Can child injury prevention include healthy risk promotion?

To reflect on the role of risk-taking and risky play in child development and consider recommendations for the injury prevention field, a symposium was held prior to the November 2013 Canadian Injury Prevention and Safety Promotion Conference. Delegates heard from Canadian and international researchers, practitioners and play safety experts on child development, play space design and playground safety, provision of recreation, and legal and societal perceptions of risk and hazard. The presenters provided multidisciplinary evidence and perspectives indicating the potential negative effect on children's development of approaches to injury prevention that prioritise safety and limit children's opportunities for risky play. Delegates considered the state of the field of injury prevention and whether alternative approaches were warranted. Each presenter prepared a discussion paper to provide the opportunity for dialogue beyond attendees at the symposium. The resulting discussion papers provide a unique opportunity to consider and learn from multiple perspectives in order to develop a path forward.

[1]  R. Poulton,et al.  A longitudinal study of the etiology of separation anxiety. , 2001, Behaviour research and therapy.

[2]  M. Brussoni,et al.  Risky Play and Children’s Safety: Balancing Priorities for Optimal Child Development , 2012, International journal of environmental research and public health.

[3]  Stephen Smith.  Risk and Our Pedagogical Relation to Children: On the Playground and Beyond. SUNY Series, Early Childhood Education: Inquiries and Insights. , 1998 .

[4]  G. Breivik,et al.  Sensation seeking as a predictor of positive and negative risk behaviour among adolescents , 2001 .

[5]  Sharon Stine,et al.  Landscapes for Learning: Creating Outdoor Environments for Children and Youth , 1996 .

[6]  Karen Malone,et al.  The bubble‐wrap generation: children growing up in walled gardens , 2007 .

[7]  S. Lyng.  Edgework: A Social Psychological Analysis of Voluntary Risk Taking , 1990, American Journal of Sociology.

[8]  Sanford Gaster,et al.  Urban Children's Access to their Neighborhood , 1991 .

[9]  A. Stephenson,et al.  Physical Risk-taking: Dangerous or endangered? , 2003 .

[10]  R Martinez,et al.  Injury control: a primer for physicians. , 1990, Annals of emergency medicine.

[11]  David J. Ball,et al.  Playgrounds - risks, benefits and choices , 2002 .

[12]  A. P. Humphreys,et al.  Rough and tumble, friendship, and dominance in schoolchildren: Evidence for continuity and change with age. , 1987 .

[13]  F. Shirani,et al.  Meeting the Challenges of Intensive Parenting Culture: Gender, Risk Management and the Moral Parent , 2012 .

[14]  Grant Tyler Peterson.  ‘Playgrounds which would never happen now, because they'd be far too dangerous’: risk, childhood development and radical sites of theatre practice , 2011 .

[15]  R. Poulton,et al.  Non-associative fear acquisition: a review of the evidence from retrospective and longitudinal research. , 2002, Behaviour research and therapy.

[16]  E. B. H. Sandseter,et al.  Do theory and pedagogy have an impact on provisions for outdoor learning? A comparison of approaches in Australia and Norway , 2012 .

[17]  A. Macpherson,et al.  School Playground Surfacing and Arm Fractures in Children: A Cluster Randomized Trial Comparing Sand to Wood Chip Surfaces , 2009, PLoS medicine.

[18]  Peter L Davidson,et al.  Analysis of energy flow during playground surface impacts. , 2013, Journal of applied biomechanics.

[19]  J. Byers,et al.  Refining the Motor Training Hypothesis for the Evolution of Play , 1995, The American Naturalist.

[20]  Ellen Beate Hansen Sandseter,et al.  Children's Risky Play from an Evolutionary Perspective: The Anti-Phobic Effects of Thrilling Experiences , 2011, Evolutionary psychology : an international journal of evolutionary approaches to psychology and behavior.

[21]  David J. Ball,et al.  Managing risk in play provision : implementation guide , 2008 .

[22]  A. Frank.  Risk vs Risk: Tradeoffs in Protecting Health and the Environment , 1996 .

