When Bernadette Bove started teaching eight years ago, it was fairly easy to block students' line of communication with their peers in class by intercepting the notes they passed back and forth.
Now, these paper notes have gone digital in the form of text messages and are harder to stop.
"Even though the students are not supposed to have cell phones with them or on, they still do it," said Ms. Bove, a Spanish teacher at Beaver Area High School.
"Students will hide their phone under his or her desk and be texting back and forth. From a teacher's point of view, they have a look about them, a far-out look.
"They are not paying attention."
School is just one place where texting has become a distraction, and it is growing. The Nielsen Co. recently published a report that U.S. mobile subscribers now send and receive more text messages in a month than they do phone calls.
In 2001, only about 2 percent of U.S. residents used text messaging. But texting took off in the last few years as mobile carriers such as Verizon and AT&T debuted pricing plans that permitted unlimited text messaging.
American teenagers sent and received an average of 2,272 text messages per month in the fourth quarter of 2008. That averages out to about 80 messages a day, which is more than double the average from last year.
That number is spurring concern for some local doctors, who think texting is causing anxiety, sleep loss, distraction in school, falling grades and repetitive stress injury among youngsters.
Allyson Havill, an assistant professor at the University of Pittsburgh School of Nursing and a psychotherapist in private practice, has seen the effects firsthand.
"Teens are starting to bring up texting in therapy sessions as measures of social standing," Dr. Havill said. "It can have positive or negative effect on self-esteem."
On one hand, texting helps teens feel socially connected and lets them share their experiences instantly, leading to a boost in self-esteem. On the other hand, if teens feel left out or disconnected, texting can lead to anxiety and feelings of sadness.
Also, many teens stay up late and text throughout the night, leading to daytime fatigue and anxiety.
"There is short- and long-term anxiety," said Dr. Jonathan Pletcher, an adolescent medicine specialist at Children's Hospital of Pittsburgh of UPMC. "The short-term anxiety is, 'Will he or won't he answer?' It's unnecessarily negative, but the same as a phone call we learn to deal with over time. Long term, it impairs your daily functions. They are doing it late and not sleeping as well, leading to daytime anxiety."
Torrance Shepherd, a new graduate of Seneca Valley Senior High School headed to Penn State in the fall, does not think her texting is causing anxiety, but she does admit to staying up at night waiting for someone to answer. She says she sends late-night texts more on the weekends, and uses the 100 she sends daily as a quick way to get information to her parents and peers.
"It's faster than calling," Ms. Shepherd said. "I normally have to get important text messages out to my parents or other people. It's easy to send one text message and get a hold of someone."
Ms. Shepherd also pointed out that sometimes she sends one message to 30 people at a time. When teens are sending out mass texts, it is easier to see how they rack up an average of 80 per day.
Mass texting can work both ways. If, for example, a person sends something to a friend, that friend can forward the message onto other friends quickly and without the original sender's knowledge. Sometimes this can lead to the message being lost in translation since it is stripped of its context.
"My No. 1 concern [with texting] is misinterpretation," Dr. Pletcher said. "Look at basic communication. We have inflection and body language to help others interpret what we say. That's not there in texting."
Both teens and adults agree that texting is a distraction. But sending a text message late at night is one thing; sending one while driving is another.
Marcel Just, a psychology professor at Carnegie Mellon University, completed a study last year showing that simply listening to a cell phone while driving can cause drivers to commit errors as if they were under the influence of alcohol. Making the phones hands-free did not help eliminate those distractions.
Pennsylvania does not have laws limiting texting while driving, but a bill introduced by state Rep. Joe Markosek, D-Monroeville, is gaining momentum in the Legislature. It would, among other things, prohibit young drivers from talking on handheld cell phones or texting while driving.
"Listening was bad enough," Dr. Just said. "One does not need to do research [to see] that texting while driving is a very risky thing to do."
Statistics back up his concerns. According to data from the Pennsylvania Department of Transportation, cell phone-related car accidents shot up by 43 percent in Western Pennsylvania between 2003 and 2006.
Moreover, almost 50 percent of drivers between the ages of 18 and 24 have admitted to texting or sending an e-mail or instant messages while driving, according to a survey by www.findlaw.com, a legal information site.
Among other negative effects of texting, a recent British study reported that one in six texters between 16 and 24 experience pain in their hands when they text. Dr. Pletcher, though, thinks these concerns may be overblown.
While students may not always suffer physically, their grades might. Ms. Bove reports seeing a correlation between drops in grades and the number of times she catches a student texting.
At least one school, though, seems to have the problem under control. When Matt and Sean Duckett, both freshmen at Sewickley Academy, were asked if they texted during class, the response was an emphatic "no."
"You would be dead meat," Mr. Duckett said. "If your phone goes off, you go straight to the dean's office."