Spring 2009

Helping Patients and Their Parents
Understand the Risks of Online Communication
 
Ellen Link, MD, Department of Pediatrics, University of Iowa Children’s Hospital,
Allison Link, and Austin Link

Social networking on sites such as Facebook (www.facebook.com) and MySpace (www.myspace.com) has become a common form of communication among teenagers. Pediatricians must develop an understanding of what occurs on social networking sites in order to communicate with their teenage patients and to provide anticipatory guidance to teens and their families about safety considerations when using these online social sites. 

Facebook is one of the most popular sites for social networking. It is based on networks of high schools, colleges, workplaces, and geographic regions. Each user’s profile can be seen only by members of the same network or by people in other networks who are invited to be a “friend” and whose invitation is accepted.  Facebook privacy settings can be customized to restrict access to information. 

Facebook users share information about themselves and communicate with friends, or other people in their network.  This can be particularly valuable for incoming freshmen looking to meet people at their college, or as a way for former members of a school or program to keep in touch. Many teenagers frequently use it for social communication with friends.  

On Facebook, each individual has a profile in which they share some personal information. This profile can include the user’s name, pictures, personal interests, and phone numbers. Only members of the network can see a person’s profile, unless that person adds an outsider as a friend (which must be approved by both people involved).  

An individual also can adjust privacy settings so that only friends, and not an entire network, can see their profile.  Even members of a network must “friend” an individual before they can write on each other’s “walls.” The wall is a portion of the profile page that everyone with access to the profile can see.

Another form of communication often used by Facebook members is the message, similar to an e-mail. Anyone can send a message to someone on Facebook, but only the individual or individuals receiving the message can see the content. Others in the network would not be able to see messages on someone else’s Facebook page. It is not necessary to “friend” the sender in order to read the message they sent and there is an option to block the sender if necessary. Students on Facebook also may communicate via instant messaging, but only with their friends.

Unlike profiles on MySpace, complete Facebook profile pages cannot be accessed through search engines such as Google. Facebook blocks all information except a name, thumbnail profile picture, and limited aggregated data. This gives Facebook an added safety benefit over MySpace, a fact primary care providers should keep in mind when providing guidance to families.

One very important recommendation for all teens and their families is that teens should communicate online only with people they know in person. This rule should be enforced whether they are on Facebook, instant messaging, or e-mailing. On Facebook they should “friend” only people they know and confirm that they know them by looking at their profile. Parents should regularly discuss this with their teens and ensure that they comply with this important safety requirement.  An exception to this rule might be made for freshman heading off to college. It can be helpful during this transition to network with other incoming freshman, even those they have not yet met. 

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