Journal of Pediatric Psychology, Vol. 26, No. 2, 2001, pp. 105-115
© 2001 Society of Pediatric Psychology
Don't Run With Scissors: Young Children's Knowledge of Home Safety Rules
University of Guelph
All correspondence should be sent to Barbara A. Morrongiello, Psychology Department, University of Guelph, Guelph, Ontario, N1G 2W1, Canada. E-mail: bmorrong{at}uoguelph.ca .
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Abstract |
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Objective: To examine 4- to 6-year-old children's knowledge of their parents' home safety rules and to identify predictors of children's home injuries.
Methods: Within the context of an interview, parents completed a home safety questionnaire in which they specified home safety rules, rated their child's compliance with each rule, explained not having rules, reported on maternal supervision, and reported on the frequency of their child's injuries. We evaluated children's knowledge of home safety rules by having them play a home safety game designed for this study.
Results: Children spontaneously recalled only about half of their parents' home safety rules. Prompting resulted in their recognition of about 40% more rules. However, children's knowledge scores did not predict the frequency of their injuries. The best predictors of children's injuries were children's compliance with home safety rules and extent of parental supervision.
Conclusions: These findings suggest that interventions to promote young children's safety knowledge will not likely reduce childhood injuries unless children consistently comply with these rules or parents supervise children to ensure compliance.
Key words: home injuries; supervision; safety rules; compliance.
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Introduction |
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Unintentional injuries are the leading cause of death for children in North America (Baker, O'Neill, & Ginsburg, 1992
; Canadian Institute of
Child Health [CICH], 1994). Moreover, each year, 16 million
children are treated in emergency rooms, 600,000 children are hospitalized,
and 30,000 children suffer permanent disabilities
(Rodriguez, 1990). Indeed, it
has been estimated that one in four children in the United States experiences
a medically attended injury each year
(Scheidt et al., 1994).
Unintentional injury is one of the most prevalent child health problems of our
time; thus, injury prevention is a major focus among advocates of children's
health (e.g., Finney et al.,
1993).
Not surprisingly, the nature of children's injuries varies with their
developmental level (Rivara, Calonge,
& Thompson, 1989; Rivara
& Mueller, 1987). School-age children often experience
injuries when playing outside (e.g., bicycle-related injuries, pedestrain
injuries), and other children can substantially influence these events
(Christenson & Morrongiello,
1997; Morrongiello &
Bradley, 1997; Rivara et al.,
1989; Sandels,
1977; Shannon, Bashaw, Lewis,
& Feldman, 1992). In contrast, injuries to younger children
typically occur at home (Rivara et al.,
1989; Shannon et al.,
1992); burns, falls, and poisonings are some of the more common
types of injuries (Baker et al.,
1992; CICH,
1994).
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Approaches to Managing Young Children's Injury Risk at Home |
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Prior research suggests that teaching preschool children safety rules, parent supervision, and interventions to prevent access to hazards are the injury prevention approaches most commonly used to prevent home injuries (e.g., Wortel & de Gues, 1993
). However, because constant supervision is unrealistic, and
barriers to prevent a child's access to hazards are not appropriate under all
circumstances (Peterson & Roberts,
1992), or even favored by many parents
(Kendrick, 1994;
Ueland & Kraft, 1996;
Wortel & de Geus, 1993;
Wortel, de Geus, & Kok,
1995), parents usually emphasize implementing safety rules at
home. Parents apparently believe that teaching safety rules to children will
prevent injury (Peterson, Farmer, &
Kashani, 1990).
Studies examining socialization practices reveal that parents stress the
teaching of safety rules to very young children. Parents apparently shift
their emphasis from barrier methods that prevent the child from accessing
hazards to teaching strategies when their children are between 1 and 3 years
of age (Garling & Garling,
1995), with verbalizations of safety rules peaking at around 2
years of age (Gralinski & Kopp,
1993). Surprisingly, however, the teaching of safety rules
apparently declines thereafter, as parents assume children have internalized
rules and they shift their emphasis to teaching about other social norms for
behavior (Gralinski & Kopp,
1993). Obviously, shifting emphasis to rules about nonsafety
behavior may place young children at risk of injury if parents inaccurately
judge their child's knowledge of home safety rules. Research with 8-year-old
children indicates that parents generally overestimate their child's knowledge
about safety (Peterson, Mori, &
Scissors, 1986). However, whether parents act similarly for
younger children, and whether this places children at risk of injury, remains
to be determined.
