49–010 

Calendar No. 585 

109TH CONGRESS REPORT " ! SENATE 2d Session 109–323 

CHILDREN AND MEDIA RESEARCH ADVANCEMENT ACT 

OR THE CAMRA ACT 

SEPTEMBER 5, 2006.—Ordered to be printed 

Mr. ENZI, from the Committee on Health, Education, Labor, and 

Pensions, submitted the following 

R E P O R T 

[To accompany S. 1902] 

The Committee on Health, Education, Labor, and Pensions, to 

which was referred the bill (S. 1902) to amend the Public Health 

Service Act to authorize funding for the establishment of a program 

on children and the media within the Centers for Disease Control 

and Prevention to study the role and impact of electronic media in 

the development of children, having considered the same, reports 

favorably thereon with an amendment in the nature of a substitute 

and recommends that (as amended) do pass. 

CONTENTS 

I. Purpose and Summary of the Bill ................................................................ 1 

II. Background and Need for the Legislation ................................................... 2 

III. Legislative History and Committee Action .................................................. 2 

IV. Explanation of Bill and Committee Views ................................................... 3 

V. Cost Estimate ................................................................................................. 5 

VI. Application of Law to the Legislative Branch ............................................. 7 

VII. Regulatory Impact Statement ....................................................................... 7 

VIII. Section-by-Section Analysis .......................................................................... 7 

IX. Changes in Existing Law .............................................................................. 8 

I. PURPOSE AND SUMMARY OF THE BILL

The purpose of the Children and Media Research Advancement 

Act is to establish a centralized research program within the Federal Government to examine the impact of electronic media on children and adolescents. Children today live and develop in a world 

of media, where access is at the fingertips of almost every child. 

This emerging digital world is well known to children, but its efVerDate Aug 31 2005 03:36 Sep 07, 2006 Jkt 049010 PO 00000 Frm 00001 Fmt 6659 Sfmt 6602 E:\HR\OC\SR323.XXX SR323

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fects on their development are not well understood. Reports vary 

as to the amount of time that children spend either watching 

media or engaged in activities on a computer screen. However, we 

know very little about how exposure to media, particularly the 

newer interactive media, affects children’s development. 

S. 1902 amends Title III of the Public Health Service Act to establish a program within the Centers for Disease Control and Prevention to examine the role and impact of media on children’s and 

adolescents’ cognitive, social, emotional, physical and behavioral 

development, and to award research grants based on a coordinated 

research agenda. The bill calls on the Centers for Disease Control 

and Prevention to contract with the National Academies or other 

entity to review, synthesize, and report on existing research on 

children and media, and to establish priorities for a subsequent research program on the impact of media on children. 

II. BACKGROUND AND NEED FOR THE LEGISLATION

The committee directs the National Academies or other entity to 

perform such a review and to establish such research priorities by 

working with recognized experts in the relevant field of study. Taking into consideration these recommendations, the Centers for Disease Control and Prevention will—subject to appropriations—and 

in coordination with the Director of the National Institutes of 

Health award research grants to examine the role of media in children’s cognitive, social, emotional, physical, and behavioral development. Such research will examine all forms of electronic media, 

including television, movies, DVDs, interactive video games, cell 

phones, digital music, and the Internet. It may examine effects 

among children of all ages—from infancy through adolescence. 

Not later than 15 months after the bill is enacted, the National 

Academies or other entities shall submit a report reviewing and 

synthesizing research on children and media to the Director of the 

Centers for Disease Control and Prevention and the appropriate 

committees of Congress. Not later than the end of the calendar 

year 2012, the Centers for Disease Control and Prevention shall 

submit to Congress a report synthesizing and reporting on the research conducted pursuant to grants authorized under this act and 

elsewhere. 

There are still many unanswered questions about media’s impact 

on children. For example, while Congress may agree that there is 

a need to protect our children from online pornography, there is insufficient research on whether, when, how, and to what extent inadvertent exposure to online pornography affects children, their behavior, moral values, and standards of decency. We also know very 

little about how to address even the most practical of questions, 

such as how to prevent children from falling prey to adult strangers who approach them online. 

