Child Neuropsychology 0929-7049/01/0702-072$16.

00
2001, Vol. 7, No. 2, pp. 72±83 # Swets & Zeitlinger

Sustained Attention and Unintentional Injury

Among Preschool-Aged Children
Laura Bennett Murphy1, Caroline E. Murphy2, and Cynthia Laurie Rose1
1
Department of Psychology, One Otterbein College, Westerville, OH, USA, and
2
Department of Psychology, Ohio University, Athens, OH, USA

ABSTRACT

This study examined vigilance in preschool-aged children and explored the relationship between vigilance
and unintentional injury. There were 28 participating children, aged 4 and 5 years, who completed a
computerized vigilance task for two 5-min sessions. The task generated measures of correct detections, false
alarms, reaction time, and the signal detection indices of d0 and c. Primary caregivers completed daily injury
phone journals for a 4-week period. Results indicated that age and signal probability affected vigilance.
Older children made more correct detections, had greater perceptual sensitivity, and performed in patterns
similar to adults. Performance was enhanced in the high signal probability condition. In addition, vigilance
indicators of perceptual sensitivity and response bias were predictive of injury, while age was not.
Speci®cally, children with lower perceptual sensitivity scores, and who were less responsive to the vigilance
task, experienced more unintentional injures over the course of the study.

The ability to sustain attention to stimuli over an
extended period, facilitates the processing of
information and thus forms a basis for a wide
array of cognitive functions (Parasuraman &
Davies, 1977). Adult vigilance is of signi®cant
interest in occupational settings where sustained
attention is key to safety, productivity, and com-
fort (Warm & Dember, 1998). Vigilance also is
relevant in children's lives. Whether one exam-
ines social interactions (Adamson & Russell,
1999; Goldsmith & Rogoff, 1997), cognitive
development (Bell, 1998; Choudhury & Gorman,
2000), or the early identi®cation of children at
risk (Bornstein, 1990; Fagan & Haiken-Vasen,
1997), attentional processes are central to expla-
nations of individual behavior. ``Attention . . . is
conceded by everyone to be essential to an under-
standing of behavior'' (Burack & Enns, 1997,
p. 9).
Most research on children's vigilance has
focused on the identi®cation of attention pro-
blems, differentiating clinical from non-clinical
populations. However, there is a dearth of norma-
tive developmental data on sustained attention.
This paucity of data makes assessment of de®cit
or delay dif®cult (Burack & Enns, 1997). Further,
there are many implications for understanding the
development of children's vigilance beyond iden-
tifying clinical subgroups. For example, Edley
and Knopf (1987) suggest that vigilance may be
an indicator for school readiness. Further, the
study of individual differences in vigilance may
be useful for theory construction. For instance, in
the adult literature some researchers have used
individual differences research to examine com-
peting theories of vigilance (Berch & Kanter,
1984). Ballard (1996a) argued that to fully under-
stand vigilance, one had to take into account

Address correspondence to: Laura Bennett Murphy, Ph.D., Department of Psychology, One Otterbein College, West-
erville, OH 43081, USA. Tel.: ‡ 1-614-823-1698. Fax: ‡ 1-614-823-3285. E-mail: LBennett-Murphy@otterbein.edu
Accepted for publication: October 17, 2001.
 SUSTAINED ATTENTION AND INJURY
subject characteristics (here referred to as partic-
ipant characteristics), task parameters of the vigil,
and the environment in which vigilance is being
assessed. All of these factors in¯uence sustained
attention and may interact. One such participant
characteristic is age.
