By- Dr. Amy Movius
School is back in session and for households with children, this necessitates a shift of routine that includes getting kids to and from school as well as school related activities. The logistics of more coming/going from more places deserves some special attention, as each year approximately 900 children in the US are killed while walking and more than 50,000 are injured. Unlike adult, child pedestrians tend to be injured in broad daylight under optimal conditions - meaning no impairment of visibility or poor road conditions. Boys outnumber girls in injuries sustained.
Looking back, the number of child pedestrian fatalities has decreased by almost 50% since 1997. Before congratulating ourselves, however, we must realize this is not due to an improvement in pedestrian safety. Rather it is merely a consequence of fewer kids walking at all. In 1969, 42% of all children walked or biked to school; increasing to 87% for those who lived within a mile of school. Today, a whopping 16% of children walk or bike to school and a large proportion of kids living less than a mile away are still driven to/from school. This behavior is consistent with the alarming increases in obesity and decreases in exercise seen in our country's children.
One of the goals of the Healthy People 2010 initiative is to increase the proportion of trips less than a mile that are made by walking. Weather permitting, school travel is a great opportunity to incorporate this healthy lifestyle, though obviously not at the expense of children's safety. Safety is the second most common reason cited by parents who opt not to have their children walk to school. Evaluating the factors that contribute to child pedestrian injuries can be helpful in creating safer walking conditions for children.
The first contributor to child pedestrian injuries is the child him/herself. Children have limited ability to scan traffic activity and are poor judges of vehicle distance, speed, and estimating time needed for street crossing. Children are also inherently quick moving and impulsive. That most child pedestrian accidents occur when children dart into the street, not at intersections is further proof of this. Adults tend to overestimate the ability of our children to navigate traffic, simply because we don't appreciate the physical and perceptive limitations of their age. For this reason, the AAP states children less than 10 should not be unsupervised pedestrians.
A second contributor to pedestrian accidents is, unsurprisingly, the driver. It is more difficult to see children because they are small. This is even worse in vehicles of elevated height such as SUVs, vans, and trucks. (Incidentally, the injuries caused by these vehicles tend to be worse than normal passenger cars). Also just as children are poor judges of traffic distance, drivers are poor judges of child pedestrian distance, again because of their smaller size. Speed is a huge contributor to accident occurrence and severity of injuries. Cars going fast take longer to slow and stop. Whereas there is an 85% chance of survival for a pedestrian struck by a vehicle going 20mph, there is an 85% chance of death for a pedestrian stuck by a vehicle going 40mph.
A last consideration is the environment in which a child walks. In urban areas, high traffic and poor visibility due to parked cars are concerns. For more rural areas, few traffic lights, lack of sidewalks or any barrier between pedestrian and vehicle routes are major concerns.
Encouraging children to walk more is a worthwhile effort and a few guidelines can make is much safer. First, supervision by an adult is the most effective tool to keeping child pedestrians safe. Remember, no child pedestrian under 10 yrs of age should be unsupervised. Second, adults should be good role models when walking. We can hardly expect our children to take crosswalks, sidewalks and crossing signals seriously if we do not. Plan the safest route to your child's destination, perhaps enlisting community and government resources to establish and protect these paths. The pedestrian equivalent of a car pool can also be formed, where parents take turns walking a group of children to school. Several resources such as Safe Routes to School (which is federally funded), Kids Walk, and Walk to School Day can help get you started.
Lastly, children who have been involved as pedestrians in accidents have a very high incidence (30%) of Acute Stress Disorder and Post-Traumatic Stress Disorder. This is true even for very minor accidents. Most are not brought to professional help. If your child has been in a "near miss" accident they may have symptoms such as reexperiencing the incident, avoidant behavior, hyper arousal, or dissociation (shut down). Please take your child to their medical provider if there is any concern.
Policy Statement - Pedestrian Safety, American Academy of Pediatric 2009, www.aap.org
Walk This Way; Child Pedestrian Safety
By- Dr. Amy Movius
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