Objectives

• To increase awareness among parents and caregivers of the

injury risks children face.

• To understand how the various stages of a child’s

development can affect the risk of injury among children.

• To learn various developmental activities, hazards and risks,

and prevention tips and strategies to keep children safe at
different stages of their life.

Raising Safe Kids: One Stage at a Time

Childhood Injury
• How do injuries happen?

• What are unintentional injuries?

• Unintentional childhood injury is the leading cause of death

and disability for children ages 1 to 14 in the U.S.

• An average of 12 children are injured every minute.

– In 2007, there were more than 6 million reported
unintentional injuries in the U.S.

Raising Safe Kids: One Stage at a Time

Childhood Injury
• Approximately 101 minutes, a child in the U.S. dies from an
unintentional injury, such as a vehicle crash or a fire.
– In 2005, there were 5,162 unintentional injury deaths
among children less than 14 years of age.

• Injuries have a significant economic impact

as well.
– Costly emergency department
bills
– Missed school days
– Lifelong disabilities
– Limited future job opportunities

Raising Safe Kids: One Stage at a Time

Child Development and Injury Risk
• Research has identified specific developmental abilities and
limitations that can increase a child’s risk of injury.

• Understanding your child’s growth and development is an

important part of parenting. 

•  As your child grows from infancy through early adolescence, it’s
important to promote safety.

•  A child’s developmental stage is the key to identifying which

types of injuries are of greatest risk to him or her.

Raising Safe Kids: One Stage at a Time

Newborns
• Although a newborn spends about 16 hours a day sleeping,
the time a baby is awake can be busy.

• Much of a newborn’s movements and activity are reflexes or

involuntary, meaning the baby doesn’t purposefully make
these movements.

• As the nervous system begins to mature, these reflexes give

way to purposeful behaviors.

• Newborn babies have unique reflexes and a number of

physical characteristics and behaviors such as:
– Their head sags when lifted up and needs to be supported
– Jerky and erratic movements
– Hand-to-mouth movements
Raising Safe Kids: One Stage at a Time
Infants 1 to 3 months

• Most reflexes begin to disappear

• Bring hands or objects to mouth
• Look at hands
• Follow light, faces and objects
• Listen to sounds
• Open and close hands
• Can hold and then drop a toy, rattle or other object
• Have active leg movements

At the end of the 3rd month, they:

• Can lift their head, neck and upper chest
• Begin to reach hands to objects
• May bat at hanging objects with hands

Raising Safe Kids: One Stage at a Time

Infants 4 to 6 months

• Reflexes normally present in young infants disappear

• Balance head well
• Can sit with support
• Begin to support body with legs when held in standing
position
• Roll from back to front and front to back by 6 months
• Move objects from one hand to other
• Grab feet and toes when lying on back
• Begin to sleep longer at night

Raising Safe Kids: One Stage at a Time

Infants 7 to 9 months

• Roll over easily from front to back and back to front

• Sit leaning forward on hands at first, then unsupported
• Bounce when supported to stand
• Get on hands and feet and rock back and forth
• May creep, scoot, crawl (backwards first, then forward)
• Begin to pull up to stand with help
• Reach for and grasp objects using whole hand
• Like to bang objects on tables
• May hold a bottle
• Grasp objects with thumbs and fingers by the 8th or 9th month
• Put everything into their mouths

Raising Safe Kids: One Stage at a Time

Infants 10 to 12 months

• Pull up to a standing position

• Can sit back down from standing position
• Cruise or walk around holding on to furniture
• May stand next to furniture without holding on
• May walk holding on to a finger or hand
• May begin to take steps and walk on their own
• Play receiving and returning a rolled ball
• Are able to pick up food and small objects with fingers
• Bang objects together
• May wake up at night looking for their parents

Raising Safe Kids: One Stage at a Time

Infants (Birth to 12 months)

Did you know babies…?

✔ Have a slower digestion rate than adults
✔ Breathe more quickly than adults, putting them at a higher risk
of inhaling harmful gasses faster
✔ Have been observed making 10 hand-to-mouth movements
per hour
✔ Have thinner and more sensitive skin that can burn in
approximately 1/4 of the time it takes to burn an adult’s skin

Raising Safe Kids: One Stage at a Time

 Keep your baby safe
❑ Supervise, supervise and supervise!
❑ Install stair gates.
❑ Secure furniture to the wall.
❑ Don’t use baby walkers. Use stationary play centers instead.
❑ Never leave your baby unattended on changing tables, beds or
other furniture. Keep one hand on your baby while changing
diapers.
❑ Use a rear-facing car seat in the back seat of your car until your
baby is at least age 1 and 20lbs.
❑ Have your car seat checked by a child passenger safety technician
to make sure it’s properly installed.
❑ Install smoke alarms and carbon monoxide detectors in your
home.

Raising Safe Kids: One Stage at a Time

 Keep your baby safe

❑ Set your water heater at 120 degrees Fahrenheit or lower.