Studies of sustained attention in children
clearly document the dynamic nature of the
developmental course of attention. For example,
Levy (1979) demonstrated a distinct increase in
capacity for vigilance in normal children across
the ages of 4±6 years. This development also
correlates to an increase in ability for motor
inhibition, which is essential for completing vig-
ilance tasks. Sarid and Breznitz (1997) found that
the development of vigilance follows a linear
trend until age 4 and then reaches a plateau
around age 5, and that vigilance may develop as
a stage in a sequential development of different
aspects of attention. The results of a study con-
ducted by Woody-Ramsey and Miller (1988) also
give rise to the idea of sequential development:
The period between ages 3 and 6 was found to be
a transition point in the development of selective
attention skills. This dynamic character of devel-
opment of attention and vigilance among the
preschool years presents a special challenge in
using a vigilance task to assess the level of atten-
tion of a preschool child. Since this period seems
to be a point of transition, it is likely that there
exists wide variation in vigilance skills between
ages 3 and 5. However, beyond the studies men-
tioned above, there remains limited information
on the normal development of attention and appli-
cations of laboratory-based measures of attention
to function.
While the majority of research with children
has been conducted with school-aged clinical
samples (Huguenin, 1997; Losier, McGrath, &
Klein, 1996; Schachar, Logan, Wachsmuth, &
Chajczyk, 1988; Sykes, Douglas, & Morgenstern,
1973), a few studies exist that have examined
sustained attention in younger children (Byrne,
DeWolfe, & Bawden, 1998; Ruff, Capozzoli, &
Weissberg, 1998; Ruff, Lawson, Parrinello, &
Weissberg, 1990). Kerns and Rondeau (1998)
developed a vigilance task for use with preschool
children, aged 3±6 years, to differentiate children
with atypical attention from their normal peers.
73
Across subject groups, Kerns and Rondeau
described a developmental trend such that chil-
dren performed better on the task with age. While
the authors made an important contribution to the
literature and demonstrated that young children
could successfully complete their continuous per-
formance task, there were several limitations to
the study. First, there was no systematic manip-
ulation of task parameters known to affect vigi-
lance performance in adults (e.g., event rate,
stimulus duration, signal probability). Second,
while the study effectively differentiated clinical
subgroups, there was no measure of functional
utility for the typically developing children.
Third, the authors did not examine changes in
attention over time. A common ®nding in such
tasks is the decline in performance over time,
which is referred to as the vigilance decrement
(Dember & Warm, 1979). Finally, Kerns and
Rondeau examined only correct detections and
errors of commission (false alarms). However,
signal detection analyses often are applied in
adult vigilance studies and promise a fuller
assessment of participants' performance (Losier
et al., 1996; Nuechterlein, 1983; O'Dougherty,
Nuechterlein, & Drew, 1984). The current study
adapts Kerns and Rondeau's task with children,
aged 4±5 years, and addresses the above four
issues. Further, the current study examines how
age interacts with task variables.
Ballard (1996b) provides an extensive review
of factors that affect performance on vigilance
tasks, including participant characteristics (e.g.,
personality, level of arousal, demographics), task
parameters (e.g., event rate, stimulus duration,
nature of the stimuli), and the testing environ-
ment. Unfortunately, many such factors and para-
meters are ignored in vigilance studies with
children, leading some researchers such as
Corkum and Siegel (1993) to question the util-
ity of vigilance tasks in assessing attention in
children.
Signal probability is an example of a task
parameter that is virtually ignored in the child
literature on vigilance. A powerful in¯uence on
adult response criterion, signal probability, is
de®ned by See, Howe, Warm, and Dember (1995)
as the ratio of critical signals to the total number of
events that occur in a given time period. Generally,
74 LAURA BENNETT MURPHY ET AL.
adults are more receptive to critical signals in
higher signal probability conditions (Baddeley &
Colquhoun, 1969; Parasuraman & Davies, 1976).
Thus, an increase in signal probability typically
will elicit maximization of ef®ciency and accuracy
of signal detection in adults (Jenkins, 1958; Warm
& Alluisi, 1971).
Although signal probability manipulations
have been made consistently in examinations
of adult vigilance, only one study has made
such manipulations while examining vigilance
in children (Laurie Rose, Bennett Murphy,
Schickedantz, & Tucci, 2001). Laurie Rose et al.
(2001) found that children's performance was opti-
mal in higher probability conditions. However,
Losier and coworkers (1996) found that in studies
of children's vigilance, signal probability varies
from 8 to 30% of the total stimuli presented in a
typical testing session. This range stands in stark
contrast to the typical range presented in studies on
vigilance performance in adults, which Craig
(1984) identi®ed as between 2 and 5% of the total
stimuli in a vigilance session. Clearly, a more
consistent approach to signal probability and its
manipulation in research on children's vigilance
is necessary to gain a more complete picture of
vigilance performance.
