Safety through the ages

Understanding your child's growth and development is an important part of parenting.

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"Growth and development includes not only the physical changes that occur from infancy to early teens, but also some of the changes in emotions, personality, behavior, thinking  and speech that children develop as they begin to understand and interact with the world around them," says Eileen Kasten, MD, medical director of developmental pediatrics at The Children’s Medical Center of Dayton.

Understanding your infant and toddler’s development is especially important because children in these age groups have a poor understanding of risks and curiosity and impulsiveness, failure to appreciate danger  and limited ability to handle more than one stimulus at a time puts them at increased risk for injury.

"Young children between 0 to 4 years are particularly susceptible to injury because they lack experience, strength and physical skill," says Dr. Kasten.  "Children at this age are impulsive and don’t have fear. They also tend to disappear quickly from a parent’s view."

Take a moment to learn some key developmental features to protect your infant or toddler from accidental injury.

Infancy (children 0 to 12 months)

During this stage, your child is completely dependent on you. Infants are vulnerable to many injury hazards because of their small size and lack of strength, experience and physical skills.  As a parent, it is your responsibility to create a safe environment for them.

Follow these tips from Dayton Children’s to protect children at this age:

Motor vehicle crashes

• Use a rear-facing car seat until at least age 1 and a weight of 20 lbs. This is the safest option to support an infant’s weak head, neck and back and prevent spinal cord injuries. Use a rear-facing car seat longer if the seat has a higher weight and height limits.
  

Drowning

• Supervise children at all time when they are near water. A supervised child is in sight at all times with your undivided attention focused on the child. Infants can die in less than one inch of water. Never leave your baby unattended in or near water, even for a second. 
  

Unsafe sleep practices

• Practice the ABCs of Safe Sleep. Infants should sleep Alone, on their Back and in a Crib.  Make sure the crib is free from blankets, bumper pads, and stuffed animals and meets the Consumer Product Safety Commission’s guidelines.
  

Shaken Baby syndrome

• Have a plan.  Infants will cry, sometimes for prolonged periods of time, and it’s important to plan how you will stay calm if you’ve tried everything and your baby is still crying. Take care of yourself so you can take care of your baby.  Calming activities that can be part of your plan include breathing, going for a walk with your baby and talking to someone.babies cry and

Early Childhood (children 1 to 4 years old)

During this stage, limit your child’s access to hazards.  As children grow from infants to toddlers to preschoolers, one of the most effective ways to prevent an injury is to keep hazards away from them.  At this stage, children are little explorers.  As they become more mobile and curious they open cupboard doors, pull themselves up on furniture and pull items down from tables. They don’t recognize dangers that surround them every day and therefore need you to create a safe environment.

Follow these tips from Dayton Children’s to protect children at this age:

Motor Vehicle Crashes

• Use a forward-facing car seat until the harness no longer fits.  The five-point harness will protect small children and keep them in place.  Children’s behavior in the car may also become distracting to the driver because they want to ride like older children or get bored.
  

Drowning

• Supervise children at all time when they are near water. A supervised child is in sight at all times with your undivided attention focused on the child. Don’t leave toys in or near the pool, where they could attract unsupervised kids. For extra protection, consider a pool alarm and alarms on the doors, windows and gates leading to the pool.
  

Burns

• Make the kitchen a child-free zone when someone is cooking. Children want to stay close to their parents, but their cognitive skills are not developed to recognize the danger of hot items or control their impulses. As children grow in height, they can reach the counter and front burners, but can’t see what’s in them.  A child’s skin burns deeper and quicker at lower temperatures than adult’s skin.

Falls

• Install stair and door gates. A toddler’s increased mobility and active lifestyle put him/her at risk of falling down a staircase or wandering into areas of the home that are not child-safe.

Special Considerations: Children with special needs

Kids with attention-deficit hyperactivity disorder (ADHD) and other special needs get hurt more often than the average child.  Children with autism may be more impulsive and have limited communication skills to communicate who they are if they are lost or injured.

If your child has a special need consider these additional safety tips from Dayton Children’s and Safe Kids USA :

• Beware of common dangers: Parents don’t realize that young children can drown in less than inch of water, that drinking mouthwash can cause a young child to fall into an alcohol coma, or that children can fall out of a window that is only opened 5 inches. Make sure your child’s environment is as safe as possible.
• Use visuals reminders: The "Mr. Yuk" stickers from poison prevention centers prevent many tragedies for preschoolers and their parents. This same strategy can work for older children with ADHD, who tend to be developmentally immature and have poor memories. Use stickers with phrases such as "Don't Touch!" and "Off Limits!" Put them on the power tools, the attic door, the stove, the knife drawer or any other potential source of injury.
• Make rules specific  and clear: Give specific instructions instead: "Before crossing the street, look left, look right, then look left again. When there are no cars, cross the street and keep looking until you reach the other side." Establish exactly what's off limits: the quarry, the roof, the windowsill, the pool, the oak tree. Make a chart of specific safety rules and post it in your child's room and in the kitchen as a daily reminder.
• Role play and rehearse: Develop and role-play risky scenarios with your kids Go over situations such as: "What do you do when the ball rolls into the street? What do you do when someone starts a fight with you on the playground?" Play out several options and review their possible consequences: "If you do that, what do you think might happen? What if you did this instead?" Help children be prepared for the dangerous situations they may encounter.
• Arrange for supervision: Supervising ADHD kids is critical. Don't pair them with other ADHD kids and send them off to the park; send them with responsible older kids who can serve as role models and mentors. If you or another adult can't be around after school, enroll your kids in supervised activities such as music lessons and team sports.
  

Additional resources

• Safe Kids USA - Raising Safe Kids, One Stage at a Time
  www.safekids.org/stages
• American Academy of Pediatrics - The Injury Prevention Program (TIPP)
  http://www.aap.org/family/tippmain.htmNational
• Autism Association http://www.nationalautismassociation.org/safetytoolkit.php

 

About our Expert

Eileen F. Kasten, MD, is an assistant professor of pediatrics at Wright State University Boonshoft School of Medicine and is board certified in pediatrics. She joined Dayton Children's from Columbus Children's Hospital where she was medical coordinator for the Down syndrome clinic. The department of developmental pediatrics offers a variety of diagnostic and treatment services for children with developmental problems. Dr. Kasten focuses on services for preschool-age children (age 5 years and under) with developmental delays, including language, cognitive, motor or social.

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