About this Issue

Children occupy a unique place in public policy. They are among the very few constituencies who cannot vote, but they will in time. As adults, we make many decisions for them, whether through the institutions of the state or private life. How do we balance liberty and safety for this vulnerable and very important population? It is clearly possible to have too little safety, but can we have too much?

Lenore Skenazy, this month’s lead essayist, says yes. She’s the author of the book and blog Free Range Kids, which argues that children need a healthy dose of independence, and that many of the dangers of childhood have been exaggerated to the children’s own detriment.

To discuss with her, we’ve invited Anthony Green, director of Safe Kids USA; James A. Swartz, director of World Against Toys Causing Harm; and sociologist Joel Best of the University of Delaware.

Lead Essay

Smothered by Safety

Very few people think children are NOT precious and should be hurled into harm’s way with a gleeful whoop. And yet, any time a politician, principal, or bureaucrat wants to score points, he or she lets us know that kids are even more precious—and endangered—than we thought.

Safety-wise, we’re told that our kids are dancing—or at least doing their low-impact kiddie yoga—on the lip of a live volcano. This explains the explosion of new laws, products, and policies to protect them from, well, everything: Creeps, kidnappers, germs, grades, flashers, frustration, baby snatchers, bugs, bullies, men—all men are pedophiles until proven otherwise—sleepovers, toys from China, and/or the perils of a non-organic grape.

How far has society gone in dreaming up new dangers to protect our children from? Until you take a step back and look at all the new laws and regulations, you probably have no idea. So to start out, let’s test your Child Safety IQ. Which of the following did NOT happen this past year?

(A.) Local licensing authorities outlawed soap in pre-school bathrooms for fear that children might suddenly start drinking it. Now kids must come out and ask an adult to squirt some soap in their hands.
(B.) Unaccompanied children under age 12 were banned from the Boulder, CO, library, lest they encounter “hazards such as stairs, elevators, doors, furniture…and other library patrons.”
(C.)The Consumer Product Safety Commission announced a recall of certain fleece hoodies sold at Target because of lead paint on the zipper, which presumably could raise blood lead levels if the zippers are eaten.
(D.) Children under age 18 were prohibited from gathering on the streets of Tucson, AZ, for fear they might “talk, play or laugh” in groups, which could lead to bullying.
(E.) A New Canaan, CT, mom was charged with “risk of injury to a minor,” for letting her 13-year-old babysit the three younger children at home for an hour while the mom went to church.
(F.) A Tennessee mother was thrown in jail for letting her kids, aged 8 and 5, go to the park without her, a block and half away from home.

Okay, okay, I’ll stop! Except…I can’t resist. Here’s one more:

(G.) A Hazmat crew was summoned to Seminole High School in Florida after a science student brought in a mercury thermometer.

If you guessed (D.), you are either incredibly brilliant or a loyal reader of my blog. (Not mutually exclusive!) If you guessed any of the others, well, welcome to the world of “dangerism.” That’s a term coined by Gever Tulley, author of 50 Dangerous Things (You Should Let Your Kids Do). He uses it to describe the way normal, everyday objects and activities can be reclassified as dangerous when seen through the worst-case-scenario lens. That’s why, for instance, federal playground safety guidelines propose removing “tripping hazards, like tree stumps and rocks.”

Throughout history until just very recently, tree stumps were things for kids to stand on, jump off, sit on, or use as tables for tea parties. But seen through the lens of risk, they are simply hazards.

That’s the lens government is looking through all the time. If to a hammer everything looks like a nail, to a government agency charged with protecting children, everything looks like a health threat, death trap, or predator.

But doesn’t it make sense to protect children? Of course it does. I’m thrilled we have eradicated big killers like diphtheria, polio, and cars without seatbelts. It’s wonderful that we can talk candidly now about child abuse, making it easier for kids to open up and be believed.

But the dark side of protecting kids is how easily this slips into over-protecting them from ever doing or encountering anything on their own, and insisting on constant oversight of everything they might encounter. At its very worst, whether out of real concern or political pandering, the government steps in and tells parents that their children are in such danger that only the authorities can do a good enough job of protecting them. Let’s look at some disturbing cases.