While inconsistent manipulation of task para-
meters has been one limitation of the literature on
children's vigilance, failure to examine vigilance
over time is another. One of the most signi®cant
®ndings in adult vigilance performance is the
vigilance decrement. Known to appear within
the initial moments of a vigil, the vigilance
decrement is a decrease in accuracy of perfor-
mance and increase in reaction time or response
latency to stimuli over time (See et al., 1995).
Participants usually demonstrate longer reaction
times to presented stimuli, and correctly detect
fewer target signals. The vigilance decrement
has not been explored consistently in studies with
children (Corkum & Siegel, 1993). Most studies
of children's attention have calculated an average
score over the entire vigilance session. Such
scores provide no information about how atten-
tion changes over time. Halperin, Sharma, Green-
blatt, and Schwartz (1991) argued that these
average scores actually may re¯ect selective,
and not sustained, attention.
The few studies that have attempted to mea-
sure change over time in children have success-
fully documented the vigilance decrement
(Halperin et al., 1991; Laurie Rose et al., 2001;
McKay, Halperin, Schwartz, & Sharma, 1994).
The current study examines effects of prob-
ability manipulations on preschool-aged chil-
dren's vigilance and examines vigilance over
time. Further, the current study considers the
external validity of this task by examining the
relationship between vigilance and unintentional
injury. Unintentional injury remains the leading
cause of death for Americans from birth to middle
adulthood (U.S. Senate, 1996). The U.S. Depart-
ment of Health and Human Services identi®ed the
reduction of unintentional injuries as a major
health goal for the United States (CDC, 1998).
A non-fatal injury occurs every 2 s in the United
States (Heubusch, 1998) and injury is the leading
cause of childhood morbidity and mortality in the
United States (CDC, 1998). Among children, the
incidence of injury increases dramatically from
birth to age 2, peaks between ages 2 and 4, and
then declines in the school years (Matheny, 1988).
Because of the public health threat and the sig-
ni®cant cost in treating injuries (approximately
$80 billion in 1994 [CDC]), this problem warrants
scienti®c attention (Peterson, Brown, Bartelstone,
& Kern, 1996).
Identifying and eliminating risk factors for
injury has been a major goal of research and
public health initiatives. Repeatedly, the presence
of attention de®cits has been identi®ed as a
positive risk factor for injury (Farmer & Peterson,
1995; Rivara, 1995a). While it has been estab-
lished that children with attention de®cits do incur
unintentional injuries more often than their nor-
mal peers (Farmer & Peterson, 1995), there are
limitations in the literature. First, most studies on
attention and injury have looked solely at school-
age children (Matheny, 1988; Peterson, 1994;
Rivara, 1995a, b), effectively ignoring children
under 6 years. Further, there has been little
examination of the relationship between attention
and injury among typically developing children
with the notable exception of Pless and Taylor
(1995).
In a case-control study of injured children,
aged 5±15, Pless and Taylor compared 286 children
 SUSTAINED ATTENTION AND INJURY
who had been involved in traf®c injuries either as
a pedestrian or as a bicyclist. To be included in the
study, children could not have received severe
head trauma, upper limb damage, or sensory
impairments. A total of 562 children served as
controls. Children in the control group had experi-
enced injuries where their behavior was not a
major factor in the injury, for example, as a
passenger in a car. The study found that children,
who had been injured in part due to their own
behavior, made more errors of omission and
commission on a continuous performance task
of attention than the children in the control group.
The authors concluded that de®cits in vigilance
may be related to increased risk for injury in
typically developing children.
The Pless and Taylor study suggests that vari-
ability in attention may play a role in the occur-
rence of unintentional injury. However, little
remains known about the relationship between
attention and injury in preschool-age children
who experience the highest rates of injury. The
current study further examines that relationship
using a prospective design.
