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BONNIE BOSEWELL: Hello, I'm Bonnie Bosewell and welcome to our program. As kids get closer to their teenage years, they'll be spending more and more time away from home and with their friends. Peer pressure can encourage them to take risks that would be greater than they would have before. Parents often find it hard to find a balance between encouraging their kid's independence, while at the same time remaining concerned with their safety.
Well, helping me to discuss injury prevention with pre-teens is our guest, Dr. Luis Montes. He is a Medical Director of the Rehabilitation Program at Children's Hospital Los Angeles. Thank you for coming in to talk about this important topic because kids at this age are beginning to feel their oats a little bit. They're getting out there, and what kind of injuries are they likely to receive as they go out into the world?
LUIS MONTES, MD: Well, if you think about kids at this age, they're going out exploring their community. But there's also a lot of peer pressure with them. I mean, it ranges. Many kids are learning to ride their bikes at a young age of eight, or just graduating into a two-wheeler. And some of them are very adept to riding roller blades and skateboards. And so there's a lot of recreational sports that they're experimenting with.
BONNIE BOSEWELL: Yes, there are a lot of ways for kids to be mobile these days that weren't there before. There's scootering around. And so many more options for them. What kind of injuries do you see coming in and what can parents do specifically to help their kids?
LUIS MONTES, MD: Well, we see sometimes very benign injuries, ankle sprains and cuts and bruises. But sometimes they're a lot more serious, because kids do hit stationery objects and they're going at a high speed. Sometimes they're reckless with their sports. And so there's a lot of things that we need to consider when we talk about injury prevention in these areas. And we have to look at not only the child and look at the environment which they play in.
BONNIE BOSEWELL: So specifically we can talk about looking at the equipment itself, for example. Is that something parents should be aware of, the equipment?
LUIS MONTES, MD: Absolutely. I think so. You have to have safe equipment. If you look at a bike, there's things that you can do to make sure that the bike is safe: the chain is on tight, there's protectors so that your pants don't get caught into the chain. Make sure that the tires are inflated right and all the parts are nice and secure.
BONNIE BOSEWELL: And that the area that they're playing in is also safe.
LUIS MONTES, MD: Well yes. That's a big thing. I think most of the injuries can be prevented if you really do control the environment and you don't have to rely on the human nature of injury prevention. It's hard to change behavior. But if you can, for instance, in bicycle riding, if you had bicycle lanes on the street, if you had protective environment, we wouldn't have bicycle-automobile accidents.
BONNIE BOSEWELL: Exactly. Let's talk about another area that kids of this age get into a lot. That's sports. What kinds of injuries do you see that result from sports activities?
LUIS MONTES, MD: Well you know, at this age group serious injuries from sports aren't usually seen until you get into high school. But still they do occur. And you have to think about sports injuries as an acute event, a spraining of an ankle, or all of sudden you twist your wrist. That's an acute event. And then you think about chronic injuries as well. And most of the chronic injuries that we see in kids this age is overuse injuries. So you have kids that are trying new sports out and they're not prepared. They don't have the coordination or balance, and yet they're going ahead and getting out there and stressing their muscles and their joints.
BONNIE BOSEWELL: So supervision is important. And teaching them what they're doing.
LUIS MONTES, MD: Yes. Well, that's one of the things. It's preparing the child to participate in a particular sport, whether it's football, baseball, all of these things. Really the most important things in injury prevention is looking at teaching your child to obey the rules of the game and to also wear the proper equipment. Equipment, use of equipment, can dramatically reduce serious injuries. We know that for a fact in football, for instance. Proper helmets can prevent head injuries. Also changing the rules of the game by, for instance, in football there used to be a common practice to do spearing and hit the body. And this would result in a significant number of spinal cord injuries.
BONNIE BOSEWELL: So those are all great tips in things that maybe should be applied when parents are going into these new situations with their kids, to really go through the rules, have them incorporate them into their play.
Let's go into another topic. Let's talk about pool accidents, because, again, these kids are moving out there and they're swimming. At this point they're pretty good swimmers in many cases would you say?