This study examined 4- to 6-year-old children's knowledge of their parents'
rules for home safety and sought to determine if such knowledge related to
children's frequency of home injuries. Prior research with 8-year-olds reveals
that rules serve a protective function: families with more rules about safety
had children with fewer injuries (Peterson
& Saldana, 1996). However, whether the number of rules relate
to injury incidence among younger children remains to be determined.
In this study we also examined mothers' reports of children's compliance
with home safety rules. A number of findings indicate that compliance with
parental requests generally improves with age during early childhood (e.g.,
Howes & Olenick, 1986;
Vaughn, Kopp, & Krakow,
1984). However, exceptions to this developmental trend have been
noted (e.g., Schneider-Rosen &
Wenz-Gross, 1990), and there have been numerous demonstrations of
factors that influence the likelihood of compliance (e.g.,
Kaler & Kopp, 1990;
Kuczynski, Kochanska, Radke-Yarrow, &
Girnius-Brown, 1987; Parpal
& Maccoby, 1985), suggesting that children's compliance with
home safety rules might vary considerably. We reasoned that rules can serve a
protective function only if children comply with them. Hence, we hypothesized
that compliance may be a better predictor of children's injuries than their
knowledge of home safety rules per se.
Because of interest in the relation between supervision and childhood
injuries, we also asked parents to complete a measure of their proneness to
protect by supervision (cf., Thomasgard,
Metz, Edelbrock, & Shankoff, 1995). We expected supervision
scores to relate to the frequency of childhood injury such that those more
prone to protect by supervision would have children who experience fewer home
injuries.
Finally, we asked parents to provide an explanation about home situations that could pose risk of injury but about which they did not have rules for their child. Such information was expected to contribute to an increased understanding of the thought processes underlying parental decisions about managing injury risks to their children in their home.
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Method |
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Participants
The sample included 97 parent-child pairs, recruited through local schools and daycare centers; approximately 240 families were initially contacted via a letter, resulting in a participation rate of approximately 40%. With the exception of five families, the parent interviewed was the mother. Children were 4 to 6 years old (M = 5.3 years, SD = 8.2 months), with no age difference evident between boys (N = 50) and girls (N = 47). Generally, this was a fairly well-educated sample, although income levels varied somewhat: 22% of parents had at least some graduate training, 45% had completed a university degree, and 13% had some university experience, with the remaining 20% having completed high school. Fifty-eight percent of parents had taken a first aid course. Thirty-six percent reported incomes exceeding $80,000, 27% reported incomes between $60,000 and $80,000, 26% reported earning between $40,000 and $59,999, 9% had incomes between $20,000 and $39,000, and 2% of families reported an income below $20,000. There was little ethnic diversity in the sample; all families were Caucasian.
Materials
Parent Materials. Using an interview format, parents completed a
home safety questionnaire with 33 items (see
Table I). The goal of this
measure was to identify home safety rules they had taught their child and,
when appropriate, reasons for not having rules about potential safety issues.
Selected based on a pilot study of 21 parents using a 66-item questionnaire,
the items resulted from an extensive review of literature on home safety
issues relating to preschool children. The 66-item questionnaire was reduced
to 33 items by excluding items that parents consistently judged not applicable
(e.g., a question about balconies) or not representing safety issues (e.g.,
throwing bed pillows around) and by combining items to avoid redundancy. The
33 items were organized to form groups of safety items relevant to individual
rooms or areas within the home (i.e., kitchen, bathroom, play/living/family
room, bedroom, stairs area). If an item could apply to more than one room, we
randomly assigned the item to one room. For example, in discussion of safety
in the kitchen, parents were asked, "Would your child know any home
safety instructions, guidelines, rules, or precautions... about sharp
scissors?"