As Pless and Taylor (1995) point out, prospec-
tive designs are almost impossible when studying
serious injuries. One would have to follow more
than 35,000 children for 1 year to yield 100
relatively serious injuries (Pless & Taylor, 1995).
However, minor unintentional injuries could serve
as a useful dependent measure of attention. First,
minor unintentional injuries affect all children and
occur with some frequency. Second, there is wide
variability in the frequency of occurrence of injury.
Third, Peterson, Brown, and coworkers (1996)
have demonstrated that minor injury can be reliably
measured and systematically studied. Finally, even
minor injuries may cause distress to the involved
child and parent. For these reasons, injury was
selected as an index of external validity for the
vigilance task.
The current study examines normal sustained
attention with respect to the incidence of unin-
tentional injury in preschool children. This pro-
ject adapts an age-appropriate vigilance task for
use with preschool-age children with normal
attention patterns. The study builds on prior work
by: (1) manipulating a task parameter, signal
probability, within the vigilance task; (2) examin-
75
ing the relationship between visual attention and
the incidence of unintentional injury; and (3)
establishing that a vigilance decrement can be
demonstrated in a 5-min vigil with young chil-
dren. Further, the current study makes use of
signal detection analyses. Signal detection ana-
lysis are frequently utilized in the adult literature,
and provide a ®ne-grained and sensitive analysis
of performance. These analyses are described
below.
Ballard (1996a) charged researchers to system-
atically examine participant, task, and environ-
mental variables conjointly. The current study
accepted that charge by examining the participant
characteristic, age, and the task parameter, signal
probability, within the context of a constant test-
ing environment. First, it was predicted that age
would affect vigilance. It was expected that older
children (5-year-olds) would make more correct
detections and fewer false alarms. In addition, it
was hypothesized that 5-year-olds would have
faster reaction times, greater perceptual sensitiv-
ity (d0 ), and greater conservatism (c). Based on
®ndings in the adult literature, it was predicted
that (1) probability would in¯uence performance
with the low probability condition eliciting greater
conservatism and slower response times than the
high probability condition; (2) over the duration of
the session, children would tend to adopt a more
conservative criterion (c), that is, children will be
less willing to risk a false alarm and thus would
respond less frequently; and (3) a vigilance decre-
ment would reveal itself by a decrement of hits, a
decline in perceptual sensitivity (d0 ), and an
increase in reaction time. With respect to the
relationship between vigilance and injury, it was
hypothesized that those children with lower per-
ceptual sensitivity (d0 ) and a more lenient response
bias as indicated by a lower c value, would incur
more unintentional injuries.
METHOD
Participants
The participants in this study were 28 children, aged
4 years, 0 months to 5 years, 11 months and their
respective primary caregivers. There were 12 young-
sters aged 4; 16 were 5-years-old. The children, 17
boys and 11 girls, had a mean age of 4.54 years and
76 LAURA BENNETT MURPHY ET AL.
all were Caucasian. All participants were recruited
from local preschools. The preschools were not
af®liated with the local college or university. As such,
participating children were representative of the
suburban area of a large Midwestern city from where
they were drawn. Primary caregivers were the source
of injury reports for the second part of the study.
Since this study was concerned with normal
patterns of attention, the Conners' Parent Rating
Scale ± Revised (Conners, 1997) was used to exclude
children with perceived atypical patterns of atten-
tion. The Conners' is a standardized instrument used
widely to assist in identifying inattention and
overactivity. Each child's data was included only if
the Conners' subscale scores indicated that the
child's behavior was within the range speci®ed as
normal (less than 1.5 SD above the M). All children
fell within the normal range, so no children were
excluded.
Measures
Vigilance Task
Visual attention was measured by a computer
vigilance task, which was adapted from Kerns and
Rondeau (1998). Stimuli consisted of pictures of
common animals: bird, dog, elephant, cat, duck,
rabbit, frog, ®sh, and pig. Pilot data determined that
children of this age range are familiar with these
animals. Each picture was a simple black-and-white
outline drawing of an animal, similar to those found
in children's coloring books. These pictures were
scanned and saved on a Toshiba Tectra 720 laptop
computer as individual events for the task, which
was programmed using SuperLab Pro software.