III. LEGISLATIVE HISTORY AND COMMITTEE ACTION

During the first session of the 109th Congress, S. 579, the ‘‘Children and Media Research Advancement Act’’ or the ‘‘CAMRA Act’’

was introduced on March 9, 2005. CAMRA was re-introduced on 

October 20, 2005 as S. 1902. S. 1902 modified S. 579 by specifying 

that the Director of the Centers for Disease Control and Prevention 


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rather than the Director of the National Institute of Child Health 

and Human Development would oversee the research provided for 

by CAMRA, as this research complements ongoing efforts by the 

Centers for Disease Control and Prevention. 

The Committee on Health, Education, Labor, and Pensions reported S. 1902 favorably with an amendment in the nature of a 

substitute on March 8, 2006, by unanimous consent. 

IV. EXPLANATION OF THE BILL AND COMMITTEE VIEWS

The committee believes there is a need for the Federal Government to sponsor research on the impact of media on children and 

there is precedent for Congressional interest. For example, Congress passed the Children’s Television Act to promote media that 

foster positive values like helping, sharing, and cooperating among 

children. Congress also passed the Children’s Online Privacy Protection Act (COPPA) to safeguard children from exploitation as 

they explore the Internet. In addition, Congress passed the Communications Decency Act and the Children’s Internet Protection 

Act to shield children from exposure to sexually-explicit online content that may be harmful to minors. 

The committee believes media can have positive and negative effects on children’s health, behavior and development, but there is 

insufficient knowledge of the nature of these effects. We have only 

some limited knowledge of the effects of children’s exposure to established media, and even less is known about the effects of new, 

electronically based media. The committee therefore believes that 

we need more research in these areas. The committee wants to better understand how interactive media can promote positive health 

awareness and lifestyles. The committee views positively the development of interactive media products to promote health—including ‘‘exergames’’ to promote physical activity, and media products to 

train physicians and other medical professionals, to help people 

manage chronic pain and other health conditions, and to enhance 

cognitive development and educational outcomes. The use and effectiveness of such products should be a subject of research. 

The committee agrees with the view that time spent with computers can be good for children, teaching them the skills that they 

will need for success in the 21st century. The committee also expects that research could examine how the newest kinds of interactive programs designed to teach as they entertain can foster academic development and ensure that no child is left behind. The 

committee would expect that research could reveal more about how 

time spent with computers is different from time spent in front of 

the television. Perhaps it can help us understand some of the underlying mechanisms that facilitate or disrupt children’s learning 

from different media? Can academic development, for example, be 

fostered by the use of interactive online programs designed to teach 

as they entertain? Thus, research can help us understand the underlying mechanisms that facilitate or disrupt children’s learning 

from different media. In addition, research is needed to understand 

the impact of marketing in electronic media on children and their 

health and development, including traditional television advertising as well as online ‘‘stealth’’ marketing including advergames 

and pop-up ads and new forms of marketing such as advertisements on cellar phones. 


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The committee also believes that research in children is needed 

to more fully understand the effects of violence in media. Research 

is needed to understand the effects of violence in new media technologies, including what features of violent video games produce 

the strongest effects, whether the context or venue in which a child 

plays such games moderates the effects, and which children are 

most likely to be affected by violent video games. The committee 

is also interested in electronic media products marketed for toddlers and babies less than 3 years of age, as media products for 

very young children proliferate, it is important to better understand the impact of such products. 

The committee believes that the research conducted pursuant to 

the legislation could help ensure that the recommendations and 

public policy decisions made by Congress will be grounded in objective behavioral, social, and scientific research. At present no Federal research agency has the responsibility to oversee and set a coherent media research agenda that can guide public policy decisions. The committee anticipates that the research will cover all 

forms of electronic media, including television, movies, DVDs, 

interactive video games, cell phones, digital music, and the Internet, and will examine children of all ages. The legislation created 

by the committee also calls for a report to Congress about the results and conclusions of this research program. 

The committee believes by passing the Children and Media Research Advancement Act the Congress can advance knowledge and 

enhance the constructive effects of media while looking to minimize 

negative effects. Specifically, the Centers for Disease Control, in cooperative arrangements with the National Academy of Sciences 

and the Institute of Medicine will be directed by this legislation to 

look at the following areas in which media may have an impact on 

aspects of development of children: 

Cognitive. The role and impact of media use and exposure in 

the development of children and adolescents within such cognitive areas as language development, attention span, problem 

solving skills (such as the ability to conduct multiple tasks or 

‘‘multitask’’), visual and spatial skills, reading, and other learning abilities. 

Physical. The role and impact of media use and exposure on 

children’s and adolescents’ physical coordination, diet, exercise, 

sleeping and eating routines, and other areas of physical development. 