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When parents endorsed an item, they were asked to state the specific rule or phrase with which the child would be familiar (e.g., "Don't run with scissors"); these statements were used in personalizing probes for individual children in the home safety game. Parents then gave a rating of how often the child complied with this rule, using a 5-point scale (1 = never, 5 = always).
If parents indicated they did not have any specific rule for an item, we asked them to provide an explanation by selecting from among five options based on the pilot testing: (1) this is not an issue in our home because of some characteristic of my child (e.g., age, personality, motor ability, etc); (2) injuries related to this issue are prevented by supervision or by environmental devices (e.g., safety locks) that restrict the child's access to the risk factor or hazard; (3) we have not discussed this issue yet; (4) my child should know this because it is common sense; and (5) injuries in this situation are infrequent or not serious enough to worry about; hence, I do not have a rule about this.
Parents were also asked to complete several other questionnaires. The
Injury History Questionnaire (IHQ) asks about the frequency with which the
child has sustained 17 types of injuries in the home (e.g., crushing injury
such as by a door closing on their fingers, bump related to a fall from a
height such as off a chair) during the last year. An injury was defined for
parents as resulting from tissue damage (e.g., bump, cut, scrape) that lasted
for longer than 30 minutes. The definition did not include any requirement
about intervention or pain. Although investigators have defined injuries in
ways that include consideration of the child's pain (e.g.,
Peterson, Harbeck, & Moreno,
1993, p. 138, define an injury as "resulting from tissue
damage, specifically a mark that lasted over an hour... or pain lasting more
than 10 minutes"), we did not allow this definition of injury because
our pilot data revealed that young children seemed particularly prone to carry
on (e.g., whine, cry, complain) about pain in response to minor tissue damage
that lasted only a few minutes. Hence, to eliminate from consideration such
minor injuries, we told parents to limit injuries to observable tissue damage
that lasted for at least 30 minutes. Summing across items in the
injury-history questionnaire yields an index of total injuries for a child.
Prior research has documented that parents are accurate reporters of
child-injury information for more serious injuries
(Pless & Pless, 1995),
although this remains to be determined for minor injuries to their children
(see Peterson et al., 1993,
for further discussion).
Finally, parents also completed the Parent Protection Scale (PPS), which
provides a measure of their tendency to protect by supervision for children
2-10 years of age (cf., Thomasgard et al.,
1995). This questionnaire asks parents to indicate how frequently
each item applies to them using a 4-point Likert scale (0 = never, 3 =
always). Using the Supervision subscale, which indicates the extent to which a
parent engages in behaviors to promote their child's safety (e.g., "I
keep a close watch on my child," "I know exactly what my child is
doing"), we summed across items to obtain a total score, with higher
scores indicating greater proneness to keep a child safe by parental
supervision. Internal consistency is acceptable (.73), and test-retest
reliability was.86 over a 3- to 5-week interval (cf.
Thomasgard et al., 1995). In
this study, the reliability coefficient for the Supervision subscale was found
to be acceptable (.77).
Child Materials. Children's knowledge of home safety rules was assessed using a home safety game developed for this study. In this table-top game, a child could play with the researcher for 20 minutes. For the game, each room of the home was colorcoded (kitchen = yellow, bathroom = blue, play/living/family room = red, bedroom = green, stairs area = black). To help the child associate the colors with each room, we used five colored sheets with pictures on these appropriate to the specific room (e.g., on the green sheet there was a picture of a bed and dresser). Adjacent to each colored paper was a small round container of the same color (i.e., one container per room) into which the child inserted matching colored tokens during the game. For each of the 33 items on the home safety questionnaire completed by the parent, the number of the item was written on a small, round, colored foam token, corresponding to the color of the room/area to which the question applied (e.g., items applying to the bedroom were numbered on green tokens). A spinner, with color sections appropriate for each room, was used during the game to determine the room for which the child was to select a colored token from a container; the number on the token indicated to the experimenter which numbered item for that room to use in a query to the child. Whenever the child indicated there was a rule for the item, the child placed the item in the container for that room. If there were not a rule for an item, the child placed the token into a small white garbage pail, also on the table. Finally, in order to allow children opportunity to utilize the garbage pail and to ensure they understood the game, for each room, three "silly" items were generated (e.g., kitchen: "Does chocolate milk come out of the kitchen taps?").
