Research In Action

In our recently published article in December’s issue of Pediatric Clinics of North America, I worked together with co-authors David Schwebel from the University of Iowa and Morag MacKay from Safe Kids Worldwide to explore the role of technology in injury prevention.

In this article, we discuss how technology can meaningfully reduce unintentional childhood injury, with a particular focus on when the technology is engineered and implemented with real-world use in mind. We open with the case of a child whose bike crash injuries were mitigated by a free helmet provided at a community event. This example illustrates a central theme: safety benefits emerge not just from invention, but from access, correct use, and sustained adoption.

We frame “injury prevention technology” broadly: product and vehicle engineering, reminders and alerts that shape behavior, and training tools that build skills. A core engineering lens is the passive–active continuum. Passive protections (e.g., airbags) reduce reliance on human action and tend to be more effective at scale. Active strategies (e.g., placing an immersion alarm on a child’s wrist, correct car-seat installation) can work well, but only when users are motivated, properly trained, and supported by intuitive design features that lower burden. We emphasize that reliability, durability, and affordability are not “nice-to-haves”—they determine whether families use and continue to use a device, and thus whether innovations widen or narrow disparities.

We place current innovations in context of classic successes such as window guards and child-resistant packaging. We also revisit Haddon’s Matrix (and Runyan’s third dimension—effectiveness, cost, equity, feasibility) as practical structures for choosing and evaluating technologies. Behavior change models also are relevant: for active interventions, adoption hinges on perceived risk, severity, benefits, and barriers.

Another key concept is that children are not small adults. History offers a cautionary tale: early airbags saved adult lives but increased child injury risk because realistic child behavior, positioning, and biomechanics were under-considered. We argue that child-centered testing must be a priority, not an afterthought—especially as automated vehicles and advanced driver-assistance systems proliferate.

To offer guidance to clinicians, we review case examples across several domains. For child passengers in motor vehicles, restraints are highly effective but misuse is common; newer indicators, sensors, apps, and virtual seat checks may reduce errors, though injury-outcome data are limited. For child pedestrians, we report that engineering (traffic calming, separation, visibility) and virtual-reality training show promise, and we assert that automated-vehicle detection must account for children’s unpredictability and stature. For teen drivers, virtual driving assessments can help identify crash risk, while simulator-based training shows mixed benefits; vehicle selection and distraction prevention remain key. For drowning, alarms are a potential layer but prone to false alarms and should not replace use of physical barriers and supervision. For firearms, secure storage and emerging “smart” access-control technologies are conceptually compelling, yet rigorous effectiveness evidence is sparse. For safe sleep, responsive bassinets may support safer practices, but there is no evidence they reduce sleep-related deaths and cost may exacerbate inequities.

Developing this manuscript was a refreshing opportunity to survey how far we've come as a field and how far we have yet to go. It was humbling to find that progress is not always a straightforward path. Broadening our perspectives by studying successes (and shortcomings) in related topics should shape how we approach progress in the future.

Our bottom line: technology is powerful but not a panacea. Human workarounds, misinformation, infrastructure needs, and affordability can undermine impact. We close with a call for pediatric clinicians to stay current, counsel families with attention to active vs passive demands, connect families to low-cost resources, and advocate -- through policy, standards committees, and equity-focused implementation -- so that effective safety technologies benefit all children.