Over the summer, according to the Manchester, Connnecticut Patch, a local mom was charged with “risk of injury to a minor and failure to appear after police say she allowed her seven-year and 11-year old children to walk down to Spruce Street to buy pizza unsupervised.” This was a walk of half a mile.

If this were an isolated incident of police over-zealousness, well, that’s all it would be. Unfortunately, at my perch I hear about incidents like this all the time—the authorities determining that they know better than a child’s own parents what their kids are capable of handling. That’s why just a few months ago a Michigan mom had to come fetch her children—12 and 15—from the police station, after she’d expected them to walk home from the library. The library staff decided it was too cold to make the kids do this (the kids had walked there without coats). Instead, staffers took them to the police station. The police called the mom and told her they’d be filing a report. For what? The crime of believing her perfectly capable kids could walk home in the cold.

The message to parents? The government is better at raising your kids than you are. The message to kids? You are weak little babies. The government will swaddle you in safety.

And I won’t even get into the letters I get almost monthly from distraught parents who let their kids wait in the car for a few minutes while they picked up a pizza or prescription, only to get back and find a cop waiting for them. This happens because onlookers now routinely call 911 when they see kids waiting in cars, usually because they are convinced that one of two extraordinarily rare tragedies are happening all the time. The first is children dying from hyperthermia, which DOES happen—but mostly when a parent literally forgets the child is in the car and goes into work for eight or nine hours. Death by hyperthermia does not happen in the time it takes a parent to pick up the dry cleaning.

Onlookers also worry that any children on their own will be instantly kidnapped, because on TV you can see kids being abducted 24/7. Child abduction is ratings gold, so news shows pounce on any instance, no matter how far away or long ago it was. (That’s why you see “anniversary of so-and-so’s disappearance” stories.) Then the dramas recycle it with some added sadistic twist. That’s entertainment!

But in the “real world,” stranger abductions are so rare that if for some reason you actually WANTED your child to be kidnapped by a stranger, do you know how long you’d have to keep your child outside, unattended, so that statistically the abduction would be likely to happen?

The answer is about 750,000 years, according to author Warwick Cairns. And after the first 100,000 years or so, your kid isn’t even cute anymore. Onlookers and officers intervening to “save” children whose parents are running an errand are doing nothing of the sort. Nor are the laws in 19 states that prohibit parents from letting their kids wait in the car for a brief amount of time. These laws are simply criminalizing any parent who doesn’t want to wake a sleeping baby or drag three kids across an icy parking lot. Those parents are making a loving, rational, case-by-case assessment. The law is not. In its Zero Tolerance intolerance, it criminalizes any parent who refuses to engage in what I call “worst-first thinking”—dreaming up the very worst case scenario and acting as if it’s about to happen.

When rational parenting decisions become criminalized, parents are forced to think irrationally. I hear from parents all the time who’d like to let their kid walk to school, or play outside, but worry they could be cited for negligence. As law professor David Pimentel explains in his Utah Law Review article “Criminal Child Neglect and the ‘Free Range Kid,’” this is the way over-parenting becomes the law of the land: “If criminal child neglect standards are sufficiently vague, and are applied at the discretion of prosecutors… (and) juries steeped in the media’s fear-mongering, parents will have little choice but to stifle their children’s independence and initiative and buy into the Intensive Parenting culture.”

Law professors Gaia Bernstein and Zvi Triger noticed something similar: In several divorce proceedings they reviewed, the parents who could prove they were the most over-involved were the ones awarded custody. The judge’s assumption in those cases was that the parent who hovers most must care most. The authors even found lawyers instructing their clients to obsessively text their kids all day, in order to leave a digital trail to document their pestering. Thus helicopter parenting becomes not just the social norm but the legal one, too.