Interrater reliability for coding of children's responses to each of the 33 items of the safety game was computed for 25% of the sample and reached 99% agreement. Disagreements were resolved by discussion.
Procedure
Three interviewers, a graduate student and two undergraduate students,
received extensive training in completing the safety questionnaire with
parents and the safety game with children. In addition, each interviewer
brought to the position considerable prior experience in working with children
and parents. Before data collection, pilot testing confirmed that the
expertise of the interviewers was comparable and uniformly high.
Parents were interviewed at their home or place of employment. We emphasized to parents that we did not expect them to have rules for all items mentioned and that we were especially interested in understanding why parents felt rules were not necessary. Each of the 33 items on the questionnaire was read to the parent one at a time, and the parent then indicated whether there was a rule. If there were a rule, parents stated exactly what the child should know or the phrase with which the child would be familiar. Subsequently, they rated the child's compliance with each rule; if there were more than one rule for an item, parents provided multiple corresponding compliance ratings. If there were no rule for an item, they selected from the five options provided to explain why not. At the conclusion of the interview, parents completed the PPS, IHQ, and the demographic questionnaire. Parents received a Safe Seasons calendar as a gift.
Prior to interviewing the child, the researcher reviewed the parent's answers and generated individualized probes for each item for which the parent reported a rule and for which the general probe for the item may not be sufficient. A star was placed next to the item on the researcher's form to indicate that a personalized probe may be needed for that item during the safety game. Such probes were given only if the child failed to spontaneously generate the home safety rule reported by their parent for the item.
Children were seen individually at school, in daycare, or at home. Interviews were tape-recorded for later transcription. Initially, children were shown an appealing plastic pet animal (e.g., dog, cat) and asked if they would like to bring it home. Subsequently, they were told that the animal wanted to know about their home safety instructions and that they would be able to tell the animal and the researcher about this by playing a special game. The home safety game was then introduced. We intentionally avoided telling the children that the animal could go home only if it would be safe because we did not want to bias the children toward reporting more safety rules than applied to their home.
The child was told that each color on the spinner represented a different room in their home. The child was then shown the colored sheets and encouraged to tell the researcher which room of the house was indicated by the pictures on each sheet. The child was then told that each time the spinner stops on a color, some tokens would be put in a container and the child could then pick these out, one at a time. Each time the child picked out a token, the researcher would ask the child a question about home safety in that room, with the number on the token indicating for the researcher which question the child was to receive. Children were encouraged to help the researcher read the number on each token as individual tokens were selected from the container. The child was told that some items mentioned by the researcher might relate to safety rules in their home, while some might not, and some might be silly questions about which there was no safety issue. The researcher explained that after an item was read aloud (e.g., "To keep you safe, is there anything your mom or dad say about what to do, or not do, with sharp scissors?"), the child was to indicate if there were a rule about this in his or her home. Whenever the child mentioned a rule, the token was then placed in the colored container for that room. If there were no rule, or it was a silly question, then the token was put in the small garbage pail. The child was encouraged to ask questions at any time during the game.
For each item, the researcher followed a set sequence of questions and probes. If there were a rule, the child was asked to state this rule. When the child's rule was similar to, or more restrictive than, the parent's rule, the child put the token in the corresponding room container; such responses were designated as spontaneous hits in the analyses. If the child's rule did not match the parent's rule, then they were asked, "Anything else?" If the child then reported a rule similar to the parent's rule, the token was placed in the room container; and their response was also designated as a spontaneous hit. If the child did not produce a rule that matched the parent's rule, then the child received a probe, either a general one (e.g., "So, in your house, is it okay for you to touch the oven when it is on?") or one that was personalized based on what the parent had told us (e.g., "So, in your house, is it okay for you to touch the oven when it is on if you are wearing oven mitts?"). If they responded in a way to indicate knowledge of the parent's rule, then the token went in the room container; such responses were designated probed hits. If they did not indicate knowledge of the parent's rule, the token was placed in the garbage pail; such responses were designated as misses.