Children participated in two vigils during two
separate testing sessions: a low probability vigil and
a high probability vigil. In both vigils, the bird was
designated as the target stimulus and the remaining
animals were designated distracters. Each of these
vigils consisted of ®ve, 1-min continuous periods of
watch during which the children were asked to
constantly attend to the computer screen. Probability
values of .2 and .3 were set for the low and the high
probability conditions, respectively. Thus, in the low
probability condition, each 1-min period of watch
consisted of 40 stimuli, 8 of which were targets
among 32 distracters. The high probability condition
also consisted of 40 stimuli, including 12 targets and
28 distracters for each period of watch. Prior to each
vigil, participants were given a 30-s practice session.
The probability levels of the practice session were
consistent with the probability levels of the main
vigil. All stimuli were presented for 1350 ms and the
inter-stimulus interval was 150 ms.
Injury Journals
Daily injury journals were administered to the
caregivers of participating children over a 4-week
period. These journals consisted of injury reports by
the primary caregivers ± those persons most aware
of the children's activities during the past 24 hr.
Reported injuries were coded and quanti®ed using
the Minor Injury Severity Scale (MISS; Peterson,
Saldana, & Heiblum, 1996). The MISS categorizes
injury into 21 types (e.g., cuts, burns). Injuries,
then, are rated on a 7-point severity scale to quantify
tissue damage. The measure has demonstrated
acceptable reliability and stability (Peterson et al.,
1996). The total number of injuries over the 4-week
period was tabulated as the dependent measure
because, unlike the severity ratings, the number of
injuries was both continuous and had acceptable
variability.
Data Analysis
For the vigilance task, a 2 (Probability: low ˆ.20,
high ˆ .30)2 (Age)5 (Periods of Watch) repeated
measures ANOVA was utilized. The dependent
variables for sustained attention included the tradi-
tional indices of percent hits, percent false alarms,
and reaction time for correct detections. In addition,
signal detection indices were used. Signal detection
analysis yields two independent measures: percep-
tual sensitivity, often indexed by d0 , and response
bias, indexed by c. Perceptual sensitivity scores
assess an observer's ability to detect changes in
stimuli, such as those between target and distracter
stimuli. Response bias scores assess a subject's
willingness to respond to stimuli. A high score
indicates a conservative response criterion whereby
the observer is quite cautious and unwilling to make
a false alarm in response to stimuli. A low score
shows a willingness to accept false alarms (See,
Warm, Dember, & Howe, 1997).
To analyze the relationship between vigilance
and injury, data were collapsed across age groups
and a general linear model procedure was used. The
dependent variable was the frequency of injury over
4 weeks. As described above, frequency of injury, as
opposed to severity, was selected as the dependent
variable because it was continuous and had suf®cient
variability. The independent variables included the
signal detection indices of mean perceptual sensi-
tivity and mean response bias. These were selected
for two reasons. First, due to the limited sample size,
it was impossible to use all vigilance indices (e.g.,
reaction time, correct detections, false alarms), and
perceptual sensitivity and response bias are inde-
pendent from one another (See et al., 1997). Second,
signal detection scores utilize correct detection and
 SUSTAINED ATTENTION AND INJURY
false alarm data to yield indices of behavioral style
toward a task. It was believed that these indices of
behavioral style would be more informative in
explaining minor injuries.
Scores were recorded for the ®ve continuous 1-
min periods of watch of each vigilance condition for
each of the ®ve dependent variables. In order to
correct for errors of anticipation, researchers con-
sidered a response as a false alarm if a participant
pressed a key to the target stimulus during the
200 ms following the onset of that particular
stimulus, a standard ®rst described by Nuechterlein
(1983) and O'Dougherty et al., (1984). Responses
also were recorded as false alarms if the participants
responded to a distracter. Responses recorded be-
tween 200 ms after the presentation of the target
stimulus and prior to the onset of the next stimulus
were recorded as correct detections.
Procedure
Letters were sent home to parents from three local
preschool classes that served children aged 4 and 5.