At the same time, there is a parallel process going on the regulatory world, with bureaucrats looking ever more intently for ever less likely dangers, on the grounds that kids can never be safe enough. This explains things like the Consumer Product Safety Commission’s recall of a line of children’s jackets last year because the elastic waistbands had toggles on it “that could become snagged or caught in small spaces or doorways, which poses an entrapment hazard to children.”

Yes, it’s true: Those toggles could snag. Does that make them inherently more dangerous than, say, pigtails that could get caught in a door, or a charm bracelet that could get snagged on an electric window? I’m just free-associating products and problems here, because that’s what it feels like the CPSC does, too.

This past year the commission also warned parents to beware of a Fisher-Price bouncy seat because, “mold can develop between the removable seat cushion and the hard plastic frame of the sleeper when it remains wet/moist or is infrequently cleaned…” Gee, really? Mold can develop in a chair where babies sit, eat, and excrete all day, if no one ever wipes it down? Tell me, CPSC: If I “infrequently clean” between my toes, can mold develop there, too? Maybe it’s time to issue a warning about toes?

Of course, real children’s product companies don’t get the luxury of a laugh. They have to accept the commission’s decrees. And may I just mention here that “children’s products” are officially defined as products for any person under age 12? So 11-year-olds are considered the same as 1-year-olds, even though I don’t know many sixth graders who still put toys in their mouths.

The problem seems to be that because nothing is 100% safe, almost anything the commission sets its eye on is fair game for censure. One big case in point is the issue of drop-side cribs.

In 2010 the government warned consumers to stop using—and stores to stop selling, and manufacturers to stop making—all cribs where the side drops down to make it easier to get the baby out. The reason given was that over the course of the nine preceding years, thirty-two children died in such cribs.

The death of a child is so horrible to contemplate, it’s hard to say, “But!” But “But!” I must, because we are talking about three deaths a year out of approximately 8,000,000 kids under age two in America, or about one death per 2,000,000. Those odds do not mean that the product is inherently unsafe. It means that drop side cribs are vastly safer than stairs (1,300 deaths per year), much safer than eating (about 70 kids younger than 10 choke to death on food each year), and waaay safer than driving your kid in a car (over 200 baby and toddler deaths per year).

What’s more: Now that it is harder to get kids out of the crib, will parents perch on step stools to be able to reach down to the baby? How many parents will fall off, possibly dropping the child to the floor? So now should the government require shag carpet in all nurseries? Or helmets on all babies?

Just because something is not 100% safe doesn’t mean it is unsafe, but when zero risk becomes the only acceptable standard—and when politicians can point to a grieving parent and swear this will never happen again—we are expected to believe in a magic world where every danger can and must be removed.

Of course, a world with zero risk is also a world with zero anything, except maybe a phthalate-free, gender-neutral doll with no eyes. (Because these can be come detached, posing a choking hazard.) But when the government declares that we must live in a zero-risk world, it is free to outlaw almost any product or parenting practice it decides to set its sights on. And we have no recourse but to toss the toys we trust, the heirlooms we loved, and the age-old belief that if we train our kids to be brave and smart, we can gradually let them out to embrace the world, risk and all.

That’s a lot to give up for a toggle-free jacket.

Response Essays

Child Safety: More than Tree Stumps and Toe Mold

Dylan Bjorkman was days short of three years old when he let himself into his family’s unlocked car during his sister’s birthday party on an 86-degree day in West Virginia, and died of heatstroke.[1]

Tragedies like this one explain why Safe Kids Worldwide, a 25-year-old organization, advises parents to keep their cars locked in the driveway, just as we urge parents to never leave a child alone in a car.

Last year, 31 children aged two months to five years old died of heatstroke in cars in the United States.[2] Since 1998, we have lost 556 kids.[3] This is what happens to a young child left alone in a car: Even on a temperate day of say 80 degrees, a car with the windows closed or cracked open can heat up by 20 degrees in ten minutes, up to 100 degrees.[4] Because of the nature of a small child’s development, their bodies can heat up three to five times faster than an adult’s. When a child’s temperature reaches 104 degrees, major organs begin to shut down. At 107 degrees, the child dies.[5] Can death from heatstroke happen in the time it takes a parent to pick up the dry cleaning or a pizza? Yes.