Children were tested on all items to keep the game consistent in length and to establish whether children knew about safety issues for items for which parents did not have rules. In the latter case, any safety rule the child generated was accepted, and the child then placed the token in the colored container; these responses were not included in the analyses. If there were no rule, and for all silly-question items, the child placed the token in the garbage pail.
Data Reduction
For each child, items on the safety game were categorized into two groups:
items for which parents had a rule and those for which there was no rule.
Subsequently, for those items for which parents had a rule, the child was
given a percentage correct score for spontaneous and probed hits separately.
For items for which parents reported no rule, children were given a score
indicating the percentage of items for which children generated safety
rules.
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Results |
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Parental Home Safety Rules and Children's Knowledge of Home Safety Rules
Of the 33 items on the questionnaire, parents had rules for 29 items (SD = 6.28), with 94 parents reporting more than one rule related to a single safety item. The mean number of items for which parents did not have rules was 8 (SD = 4.32), with 95 parents reporting not having a rule for at least one item.
In an effort to identify factors that may have influenced parents' use of rules to promote home safety, we conducted correlational analyses between the number of items for which parents had rules and the child's injury history (IHQ) and parental supervision (PPS) scores. Assessing for linear as well as quadratic relations, we found that none of these factors significantly related to the number of rules for home safety that parents reported.
For each item for which parents had a rule, their child's knowledge of this rule was evaluated. As shown in Table II, children spontaneously named rules that matched those of their parents for 46% of the parent's rules (SD = 14%), with no significant difference between the percentage of spontaneous hits for boys (M = 46%, SD = 15%) and girls (M = 47%, SD = 14%). To examine the possibility that children may be better at recognizing a rule, we gave probes after the child failed to spontaneously provide an answer that matched their parent's rule. Such probes resulted in children recognizing an additional 42% of their parents' safety rules (SD = 12%), with no significant differences between probed hits of boys (M = 42%, SD = 12%) and girls (M = 42%, SD = 13%). Combining spontaneous hits (spontaneous recall of rules) and probed hits (recognition of rules) indicated that children were aware of 88% of their parents' home safety rules (SD = 12%).
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Data on children's responses to items for which their parents did not have rules revealed that children knew even about safety issues that their parents did not emphasize at home. Specifically, when asked about the safety issues for which parents did not indicate a safety rule, which was usually about eight items, children spontaneously named a safety rule for 54% of these items (SD = 28%), and their recognition of appropriate safety rules (i.e., probed recall) brought this score up 74% (SD = 22%); there were no gender differences in spontaneous and probed hits for items for which parents did not cite a safety rule. Hence, overall, the children in this study knew a considerable amount about rules to promote home safety.
Children's Injuries
The average number of home injuries reported by mothers for children in
this study was 13.81 (SD = 8.36), with boys experiencing
significantly more injuries than girls, F(1, 91) = 4.35, p
<.05, (M = 15.71 and 11.79, respectively, SD = 9.35 and
7.38, respectively). Correlational analyses did not reveal any significant
relationships between the child's injury history and the number of rules he or
she knew (spontaneously, probed, or, overall hits). However, compliance scores
negatively correlated with injury history scores (r[97] = -.34,
p <.01), indicating that children who behaved in ways to comply
with home safety rules experienced fewer injuries. Similarly, parental
supervision scores were found to negatively relate to children's injury scores
(r[97] = -.35, p <.001), indicating that parents prone to
protect their children by supervision had children who experienced fewer
injuries.
Drawing on our interest in children's knowledge of home safety rules, their
compliance with these rules, and parental supervision, we sought to determine
whether these variables could be used to predict children's injury scores.