Approximately 40 letters were sent home and 28
families completed the protocol. The 28 participat-
ing families were representative of the preschool
classrooms from which they were recruited. Partic-
ipating parents returned a written informed consent
form to the school. Researcher assistants then
traveled to the preschools to administer the vigilance
task; at that time the child's verbal assent was
obtained. The protocol established by Kerns and
Rondeau (1998) was followed. Each child was asked
to help `catch' all the birds on the computer by
pressing the spacebar each time a bird appeared on
Fig. 1. Age GroupPeriod of Watch interaction on mean percent correct detections in 4- and 5-year-old children.
77
the screen. Because there were two experimental
conditions, high probability and low probability,
researchers randomly administered the tasks on
separate days. The low probability task was
administered on 16 children on 1 day, and then the
high probability task approximately 4 days later; for
the remaining 12 children, the high probability
condition was administered ®rst. All tasks were run
in a small, quiet, well-lit room with a table and chair
scaled in size for preschool children. Following
completion of the vigilance task, caregivers com-
pleted the injury journals Monday through Friday for
4 weeks. Upon completion of the study, all families
were entered in a raf¯e for one of three $ 40 awards.
RESULTS
Age of participant affected vigilance perfor-
mance. The analysis of correct detections
revealed a signi®cant main effect for Age (F (1,
26) ˆ 5.38, p<.05). Five-year-olds made more
correct detections than 4-year-olds (55% vs.
38%, respectively). An AgePeriods of Watch
interaction approached signi®cance for correct
detections (F (4, 104)ˆ 2.349, p<.06). This trend
towards an interaction, presented in Figure 1,
shows that the 5-year-olds tended to decline in
accuracy, while 4-year-olds demonstrated a ¯at
function of low accuracy. Tests of simple effects
show that age was signi®cant at the ®rst three
periods of watch, with the older group performing
78 LAURA BENNETT MURPHY ET AL.

Fig. 2. Age GroupProbability interaction on mean reaction time in 4- and 5-year-old children.

signi®cantly better than the younger group, F (1,
26)ˆ 8.46, p<.01, F (1, 26)ˆ 6.26, p<.05, and F
(1, 26)ˆ 4.14, p<.05, for periods 1, 2, and 3,
respectively. Age did not affect commission of
false alarms.
With respect to reaction time, there was an
AgeProbability interaction (F (1, 26) ˆ 4.636,
p<.05). Five-year-old children performed signi®-
cantly slower in the low probability condition.
This interaction can be seen in Figure 2. Tests of
simple effects con®rmed the observation that age
was signi®cant only in the low probability condi-
tion (F (1, 26) ˆ 3.929, p<.05).
In terms of perceptual sensitivity (d0 ), 5-year-
olds were signi®cantly more sensitive than 4-
year-olds (F (1, 26)ˆ 4.68, p<.05). Mean d0 scores
were 0.15 and 0.63 for 4- and 5-year-olds, respec-
tively. Finally, with respect to the signal detection
index of response bias, there was a non-signi®cant
trend for an AgeProbability interaction (F (4,
104) ˆ 2.349, p<.06). As illustrated in Figure 3,
both groups became less conservative in the high
probability condition, however, this pattern was
more pronounced for the older children.
Results of the analyses of variance performed
on mean reaction times revealed a signi®cant

Fig. 3. ProbabilityPeriod of Watch interaction on mean reaction time in the low and high probability tasks.
 SUSTAINED ATTENTION AND INJURY
ProbabilityPeriod of Watch interaction (F (4,
104) ˆ 2.999, p<.05) as evidenced by a lengthen-
ing in reaction times across the vigilance task only
in the low probability condition (tests of simple
effects: F (4, 104) ˆ 2.999, p<.05). Also, as
described above, probability interacted with age
group such that 5-year-olds had longer reaction
times in the low probability condition.
There was a signi®cant main effect for Prob-
ability in predicting response bias (F (1, 26) ˆ
12.7, p<.001). Children became less conservative
in responding in the high probability condition.
Further, as described above, 5-year-olds were
most sensitive to this manipulation. A trend
approaching signi®cance suggested that 5-year-
olds became less conservative in the high prob-
ability condition.
