What are the causes of injuries to infants and children at child day care centers?
Injuries have replaced infectious disease as the leading health problem for children. The total number of childhood injuries that result in death surpasses the next nine causes of death totaled in the pediatric population. And naturally, the frequency of injury increases in the population of children greater than one year of age.
There are many types of injuries such as cuts, scrapes, bruises, bites and burns, etc… but falls are the most prevalent form of injury. Children in day care centers, between the ages of 0 – 5 years of age, are more likely to be injured and hospitalized due to falls compared to other types of injuries. There are different types of falls, such as falling from furniture, slipping and tumbling. And the younger the child, the more likely the child or infant is to fall head first because of the head-to-body ratio and poorly developed protective reflexes. Also the risk for a particular type of fall largely depends on the age and developmental level of the child.
Along with behavioral and developmental features of infants and children, the lack of supervision or proactive child care giving also contributes to child injury. Certainly accidents happen. However, while many accidents are considered non-intentional, some do involve a degree of negligence because the accident is not random, but is preventable. Preventable injuries occur in child care environments where foresight on the part of the caregiver is not effectively utilized when reasonably expected to be present.
What factors enhance injury prevention in child day care centers?
Child caregivers appreciate that behavioral attributes of children contribute to the risk of injury to varying degrees. Children with behavioral characteristics that are difficult to manage are at an increased risk for injury as compared to their more docile child counterparts. There are some recent studies that demonstrate when caregiver supervision is not adjusted to meet the behavioral needs of an active child then the risk for injury in a childcare setting is increased. Therefore certain child attributes call for an adjustment in the intensity of caregiver supervision. Studies show that caregiver supervision and an effective strategy that keeps the child in the caregiver’s view reduces the frequency of injury. It is also known that a lapse in supervision where the child is not in view correlates with a higher incidence of child injury. This may seem to be an obvious statement. However, even if the caregiver is highly conscientious there remains an increased risk for injury during intervals when the child is not in view. So whether a child caregiver is regarded as highly conscientious or not-highly conscientious, the risk for injury to a child is still higher when the child is not in the view of the caregiver. Close supervision contributes directly to reduced events of injury. And while passive devices and enhanced environmental safety precautions do much to protect children from injury, keeping the child in view is still a necessary component in the child day care setting. This is because keeping the child in view allows for the added feature of foresight on the part of the caregiver while providing child care services. Effective foresight facilitates anticipation of risk and execution of appropriate response by the caregiver in a given situation.
Child care workers should possess a skill set that integrates problem-solving abilities, child management skills with knowledge of child development, first-responder skills, nurturing qualities, appropriate disciplinary skills, social and stress management skills while interacting within groups and maintaining the ability to respond effectively to environmental cues. Most importantly remember that not all states require background checks or specific training for child care workers. Child care centers may be open and fully operational, but that is not a true measure of adherence to reasonable safety precautions or compliance with mandatory safety requirements.
What do I look for in a good child day care center?
1) Keep in mind your child’s needs vary according to his or her age and level of development.
2) What is the ratio of caregivers to children? How are responsibilities of the caregivers divided up or assigned?
3) Does the child care center adhere to regulatory guidelines regarding staffing and building safety as set forth by the state or county?
4) Is the day care licensed, and by what regulatory agency in the state or county?
5) Are annual physical exams and proof of childhood immunizations required?
6) Is there a file for each child that contains important contact, pick-up and health information?
7) Naturally, you will want an opportunity to interview the childcare giver(s). Ask questions about educational background, length of employment and feelings about the facility. Inquire of whether or not background checks and drug screens are done as a requirement of employment at the child care center. Also, what kind of annual education is required of the staff?
8) You will want to visit the child care center while the children are there and active.
9) Also you will want to see what provisions are available for nap time.
10) You should inquire about their emergency medical/fire/disaster plans. Of note, the leading cause of fires in day care centers is cooking, according to the U.S. Fire Administration.
11) Where is the first aid kit stored? And what is in the first aid kit? Are OSHA standards observed? Is there a phone number for Poison Control?
12) How are illness, prescription and OTC medications managed? Does the daycare have accident and illness report forms? Is there a policy and procedure for managing individual injuries? Do child care givers wash their hands between sick and well children to reduce the spread of infections?
13) Ask to see the kitchen and nutritional inventory. You will observe for cleanliness and the variety of food choices. Inquire as to where the children eat and how the food is served. Ask to see a menu.
14) Assess the building structure as you arrive to the building. As you enter the building, assess for structural integrity and the quality of maintenance. Are fire inspections for this building required?
15) Is there fencing around the outdoor play area? What activity is going on around the day care building?
16) What child safety features are in place? Are the smoke alarms in working order? How about carbon monoxide detectors?
17) What type of activity schedule is in place, do the children play outside also?
18) Are family needs respected and valued by the childcare center?
19) Does the facility provide a policy and procedure booklet?
20) Do you have reliable referrals that recommend the child care center?
21) How are disciplinary measures implemented? How is conflict managed?
22) How are toileting issues handled? Is hand washing emphasized?
23) What toys are available, how are they cleaned and are they age appropriate?
24) What stories, books and music are available for the kids?
25) And finally, how does your child respond to being left at the day care? When you pick your child up, is he/she happy or irritable?
Web link resources:
1) U.S. Fire Administration, Topical Fire Research Series. Volume 2, Issue
15 November 2001 (Rev. March 2002). Daycare Center Fires
2) Childhood Unintentional Injuries: Factors Predicting Injury Risk Among Preschoolers. Authored by Janet Abboud Dal Santo, DRPH, Robert M. Goodman, PHD, Deborah Glik, SCD, and Kirby Jackson, BA
3) Understanding Unintentional Injury Risk in Young Children II: The Contribution of Caregiver Supervision, Child Attributes, and Parent Attributes. Authored by Barbara A. Morrongiello, PHD, Michael Corbett, MM, Meghan McCourt, MM, and Natalie Johnston, BA
California daycare injury lawyers are available to help if you know a child who has been injured. The Keane Law Firm has been recognized as having an AV rating - the highest legal ability and ethics rating available, and Christopher Keane has been rated as one of the leading plaintiff's lawyers and attorneys in America as a "tireless advocate for injured children". Contact him today to see if he can help your child.
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