Childhood Injuries

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Unintentional injuries are defined as bodily harm that results from accidental causes such as falls, motor vehicle accidents, drowning, electrocution, suffocation. Unintentional injuries are the leading cause of death for children ages 5–14. More than 5.5 million children from this age group also suffer nonfatal injuries requiring emergency room care (Burt & Fingerhut, 1998; CDC, 2004). Injuries requiring medical attention, or resulting in restricted activity, affect more than 20 million children and cost $17 billion annually for medical care (Danesco, Miller, & Spicer, 2000).

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.