They are generation Gen-Tech, a tidal wave of children andteenagers who have been computer-savvy since they got their first"Blue's Clues" CD-ROM, chatted with friends via Instant Messenger, orkeyed in their homework. And already, some are paying the price,sustaining injuries more typically seen in office workers thanchildren.
At both Harvard University and the Massachusetts Insitute ofTechnology, for example, up to a dozen students at any given time usethe services of note takers when their pain from repetitive straininjury is too great to write.
For some, the problems start much earlier. In a survey of 170sixth-graders at West Middle School in Andover last year, manystudents reported aches that seem linked to computer use. Thirty-five percent said they have experienced pain, aching, discomfort ornumbness in their neck. More than one in six reported similarproblems in lower backs, shoulders, wrists or hands.
While adult computer-related injuries have leveled off in the pastfew years, largely due to greater awareness and changes in theworkplace, children have received relatively little attention. Thoughmuch of the evidence of injuries in young people is anecdotal,doctors predict injuries will increase along with a growing relianceon technology, and virtually no guidelines are in place to protectthem.
"The issues at the 20-year reunions of these kids are going to bewho's crippled, who's on disability, and who's on workers' comp,"predicted self-described ergonomics campaigner Wendy Scheinfeld ofBrighton, an outlook echoed, though less dramatically, by ergonomistsand health professionals.
Scheinfeld left a career in computer programming because of aserious repetitive strain injury. Now, as a substitute and after-school teacher in Somerville public schools, she preaches ergonomics -the science of human interaction with machines - to "the firstgeneration of techno-knowledgable kids."
Computers have become almost ubiquitous in children's lives in aremarkably short time. About 65 percent, or 23.9 million, of allhouseholds with children have at least one computer, according to a1999 study by Grunwald Associates. Only four years earlier, computerswere in 12.8 million, or 38 percent, of households with children.
Likewise, the number of computers in schools nearly doubled from1995 to 1999, now totaling one terminal for 4.9 students, accordingto Market Data Retrieval.
But relatively little thought has gone into preventing repetitivestrain injury, the name for a range of conditions caused byrepetitive motion. RSI includes carpal tunnel syndrome, which affectsthe median nerve in the wrists; tendinitis, an inflammation thatoccurs from repeated use of tendons around the thumbs; and fatigue.In computer users who are not physically fit, certain muscles becomeoverworked, while their supporting muscles are inactive, adding tothe problem.
Karen Jacobs, the Boston University professor and occupationaltherapist who surveyed the Andover middle school students, becameaware of the potential problem among young people through her ownchildren, Ariel and Josh Gold, now 14 and 16. She would see themslouching in their nonadjustable chairs at the home computer or withtheir classmates at West Middle School, which they attended at thetime. At home, Jacobs set up separate work stations for the childrenthat included keyboard trays and adjustable office chairs.
Even now, however, Ariel, a freshman day student at PhillipsAcademy in Andover, still has some pain in her fingers, wrists, andback. Some of that she attributes to "bad habits that I probablyshould get rid of. I did get a new chair, but I don't always sit upstraight."
She said she figures she spends at least three hours an evening onthe computer doing homework and chatting with friends on theInternet, mostly by Instant Messenger, which involves rapid-firetyping and mouse-clicking.
Scheinfeld said some school systems "push technology withoutconsidering the consequences. Their attitude is just get thosemachines in there."
The Somerville school system, which has no ergonomics guidelines,is by no means alone. The Boston public school system, which toutsits aggressive computer acquisition program under Mayor ThomasMenino, has no program or guidelines, nor do the state or USdepartments of education or the 10,000-member International Societyfor Technology in Education.
"That issue hasn't surfaced," said Ann Grady, director ofinstructional technology for the Boston schools who said studentsaren't at computers for an extended length of time.
In the Taunton public schools, however, where East TauntonElementary was named one of the country's Top 100 Wired Schools byFamily PC magazine, officials plan to incorporate ergonomic trainingin their new curriculum.
"It's an issue because kids are using technology more and more,"said Ragen Tiliakos, the Taunton school system's director oftechnology.
While many school officials say their budgets prevent them frompurchasing ergonomically correct equipment, Scheinfeld and otherscounter that good ergonomics doesn't have to equal big money.
For one thing, although the hardware is important, correct postureand frequent breaks are even more critical. Further, they say,getting the message out when kids are young should be considered amatter of public health. In addition, there are inexpensive ways tomake work stations more healthy.
"The Yellow Pages [for raising the monitor] is my staple," Jacobssaid. "Instead of a back rest, you can roll up old towels or usesmall pillows. You can make changes that are economical."
At West Middle School, Jacobs and two BU graduate students arehelping families make affordable changes at home through a recenthome environment study. Children who use work stations designed foradults often have to stretch to reach the mouse, can't put their feeton the floor, and don't have properly placed keyboards or monitors.The study includes a home visit and motion analysis, along withergonomic guidelines and follow up.
College administrators applaud any preventive measures, sayingthat, by the time students get to them, their habits are hard tochange.
"Healthy computing needs to be taught and reinforced at school andin families," said Marie Trottier, disabilities coordinator atHarvard University. "I see many students already having bad habitsand then exacerbating that."
Dr. Jeffrey Katz of Brigham and Women's Hospital found that 41percent of Harvard senior undergraduates reported they had RSIsymptoms after several hours of computer use. The study also foundthat "an important, potentially preventable public health problem maybe emerging on college campuses."
Now, Katz and fellow researchers are currently seeking funding fora Harvard study that would test strategies for preventing disorders.
At BU, Jacobs is in the process of starting an ergonomics programfor dorm students that could include discounts on some computerequipment such as keyboard trays.
Dr. David Diamond, the MIT medical department's chief of medicine,gives ergonomics talks on campus and hopes to start training forfreshmen, though, he said, "most people don't pay attention untilthey have symptoms."
Another concern on campuses is the proliferation of laptopcomputers, which some schools such as Framingham State College aremaking mandatory for all students. Diamond considers laptops inferiorbecause of their smaller size, nonmovable parts, and the tendency forstudents to use them in any just about any body position, many noteven approaching good posture.
At least two scientific conferences this summer will focus on theneed for more research into computer ergonomics for children, a needalready highlighted by Alan Hedge, whose ergonomics lab at CornellUniversity conducted the first major study of classroom computerergonomics two years ago.
Observing third- through fifth-graders at 11 schools, Hedge foundthat the children were often forced into awkward positions that couldcause injuries. He is now leading a study involving ergonomicssoftware at an elementary school in Westport, Conn., in conjunctionwith Magnitude Information Systems, which plans to market computer-animated monitoring software for children, called ErgoFUN, by thefall.
"There is this general assumption that we're dealing with a benigntechnology," Hedge said. But, "like with everything, it takes time tosee what the effects will be."
Diane Daniel can be reached by e-mail at ddaniel@globe.com.
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