Toward this aim, we performed a standard multiple regression with number of
injuries as the dependent variable and knowledge of home safety rules,
compliance with these rules, and parent supervision scores as independent
variables; preliminary screening to test for meeting the necessary statistical
assumptions (cf. Tabachnik & Fidell,
1989) were applied, and there were no concerns indicated. Results
of the regression indicated that children's compliance with home safety rules
and parental supervision each significantly predicted children's injury
history scores (b = -7.96 and -.95, SE = 2.10 and.25,
respectively, t [97] = -3.79 and -3.78, respectively, ps
<.001), accounting for 26 % of the variance. However, children's knowledge
of home safety rules did not add significantly to the prediction of childhood
injuries.
Parental Explanations for Not Having Rules
For those items for which parents had no rules, parents provided reasons
indicating why. The proportion of responses in each of five categories is
shown in Table III. A
repeated-measures analysis of variance was applied to these proportion scores
to assess for significant variation in the distribution of reasons provided by
parents and if responses varied as a function of child gender. Results
revealed a main effect of Type of Explanation, F(4,90) = 96.85,
p <.001, but no gender differences in reasons cited; while
Mauchly's test of sphericity was violated, this main effect persisted even
after the Huynh-Feldt correction was applied. Bonferroni t tests
indicated that the most frequently cited reason for parents not having a
safety rule referred to a child characteristic that the parent believed
preempted the need for such a rule. As shown in
Table III, child
characteristics were mentioned significantly more than each of the other
reasons cited (ps <.001). Following this reason, parents most
often said that a rule was not needed because they would supervise to keep the
child safe or there was an environmental intervention (e.g., cabinet lock)
that would maintain the child's safety. As can be seen in
Table III,
supervision/environment reasons were given significantly less than child
characteristics and significantly more than the remaining three reasons
(ps <.001). The third most frequently cited reason by mothers was
that they simply had not discussed the issue with their child yet. Parents
endorsed this reason significantly less than child characteristics and
supervision/environment but significantly more than the remaining two reasons
(see Table III, ps
<.001). Finally, as shown in Table
III, there was no significant difference in how frequently mothers
mentioned that safety is common sense and injuries are infrequent/not serious,
and they mentioned these reasons at significantly lower levels than the other
three reasons (ps <.001).
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Discussion |
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Home Safety Rules and Childhood Injuries
Prior research indicates that parents emphasize rules about safety when their children are between 2 and 4 years of age, and they shift their focus to rules that apply to other domains of socialization by the preschool years (e.g., Garling & Garling, 1995
; Gralinski & Kopp,
1993). The present results reveal that parents' assumptions that
by 4 years children are good at recalling home safety rules is not valid:
Children spontaneously recalled only 46% of home safety rules. Although
probing resulted in recognition of an additional 42% of home safety rules,
from a practical point of view, when a child faces an injury-risk situation,
the spontaneous recall of a rule, not the recognition of one, likely
determines how the child behaves. Hence, the fact that children showed
relatively poor spontaneous recall of home safety rules suggests that their
ability to draw on knowledge of home safety rules in deciding how to manage
risks they encounter at home is not sufficient to ensure safety. Consistent
with this, knowledge of home safety rules did not predict children's injuries.
Thus, these findings suggest that young children's knowledge about home safety
is quite variable and does not serve a protective function for them.
Prior research with school-age children indicates that parents overestimate
both children's knowledge of safety issues and their ability to manage
injury-risk situations (Peterson et al.,
1986). The fact that children spontaneously recalled not even half
of the rules their parents expected them to know suggests that parents of
young children similarly overestimate their children's home safety knowledge.
Moreover, although children were able to recognize an additional 42% of rules,
such knowledge does not protect them as parents assume it will. Our failure to
find any relationship between knowledge of safety issues (i.e., spontaneous
hits alone, probed hits alone, or both these combined into an overall score)
and actual injury rates demonstrates that children's knowledge of a rule does
not ensure that they will behave in ways consistent with this rule. Indeed, in
this study compliance emerged as a significant determinant of children's
injuries. Hence, for young children's safety, the rules they can recite are
not as important as whether they can act on that knowledge and behave in ways
consistent with these rules.