[23]  P. Christensen,et al.  Jumping off and being careful: children's strategies of risk management in everyday life. , 2008, Sociology of health & illness.

[24]  David J Ball,et al.  Policy issues and risk-benefit trade-offs of 'safer surfacing' for children's playgrounds. , 2004, Accident; analysis and prevention.

[25]  M. Brussoni,et al.  The perils of overprotective parenting: fathers' perspectives explored. , 2013, Child: care, health and development.

[26]  D. Lupton,et al.  'Life would be pretty dull without risk': Voluntary risk-taking and its pleasures , 2002 .

[27]  David J. Ball,et al.  Public Safety and Risk Assessment , 2012 .

[28]  J. Langley,et al.  Evidence for a non-associative model of the acquisition of a fear of heights. , 1998, Behaviour research and therapy.

[29]  A. Bundy,et al.  Everyday uncertainties: reframing perceptions of risk in outdoor free play , 2013 .

[30]  Marco Huttenmoser,et al.  Children and Their Living Surroundings: Empirical Investigations into the Significance of Living Surroundings for the Everyday Life and Development of Children. , 1995 .

[31]  Pramodita Sharma.  2012 , 2013, Les 25 ans de l’OMC: Une rétrospective en photos.

[32]  Judith Green.  Risk and the construction of social identity: children's talk about accidents , 1997 .

[33]  N. Yanchar,et al.  Preventing playground injuries. , 2012, Paediatrics & child health.

[34]  J. Jacobs.  The Death and Life of Great American Cities , 1962 .

[35]  David F. Bjorklund,et al.  Origins of the social mind: Evolutionary psychology and child development. , 2005 .

[36]  J. Langley,et al.  A consideration of severity is sufficient to focus our prevention efforts , 2012, Injury Prevention.

[37]  A. Timperio,et al.  Playing it safe: the influence of neighbourhood safety on children's physical activity. A review. , 2008, Health & place.

[38]  R. Poulton,et al.  Water trauma and swimming experiences up to age 9 and fear of water at age 18: a longitudinal study. , 1999, Behaviour research and therapy.

[39]  Philip Smith,et al.  Does play matter? Functional and evolutionary aspects of animal and human play , 1982, Behavioral and Brain Sciences.

[40]  I. B. Pless.  On preventing all injuries , 2012, Injury Prevention.

[41]  R. Hart,et al.  Containing children: some lessons on planning for play from New York City , 2002 .

[42]  G. Valentine.  ”Oh Yes I Can.”“Oh No You Can't”: Children and Parents' Understandings of Kids' Competence to Negotiate Public Space Safely , 1997 .

[43]  F. Rivara.  Counterpoint: minor injuries may not be all that minor , 2011, Injury Prevention.

[44]  A. Pellegrini,et al.  Physical activity play: the nature and function of a neglected aspect of playing. , 1998, Child development.

[45]  Martha Minow,et al.  Pricing the Priceless Child: The Changing Social Value of Children , 1987 .

[46]  A. Pellegrini,et al.  The Origins of Human Nature: Evolutionary Developmental Psychology , 2003 .

[47]  Playground Safety: What Did We Do Wrong?. , 1992 .

[48]  M. Freeman.  Children, Rights and Childhood , 2006 .

[49]  M. Douglas.  Risk as a Forensic Resource , 2016 .

[50]  R. Löfstedt,et al.  Reclaiming health and safety for all: an independent review of health and safety legislation , 2011 .

[51]  A. D. Pellegrini,et al.  Child development and evolutionary psychology. , 2000, Child development.

[52]  P. de Graef,et al.  Risky-play at school. Facilitating risk perception and competence in young children , 2014 .

[53]  Achieving Great Heights: The Climbing Child. , 1998 .

[54]  Judith Green,et al.  From accidents to risk: Public health and preventable injury , 1999 .

[55]  Tim Gill.  Response to Review of No Fear: Growing Up in a Risk-Averse Society , 2007, Children, Youth and Environments.

[56]  W. Pickett,et al.  Some thoughts about ‘acceptable’ and ‘non-acceptable’ childhood injuries , 2011, Injury Prevention.

