Objectives

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Objectives

• To increase awareness among parents and
  caregivers of the injury risks children face.
• To understand how the various stages of a childs
  development can affect the risk of injury among
  children.
• To learn various developmental activities,
  hazards and risks, and prevention tips and
  strategies to keep children safe at different
  stages of their life.

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Childhood Injury

• How do injuries happen?
• What are unintentional injuries?
• Unintentional childhood injury is the leading
  cause of death and disability for children ages 1
  to 14 in the U.S.
• An average of 12 children are injured every
  minute.
• In 2007, there were more than 6 million reported
  unintentional injuries in the U.S.

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Childhood Injury

• Approximately 101 minutes, a child in the U.S.
  dies from an unintentional injury, such as a
  vehicle crash or a fire.
• In 2005, there were 5,162 unintentional injury
  deaths among children less than 14 years of age.
• Injuries have a significant economic impact as
  well.
• Costly emergency department
• bills
• Missed school days
• Lifelong disabilities
• Limited future job opportunities

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Child Development and Injury Risk

• Research has identified specific developmental
  abilities and limitations that can increase a
  childs risk of injury.
• Understanding your childs growth and development
  is an important part of parenting. 
•  As your child grows from infancy through early
  adolescence, its important to promote safety.
•  A childs developmental stage is the key to
  identifying which types of injuries are of
  greatest risk to him or her.

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Newborns

• Although a newborn spends about 16 hours a day
  sleeping, the time a baby is awake can be busy.
• Much of a newborns movements and activity are
  reflexes or involuntary, meaning the baby doesnt
  purposefully make these movements.
• As the nervous system begins to mature, these
  reflexes give way to purposeful behaviors.
• Newborn babies have unique reflexes and a number
  of physical characteristics and behaviors such
  as
• Their head sags when lifted up and needs to be
  supported
• Jerky and erratic movements
• Hand-to-mouth movements

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Infants 1 to 3 months

• Most reflexes begin to disappear
• Bring hands or objects to mouth
• Look at hands
• Follow light, faces and objects
• Listen to sounds
• Open and close hands
• Can hold and then drop a toy, rattle or other
  object
• Have active leg movements
• At the end of the 3rd month, they
• Can lift their head, neck and upper chest
• Begin to reach hands to objects
• May bat at hanging objects with hands

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Infants 4 to 6 months

• Reflexes normally present in young infants
  disappear
• Balance head well
• Can sit with support
• Begin to support body with legs when held in
  standing position
• Roll from back to front and front to back by 6
  months
• Move objects from one hand to other
• Grab feet and toes when lying on back
• Begin to sleep longer at night

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Infants 7 to 9 months

• Roll over easily from front to back and back to
  front
• Sit leaning forward on hands at first, then
  unsupported
• Bounce when supported to stand
• Get on hands and feet and rock back and forth
• May creep, scoot, crawl (backwards first, then
  forward)
• Begin to pull up to stand with help
• Reach for and grasp objects using whole hand
• Like to bang objects on tables
• May hold a bottle
• Grasp objects with thumbs and fingers by the 8th
  or 9th month
• Put everything into their mouths

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Infants 10 to 12 months

• Pull up to a standing position
• Can sit back down from standing position
• Cruise or walk around holding on to furniture
• May stand next to furniture without holding on
• May walk holding on to a finger or hand
• May begin to take steps and walk on their own
• Play receiving and returning a rolled ball
• Are able to pick up food and small objects with
  fingers
• Bang objects together
• May wake up at night looking for their parents

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Infants (Birth to 12 months)

• Did you know babies?
• Have a slower digestion rate than adults
• Breathe more quickly than adults, putting them
  at a higher risk of inhaling harmful gasses
  faster
• Have been observed making 10 hand-to-mouth
  movements per hour
• Have thinner and more sensitive skin that can
  burn in approximately 1/4 of the time it takes to
  burn an adults skin

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Keep your baby safe

• Supervise, supervise and supervise!
• Install stair gates.
• Secure furniture to the wall.
• Dont use baby walkers. Use stationary play
  centers instead.
• Never leave your baby unattended on changing
  tables, beds or other furniture. Keep one hand on
  your baby while changing diapers.
• Use a rear-facing car seat in the back seat of
  your car until your baby is at least age 1 and
  20lbs.
• Have your car seat checked by a child passenger
  safety technician to make sure its properly
  installed.
• Install smoke alarms and carbon monoxide
  detectors in your home.

