Conversations after a serious injury help young people internalize safety values

If you're an adult, you can imagine what happens next; if you're 6 and trying to impress your little brother, not so much.

What do you think Mom and Dad say when the showoff ends up in the emergency room? You guessed it:

"Don't do that again!"

A new University of Iowa study has found that's exactly how most parents respond when their child lands in the emergency room if others -- including siblings -- are involved in the incident.

However, if a child's injury is caused by some environmental hazard -- a crack in the sidewalk or a hole in the road -- parents are more likely to caution their children to be more careful and, if the child is older, help them understand why the situation was dangerous. The study also found that parents are far more likely to urge daughters than sons to be more careful in the future.

Researchers say it's these types of conversations parents have with their children after a serious injury that help young people internalize safety values, a process similar to how a child develops a conscience.

"Even though parents often feel that these conversations are falling on deaf ears, over time they help children develop that little voice in the back of their head that keeps them from doing dangerous things," says Jodie Plumert, co-author of the study, Starch faculty fellow, and professor in the UI Department of Psychological and Brain Sciences.

When children are very young, parents prevent injury by keeping a close eye on them.

"But ultimately, kids gain independence, and they need to be out in the world exploring things on their own," says Elizabeth O'Neal, lead author of the study and a graduate student in the UI Department of Psychological and Brain Sciences. "Parents need to find a good way to teach their children how to navigate novel situations that may be dangerous. We think conversations are an important way this occurs."

The study, "Parent-Child Injury Prevention Conversations Following a Trip to the Emergency Department," was published recently in the Journal of Pediatric Psychology.

What researchers say is unique about this study is that it details the circumstances surrounding actual childhood injuries. Most behavioral research on child safety looks at the number of injuries and their correlation with different factors, such as a child's temperament or parental supervision. If the correlation is high, then that factor is considered a risk for injury in children.

"It sounds funny, but there is a real lack of research that looks at what actually happens when a child has an injury," says Plumert.

The study was part of a larger research project about childhood memory and included 87 children ages 3 to 16 and their parents, who were recruited from a hospital emergency room in Newfoundland, following the child's injury. The parents were contacted about two weeks later and asked about the circumstances surrounding the injury and the conversation they had with their child.

Here's what researchers found:

• Parents were four times more likely to tell children to be more careful in the future if an environmental hazard was involved in the injury.
• Parents were four times more likely to urge children to stop an activity if others were involved in causing the injury.
• Parents were four times more likely to tell girls than boys to be careful in the future.
• Parents were far more likely to discuss why an activity was dangerous if the child was older, generally starting at age 7.

By talking with parents about the circumstances of the injuries, researchers learned that excessive speed was involved in 55 percent of accidents and that other people -- typically peers or siblings -- played a part in causing 45 percent of injuries.

According to the study, 70 percent of parents reported talking with their child about how to prevent another injury, and more than half of those parents offered alternative strategies for dealing with a similar situation in the future.

Though most parents wait until a child is older to explain why an activity is dangerous, Plumert says it doesn't hurt to give a young child an explanation as long as parents keep it simple.

"You can talk in more detail with an older child," she says. "For example, explaining why it's harder to stop while riding a bike down a hill."

Children are generally not at fault when they are injured because of an environmental hazard. That's why parents tend to caution them to be more careful in the future, O'Neal says.

"They're telling their children to pay more attention to what they are doing," she says. "If there is a crack in the sidewalk, pay attention to where you are walking."

But parents should not assume that just because a child lands in the emergency room, they have learned their lesson about the dangers of the situation.

"I think adults can sometimes mistakenly perceive that a child understands what happened and why it happened, and that may not be the case," Plumert says. "Having parents go over that can be helpful for the child."