Sometimes the parent leaves the child in the car because they are distracted, while in other cases it’s because they thought “just a few minutes” would be fine. I have met some of these parents, distraught, guilt-ridden, and wanting to be a part of an effort to educate other parents on the risk to kids. Heatstroke must be a horrific way to die, but it is also a tragic thing for a parent to survive.

Thus, is it an overreach for a police officer to act when they see a baby alone in a car? No. Is an organization like Safe Kids Worldwide, for which I work, “smothering” kids in hyper-safety by spreading the word about heatstroke deaths? No. Was Governor Susana Martinez of New Mexico acting as a headline-seeking politician when she saw a one-year-old child left alone in car parked at a Santa Fe Walgreens and called the police to find the parent?[6] No.

Lenore Skenazy tries to make the case—with few facts to back it up—that Governor Martinez and others involved in protecting kids from preventable injury are too zealous in these efforts. We are, she argues, politicians, principals and bureaucrats wanting to score points with the public. She’s wrong, on the facts and based on civic values. Her basic premise is that safety on steroids is making parenthood more anxiety-ridden than it needs be and taking the fun out of childhood.

We want kids to live their careers in childhood to the fullest, and we know fun and reasonable safety measures complement each other. For example, kids playing sports has great value—having fun, learning teamwork, making friends forever—but a concussion can be life-changing and there are ways to minimize their consequences. The national concern about concussions in kids and pro sports is ubiquitous.

The jury has rendered its verdict on the positive impact of child safety efforts. They work. They save lives. And we have much more work to do, because unintentional preventable injury remains the number one killer of kids. Moreover, we see some troubling upward trends. Poisoning death rates are increasing, due to death rates among teens aged 15-19 increasing 91%.[7] There’s been a 54% increase in infants dying from suffocation before they reach their first birthday.[8]

Again, some facts: Child injury death rates have decreased 29% in the last decade, 2000–2009, and the number is largely attributable to a 41% decline in motor vehicle traffic-related death rates.[9] This has occurred because of evidence-based preventative safety practices to meet injury risks. Ms. Skenazy thankfully blesses the use of seat belts, but there’s much more to the progress we have made in keeping kids safer in and around cars.

The requirement to wear seat belts and its success took some time to happen, as well as the passage of federal and state laws. Thirty years ago the country’s seat belt use rate was 14%. Today, overall seatbelt use is 84%.[10] The same can be said for booster seat laws. A child 4 feet 9 inches in height and between 8 and 12 years of age should be sitting in the back seat of the car in a correctly installed[11] child restraint system. That’s according to the American Academy of Pediatrics,[12] and adopted by a great majority of the states as law.[13] Among children ages 4 to 8, the use of a booster seat reduces the risk of nonfatal injury by 45% compared to the use of seat belts alone.[14] Today, every state except Florida and South Dakota has adopted booster seat laws.[15] It is because of these efforts that overall motor vehicle fatalities for children 19 and under have declined from 3,261 deaths to 1,350 deaths between 1987 and 2009.[16]

Beyond cars, the list of successful safety measures involving our kids is long—from bike helmets to toys with lead pulled from store shelves, from smoke alarm requirements to baby proofing homes.

Our job at Safe Kids, and all of us truly dedicated to preventing child injury from genuine risks, involves serving as a partner to parents, providing them with time- and research-tested advice and pursuing effective public policy. All of the work we do at Safe Kids is based on a foundation of research[17]—as is the work of the governmental agencies with which we collaborate. Actions based on evidence better ensures the success of a prevention measure. This explains the success of laws requiring seat belts and booster seats and smoke alarms in homes. Maybe it also explains the lack of research on the bogus risks and remedies dreamed up in the Skenazy blog like shag rugs or the mold between the writer’s toes.

Being a parent can be hard, not because of the tree stumps Ms. Skenazy picks on, but because there are real risks out there. The injuries which concern us are almost all preventable. What works in this effort is when parents hold hands with firefighters, pediatricians, children’s hospitals, focused local, state and federal agencies, mommy and daddy bloggers, and organizations like Safe Kids. Together, we reinforce safety practices that have endured over time and we vigilantly keep up with emerging trends.