[57]  S. Hofferth.  Changes in American children's time - 1997 to 2003. , 2009, Electronic international journal of time use research.

[58]  David J Ball,et al.  Safety management and public spaces: restoring balance. , 2013, Risk analysis : an official publication of the Society for Risk Analysis.

[59]  C. Varcoe,et al.  Producing children in the 21st century: A critical discourse analysis of the science and techniques of monitoring early child development , 2013, Health.

[60]  K. Fox,et al.  Licence to be active: parental concerns and 10–11-year-old children's ability to be independently physically active , 2009, Journal of public health.

[61]  M. Korstanje.  The Risk Society: Towards a new modernity , 2009 .

[62]  B. Saelens,et al.  Societal Values and Policies May Curtail Preschool Children’s Physical Activity in Child Care Centers , 2012, Pediatrics.

[63]  H. Little,et al.  Risk, challenge and safety: implications for play quality and playground design , 2010 .

[64]  E. B. H. Sandseter.  Scaryfunny: A Qualitative Study of Risky Play Among Preschool Children , 2010 .

[65]  L Sminkey,et al.  World report on child injury prevention , 2008, Injury Prevention.

[66]  E. B. H. Sandseter.  Affordances for Risky Play in Preschool: The Importance of Features in the Play Environment , 2009 .

[67]  D. DiLillo,et al.  Fear and exhilaration in response to risk: An extension of a model of injury risk in a real-world context*** , 1999 .

[68]  J. Moran-Ellis.  The ambiguity of play , 1998 .

[69]  Lia Karsten,et al.  It all used to be better? Different generations on continuity and change in urban children's daily use of space , 2005 .

[70]  E. B. H. Sandseter.  Children's Expressions of Exhilaration and Fear in Risky Play , 2009 .

[71]  M. Brussoni,et al.  Striking a Balance Between Risk and Protection: Fathers' Attitudes and Practices Toward Child Injury Prevention , 2011, Journal of developmental and behavioral pediatrics : JDBP.

[72]  Providing a safe environment for our children and young people : Finland s national action plan for injury prevention among children and youth , 2010 .

[73]  J. Zinn.  Social Theories of Risk and Uncertainty , 2008 .

[74]  Tina Kelley.  Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder , 2007 .

[75]  Glen D. Johnson,et al.  Neighborhood-level built environment and social characteristics associated with serious childhood motor vehicle occupant injuries. , 2011, Health & place.

[76]  Helen Woolley,et al.  Exploring the Relationship between Design Approach and Play Value of Outdoor Play Spaces , 2013 .

[77]  Graham D. Burchell,et al.  The Foucault Effect: Studies in Governmentality , 1991 .

[78]  Brenda Jones,et al.  Assessment of lightning-related fatality and injury risk in Canada , 2008 .

[79]  E. B. H. Sandseter.  ‘it tickles in my tummy!’ understanding children’s risk-taking in play through reversal theory , 2010 .

[80]  M. Brussoni,et al.  Heterosexual Gender Relations In and Around Childhood Risk and Safety , 2013, Qualitative health research.

[81]  S. Herrington,et al.  Outdoor play spaces in Canada: The safety dance of standards as policy , 2007 .

[82]  R. Poulton,et al.  Fears born and bred: toward a more inclusive theory of fear acquisition. , 2002, Behaviour research and therapy.

[83]  David J. Ball,et al.  Ships in the night and the quest for safety , 2000 .

[84]  Glenda Wall,et al.  Mothers' experiences with intensive parenting and brain development discourse , 2010 .

[85]  K. Quinlan.  Injury and Violence Prevention: Behavioral Science Theories, Methods, and Applications , 2007 .

[86]  E. B. H. Sandseter.  Restrictive Safety or Unsafe Freedom? Norwegian ECEC Practitioners' Perceptions and Practices Concerning Children's Risky Play , 2012 .

[87]  J. Zinn.  Social Theories of Risk and Uncertainty: An Introduction , 2007 .

[88]  Rhonda L. Clements.  An Investigation of the Status of Outdoor Play , 2004 .