Ninth Annual MediaWise
Video Game Report Card
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
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
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
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 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 www.mediafamily.org.
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.
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.
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.
- We sent opinion surveys to the thirty-four CEOs of
the companies who are members of the IEMA.
- We did a phone survey of clerks at forty-six stores
in 12 states.
- We conducted a secret shopper survey to test enforcement.
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
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.
- 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
- Many advertisements for games in Sunday newspaper
inserts are so small that the rating is not legible.
Game ratings should be visible.
- 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."
- Retailers should fulfill their commitment to restrict
the sale of M-rated games to those 17 and older.
- Retailers should enforce their restriction policies
with both boys and girls.
- The ESRB should apply the AO rating in accordance
with its own guidelines.
MediaWise Video Game Report
|ESRB Ratings Accuracy
|Retailers' Policy and Employee Training
|Screen time related to overweight
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, &
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.
- Anderson, C.A. (2004). An update on the effects of
violent video games. Journal of Adolescence, 27,
- Anderson, C.A., Berkowitz, L., Donnerstein, E., Huesmann,
R.L., Johnson, J., Linz, D., Malamuth, N., & Wartella,
E. (2003). The influence of media violence on youth
. Psychological Science in the Public Interest, 4,
- Anderson, C.A., & Bushman, B.J. (2001). Effects
of violent video games on aggressive behavior, aggressive
cognition, aggressive affect, physiological arousal,
and prosocial behavior: A meta-analytic review of the
scientific literature. Psychological Science, 12,
- Anderson, C. A., & Dill, K. E. (2000). Video games
and aggressive thoughts, feelings, and behavior in the
laboratory and in life. Journal of Personality &
Social Psychology, 78, 772-791.
- 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 .
- Badinand-Hubert, N., Bureau, M., Hirsch, E., Masnou,
P., Nahum, L., Parain, D., & Naquet, R. (1998).
Epilepsies and video games: Results of a multicentric
study. Electroencephalography & Clinical Neurophysiology,
- Berkey, C. S., Rockett, H. R., Field, A. E., Gillman,
M.W., Frazier, A. L., Camargo, C. A., Jr., & Colditz,
G. A. (2000). Activity, dietary intake, and weight changes
in a longitudinal study of preadolescent and adolescent
boys and girls. Pediatrics, 105(4), E56.
- Brasington, R. (1990). Nintendinitis. New England
Journal of Medicine, 322, 1473-1474.
- Buchman, D. D., & Funk, J. B. (1996). Video and
computer games in the '90s: Children's time commitment
and game preference. Children Today, 24, 12-16.
- Children Now. (2001). Fair play? Violence, gender
and race in video games. Los Angeles, CA: Children
- De Lisi, R. & Wolford, J. L. (2002). Improving
children's mental rotation accuracy with computer game
playing. Journal of Genetic Psychology, 163,
- Dietz, T. L. (1998). An examination of violence and
gender role portrayals in video games: Implications
for gender socialization and aggressive behavior.
Sex Roles, 38, 425-442.
- Dill, K. E., Gentile, D. A., Richter, W. A., &
Dill, J. C. (in press). Violence, sex, race, and age
in popular video games: A content analysis. In (E. Cole
& D.J. Henderson, Eds.) Featuring females: Feminist
analyses of the media. Washington, DC: American
- Dorval, M. & Pepin, M. (1986). Effect of playing
a video game on a measure of spatial visualization.
Perception and Motor Skills, 62, 159-162.
- Fery, Y. & Ponserre, S. (2001). Enhancing the
control of force in putting by video game training.
Ergonomics, 44, 1025-1037.
- Funk, J. B. (1993). Reevaluating the impact of video
games. Clinical Pediatrics, 32,86-90.
- Gentile, D. A., Oberg, C., Sherwood, N. E., Story,
M., Walsh, D. A., & Hogan, M. (2004). Well-child
exams in the video age: Pediatricians and the AAP guidelines
for children's media use. Pediatrics.
- Gentile, D.A., Lynch, P.L., Linder, J.R., & Walsh,
D.A. (2004). The effects of violent video game habits
on adolescent hostility, aggressive behaviors, and school
performance. Journal of Adolescence, 27, 5-22.