Socio-Behavioral. The influence of interactive media on children’s and adolescents’ family activities and peer relationships, 

including indoor and outdoor play time, interaction with parents, consumption habits, social relationships, aggression, 

prosocial behavior, and other patterns of development. 

To do our very best by children, the committee believes we must 

make public policy decisions on the basis of sound behavioral and 

social scientific research. Today, Federal agencies fund media research in a piecemeal fashion resulting in a patchwork quilt of 

studies and findings. CAMRA is intended to coordinate research 

projects and contribute to the development of a comprehensive view 

of the role of media in children’s cognitive, social, emotional, physical, and behavioral development. 


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The Kaiser Family Foundation (KFF) recently released a report 

on electronic media in the lives of infants, toddlers, and preschoolers-ages 0 to 6 years old. The study found that children today 

are reared in a media saturated environment. According to the 

study, 99 percent of all children live in a home with a TV set and 

50 percent of these children live in a home with three or more TVs 

of which 36 percent have a TV in their bedroom. Thirty percent of 

children ages 0 to 3 years and 43 percent of 4 to 6 year olds have 

a TV in their bedroom. 

The committee believes that parents have the primary responsibility to examine the positive and negative effects media may have 

on their children—whether it encourages creativity in children or 

has the capability of harmful affects on children. However, there is 

insufficient information to enable parents to make informed decisions about how media, particularly the newer digital media, affects children’s health, education, and development. America is a 

media-rich society, but despite the incredible amounts of information, we still lack the most important piece of all—the effect that 

media has on our children. 

It is essential to provide parents and guardians with the most accurate information and current research on the impact of media 

has on their children. In spite of the lack of research, parents already feel very strongly about what is portrayed in the media. According to a recent study by Common Sense Media, approximately 

9 out of 10 American parents believe today’s media contribute to 

their own children becoming too materialistic, using more coarse 

and vulgar language, engaging in sexual activity at younger ages, 

experiencing a loss of innocence too early, and behaving in violent 

or anti-social ways. 

Hopefully, through a better understanding of the power of media, 

we can use it in a healthy and productive way to educate our children and give parents helpful tools to raise their children. 

V. COST ESTIMATE

U.S. CONGRESS, 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, August 17, 2006. 

Hon. MIKE ENZI, 

Chairman, Committee on Health, Education, Labor, and Pensions, 

U.S. Senate, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for S. 1902, the Children and 

Media Research Advancement Act. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Tim Gronniger. 

Sincerely, 

DONALD B. MARRON, 

Acting Director. 

Enclosure. 

S. 1902—Children and Media Research Advancement Act 

Summary: S. 1902 would direct the Centers for Disease Control 

and Prevention (CDC) to promote research on the effects of electronic media on children. The bill would authorize the appropriaVerDate Aug 31 2005 02:29 Sep 07, 2006 Jkt 049010 PO 00000 Frm 00005 Fmt 6659 Sfmt 6602 E:\HR\OC\SR323.XXX SR323

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tion of such sums as are necessary to implement those policies. 

Based on information from CDC and comparison with similar activities, assuming appropriation of necessary funds, CBO estimates 

that implementing S. 1902 would cost less than $500,000 in 2007 

and about $5 million over the 2007–2011 period. S. 1902 would not 

affect direct spending or receipts. 

S. 1902 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA) 

and would not affect the budgets of state, local, or tribal governments. 

Estimated cost to the Federal Government: The estimated budgetary impact of S. 1902 is shown in the following table. The costs 

of this legislation fall within budget function 550 (health). 

By fiscal year, in millions of dollars— 

2007 2008 2009 2010 2011 

CHANGES IN SPENDING SUBJECT TO APPROPRIATION 

Estimated authorization level ....................................................................... 1 1 1 1 1 

Estimated outlays ......................................................................................... * 1 1 1 1 

Note: *= increase of less than $500,000. Amounts do not sum to totals in the text because of rounding. 

Basis of estimate: S. 1902 would modify the Public Health Service Act to require the CDC to pursue research on the effects of electronic media—including television, movies, DVDs, video games, 

digital music, the Internet, and cell phones—on childhood development. In particular, the CDC would be required to contract with 

either the National Academy of Sciences or another research organization to conduct a study summarizing existing research on the 

topic and to provide recommendations for future research. Taking 

account of the recommendations of that report, the Director of the 

CDC would then be required to provide grants to fund research on 

the effects of electronic media on the cognitive, physical, and sociobehavioral development of youth. The bill would authorize the appropriation of such sums as may be necessary for that research for 

fiscal years 2007 through 2011. 

