Childhood Injuries

To reduce the incidence of future unintentional injuries, researchers focus on factors that identify which children are more likely to experience injury based on past statistics. Both internal and external variables place some children more at risk than others. Variables that contribute to increased injury rates in children include:

• Individual variables (e.g., age, gender, temperament, race/ethnicity)
• Behavioral variables (e.g., antisocial or conduct disorders)
• Risk-taking behavior (e.g., not wearing helmets or using seatbelts)
• Caregiver behaviors (e.g., level of parental supervision)
• Economic variables (e.g., income)
• Environmental variables (e.g., streets, playgrounds, neighborhoods)
• Sociocultural variables (e.g., crime rates, overcrowding) (Sleet & Mercy, 2003)

By identifying the individual and ecological characteristics of children who experience higher rates of injury, safety prevention programs can target populations who exhibit greater need.

Injury patterns appear to change over the life course and are closely related to developmental stage (Dahlberg & Potter, 2001). For example, there are high rates of injury in children ages 1–4, followed by a slight drop for children ages 5–9, then a sharp rise in injuries in children ages 10–14 that continues through adolescence and early adulthood. The increase in unintentional injuries, particularly in children ages 10–14 may, in part, be a result of children’s increased exposure to activities and environments outside the home. During this time in children’s lives, safety monitoring shifts from a reliance on parents/guardians in the home to reliance on self and others (e.g., peers, teachers, coaches).

Studies that examine car-pedestrian and car-bicycle collisions, in particular, find that immature perceptual and cognitive skills may also be putting children at greater risk for these injuries (Connelly, Conaglen, Parsonson, & Isler, 1998; Plumert, Kearney, & Cremer, 2004). For example, to safely cross a street with moving traffic, children must accurately judge the size of the gap between 2 cars in relation to the time it will take them to cross the road. When a “pretend road” was set up parallel to an actual road, children, ages 5–9 years, were asked to watch the cars on the actual road and cross the pretend road when they thought they could safely get to the other side. The younger children in the study picked gaps that were too short. They would have been hit on 6% of their crossings if they had been on the actual road. Approximately 75% of 5-year-olds made at least one road-crossing error and only 58% of 9-year-olds did so. These findings suggest that although 9-year-olds are better than 5-year-olds at making moving-car judgments, children in middle childhood still misjudge their ability to walk through traffic gaps safely.

In another study, researchers asked 5–12-year-old-children to stand at a roadside and indicate the last possible moment they could safely cross (Connelly et al., 1998). The researchers varied the car speeds throughout the study. Overall, the older children selected safe crossing gaps 92% of the time, whereas 5-year-olds selected safe gap crossings only 66% of the time. It was notable that the older children based their judgments more on distance away from the car rather than on the speed of the approaching vehicle. These results imply that children in middle childhood would make more crossing errors when cars are traveling faster than normal on a given roadway.

Finally, a study that used an interactive bicycling simulator demonstrated that children ages 10- and 12-years-old left far less time to spare between themselves and a vehicle approaching an intersection. When compared to adults in this study, children took longer in getting started on their bicycles and took longer to approach the roadway, thus underestimating their cycling abilities in their crossing calculations (Plumert et al., 2004).

These findings are consistent with other applied developmental research showing that children in middle childhood, when compared to adolescents or adults, have more difficulty judging how long it would take a moving vehicle to cross a line (Caird & Hancock, 1994), overestimate their physical abilities (e.g., starting their bikes), and generally have more difficulty coordinating their own physical movements with that of moving objects (Pitcairn & Edlmann, 2000; Schwebel & Plumert, 1999).

It appears that developmental changes in coordinating motor movements with visual information occur as children gain experience with specific tasks (Savelsbergh & van der Kamp, 2000). In other words, the more guidance and practice children have in crossing streets with adults who point out key variables, such as starting across the road before the first car clears, will assist children as they perform the same tasks on their own. This information is useful to professionals who design injury prevention strategies and to parents and teachers who want to reduce unintentional injuries in children of all ages.