- Green, C. S. & Bavelier, D. (2003, May 29). Action
video game modifies visual selective attention. Nature,
- Greenfield, P.M., P. deWinstanley, H. Kilpatrick,
and D. Kaye. 1994. "Action video games and informal
education: Effects on strategies for dividing visual
attention." Journal of Applied Developmental
Psychology, 15, 105-123.
- Griffith, J. L., Volschin, P., Gibb, G. D., &
Bailey, J. R. (1983). Differences in eye-hand motor
coordination of video-game users and non-users. Perception
and Motor Skills, 57, 155-158.
- Harris, M. B., & Williams, R. (1985). Video games
and school performance. Education,105(3), 306-309.
- Kasteleijn-Nolst Trenite, D. G., da Silva, A. M.,
Ricci, S., Binnie, C. D., Rubboli, G., Tassinari, C.
A., & Segers, J. P. (1999). Video-game epilepsy:
A European study. Epilepsia, 40 (Supplement 4),
- Kim, Q. S. (2004, September 8). Playing games: Toymakers
launch video game consoles aimed at preschoolers. The
Wall Street Journal. Page B1.
- Lieberman, D. A. (1997). Interactive video games for
health promotion: Effects on knowledge, self-efficacy,
social support, and health. in R. L. Street, W. R. Gold,
& T. Manning (Eds), Health promotion and interactive
technology: Theoretical applications and future directions
(pp. 103-120). Mahwah, NJ: Lawrence Erlbaum Associates.
- Lieberman, D. A. (2001). Management of chronic pediatric
diseases with interactive health games: Theory and research
findings. Journal of Ambulatory Care Management,
- Murphy, R., Penuel, W., Means, B., Korbak, C., Whaley,
A. (2001). E-DESK: A Review of Recent Evidence on
the Effectiveness of Discrete Educational Software.
Menlo Park, CA: SRI International. Available: http://ctl.sri.com/publications/downloads/Task3_FinalReport3.pdf,
Accessed May 19, 2004.
- Okagaki, L., & Frensch, P. A. (1994). Effects
of interactive entertainment technologies on development.
Journal of Applied Developmental Psychology, 15,
- Pearson, A. M., Gallagher, A. G., Rosser, J. C., &
Satava, R. M. (2002). Evaluation of structured and quantitative
training methods for teaching intracorporeal knot tying.
Surgical Endocopy, 16, 130-137.
- Ricci, S., & Vigevano, F. (1999). The effect of
video-game software in video-game epilepsy. Epilepsia,
40 (Supplement 4), 31-37.
- Ricci, S., Vigevano, F., Manfredi, M., & Kasteleijn-Nolst
Trenite, D. G. (1998). Epilepsy provoked by television
and video games: Safety of 100-Hz screens. Neurology,
- Rosser, J.C. Jr., Lynch, P.J., Haskamp, L.A., Yalif,
A., Gentile, D.A., & Giammaria, L. (2004, January).
Are Video Game Players Better at Laparoscopic Surgery?
Paper presented at the Medicine Meets Virtual Reality
Conference, Newport Beach, CA.
- SafetyAlerts. (2000, March 9). Hand injuries prompt
Nintendo to provide protective gloves for "Mario
Party" video game users [on-line]. Available: http://www.safetyalerts.com/t/ch/mario.htm
- Subrahmanyam, K., R.E. Kraut, P.M. Greenfield, &
E.F. Gross. (2000). The impact of home computer use
on children's activities and development. Children
and Computer Technology, (Fall/Winter), 123-144.
- Tsai, C. L., & Heinrichs, W. L. (1994). Acquisition
of eye-hand coordination skills for videoendoscopic
surgery. Journal of the American Association of Gynecological
Laparoscopy, 1(4, part 2), S37.
- Vandewater, E. A., Shim, M., & Caplovitz, A.G.
(2004). Linking obesity and activity level with children's
television and video game use. Journal of Adolescence,
- Yuji, H. (1996). Computer games and information-processing
skills. Perception and Motor Skills, 83, 643-647
MediaWise Video Game Report Card
|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
The National Institute on Media and the Family
regrets this omission.