We estimate that the CDC would require the appropriation of $1 

million for 2007 to contract with the National Academy of Sciences 

or a similar organization for the initial report. In subsequent years 

the CDC would fund research in each of the three areas targeted 

by the bill—at a cost of about $400,000 per area per year—for a 

total of about $1.2 million per year for fiscal years 2008 through 

2011. That estimate is based on comparison with past CDC activities and information provided by CDC staff, Based on historical 

rates of spending for funds appropriated to CDC, and assuming appropriation of the necessary amounts, CBO estimates that implementing S. 1902 would cost less than $500,000 in 2007 and about 

$5 million over the 2007–2011 period. 

Intergovernmental and private-sector impact: S. 1902 contains no 

intergovernmental or private-sector mandates as defined in UMRA 

and would not affect the budgets of state, local, or tribal governments. 

Estimate prepared by: Federal costs: Tim Gronniger. Impact on 

state, local, and tribal governments: Leo Lex. Impact on the private 

sector: Peter Richmond. 


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Estimate approved by: Peter H. Fontaine, Deputy Assistant Director for Budget Analysis. 

VI. APPLICATION OF LAW TO THE LEGISLATIVE BRANCH

The committee has determined that there is no impact of this 

law on the Legislative Branch. 

VII. REGULATORY IMPACT STATEMENT

In accordance with paragraph 11(b) of rule XXVI of the Standing 

Rules of the Senate, the committee has determined that there will 

be no increase in the regulatory burden imposed by this bill. 

VIII. SECTION-BY-SECTION ANALYSIS

Section 1. Short title 

‘‘Children and the Media Research Advancement Act’’ or the 

‘‘CAMRA Act.’’

Section 2. Purpose 

This section indicates that the purpose of the Act is to enable the 

Centers for Disease Control and Prevention to examine the role 

and impact of electronic media in children’s development, and to 

provide a report to Congress summarizing research in this area. 

Section 3. Research on the Role and Impact of Electronic Media in 

the Development of Children and Adolescents 

This section requires the Centers for Disease Control and Prevention to contract with the National Academies of Science (NAS) 

or another appropriate entity to review, synthesize, and report on 

the research concerning the effect of exposure to media on children 

and adolescents’ cognitive, physical, and socio-behavioral development, and to establish research priorities in this area. The NAS or 

other entity shall review, synthesize and report on scientifically 

valid and peer reviewed studies in its report. The committee assumes that the National Academies or other entity will conduct 

this review and establish these research priorities by convening a 

panel of media experts through the Institute of Medicine and other 

relevant Divisions and Boards, including the Board on Children, 

Youth and Families. 

Taking into account these recommendations, the Centers for Disease Control and Prevention is required to award grants for research concerning the role and impact of electronic media in children’s development—subject to appropriations. This research shall 

focus on the impact of such factors as the format, length of exposure, age of youth, nature of parental involvement, and venue (i.e., 

the place or setting in which media is consumed, such as at school 

or at home). It may also focus on the impact of direct and indirect 

media content. Direct media content refers to media content that 

is not intended to promote or sell a product. Indirect media content 

refers to media content that is intended to promote or sell a product, including advertising, ‘‘advergames,’’ product placement, and 

other forms of marketing. However, the program will not duplicate 

other research including other Federal Research activities. 


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To receive a grant under this section, entities shall submit applications to the Director of the Centers for Disease Control and Prevention at such time, in such manner, and containing such information as the Director requires. They shall use amounts received 

under the grant to carry out activities as described in this subsection. 

Not later than 15 months after the bill is enacted, the report prepared by the National Academies or other entity shall be submitted 

to the Director of the Centers for Disease Control and to the appropriate committees of Congress. Not later than December 31, 2012 

the Secretary of Health and Human Services, acting through the 

Director of the Centers for Disease Control, shall submit a report 

synthesizing the findings of research provided for by CAMRA and 

other related research to the appropriate committees of Congress. 

This section further authorizes to be appropriated to carry out 

this section such sums as may be necessary for 2007 through 2012. 