LUIS MONTES, MD: Yes, I think so. We don't have to necessarily worry about-
BONNIE BOSEWELL: --They're not going to fall and accidentally-
LUIS MONTES, MD: Right. But you know there is a significant number of kids that don't know how to swim. And we have to be concerned about them, especially if kids, for instance, in the Southwest United States there's-it's warm and there's a lot of pools out there. And so a lot of the kids know how to swim. But in the Northeast states that's not the case. As a matter of fact, drowning in the Northeast states is usually caused by boating accidents. So there's a lot of things that we have to consider with water safety.
But kids generally, this age, one of the things is we have to make sure that they know how to swim. And again, follow the rules, the safety rules around a pool. But there's other interventions as well. One, for instance, adult supervision. Swimming with a buddy.
BONNIE BOSEWELL: So even though they know how to swim, they should be supervised. And should have a buddy-or what if they have a buddy?
LUIS MONTES, MD: Yeah, I think having a buddy is actually a very important thing. It's mostly with any type of high risk activities, if you have a friend-if you're by yourself, you're increasing your risk dramatically. So I do advocate for the kids to have a buddy with them, a friend or someone, some older brother supervising them.
BONNIE BOSEWELL: Well also kids at this age are likely to try to show off a little bit. And maybe they're not as careful about where they're diving. So what about diving? What kind of precautions can they use in terms of getting in the pool?
LUIS MONTES, MD: Well, diving is a very dangerous activity that you have to actually teach your children how to dive properly so they don't injure their head and neck.
BONNIE BOSEWELL: And make sure they're diving in the deep end and not the shallow end.
LUIS MONTES, MD: Yes, absolutely. You know, many times parents teach their kids to dive in feet first. And I think that's a good rule until you really do practice the art of diving. I mean many pools now don't have diving boards in them because of the injuries associated with them.
BONNIE BOSEWELL: Okay. Well another concern many parents have has to do with gun safety. What can you tell us about what parents should do to make sure their kids are safe?
LUIS MONTES, MD: Unfortunately this is a very serious problem in the United States. We see a significant number of kids being killed and injured by guns, by firearms, mostly guns in the home. Handguns in the home.
BONNIE BOSEWELL: Not from intruders.
LUIS MONTES, MD: Not from intruders, no. I mean a gun in the home-there's no such thing as a safe gun. And unfortunately, more than half of the homes in the United States have a gun in them. So that even though you may not have a gun, there's very much a likelihood that anyone in your neighborhood may have a gun and your child may come in contact with a gun.
BONNIE BOSEWELL: So should a parent then talk to the parent of somebody that they're going to have a play date with?
LUIS MONTES, MD: Well yes, absolutely. I think, you know, you need to ask is there a gun in the home. Is there a gun in the home that my child is playing in. But the other thing that parents can do is talk to their child: what do you do if you see a gun.
BONNIE BOSEWELL: And your friend is playing with a gun?
LUIS MONTES, MD: Right.
BONNIE BOSEWELL: For example. Or has one out sometimes.
LUIS MONTES, MD: Yes, absolutely. You say, what do you do. You have to teach them that guns aren't toys, that if you find a gun, that you have to assume that it's loaded. And that then you're supposed to distance yourself away from that gun and go tell the responsible adult.
BONNIE BOSEWELL: So a little role playing to act it out and make sure that you know what to do. But your recommendation is basically, if you had your choice, would be-
LUIS MONTES, MD: Well, the American Academy of Pediatrics is recommending that basically there should be no guns in the home. And I feel strongly about that as well. But it's up to the individual opinion of each-how you deal with guns. But if there is a gun in the home, we certainly advocate that it's locked up and that the ammunition is kept separately. And that there's other barriers to protect the child; for instance, trigger locks. Again, education. You have to be careful with some of the firearm education programs that are out there because sometimes they give the parents a false sense of security. They feel like, oh my child knows how to play with a gun-excuse me, how to use a gun. And unfortunately, we see, again, a lot more unintentional injuries than we should be seeing at this day and age.
BONNIE BOSEWELL: Well thank you so much for being with us and sharing your comments. We really appreciate that.
LUIS MONTES, MD: Thank you.
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