Parent-Child Injury Prevention Conversations Following a Trip to the Emergency Department

A longitudinal study of parents' expectations about infants' emerging behaviors and their safety strategies to moderate injury risk

RATIONALE

Unintentional injuries are the leading cause of preventable deaths for children under 19 years of age. Infancy has been identified as a high-risk stage for injury. Throughout infancy, infants acquire increasing motor competencies but have limited capabilities to appraise danger. This longitudinal multi-method study examined parents' expectations about their infant's emerging behaviors and their in-home safety practices when their infants were at two stages of motor development: pre-mobile (i.e. sitting independently) and mobile (i.e. walking independently).

METHODS

At each motor development stage, parents completed an interview and rating scales to report on their infants' current and anticipated (3 months later) behavioral competencies, as well as their own safety practices and anticipated changes in these.

RESULTS AND IMPLICATIONS

Findings revealed that parents engaged in poorer supervision (reduced proximity, decreased attention) when infants were mobile than pre-mobile, while at the same time doing less to constrain their infants' movements around the room when mobile than pre-mobile. At both stages of motor development, parents reported expecting increased unpredictability in how their infants would behave in the upcoming months, due primarily to motor development (pre-mobile infants) or cognitive curiosity (mobile infants). In response, they planned to change their safety practices by decreasing supervision and increasing teaching about safety, despite the young ages of the children. Implications for injury risk to infants and prevention initiatives focusing on parents are discussed.

What is your earliest memory? It depends

This article is a selective review of the literature on childhood amnesia, followed by new analyses of both published and unpublished data that has been collected in my laboratory over two decades. Analyses point to the fluidity of people's earliest memories; furthermore, methodological variation leads to individuals recalling memories from substantially earlier in their lives. How early one's "earliest" memory is depends on whether you have multiple interviews, how many early memories were requested within an interview, the type of interview, participation in prior tasks, etc. As well, people often provide chronologically earlier memories within the same interview in which they later identify a chronologically older memory as their "earliest". There may also be systematic mis-dating to older ages of very early memories. Overall, people may have a lot more memories from their preschool years than is widely believed, and be able to recall events from earlier in their lives than has been historically documented.

Let's Cross the Next One: Parental Scaffolding of Prospective Control Over Movement

This investigation examined parental scaffolding of children's prospective control over decisions and actions during a joint perception-action task. Parents and their 6-, 8-, 10-, and 12-year-old children (N = 128) repeatedly crossed a virtual roadway together. Guidance and control shifted from the parent to the child with increases in child age. Parents more often chose the gap that was crossed and prospectively communicated the gap choice with younger than older children. Greater use of an anticipatory gap selection strategy by parents predicted more precise timing of entry into the gap by children. This work suggests that social interaction may serve as an important experiential mechanism for the development of prospective control over decisions and actions in the perception-action domain.

Unintentional child injury in child welfare placements

BACKGROUND

Child welfare professionals are charged with protecting children from non-accidental caregiving behaviors resulting in intentional injuries as well as environmental risks and parenting behaviors resulting in unintentional injuries. Yet little is known about unintentional injury prevalence and risk factors by child welfare placement type.

OBJECTIVE

To examine factors related to unintentional child injury requiring medical attention, including child welfare placement type, child behavioral problems, caregiver characteristics, and neighborhood factors.

METHODS

Data from the second and third wave of the 2010 National Survey of Child and Adolescent Well-Being (NSCAW II) were used. Stable child welfare placements between waves 2 and 3 included investigated biological, reunified, adopted, licensed and unlicensed kin, and nonkin foster homes. Logistic regression analysis modeled injury as a function of placement type while controlling for other covariates. Interaction effects between placement and child behavioral scores were also modeled.

RESULTS

Children with more behavioral problems were at greater odds of an injury (OR = 1.05, p < .01) compared to children with fewer behavioral problems. However, interaction models showed that children with more behavioral problems were at decreased odds of injury if living with unlicensed kin (OR = .91, p < .05), licensed kin (OR = .92, p < .001), or foster care (OR = .92, p < .001) compared to biological homes.

CONCLUSION

The absence of a behavioral problem was associated with higher risk of injury for children placed in foster care. More research is needed to better understand injury type, prevalence and specific risk factors.

Parent-adolescent bicycling safety communication and bicycling behavior

INTRODUCTION

Efforts to encourage bicycling to school have increased in the United States. However, little is known about how parent-child communication affects bicycle safety. The purpose of this study was to examine parent-child agreement on biking instructions and their correlation with the early adolescents' real-world riding behavior.

METHODS

Parent-child dyads were asked open-ended questions about instructions they had given/received about bicycling. Answers were then coded into nine categories (e.g., crossing the road, bicycle control/handling). Distributions of parent-child agreement on parent-given bicycle safety instructions were examined in relation to the adolescent's real-world riding behaviors.

RESULTS

36 parent-child dyads were included. Average age was 11.9 (Range: 10-15) for adolescents and 43.3 (Range: 30-59) for parents. Common parental instructions included: wear helmet, ride on sidewalk, and trip routing specifications. High 'ride on sidewalk' instruction (38.9% both parent and adolescent, 22.2% parent only, 16.7% adolescent only) was concerning due to potential driveway conflicts. Agreement between parents and adolescents on reported instructions was low, overall. Mean safety-relevant event rates in real-world cycling did not differ significantly between bicycle safety instruction agreement groups (both parent & adolescent reported, parent only, adolescent only, neither). The proportion of time an adolescent rode on different infrastructure types (sidewalk, street, etc.) did not vary between dyads reporting parents had given instructions to ride on the sidewalk and those who had not.

CONCLUSIONS

Results highlight lack of agreement between parents and adolescents on cycling instructions the adolescent receives from the parent. Parent instructions to adolescents regarding bicycling safety were not associated with actual riding behaviors. Results suggest parent messaging to adolescents may be ineffective. Given parents are in a position of influence, results indicate a need for parental training on effective safety-related communication strategies to assist them in capitalizing on their parental role to increase their child's safety.