❑ Test the bathwater with your wrist or elbow before placing your
baby in it.
❑ Don’t hold your baby while cooking or carrying hot foods and
liquids.
❑ Never microwave your baby’s bottle. Heat bottles with warm
water and test them before feeding your baby.
❑ Follow instructions and read labels when giving medicines to your
baby.
❑ Use child-resistant packages.
❑ Learn the Poison Control number: 1-800-222-1222.
❑ Lock up medicines, household cleaners, poisons and dangerous
items out of your baby’s sight and reach. 

Raising Safe Kids: One Stage at a Time

Children 1 to 2 years old
1 year olds
• Can usually walk alone by 15 months and then begin to run
• Can stop, squat and then stand again
• Can sit down on a small stool or chair

2 year olds
• Walk and run well
• Can climb stairs while holding on and stand briefly on one foot
• May jump awkwardly
• Begin to throw, kick and catch balls
• Can climb on playground equipment
• Can turn doorknobs and open lids
• Begin to ride a tricycle
• Have good thumb and finger control

Raising Safe Kids: One Stage at a Time

Children 3 to 4 years old
3 year olds
• Can run and jump easily
• Walk up stairs without help
• Can ride a tricycle and stand on tip-toes
• Begin to share and like to play with other children
 
4 year olds
• Can skip, hop on one foot, catch and throw a ball overhand and
walk downstairs alone
• Begin to become less aware of only one’s self and more aware of
people around them
• May obey parent’s rules but don’t understand right from wrong
• Are very independent and want to do things on their own
• May have imaginary playmates and will often play with others in
groups
Raising Safe Kids: One Stage at a Time
Children 1 to 4 years old

Did you know…?

✔ Like to imitate older playmates and may go beyond their own
physical abilities
✔ Want to role play adult activities and use adult tools and
objects
✔ Are much more likely to get hurt at a playground when they
play on equipment designed for older kids
✔ Breathe more quickly than adults and their lungs are still
developing
✔ Have thinner skin that burns more deeply and quickly at lower
temperatures than adult’s skin
✔ Are more likely to start fires with matches, lighters and other
heat sources

Raising Safe Kids: One Stage at a Time

Keep your 1- to 4-year old safe
❑ Limit access to hazards.
❑ Keep supervising!
❑ Install stair gates.
❑ Don’t use baby walkers. Use stationary play centers instead.
❑ Use playgrounds that are age-appropriate (for children under 5)
and have safe surfacing (shredded rubber, sand, etc).
❑ Don’t put toys or things that attract children on top of furniture.
❑ Place furniture away from windows and secure it to the wall.
❑ Use a forward-facing car seat in the back seat of the car.
❑ Have your car seat checked by a child passenger safety
technician to make sure it’s properly installed.
❑ Walk all the way around your parked car.
❑ Never leave your child alone in a car.

Raising Safe Kids: One Stage at a Time

Keep your 1- to 4-year old safe

❑ Install smoke alarms and carbon monoxide detectors in your

home.
❑ Lock up matches and lighters out of his or her sight and reach.
❑ Set your water heater at 120 degrees Fahrenheit or lower.
❑ Make the stove area a "kid-free" zone.
❑ Cook with pots and pans on back burners. Turn handles away
from the front of the stove when cooking.
❑ Place hot foods and liquids on the center of the table. Don’t set
them on the edges of tables or counters.
❑ Lock up poisons out of his or her reach and sight. 
❑ Use child-resistant packages.
❑ Keep products in their original containers.
❑ Don’t call medicine “candy”.

Raising Safe Kids: One Stage at a Time

Children 5 to 9 years old

Did you know that…?

✔ Have less coordination for pedaling, more trouble recognizing
and avoiding obstacles and lack adults’ hand-eye coordination
abilities
✔ Are at higher risk for cooking-related scald injuries, especially
from tableware and microwave ovens
✔ Have lungs that are still developing
✔ Are less likely to wake up if a smoke alarm sounds while
they’re sleeping

Raising Safe Kids: One Stage at a Time

Children 5 years old
• Can jump rope
• Can balance on one foot with eyes closed
• Know addresses and phone numbers
• Are curious about real facts about the world
• Are generally more responsible and helpful than 4-year olds
• Get along well with parents
• Like to cook and play sports
• May become more attached to parents as they enter school

Raising Safe Kids: One Stage at a Time

Children 6 to 9 years old
6- to 7-year olds:
• Enjoy many activities and stay busy
• Practice skills in order to become better
• Can jump rope and ride a bike
• Like to copy adults
• Like to play alone but friends are becoming important
 
8- to 9-year olds:
• Are more graceful with movements and abilities
• Can jump, skip and chase
• Like competition and games
• Begin to mix friends and play with kids of the opposite gender

Raising Safe Kids: One Stage at a Time

 Keep your 5- to 9-year old safe
❑ Teach your child safety.
❑ Make sure your child wears a helmet and protective gear every
time he or she bikes, skates, rides a scooter, skateboards or skis.
❑ Teach proper playground behavior: no pushing, shoving or
crowding.
❑ Place furniture away from windows and secure it to the wall.
❑ Keep your child in the right type of car seat or booster seat until
the adult lap belt and shoulder belt fits correctly.
❑ Do a safety check around your car.
❑ Never leave your child alone in a car.
❑ Talk to your child about fire safety.
❑ Practice an escape plan with your child.

