Patricia Schnitzer, associate professor in the MU Sinclair School of Nursing, says that most unintentional child injury deaths of young children result from inadequate supervision or failure to protect children from harm. Although injuries to children may be unintentional, they can be prevented and should not be considered accidents.
"Persistent references to tragic, freak, and horrible accidents indicate there is still important work needed to frame unintentional injuries as preventable," Schnitzer said. "Understanding and addressing social norms about the circumstances for child injuries -- such as safe sleep environments for infants and the use of car seats, helmets and other safety devices -- is important to creating effective prevention strategies."
According to the Centers for Disease Control and Prevention, approximately 7.1 million injury-related emergency department visits are made by children younger than 15 each year. In previous research, Schnitzer found that the majority of injuries to young children are not the result of physical abuse but are rather unintentional injuries including suffocation, being burned, ingestion of harmful substances, resulting from inadequate supervision. She encourages increased awareness by health care providers, social workers and others who work with families to identify children at risk of injury and provide interventions to help parents reduce injuries.
"What we know is that child injuries can be prevented," Schnitzer said. "The importance of intervention is huge; recognizing at-risk families -- those with low-income or education levels, and young or single parents -- can help care providers take proper action. Public health professionals, social workers and other care professionals can recommend parenting services and consider making reports to social services or family support agencies if inadequate supervision is suspected."
Parents, professionals and caregivers need to work together to facilitate injury prevention with the knowledge that injuries are preventable, Schnitzer said. Efforts aimed at improving caregiver skills can reduce unintentional harm to children. Currently there are no published guidelines for child supervision, beyond recommendations for constant supervision of toddlers and infants. Schnitzer and other researchers are developing strategies to help parents realistically provide adequate supervision for their children.
Schnitzer's most recent study, "Assessment of caregiver responsibility in unintentional child injury deaths: challenges for injury prevention," included surveys of child death review team members. Child death reviews are conducted by multidisciplinary teams that share information about the circumstances of child deaths, with one goal being to prevent future deaths. Supervision levels, failure to use safety devices, intent and patterns of previous neglectful behavior influenced reviewers' assessments of caregiver responsibility for unintentional injury deaths. The findings offer insights into how child death review teams might incorporate injury prevention messages and actions more effectively.
The study, published in Injury Prevention, was co-authored by Theresa Covington, director of the National Center for Child Death Review at the Michigan Public Health Institute, and Robin Kruse, research associate professor in the MU Department of Family and Community Medicine.
- B. D. Johnston, T. M. Covington. Injury prevention in child death review. Injury Prevention, 2011; 17 (Suppl I): i1 DOI: 10.1136/ip.2010.031161
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