IX. CHANGES IN EXISTING LAW

In compliance with rule XXVI paragraph 12 of the Standing 

Rules of the Senate, the following provides a print of the statute 

or the part or section thereof to be amended or replaced (existing 

law proposed to be omitted is enclosed in black brackets, new matter is printed in italic, existing law in which no change is proposed 

is shown in roman): 

PUBLIC HEALTH SERVICE ACT 

* * * * * * * 

TITLE III—GENERAL POWERS AND DUTIES OF PUBLIC 

HEALTH SERVICE 

PART A—RESEARCH AND INVESTIGATION

IN GENERAL

* * * * * * * 

PART P—ADDITIONAL PROGRAMS

SEC. 399L. ø280g¿ CHILDREN’S ASTHMA TREATMENT GRANTS PROGRAM. 

(a) AUTHORITY TO MAKE GRANTS.—

(1) IN GENERAL.—* * * 

* * * * * * * 

SEC. ø399O¿ 399P. ø1280k–4¿ GRANTS TO FOSTER PUBLIC HEALTH RESPONSES TO DOMESTIC VIOLENCE, DATING VIOLENCE, 

SEXUAL ASSAULT, AND STALKING. 

(a) AUTHORITY TO AWARD GRANTS.—* * * 

* * * * * * * 

SEC. 399Q. RESEARCH ON THE ROLE AND IMPACT OF ELECTRONIC 

MEDIA IN THE DEVELOPMENT OF CHILDREN AND ADOLESCENTS. 

(a) IN GENERAL.—Subject to the availability of appropriations, the 

Secretary, acting through the Director of the Centers for Disease 

Control and Prevention (referred to in this section as the ‘‘Director’’), 


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shall enter into a contract with the National Academy of Science or 

another appropriate entity to review, synthesize, and report on research, and establish research priorities, regarding the roles and 

impact of electronic media (including television, motion pictures, 

DVD’s, interactive video games, digital music, the Internet, and cell 

phones) and exposures to such media on youth in the following core 

areas of development: 

(1) COGNITIVE.—Cognitive areas such as language development, attention span, problem solving skills (such as the ability 

to conduct multiple tasks or ‘‘multitask’’), visual and spatial 

skills, reading, and other learning abilities. 

(2) PHYSICAL.—Physical areas such as physical coordination, 

diet, exercise, sleeping and eating routines. 

(3) SOCIO-BEHAVIORAL.—Socio-behavioral areas such as family activities and peer relationships including indoor and outdoor play time, interactions with parents, consumption habits, 

social relationships, aggression, and positive social behavior. 

(b) RESEARCH PROGRAM.— (1) IN GENERAL.—Taking into account the report provided for 

under subsection (a), the Secretary, acting through the Director 

and in coordination with the Director of the National Institutes 

of Health, shall, subject to the availability of appropriations, 

award grants for research concerning the role and impact of 

electronic media on the cognitive, physical, and socio-behavioral 

development of youth. 

(2) REQUIREMENTS.—The research provided for under paragraph (1) shall comply with the following requirements: 

(A) Such research shall focus on the impact of factors 

such as media content (whether direct or indirect), format, 

length of exposure, age of youth, venue, and nature of parental involvement. 

(B) Such research shall not duplicate other Federal research activities. 

(C) For purposes of such research, electronic media shall 

include television, motion pictures, DVD’s, interactive video 

games, digital music, the Internet, and cell phones. 

(3) ELIGIBLE ENTITIES.—To be eligible to receive a grant 

under this subsection, an entity shall— (A) prepare and submit to the Director an application at 

such time, in such manner, and containing such information as the Director shall require; and 

(B) agree to use amounts received under the grant to 

carry out activities as described in this subsection. 

(c) REPORTS.—

(1) REPORT TO THE DIRECTOR.—Not later than 15 months 

after the date of the enactment of this section, the report provided for under subsection (a) shall be submitted to the Director 

and to the appropriate committees of Congress. 

(2) REPORT TO CONGRESS.—Not later than December 31, 

2012, the Secretary, acting through the Director, shall prepare 

and submit to the appropriate committees of Congress a report 

that—(A) synthesizes the results of— (i) research carried out under the grant program 

under subsection (b); and 


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(ii) other related research, including research conducted by the private or public sector and other Federal entities; and 

(B) outlines existing research gaps in light of the information 

described in subparagraph (A). 

(d) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to 

be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2007 through 2012. 

* * * * * * * 

Æ 


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