Hair loss Treatment Center

• Pedestrian injuries
• Bicycle injuries
• Car injuries

PARTICIPANTS Alan Nager, MD Children's Hospital of Los Angeles

Joining me to discuss injury prevention for five to eight year olds is Dr. Alan Nager.  He is the Director of the Emergency Department at the Children's Hospital Los Angeles.  Thank you so much for being with us to talk about this really interesting age because these kids are a little bit more savvy than they've ever been before.  Describe what it's like for them to understand the rules of behavior that will keep them safe.

ALAN NAGER, MD:  Well this is an interesting age because, contrary to children at younger ages, this is the age range in which children are trying to understand the rules.  They learn by examples.  So if you as a parent are good role models for your children and set concrete, good, wholesome examples, your children will follow those.  Also children are gaining independence; they want to go out there and see what's the real world like.  They might try to get away with things.  They may want to try and impress their peers.  So there are a number of issues which make this age group very complicated, and especially trying to instill safety guidelines or rules for them.

BONNIE BOSEWELL:  So they're risk takers at this point.  And what about their judgment at this point?

ALAN NAGER, MD:  Their judgment is really questionable. Kids have difficulty judging and perceiving sounds, distances, sort of those concrete things in our environment which make their world very complicated.  Those perceptions ultimately may make them make bad choices, ultimately causing accidents.

BONNIE BOSEWELL:  Okay, well that becomes particularly important in just their everyday life.  For example, crossing the street.  Let's talk about some of the things that happen to kids just being on the street.  What kinds of things do you find typical that will happen to kids as they're learning these rules in the street?

ALAN NAGER, MD:  Well our emergency department is jam packed full of concrete examples and the kinds of injuries we see on a daily basis.  We see kids crossing the street without looking.  We see kids making playgrounds out of streets.  We see a number of, for instance, scooter injuries in which kids cross the street on their scooter.  They have isolated a particular area of the street or parking lot into their own, or their so-called own play area.  And it eventually leads to disaster.  We see kids every week who come in after getting hit by cars, having cars back into them, riding bikes into parking lots.  Those kinds of things all lead to disaster.

BONNIE BOSEWELL:  Well what's a parent to do?  For example, my child, who I've always told, you know, look both ways before you cross the street.  And he goes, "Yeah Mom, I know."  And then right away he goes out.  And I really don't have the sense that he's got it.  I mean he tells me he has it.  And I know he's heard it.  But he doesn't really get it.  How is a parent to really give them enough leeway and independence to honor that, but then still check them out.  What do you suggest?

ALAN NAGER, MD:  Well I think the key is, first off, teaching your kids appropriate ways of playing.  By that I mean they must learn the rules.  Going out to play a game which involves particular rules or particular equipment, the game must be played by those rules using those pieces of equipment.  A child who goes out to play baseball but uses the bat to swing at another child because they got upset isn't following the rules of the game.  There are other examples.  For instance, incorporate your child into the rule making.  Ask the child, what do you think would happen if you played here, or if you used this piece of equipment. By incorporating the child's opinions, making them part of the active process, you'll get better control of that child because he or she may feel that they're helping to invent the rules and therefore following them more closely.

BONNIE BOSEWELL:  I like that.  I'm going to try to use that myself.  Now one thing I want to ask about kids, you talk about them exploring.  I mean, my kid on his bike loves to do it.  He thinks he's like in Barnum & Bailey circus or something because he likes to, you know, get up on that handlebar.  I mean that's just what he likes to do.  How do you handle that?

ALAN NAGER, MD:  Well kids like to take risks.  You know, we had a child come in a few months ago who was walking on the top of the fence.  And when we asked him, "Why were you walking on the top of the fence" he said, "Well the other children were doing it so I wanted to do it."  The emphasis that I think this child was trying to portray to us was, in front of a peer group, in front of his friends, he wants to look, or he wanted to look just as good.  So there's lots of peer pressure out there to perform, to be the best, to be accepted.  And all of those things create dangerous situations.

BONNIE BOSEWELL:  What about things like bicycles?  Because kids moving fast, now we have scooters—we used to have just bicycles, now we have multiple ways.  We have scooters that they use themselves, but also motorized scooters.  So what are the things that they should be aware of?  And parents, what should they do to help their kids be safe?

ALAN NAGER, MD:  Well first off I think the bicycle has to be of the appropriate size for that child.  Kids like to feel big and in control.  So it's not uncommon that a child will get on a brother or sister's big bike.  Next, making sure they ride in the appropriate designated area, in a well-lit area.

BONNIE BOSEWELL:  So location is important.

ALAN NAGER, MD:  Very important.  Also making sure they have adequate protection, which is a properly, well-suited helmet for that child.  And again, looking at the safety rules for bicycle riding.  You look both ways.  You ride in a particular bike lane.  You ride with supervision.  And you make sure that you understand the rules incorporated with bicycle riding.

BONNIE BOSEWELL:  And I suppose even in some cases, a lot of times there are those skateboards that you can go to actual areas where it's designated for that, as you said.

ALAN NAGER, MD:  Exactly.

BONNIE BOSEWELL:  It can actually be fun.  Let's talk a little bit about being in the car.  What should kids at this age be aware of, and their parents?

ALAN NAGER, MD:  We see a number of auto related injuries, kids getting hit by bikes, kids getting hit by cars, car getting hit by other cars.  There's really a combination.  A child has to take the responsibility with reminders from a parent to make sure they're in a seatbelt with an appropriate restraint, and that's a restraint across the chest, not on the neck, or across the head, or in back of the child.

BONNIE BOSEWELL:  Those don't work.

ALAN NAGER, MD:  Those absolutely don't work.  And we do see kids who come in, and they have marks on their body that tell us the belt wasn't put on properly.  Otherwise those marks wouldn't exist.  But it has to be enforced as well.  Kids would much rather get in a car and not take the time or the energy.  So it does take some consistent rules, and those have to take place by a parent providing that inspiration.

BONNIE BOSEWELL:  Thank you so much for your comments. We really appreciate them and I'm sure parents will put them to use.  thank you.

ALAN NAGER, MD:  Thank you.