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Keep your baby safe

• Set your water heater at 120 degrees Fahrenheit
  or lower.
• Test the bathwater with your wrist or elbow
  before placing your baby in it.
• Dont hold your baby while cooking or carrying
  hot foods and liquids.
• Never microwave your babys bottle. Heat bottles
  with warm water and test them before feeding your
  baby.
• Follow instructions and read labels when giving
  medicines to your baby.
• Use child-resistant packages.
• Learn the Poison Control number 1-800-222-1222.
• Lock up medicines, household cleaners, poisons
  and dangerous items out of your babys sight and
  reach. 

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Children 1 to 2 years old

• 1 year olds
• Can usually walk alone by 15 months and then
  begin to run
• Can stop, squat and then stand again
• Can sit down on a small stool or chair
• 2 year olds
• Walk and run well
• Can climb stairs while holding on and stand
  briefly on one foot
• May jump awkwardly
• Begin to throw, kick and catch balls
• Can climb on playground equipment
• Can turn doorknobs and open lids
• Begin to ride a tricycle
• Have good thumb and finger control

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Children 3 to 4 years old

• 3 year olds
• Can run and jump easily
• Walk up stairs without help
• Can ride a tricycle and stand on tip-toes
• Begin to share and like to play with other
  children
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• 4 year olds
• Can skip, hop on one foot, catch and throw a ball
  overhand and walk downstairs alone
• Begin to become less aware of only ones self and
  more aware of people around them
• May obey parents rules but dont understand
  right from wrong
• Are very independent and want to do things on
  their own
• May have imaginary playmates and will often play
  with others in groups

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Children 1 to 4 years old

• Did you know?
• Like to imitate older playmates and may go
  beyond their own physical abilities
• Want to role play adult activities and use adult
  tools and objects
• Are much more likely to get hurt at a playground
  when they play on equipment designed for older
  kids
• Breathe more quickly than adults and their lungs
  are still developing
• Have thinner skin that burns more deeply and
  quickly at lower temperatures than adults skin
• Are more likely to start fires with matches,
  lighters and other heat sources

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Keep your 1- to 4-year old safe

• Limit access to hazards.
• Keep supervising!
• Install stair gates.
• Dont use baby walkers. Use stationary play
  centers instead.
• Use playgrounds that are age-appropriate (for
  children under 5) and have safe surfacing
  (shredded rubber, sand, etc).
• Dont put toys or things that attract children on
  top of furniture.
• Place furniture away from windows and secure it
  to the wall.
• Use a forward-facing car seat in the back seat of
  the car.
• Have your car seat checked by a child passenger
  safety technician to make sure its properly
  installed.
• Walk all the way around your parked car.
• Never leave your child alone in a car.

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Keep your 1- to 4-year old safe

• Install smoke alarms and carbon monoxide
  detectors in your home.
• Lock up matches and lighters out of his or her
  sight and reach.
• Set your water heater at 120 degrees Fahrenheit
  or lower.
• Make the stove area a "kid-free" zone.
• Cook with pots and pans on back burners. Turn
  handles away from the front of the stove when
  cooking.
• Place hot foods and liquids on the center of the
  table. Dont set them on the edges of tables or
  counters.
• Lock up poisons out of his or her reach and
  sight. 
• Use child-resistant packages.
• Keep products in their original containers.
• Dont call medicine candy.

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Children 5 to 9 years old

• Did you know that?
• Have less coordination for pedaling, more
  trouble recognizing and avoiding obstacles and
  lack adults hand-eye coordination abilities
• Are at higher risk for cooking-related scald
  injuries, especially from tableware and microwave
  ovens
• Have lungs that are still developing
• Are less likely to wake up if a smoke alarm
  sounds while theyre sleeping

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Children 5 years old

• Can jump rope
• Can balance on one foot with eyes closed
• Know addresses and phone numbers
• Are curious about real facts about the world
• Are generally more responsible and helpful than
  4-year olds
• Get along well with parents
• Like to cook and play sports
• May become more attached to parents as they enter
  school

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Children 6 to 9 years old

• 6- to 7-year olds
• Enjoy many activities and stay busy
• Practice skills in order to become better
• Can jump rope and ride a bike
• Like to copy adults
• Like to play alone but friends are becoming
  important
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• 8- to 9-year olds
• Are more graceful with movements and abilities
• Can jump, skip and chase
• Like competition and games
• Begin to mix friends and play with kids of the
  opposite gender

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Keep your 5- to 9-year old safe

• Teach your child safety.
• Make sure your child wears a helmet and
  protective gear every time he or she bikes,
  skates, rides a scooter, skateboards or skis.
• Teach proper playground behavior no pushing,
  shoving or crowding.
• Place furniture away from windows and secure it
  to the wall.
• Keep your child in the right type of car seat or
  booster seat until the adult lap belt and
  shoulder belt fits correctly.
• Do a safety check around your car.
• Never leave your child alone in a car.
• Talk to your child about fire safety.
• Practice an escape plan with your child.