The number of injuries each child incurred
within the 4-week period ranged from 2 to 11
injuries, with a weekly mean of 1.41 injuries. The
average severity rating for these injuries was 1.47
on a scale from 0 to 6, where 0 re¯ects no tissue
damage and 6 re¯ects permanent dis®gurement or
impairment. In general, the 1±2 range indicates a
minor injury with modest bleeding, swelling, or
both. Average scores for perceptual sensitivity
and response bias for each probability condition
were entered into an univariate general linear
model to predict injury. Since age and gender
are factors known to in¯uence injury, a prelimin-
ary analysis was conducted to determine whether
these variables should be included as covariates in
the model. Results revealed that there was no
relationship between age, gender, and injury in
this study, so these variables were excluded.
In the high probability task, neither of the
variables reached signi®cance as predictors of
unintentional injury. In the low probability task,
however, both mean perceptual sensitivity and
mean response bias scores were found to be sig-
ni®cant predictors of injury (F (2, 25)ˆ 6.7, p<.05,
Z2 ˆ .21 and F (1, 26)ˆ 18.656, p<.001, Z2 ˆ .43,
respectively). The observed power for the model
was .982 and the model accounted for 46% of the
variability in injury. As mean perceptual sensitivity
scores increased, indicating increased sensitivity
to changes in stimuli, the number of injuries
incurred decreased (b coef®cientˆ ÿ1.422). As
mean response bias scores increased, however,
79
the number of injuries also increased (b coef®-
cientˆ ÿ5.568). R2 values for mean perceptual
sensitivity and mean response bias were .16 and
.30, respectively.
DISCUSSION
This study measured preschool-aged children's
vigilance and provided evidence for the func-
tional utility of such measures. The current
study illustrates that within a 5-min vigil: (1)
participant and task parameters critically affect
vigilance, (2) a vigilance decrement might be
likely, at least with 5-year-olds, and (3) signal
detection analyses might capture individual dif-
ferences in behavior. Finally, the study shows
that perceptual sensitivity and response bias
accounted for almost half of the variability in
unintentional minor injuries over a month's time.
With respect to the study hypotheses, many
were supported. First it was hypothesized that age
would affect performance in all indices of vigi-
lance (correct detections, false alarms, reaction
time, perceptual sensitivity, and response bias).
Indeed, older children made more correct detec-
tions and had greater perceptual sensitivity than
4-year-olds. As described below, age effects were
modi®ed by probability condition in predicting
reaction time and response bias. No age effects
were found with respect to false alarms.
Beyond the age hypotheses, several predic-
tions were made regarding vigilance and most
were supported. First, it was hypothesized that the
low probability condition would be associated
with greater conservatism and longer reaction
times. The hypothesis was partially supported.
Five-year-olds demonstrated longer reaction
times. Further, there was a trend for higher re-
sponse bias scores (greater conservatism) in the
low probability condition. There was no support
for the hypothesis that children would become
more conservative over time. This may be due, in
part, to the brevity of the task required by such
young participants. Finally, as a few others have
demonstrated (Halperin et al., 1991; Laurie Rose
et al., 2001; McKay et al., 1994), the current
vigilance task was useful in eliciting a vigilance
decrement in 5-year-old children similar to those
80 LAURA BENNETT MURPHY ET AL.
observed in adult studies (Ballard, 1996b). This
decline in vigilance performance was manifested
in general by longer reaction times over time and
a trend for decreased correct detections. These
effects were modi®ed by age group and signal
probability manipulations.
Thus, in general, 5-year-old children responded
to the vigilance task much like adults and older
children, in terms of responding to probability
manipulations, and by evidencing a vigilance
decrement (Baddeley & Colquhoun, 1969; Jenkins,
1958; Laurie Rose et al., 2001; Parasuraman &
Davies, 1976; See et al., 1997; Warm & Alluisi,
1971). Prior studies have described the period
between 3 and 6 years as a transition point in
the development of vigilance abilities (Sarid &
Breznitz, 1997; Woody-Ramsey & Miller, 1988).