Prior research with toddlers has demonstrated a relation between children's
compliance and comprehension of rules (e.g.,
Kaler & Kopp, 1990). Such
findings suggest that compliance with home safety rules may be enhanced if
efforts are made to promote young children's understanding of the safety issue
and the basis for the rule regulating their behavior. Consistent with this
notion is the demonstrated success of a program to reduce injury-risk play
behaviors by incorporating a participatory, problem-solving approach to build
understanding of safety issues among school-age children
(Morrongiello, Miron, & Reutz,
1998). Several lines of evidence highlight the potential
importance for reducing risk behaviors and promoting rule compliance by
focusing on enhancing children's comprehension of rules and the underlying
safety issue.
Prior research with school-age children indicates a significant negative
relationship between the number of parents' rules and their children's
injuries (Peterson & Saldana,
1996), suggesting that rules can prevent injury, as parents
believe they can. Our results, however, did not substantiate this finding.
This discrepancy may be attributable to the ages tested in these two studies.
Peterson and Saldana (1996)
sampled parents of second graders, whereas this study focused on younger
children. Compliance with rules generally improves with age
(Howes & Olenick, 1986;
Vaughn, Kopp, & Krakow,
1984). Peterson and Saldana's
(1996) finding suggesting a
relation between number of rules and injuries may actually reflect a tendency
toward greater compliance with rules as a child ages. Future research should
seek to clarify the causative links between number of rules and childhood
injuries and if they vary during childhood according to developmental
level.
These findings also provide insights into reasons why parents do not
utilize a rule strategy to address a safety issue in their homes. The findings
revealed that parents most often believed that some characteristic of their
child precluded the need for a rule about a specific safety issue. Hence, they
often had no preventative strategy in place. This finding is important because
it demonstrates that ensuring young children's safety at home is not simply a
matter of increasing parental awareness of a safety issue, as has been
suggested in the literature (e.g.,
Eichelberger, Gotschall, Feely, Harstad,
& Bowman, 1990). Apparently, in parents' decisions whether or
not to act and enforce a preventative strategy at home, a key consideration is
the characteristics of the individual child. These results suggest that, at
least for some parents, when parents do nothing, this represents a conscious
decision that follows a careful assessment of the degree of risk the issue
poses to their child. For such parents, they are not unaware of the
injury-risk issue nor do they necessarily believe their child will not
interact with the hazard. Rather, they have decided that the issue does not
pose sufficient risk for their particular child to warrant a preventative
intervention (i.e., the child won't interact with the hazard or can
manage the risk in doing so). Thus, consistent with prior research
(Morrongiello & Dayler,
1996), our findings indicate that parents are often fully aware of
potential injury risks to their child, but they make decisions that
nonetheless place their child at risk of injury.
Prior research also reveals that parents often make decisions that elevate
their child's risk of injury when competing demands produce stress, such as
the demand to save time (Morrongiello
& Dayler, 1996). These results extend those findings by
indicating that individual child characteristics also have a moderating
influence on parents' decisions about home safety practices. Obviously,
misjudgments about the child's potential for interacting with such hazards
would increase the child's risk of injury at home (see also
Peterson, Harbeck, & Moreno,
1993). Other studies have found that children do not have the
skills to evaluate risk or make smart risk decisions until age 7 or 8 (e.g.,
Rivara, Booth, Bergman, Rogers, &
Weiss, 1991). Hence, future research should discern whether young
children are at elevated risk of injury because their parents assume that, due
to an individual characteristic, a safety issue does not pose a threat.
Longitudinal analyses, for example, may reveal how often young children's
injuries at home result from behavior inconsistent with parents' beliefs about
child characteristics serving a protective function.
Parent Supervision and Childhood Injuries
Many authors have presented logical arguments to support the premise that
inadequate parent supervision is responsible for a sizeable proportion of
children's injuries (e.g., Garbarino,
1988). Interview and scenario studies substantiate that parents
are aware of the need to provide different levels of supervision for young
children in different injury-risk situations (e.g.,
Garling & Garling, 1991;
Garling & Garling, 1993;
Peterson, Ewigman, & Kivlahan,
1993). Surprisingly, however, no direct observational data have
been gathered to confirm that extent of parent supervision varies
systematically with degree of injury-risk environment; some studies provide
information about parental supervision of children in high-risk situations
(e.g., Cataldo et al., 1998), but variation in supervision as a function of
degree of injury risk remains to be documented.