One of those trends is when televisions and furniture tip over and kill kids. Recently, Safe Kids and the Consumer Product Safety Commission investigated this rising trend,[18] we found that between 2000 and 2010, every three weeks, a child died from a TV tipping over. We concluded that kids would be safer if televisions and furniture were effectively mounted to the wall.

Chance died this way. She was playing in a bedroom and began pulling out the drawers to a dresser in order to climb up and reach a TV, which was sitting on top.[19] In an instant, both the TV and dresser tipped over:

My daughter, Chance, was a beautiful, curious two-year-old. I think about her every minute of every day. I never thought this could happen to us. We’re just a normal family. But now I know it can happen to anyone and I want to tell people to check their homes. Because things can change in an instant.

One child dies from a preventable injury every hour,[20] kids like Chance and Dylan. This is why facts matter, why the work of the child protection community matters and why it’s important to be responsible in talking about these issues.

It is simplistic and wrong to create a rivalry between fun and safety. It is also unfair to create this imaginary army of purported kid-coddling, fun-inhibiting evil doers out of police officers, fire fighters, coaches, pediatricians, child safety researchers and professionals, children’s hospitals, all with a proven track record of saving lives. Common sense measures such as taking a kid out of a football game after a hard hit are intended to raise a kid for a lifetime of play, fun and sports activity. That’s not a team of rivals, but rather a community of care.

Notes

[1]Toomer-Cook, J and Dobner, J, “W.V. boy found dead in car,” Deseret News, September 8, 1998, http://news.google.com/newspapers?nid=336&dat=19980908&id=u-5LAAAAIBAJ&sjid=2OwDAAAAIBAJ&pg=4173,3673706.

[2] Null, Jan, “Hyperthermia Deaths of Children in Vehicles,” Department of Geosciences, San Francisco State University, January 7, 2013, http://www.ggweather.com/heat/.

[3] Ibid.

[4] “How Fast a Car Heats Up,” http://www.youtube.com/watch?feature=player_detailpage&v=7hfCM4Zo37Y.

[5] “Fact Sheet: Children Left in Cars and Heatstroke,” National Highway Traffic Safety Administration, http://www.safercar.gov/parents/downloads/pdfs/Sample_Fact_Sheet.pdf, last accessed 01.31.2013

[6] Miller, J, “Governor sees unattended baby, tracks down father,” CBS News, October 5, 2012, http://www.cbsnews.com/8301-250_162-57526816/governor-sees-unattended-baby-tracks-down-father/.

[7] Vital Signs: Unintentional Injury Deaths Among Persons Aged 0–19 Years — United States, 2000–2009, Morbidity and Mortality Report, April 16, 2012 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm61e0416a1.htm.

[8] Ibid.

[9] Ibid.

[10] “Occupant Restraint Use in 2011: Results From the National Occupant Protection Use Survey Controlled Intersection Study,” NHTSA, January 2013, available at http://www-nrd.nhtsa.dot.gov/Pubs/811697.pdf.

[11] To have your baby’s car seat checked, find a location near you here.

[12] Iannelli, V., M.D.“New AAP Car Seat Recommendations,” American Academy of Pediatricians, March 21, 2011, http://pediatrics.about.com/b/2011/03/21/new-aap-car-seat-rules.htm.

[13] “Car Seat Safety for Kids,” The Children’s Hospital of Philadelphia, http://www.chop.edu/service/car-seat-safety-for-kids/car-seat-safety-by-age/for-your-4-to-8-year-old-child.html.

[14] Ibid.

[15] “Child Passenger Safety Laws,” Governor’s Highway Safety Association, available at http://www.ghsa.org/html/stateinfo/laws/childsafety_laws.html, last accessed 01.31.2013.

[16] “Injury Trends Fact Sheet,” Safe Kids Worldwide, http://www.safekids.org/our-work/research/fact-sheets/injury-trends-fact-sheet.html.

