Background Recent research reveals that care giver supervision is a critical determinant of childhood injury. In virtually all of this research, however, the focus has been limited to care givers of preschool children (<6 years). Little is known about how care givers supervise school-age children, what factors influence supervision practices, and how supervision relates to children's risk of injury. The present study addressed these gaps in knowledge.

Objectives Using a prospective design this study examined school-age children's supervision and relations between supervision and injury.

Methods Mothers reported on school-age children's history of injuries and recorded home supervision over a 2-month interval. The children independently completed diaries about daily events that included injuries. Relations between supervision and both parent permissiveness and children's propensity to risk take were examined.

Results Children spent 24% of time alone, mostly supervised intermittently or not at all. Parent permissiveness was associated with increased time unsupervised, while children's risk taking propensity was associated with decreased time unsupervised. Extent of direct supervision served a protective function associated with fewer injuries, while extent of indirect- and non-supervision time emerged as risk factors for injury.

Conclusions These findings reveal that care giver supervision influences risk of injury across a broad age range throughout childhood. Implications for children's safety are discussed.