Our findings confirm that parent supervision relates to the frequency of
children's injuries in ways that one might expect: children of parents who are
prone to protect them via supervision have fewer injuries. Less clear,
however, are the details of how parents in this study actually
supervised children differentially to result in elevated or decreased injury
risk. Prior research indicates that quality of supervision during children's
play depends both on parents' knowledge of socialization strategies (i.e.,
ways they could attempt to influence their child's behavior) and their beliefs
about the likely impact on the child
(Mize, Pettit, & Brown,
1995). Such findings suggest that efforts to examine the processes
by which supervision produces differential effects on child injury should be
broadly focused, not only examining what parents do to supervise and under
what conditions but also considering parents' knowledge of socialization
strategies and beliefs about how supervision efforts will influence children's
injury-risk behaviors. In addition, research examining more process-level
factors may also reveal important risk or protective factors for child injury
at home. For example, child-rearing practices have been related to
impulsiveness in young children (Power
& Chapieski, 1986) and to infant injury-risk behaviors
(Mathews, Friman, Barone, Ross, &
Christophersen, 1987). Future research then must be broad in scope
and incorporate a consideration of parents' knowledge, beliefs, behavioral
practices, and goals with respect to home safety and the socialization of
their child's behavior.
Limitations
Although this study provides important insights into parents' home safety
rules and their young children's knowledge of such rules, several limitations
of this research should be noted. First, this was a fairly well-educated
sample and over half the sample had taken a first aid course. As a result, the
findings may not generalize well to explain home safety practices and rules
among parents who are less educated or less focused on the issue of child
safety. Second, when parents provided explanations for not having safety
rules, they did so by selecting from among five response options, as opposed
to stating whatever reason came to mind. Although the parents reported no
difficulty in selecting from among the options provided and these response
options were developed based on extensive pilot testing in which parents
spontaneously reported reasons for not having rules, we cannot say with
certainty that the presentation of fixed options did not result in parents'
false endorsements. Finally, child injuries were reported retrospectively by
parents, and reporting biases by parents may therefore have influenced these
data in unanticipated ways. Although prior research indicates reliable
reporting by parents about medically attended injuries
(Pless & Pless, 1995), it
would have been best to include some measure to confirm the reliability of
parent reporting in this study.
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Conclusions |
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TopAbstractIntroductionApproaches to Managing Young...MethodResultsDiscussionConclusionsReferences |
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In conclusion, these findings emphasize that 4- to 6-year-olds' knowledge of home safety rules is quite variable, with children spontaneously recalling only about half such rules. Moreover, this knowledge is not sufficient to ensure their safety, as indicated by the fact that increased knowledge did not predict fewer injuries. Both increased parental supervision and children's compliance with home safety rules predicted fewer injuries to young children. Thus, to promote safety at home for 4- to 6-years-olds, one should focus on ways to ensure that children are behaving in ways consistent with the rules. Limiting the focus to increasing their knowledge and awareness of safety rules is not likely to serve a protective function for young children. The findings also indicate that parents' decisions not to address a recognized safety issue in their home most often reflect a belief that some characteristic of their child prevents any substantial risk to the child's safety. Increasing parents' awareness of the potential for injury when they misjudge either the likelihood of their child's interacting with hazards at home or the child's ability to manage these risks successfully may lead to greater preventative actions at home, thereby reducing in-home injuries to young children.
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Acknowledgments |
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This research was supported by grants to Dr. Morrongiello from the Social Sciences and Humanities Research Council of Canada and the Medical Research Council of Canada. We thank the parents and children for their interest and participation, the schools for welcoming us, and Kathy Major and Kim Jenner for assistance with data collection.
Received August 3, 1999; revision received December 14, 1999; revision received May 21, 2000; accepted July 20, 2000
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References |
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