb, & Bailey, 1983; Okagaki, & Frensch, 1994; Yuji, 1996). Finally, research on educational software has shown that educational video games can have very significant effects on improving student achievement (Murphy, Penuel, Means, Korbak, & Whaley, 2001).

Given the fact that video games are able to have several positive effects, it should come as no surprise that they also can have negative effects. Research has documented negative effects of video games on children's physical health, including obesity (Berkey et al., 2000; Subrahmanyam et al., 2000; Vandewater, Shim, & Caplovitz, 2004), video-induced seizures (Kasteleijn-Nolst Trenite et al. 1999; Badinand-Hubert et al., 1998; Ricci & Vigevano, 1999; Ricci et al., 1998), and postural, muscular and skeletal disorders, such as tendonitis, nerve compression, and carpal tunnel syndrome (e.g., Brasington, 1990; SaftetyAlerts, 2000). However, these effects are not likely to occur for most children. The research to date suggests that parents should be most concerned about two things: the amount of time that children play, and the content of the games that they play.

Simply put, the amount of time spent playing video games has a negative correlation with academic performance (e.g., Anderson & Dill, 2000; Anderson et al., under review; Gentile et al., 2004; Harris & Williams, 1985). Playing violent games has a positive correlation with antisocial and aggressive behavior (most researchers define violence in games as when the player can intentionally harm other characters in the game; e.g., Anderson & Dill, 2000; Anderson et al., under review; Gentile et al., 2004). Content analyses show that a majority of games contain some violent content, and about half of those include violence that would result in serious injuries or death (Children Now, 2001; Dietz, 1998; Dill, Gentile, Richter, & Dill, in press). A majority of 4th - 8th grade children prefer violent games (Buchman & Funk, 1996; Funk, 1993).

Looking across the dozens of studies that have now been conducted on violent video games, there appear to be five major effects. Playing violent games leads to increased physiological arousal, increased aggressive thoughts, increased aggressive feelings, increased aggressive behaviors, and decreased prosocial helping behaviors (Anderson, 2004; Anderson & Bushman, 2001). These studies include experimental studies (where it can be shown that playing violent games actually causes increases in aggression), correlational studies (where long-term relations between game play and real-world aggression can be shown), and longitudinal studies (where changes in children's aggressive behaviors can be demonstrated). For example, in a study of over 400 3rd - 5th graders, those students who played more violent video games early in the school year changed to become more physically aggressive later in the school year, even after statistically controlling for sex, race, total screen time, prior aggression, and other relevant variables (Anderson et al., under review). Apparently practice does make perfect.

The research also seems to show that parents have an important role to play. Children whose parents limited the amount of time they could play and also used the video game ratings to limit the content of the games have children who do better in school and also get into fewer fights (Gentile et al., 2004). Regarding limiting the amount, the American Academy of Pediatrics recommends that children not spend more than one to two hours per day in front of all electronic screens, including TV, DVDs, videos, video games (handheld, console, or computer), and computers (for non-academic use). This means seven to 14 hours per week total. The average school-age child spends over 37 hours a week in front of a screen (nine hours of which is with video games, although there are large sex-differences - boys average 13 hours/week and girls average five hours/week; Gentile et al., 2004). We all like to think our children are above average, but on this dimension it's not a good thing. Regarding content, educational games are likely to have positive effects and violent games are likely to have negative effects. Almost all (98%) of pediatricians believe that violent media have a negative effect on children (Gentile, Oberg, Sherwood, Story, Walsh, & Hogan, 2004).

The conclusion we draw from the accumulated research is that the question of whether video games are "good" or "bad" for children is oversimplified. Playing a violent game for hours every day could decrease school performance, increase aggressive behaviors, and improve visual attention skills. Instead, parents should recognize that video games can have powerful effects on children, and should therefore set limits on the amount and content of games their children play. In this way, we can realize the potential benefits while minimizing the potential harms. The accumulated research shows that the video game industry must stop giving a mixed message to parents - that they have a good rating system but that there's no research to show that video games can have harmful effects. There is starting to be a large body of evidence that games can have powerful effects, both for good and ill.


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  • Anderson, C. A., Gentile, D. A., & Buckley, K. E. (under review). Violent video game effects on children and adolescents: Further developments and tests of the general aggression model .
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MediaWise Video Game Report Card
Game Lists:
Parent Alert! Games to avoid for your children and teens
1. Doom 3
2. Grand Theft Auto: San Andreas
3. Half Life 2
4. Halo 2
5. Resident Evil: Outbreak
6. Psi Ops: the Mindgate Conspiracy
7. The Guy Game
8. Leisure Suit Larry: Magna Cum Laude
9. Mortal Kombat Deception
10. Rumble Roses
MediaWise Recommended Games for children and teens
1. ESPN NFL 2 K5
2. Pikmin 2
3. Sly 2: Band of Thieves
4. Karaoke Revolution Volume 3
5. Madden NFL 2005
6. Jak 3
7. Prince of Persia - Sands of Time
8. Myst IV: Revelation
9. RollerCoaster Tycoon 3
10. SimCity 4

CORRECTION: The Ninth Annual MediaWise Video Game Report Card inadvertently omitted the full title of one of its MediaWise Recommended Games for children and teens. Prince of Persia should be listed as Prince of Persia: The Sands of Time. The video game is rated T.

The National Institute on Media and the Family regrets this omission.

  © National Institute on Media and the Family.