[17] “Research and Statistics,” Safe Kids Worldwide, http://www.safekids.org/our-work/research.

[18] Ferguson, R.W., Mickalide, A.D.. “A Report to the Nation on Home Safety: The Dangers of TV Tip-Overs.” Washington, DC: Safe Kids Worldwide, December 2012.

[19] To see the power of a tip-over, see Rossen, J, “Toppling TVs,” Today Show, December 13, 2012, http://video.today.msnbc.msn.com/today/50185372#50185372.

[20] “National Action Plan for Child Injury Prevention: Protecting our Nation’s Future,” Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, http://www.cdc.gov/safechild/nap/overviews/index.html.

Child Safety: The First Priority

Chronology of Failure

On a cold January day, 14-month-old Iain Cunningham and his mother, Margaret, were playing with his Play Family School Bus, his favorite first-year birthday gift. Iain stood up to follow his dad, who was walking by, when he suddenly stopped and began to gag. During the parents’ frantic attempts to help Iain, his teeth clenched, he stopped breathing, and a frightening sea of blood poured from his mouth. Iain was rushed to the hospital, where his parents were informed that Iain’s life was saved, but he suffered irreversible brain damage due to lack of oxygen. The play figurine that had lodged in Iain’s throat ultimately caused cerebral palsy, loss of muscle control, and irreversible brain damage rendering him incapable of leading an independent, self-supporting life.

The manufacturer, Fisher-Price, had for years marketed its “Little People” play figurines to oral-age children, sized to be small enough to enter a child’s airway, but too large to pass through. As a result, numerous children suffered brain damage or died. Other details in this tragic chronology include: (1) The manufacturer marketed the toys as “safe” for oral-age children; (2) six years prior to Iain’s incident, experts and concerned parents made the company aware of the choking risks, among them one parent whose child nearly suffered a choking tragedy, and who notified Fisher-Price about a “death trap” it was selling; (3) there was no testing done by the manufacturer, pre-market or otherwise, regarding the toy’s ability to block a child’s airway; and (4) the company did not initially redesign or recall the toy during the 1980s, even while evidence mounted of the hazard associated with it.

Fisher-Price’s eventual “response,” only after receiving numerous reports over years of tragedies—six reported deaths and one brain damaged child—was to change its labeling and marketing strategy, and to make the figurines larger, to reduce the risk of choking. To this day, the original figurines have not been recalled, and they likely remain in homes, schools, and toy-boxes across the country.[1]

Safety First

Historically, there are numerous examples of suffering and tragedy similar to young Iain’s as a result of a toy or children’s product being designed for sales rather than safety. Sadly, the record of the toy industry regarding design, manufacture, and marketing of playthings makes abundantly clear that too often, the primary goal is not the best interests and safety of our children. Just as unfortunately, there are those who enable such inexcusable neglect by suggesting that demanding accountability from a multi-billion dollar industry is an over-zealous attempt to “smother” the most precious and vulnerable in our society with “safety,” as if achieving a marketplace with the safest products in order to help prevent tragedies is an effort to be mocked or even scorned. To the contrary—as a society, we have the right and even obligation to demand that manufacturers and retailers, who are in the best position to know the hazards associated with their products, take all feasible steps to safeguard our youngest consumers.

Myth: All Toys and Children’s Products Are Safe

As parents and caregivers, we want to believe that all toys that reach retail shelves are safe – that they have been properly designed, tested, and marketed. Manufacturers and retailers often do their best to perpetuate this myth by insisting their products are safe, despite evidence to the contrary. The result is a dangerous assumption among toy shoppers, perpetuated by the industry, that toys purchased from big-name manufacturers and retailers are not dangerous. In fact, seeing a familiar name on a package can lead to a false sense of security that the toy enclosed is safe. Too many toys and children’s products are not safe.

