Elsevier

Behavior Therapy

Volume 33, Issue 2, Spring 2002, Pages 271-297
Behavior Therapy

Original Research
Improvement in quantity and quality of prevention measurement of toddler injuries and parental interventions*

https://doi.org/10.1016/S0005-7894(02)80029-6Get rights and content

Injury is the leading killer of children in the United States, yet little research has focused on this vital subject. One of the distinct barriers to injury prevention is the absence of effective assessment devices. Epidemiological aspects of injury have been assessed, but these provide little information at a level sufficient to allow conclusions about potential behavioral prevention methods. This paper describes an alternative, the Participant Event Monitoring (PEM) system. In this paper, the PEM system is used to examine a sample of 170 toddlers (ages 18 to 36 months), over a 6-month period, resulting in data on over 4,200 injuries, 1,000 proactive interventions, and 300 reactive interventions. PEM involves a structured interview, producing detailed information concerning measures of antecedents, events, and consequences of injury. Sample PEM data are included. Its ultimate goal is to guide effective interventions to decrease childhood injury.

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    • Managing children's risk of injury in the home: Does parental teaching about home safety reduce young children's hazard interactions?

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    • Parents teaching young children home safety rules: Implications for childhood injury risk

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      Most parents report being concerned about young children's safety and that they take precautions to prevent home injuries (Gärling & Gärling, 1993, 1995; Morrongiello & Dayler, 1996; Peterson, Ewigman, & Kivlahan, 1993). Examining the nature of these precautions has revealed that caregivers use three strategies to manage injury risk for young children in the home: supervision (i.e., attention and proximity), implementation of environmental changes to prevent access to hazards (e.g., using cabinet locks), and teaching safety rules that children are then expected to follow (Morrongiello et al., 2004a, 2004b; Peterson, DiLillo, Lewis, & Sher, 2002; Wortel & de Geus, 1993). Historically, most research has focused on understanding parents' implementation of environmental changes that prevent access to hazards, including how to increase their use of this injury prevention strategy (Gielen, Wilson, Faden, Wissow, & Harvilchuck, 1995; Kelly, Sein, & McCarthy, 1987; Peterson, Mori, & Scissors, 1986; Wortel, de Geus, & Kok, 1995).

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      However, to date there are no published studies that assess whether a relationship exists between the number of injury-related medical visits and a CPS report for maltreatment. Furthermore, there is research documenting that parents do not typically change their supervision patterns or implement injury prevention measures after their toddler sustains an injury, even when the injury requires medical attention, indicating these children might be at high risk for repeat injuries (31,32). Based on this literature, we hypothesized that the number of ED visits for treatment of injuries might help identify a group of children at increased risk for maltreatment (child abuse or neglect).

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    *

    We first need to cite our funding agency, NICHD Grant #5R01HD25414-07. Connie Popkey assisted in multiple drafts of the paper and over 30 undergraduates assisted in coding the data. They deserve our sincere thanks. The interviewers Bonnie Benson, Jennifer Collins, Amy Damashek, Julie Long, Shannon Stanton, Lisa Wischmeyer, and Wendi Marien, M.S., all did consistently superb work as interviewers. The University of Missouri Pediatrics Department assisted us in recruiting, as did day care centers and parenting groups (such as “Parents as Teachers”). Jeff Crowson assisted in initial data entry and cleaning. Finally, our greatest thanks go to the women who spent such time and effort as participant observers. Without their training and willingness to accurately report on their children's behavior, such research would not be possible.

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