Raising Safe Kids: One Stage at a Time

 Keep your 5- to 9-year old safe

❑ Install and check smoke alarms and carbon monoxide alarms.

❑ Teach your child not to play with matches and lighters. Lock these
items out of his or her sight and reach.
❑ Set your water heater at 120 degrees Fahrenheit or lower.
❑ Don’t let your child use a microwave until he or she is tall enough
to reach the items in it safely and understands that steam can
cause burns.
❑ Place hot foods and liquids on the center of the table. Don’t set
them on the edges of tables or counters.
❑ Lock up poisons out of his or her sight and reach.
❑ Use child-resistant packaging.

Raising Safe Kids: One Stage at a Time

 Children 10 to 14 years old
Did you know that…?
✔ Still have trouble avoiding obstacles and preventing falls
✔ Have visual perception less defined than that of older children
✔ Lack the ability to recognize an object from within a busy
background, an important skill to have in order to identify oncoming
cars in busy intersections
✔ Are influenced by their peers and concerned about how they’re
perceived
✔ Are most likely to be injured by cooking equipment-related fires or
candle fires
✔ Have the highest fireworks injury rate
✔ Are more likely to be completely unrestrained in a car than younger
children

Raising Safe Kids: One Stage at a Time

Children 10 to 14 years old
10- to 12-year olds:
• Consider friends very important
• Peer influence and acceptance becomes important
• Respect their parents but want independence from them
• Enjoy talking to others

13 year olds and older teens:

• Develop the ability to think abstractly
• May think long term
• Set goals
• Compare themselves to their peers

Raising Safe Kids: One Stage at a Time

Keep your 10- to 14- year old safe
❑ Empower your pre-teen to make safe choices.
❑ Make sure he/she wears a helmet and protective gear every
time he/she bikes, rides a scooter, skates, skateboards, skis,
etc.
❑ Set a good example. Always model best practices whether you
are at home, at a friends’ house or someone else’s car.
❑ Once your pre-teen passes the Safety Belt Fit Test, teach
him/her to wear a seat belt every time.
❑ Teach your child that all children under age 13 should ride in a
back seat.
❑ Talk to your pre-teen about car safety.
❑ Install and check smoke alarms and carbon monoxide alarms.

Raising Safe Kids: One Stage at a Time

Keep your 10- to 14- year old safe
❑ Practice an escape plan with your family.
❑ Teach your pre-teen to never play with matches, lighters or
fireworks and to never lit candles in his/her bedroom.
❑ Set your water heater at 120 degrees Fahrenheit or lower.
❑ Place hot foods and liquids on the center of the table. Don’t set
them on the edges of tables or counters.
❑ Don’t let your child use a microwave until he/she is tall enough
to reach the items in it safely and understands that steam can
cause burns.
❑ Talk to your pre-teen about the dangers of poisonous items like
inhalants and prescription medicines.

Raising Safe Kids: One Stage at a Time

Scenarios
New parents often rely on friends and family for support and
advice when raising their baby. One of their main concerns is
providing a safe home and play area for their baby.

As you are strapping your child into his/her car seat, you notice
that it moves a few inches from side to side.

What puts young children at risk for injuries on playgrounds?

Raising Safe Kids: One Stage at a Time

Scenarios
Your child leaves the house with his bike helmet on, but as soon
as he turns the corner the helmet comes off. He bikes around
town with his friends with his helmet slung onto his handle bars.

Your daughter’s soccer team often practices without wearing

protective equipment.

Your child is always eager to play with his friends at the park in
your neighborhood. He is 8 years old and is sure he can cross the
street by himself.

Raising Safe Kids: One Stage at a Time

Hot Drink Demonstration

Children’s skin is thinner than adult skin and can burn more
quickly and deeply at lower temperatures.

Objective:
•To demonstrate how much of a baby’s body can be covered by
an ordinary mug of liquid.

Raising Safe Kids: One Stage at a Time

References

Breckon, D.J., Harvey, J.R., Lancaster, R.B. (1998). Community Health

Education: Settings, Roles, and Skills for the 21st Century. Fourth Edition.
Gaithersburg, MD: Aspen Publishers, Inc.

Bright Futures at Georgetown University. Online Materials.

www.brightfutures.org/georgetown.

Safe Kids Worldwide. Raising Safe Kids: One Stage at a Time – A Study of
Child Development and Unintentional Injury. March 2009.

Safekids New Zealand. Safekids Campaign: Burns Prevention.

www.safekids.org.nz/KidsafeFiles/Burns%20Prevention%20Projects%20
2008.pdf
. June 2008.

Raising Safe Kids: One Stage at a Time