For years, major manufacturers sold millions of small hammocks as children’s toys, but with a significant, potentially deadly hidden defect: spreader bars, typically found on adult hammocks to prevent the material from bunching together into a noose-like configuration, were not incorporated into their design. A seven-year-old girl suffered permanent brain damage from a near-strangulation in a mini-hammock marketed for children. Another near-fatal incident involved a five-year-old boy who was found entangled in a mini-hammock, but was resuscitated by his mother. In the late 1990s, numerous manufacturers and importers of mini-hammocks without spreader bars recalled more than 3 million of their dangerous products. Without spreader bars to hold the mini-hammock bed open, the mini-hammock could twist around a child’s neck as he or she was getting into or out of the mini-hammock, resulting in strangulations and deaths. The government received reports of at least 12 children between the ages of five and 17 years old who became entangled and died when using net mini-hammocks without spreader bars.[2]

From the early mini-hammock recalls until the present time, millions of toys have been recalled every year due to defects with the potential to cause harm to children, often representing hazards that are well known (or should be well known) in the industry. In fact, in 2010, thousands of “baby”-hammocks made their way into the streams of commerce, requiring yet another recall due to a suffocation hazard. The hammocks in question were deemed defective because, unbeknownst to the families of babies for whom the product was marketed, a suffocation hazard was presented by the side-to-side shifting or tilting of the hammock, which could cause an infant to roll and become entrapped or wedged against the hammock’s fabric and/or mattress pad.[3]

Tragedies from defective products strike in homes, schools, and daycare centers; they can happen when a child is alone or with a parent. Importantly, while recalls play a vital role in child safety, more emphasis needs to be on proper design and testing, so that offending products do not make their way into the streams of commerce in the first instance. Recalls may recover some defective playthings, but in reality, once the items are in toy boxes, children’s rooms, backyards, and schools, there is no feasible way to recover all of them. In short, many dangers can and should be prevented.[4]

“Machismo” and “Body-Count Consumerism” Over Safety

Those who decry the role of government and consumer advocacy in seeking protections from defective and potentially deadly products rely on certain tried and true tactics.

First, there are the attacks on the messengers with name-calling and labels that are intended to mock the efforts of truly concerned consumers, the whistleblowers who are brave enough to speak out, to ensure that manufacturers are doing all they can to promote safety. Such advocates are labeled “over-protective,” “worst-first thinking,” and viewing children as “weak little babies.” After all, so many of us survived childhoods without such attention to safety, so there should be no complaints now, even in the face of evidence of defective items destroying lives.

Second, amazingly, it is pointed out that in certain instances, only a few children have been maimed or killed, so the odds are quite good. As the Fisher-Price “Little People” (at least six deaths and one brain-damaged child) and mini-hammock (at least twelve deaths and one brain-damaged child) examples show, the approach of “body count consumerism” has been a mainstay of major corporations for decades. How many children need to be sacrificed to make a product safer, or remove a product from the market? Why is it acceptable to lose just one precious child, when the injuries suffered are wholly preventable with appropriate safety measures?

The True Stories

Apologists for manufacturers of defective and dangerous products pick and choose facts that best suit their arguments, with the goal of getting the most shock value in support of their points.

Ms. Skenazy uses the following (in part) as recent examples of alleged over-reaching: fleece hoodies with lead-coated zippers; bouncy seats with mold; and drop-side crib dangers. These short references are used as fodder for ridicule and sarcastic comment.

Here are the facts:

Drop-Side Cribs: Following the deaths of at least 32 infants and toddlers, and millions of recalls, the Consumer Product Safety Commission (CPSC) voted unanimously in 2010 to ban these poorly designed cribs. The new standards, requiring fixed sides, were implemented after determining that manufacturers were selling such cribs with malfunctioning hardware, cheaper plastics, or assembly problems, leading to the rails becoming partially detached. The resulting dangerous “v”-like gap between the mattress and side rail could, as was well known to manufacturers, cause entrapment, suffocation, or strangulation of babies. Crib-makers, in fact, had already been phasing out drop-side cribs due to the acknowledged defects, however the mounting body count required swift government action.[5]

