Research In Action

A recent outing in Center City Philadelphia with my young child highlighted just how complex and dangerous a seemingly routine task such as crossing a street can be. As my colleague, Flaura Winston, MD, PhD, recently shared in her Healthy Kids blog post, while we often link road safety to vehicle safety, more children sustain injuries as pedestrians and bicyclists than as occupants in motor vehicle crashes among CHOP’s metropolitan population. As pediatricians, we should remind parents that as careful as we are with ensuring that our kids are appropriately restrained in vehicles, we also need to be proactive about teaching “defensive” walking and biking.

According to The Children’s Hospital of Philadelphia (CHOP)’s Trauma Program registry, a record of all the patients admitted for injury treatment, CHOP treated the following number of children between January 1, 2010 and December 31, 2014:

• 343 children for significant injuries sustained as pedestrians struck by a vehicle
• 62 children for significant injuries sustained as bicyclists struck by a vehicle
• 163 children for significant injuries as occupants in a motor vehicle crash

I sometimes see young children walking along the streets on their own and worry that they may not yet have the higher level skills to be able to scan, anticipate, and respond to the actions of other drivers and cyclists on the road. Consider discussing the following questions with parents when deciding whether or not their kids are ready to manage traffic without supervision:

• When walking with your children, do they follow rules such as stopping and looking both ways before crossing without parental reminders?
• Do they independently put aside any distractions such as texting or talking on the phone?
• Do they behave predictably, such as stepping into the road only at designated crosswalks?
• Can they recognize a bicyclist’s hand signals?
• Do they automatically reach for a bike helmet when going out for a ride?
• When planning a route, do they proactively consider factors such as safe times of day and surroundings (e.g. lighting at night, etc)?

If the answer to any of these questions is “no”, their children may still benefit from active teaching and modeling to learn defensive walking and biking. And then, just as with teen driving, remind parents that practice is key. Start with familiar streets without much traffic, and then slowly introduce them to more complicated environments. For more information on pedestrian safety for teens and pre-teens from NHTSA, click here.