The current study lends modest support to the
identi®cation of the preschool years as a period
of change.
Perhaps the most important outcome of this
study is the relationship between laboratory mea-
surement of vigilance and unintentional injury in
the child's daily environment. Perceptual sensi-
tivity and response bias in the low probability
condition accounted for 15.8 and 30.4% respec-
tively, of the variability in injury. The inverse
relationship between perceptual sensitivity and
unintentional injury in the low probability task
supports the hypothesis that children who are less
vigilant are injured more often than those who
maintain high vigilance. Participants' with low
perceptual sensitivity, that is, lower receptivity
to changes between target and distracter, experi-
ence a higher incidence of minor unintentional
injuries.
The positive relationship between response
bias and incidence of injury was unexpected and
in the opposite direction than predicted. The
results indicate that children with a more con-
servative response bias experienced more injuries.
One explanation for this ®nding may be that an
exceedingly conservative response bias may indi-
cate a general lack of receptiveness to cues in the
environment. While more research clearly is
needed to understand the relationship between
response bias and injury, it may be that children
who are on the high end of conservatism demon-
strate a hesitancy to respond to critical signals for
action. This hesitancy may prevent children from
acting to avoid or escape injury.
Signal probability, notably lower signal prob-
ability, emerges from the ®ndings as a critical
variable in predicting vigilance performance and
unintentional injury. It is possible that low prob-
abilities, with the higher demand on vigilance,
may produce greater discrimination between par-
ticipants. The current study suggests that the
external validity of a vigilance task may depend
upon the context created by task parameters.
Given the typically high probability levels of
children's tasks (Losier et al., 1996) and dearth
of data on signal probability manipulations,
researchers must be increasingly attentive to sig-
nal probability. Clearly more work is needed to
understand the relationship between characteris-
tics of the task itself and its applications.
The ®nding that injury was predicted only in
the low probability condition may have practical
implications. For children under the age of 5
years, 79% of injuries occur in the home (Carter
& Jones, 1993). One might speculate that the
home, by virtue of its familiarity, has relatively
few critical signals for danger. This natural, low
probability condition may lead to less vigilance
on the part of parents and children, thereby lead-
ing to more injury.
Finally, with respect to measurement issues,
this study demonstrated the added sensitivity and
utility of signal detection analysis. Perceptual
sensitivity (d0 ) and response bias (c) were in¯u-
enced by age and signal probability manipulations
in expected directions, and were related to beha-
vior outside the laboratory: unintentional injury.
Perceptual sensitivity and response bias, which
incorporate traditional measures of attention, may
be more sensitive and speci®c in describing vigi-
lance. Given that these two factors accounted for
almost half of the variability in unintentional
injury, the functional utility of the indices appears
high. Obviously, more research is needed to
examine the relationships between perceptual
sensitivity, response bias, traditional markers of
attention, and behavioral applications such as
injury or school performance.
In conclusion, the task was successful in asses-
sing preschool children's level of attention and
provided preliminary support for the external
 SUSTAINED ATTENTION AND INJURY
validity of such tasks with children of normal
attention. Future studies may bene®t from
expanding the age range of participants to clarify
the developmental picture of attention that begins
to emerge from this study. Further, future studies
must systematically examine the effects of task
parameter manipulations. Signal probability is
rarely manipulated, and yet diagnostic instru-
ments are being developed with little heed to
optimal signal probabilities. Further, as outlined
by Ballard (1996a) a whole host of task para-
meters can serve to facilitate or impede the
maintenance of vigilance. In order to develop
appropriate diagnostic tools or computerized edu-
cational devices, a better understanding of what
elements of the task promote sustained attention
clearly is warranted. In terms of injury prevention,
more work is needed to apply the ®ndings to
prevent injuries. Children lower in perceptual
sensitivity and responsiveness may need more
frequent `critical signals' to warn them of poten-
tial hazards. This may be particularly true in
contexts low in stimulation. Future studies are
needed to examine the relationships between pre-
school and home environments, vigilance, and
injury.
ACKNOWLEDGEMENT
Appreciation is expressed to the Otterbein Col-
lege Student Research Fund.
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