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Keep your 5- to 9-year old safe

• Install and check smoke alarms and carbon
  monoxide alarms.
• Teach your child not to play with matches and
  lighters. Lock these items out of his or her
  sight and reach.
• Set your water heater at 120 degrees Fahrenheit
  or lower.
• Dont let your child use a microwave until he or
  she is tall enough to reach the items in it
  safely and understands that steam can cause
  burns.
• Place hot foods and liquids on the center of the
  table. Dont set them on the edges of tables or
  counters.
• Lock up poisons out of his or her sight and
  reach.
• Use child-resistant packaging.

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Children 10 to 14 years old

• Did you know that?
• Still have trouble avoiding obstacles and
  preventing falls
• Have visual perception less defined than that of
  older children
• Lack the ability to recognize an object from
  within a busy background, an important skill to
  have in order to identify oncoming cars in busy
  intersections
• Are influenced by their peers and concerned
  about how theyre perceived
• Are most likely to be injured by cooking
  equipment-related fires or candle fires
• Have the highest fireworks injury rate
• Are more likely to be completely unrestrained in
  a car than younger children

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Children 10 to 14 years old

• 10- to 12-year olds
• Consider friends very important
• Peer influence and acceptance becomes important
• Respect their parents but want independence from
  them
• Enjoy talking to others
• 13 year olds and older teens
• Develop the ability to think abstractly
• May think long term
• Set goals
• Compare themselves to their peers

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Keep your 10- to 14- year old safe

• Empower your pre-teen to make safe choices.
• Make sure he/she wears a helmet and protective
  gear every time he/she bikes, rides a scooter,
  skates, skateboards, skis, etc.
• Set a good example. Always model best practices
  whether you are at home, at a friends house or
  someone elses car.
• Once your pre-teen passes the Safety Belt Fit
  Test, teach him/her to wear a seat belt every
  time.
• Teach your child that all children under age 13
  should ride in a back seat.
• Talk to your pre-teen about car safety.
• Install and check smoke alarms and carbon
  monoxide alarms.

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Keep your 10- to 14- year old safe

• Practice an escape plan with your family.
• Teach your pre-teen to never play with matches,
  lighters or fireworks and to never lit candles in
  his/her bedroom.
• Set your water heater at 120 degrees Fahrenheit
  or lower.
• Place hot foods and liquids on the center of the
  table. Dont set them on the edges of tables or
  counters.
• Dont let your child use a microwave until he/she
  is tall enough to reach the items in it safely
  and understands that steam can cause burns.
• Talk to your pre-teen about the dangers of
  poisonous items like inhalants and prescription
  medicines.

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Scenarios

• New parents often rely on friends and family for
  support and advice when raising their baby. One
  of their main concerns is providing a safe home
  and play area for their baby.
• As you are strapping your child into his/her car
  seat, you notice that it moves a few inches from
  side to side.
• What puts young children at risk for injuries on
  playgrounds?

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Scenarios

• Your child leaves the house with his bike helmet
  on, but as soon as he turns the corner the helmet
  comes off. He bikes around town with his friends
  with his helmet slung onto his handle bars.
• Your daughters soccer team often practices
  without wearing protective equipment.
• Your child is always eager to play with his
  friends at the park in your neighborhood. He is
  8 years old and is sure he can cross the street
  by himself.

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Hot Drink Demonstration

• Childrens skin is thinner than adult skin and
  can burn more quickly and deeply at lower
  temperatures.
• Objective
• To demonstrate how much of a babys body can be
  covered by an ordinary mug of liquid.

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References

• Breckon, D.J., Harvey, J.R., Lancaster, R.B.
  (1998). Community Health Education Settings,
  Roles, and Skills for the 21st Century. Fourth
  Edition. Gaithersburg, MD Aspen Publishers, Inc.
• Bright Futures at Georgetown University. Online
  Materials. www.brightfutures.org/georgetown.
• Safe Kids Worldwide. Raising Safe Kids One Stage
  at a Time A Study of Child Development and
  Unintentional Injury. March 2009.
• Safekids New Zealand. Safekids Campaign Burns
  Prevention. www.safekids.org.nz/KidsafeFiles/Burns
  20Prevention20Projects202008.pdf. June 2008.