Fleece Hoodies: These clothes were sold for use by babies as young as 12 months old, who commonly mouth and suck on small parts, whether on clothes, toys, or other children’s products. Lead is a known and cumulative poison—thus, even small amounts ingested can, over time, cause serious health issues, with the potential to affect every organ and system in the human body. Children six years old and younger are most susceptible to the effects of lead, which may include permanent damage to the brain and nervous system, slowed growth, hearing problems, and anemia. The clothing in question was sold in violation of the federal lead paint standard, instituted many years ago to provide protections from these very significant health effects, which had become epidemic absent such laws.[6]

Fisher Price Infant Sleepers: The mold developing on these products was not due to dirty surfaces or a failure to clean the products. In fact, as the result of presumed manufacturing defect, black mold grew on vinyl-like surfaces hidden from sight, underneath the cloth cover in which newborns would lie. Toxic mold is known to have severe effects on the fully developed and functional respiratory systems of adults. These sleepers were sold for use by infants, with underdeveloped systems and low immunities. I have personally communicated with families whose babies have suffered and continue to suffer from respiratory illnesses (coughing, wheezing, difficulty breathing) as a result of more than 800,000 of these potentially harmful products flooding the marketplace.[7]

Flawed Statistical Comparisons

One death to one child is one too many if preventable by proper and safe design.

Ms. Skenazy, in support of her point that the tragic loss of certain numbers of our youngest children to defective products is somehow statistically acceptable, references hazards associated with stairways, eating, and driving children in cars. She attempts to make the point that in the case of drop-side cribs, for example, these other activities are statistically more hazardous. This reasoning is flawed in several respects. First, the cribs are marketed and sold for use by infants who lack the ability to make decisions about their well-being. They are foreseeably placed in an environment for sleeping (often overnight, without parental supervision), with the expectation that these infants will not lose their lives to a product defect. The defects, while brought to light sadly by the loss of innocent life, were not determined to exist as a result of the statistics, as she suggests. Rather, a closer scrutiny of the products determined that there were clear, life-threatening hazards that needed to be eliminated. Further, the environment of end use is a necessary component in a manufacturer’s decisionmaking process. There is simply no excuse for a crib’s design to be responsible for even one infant’s death. Finally, once a defect is recognized in a children’s product, it must be corrected, or removed from the market, without delay.

Vigilance, Not Indifference

The best weapon in the fight to prevent injuries to children continues to be safely designed and manufactured products. The burden must be on manufacturers and retailers, not consumers, to identify the known hazards before their products enter the channels of commerce.

While proper labeling, regulations, and recalls are important for toy safety, toy manufacturers have a responsibility to ensure that safe products reach the marketplace. For instance, toys with parts that can detach and become lodged in a child’s throat are often not considered “small parts” by the industry. Moreover, recalls are reactive, not proactive. Unfortunately, many consumers never receive notice of toy recalls and may not know that a dangerous toy sits like a time bomb in their child’s toy box. Many of the toys recalled in the last year are evidence of substandard manufacturing practices, as well as inadequate pre-market testing, which put our nation’s children at risk of serious injury or death.[8]

Notes

[1] Toys That Kill, pp. 13-24, by Edward M. Swartz (1986 Vintage Books, Div. of Random House)

[2] http://www.cpsc.gov/en/Recalls/1996/CPSC-EZ-Sales-Twin-Oaks-Hammock-Company-and-Safesport-Manufacturing-Company-Announce-Recall-of-Mini-Hammocks/

[3] http://www.cpsc.gov/en/Recalls/2010/Baby-Hammocks-Recalled-by-MamaLittleHelper-Due-to-Suffocation-Hazard/

[4] Toys That Kill, pp. 69-70.

[5] http://www.nbcnews.com/id/40678788/ns/health-kids_and_parenting/?GT1=43001; http://abclocal.go.com/wls/story?section=news/consumer&id=8218623

[6] http://www.cpsc.gov/vi-VN/Recalls/2013/Childrens-Apparel-Network-Recalls-Fleece-Hoodie-and-T-Shirt-Sets-Due-to-Violation-of-Lead-Paint-Standard-Sold-Exclusively-at-Target/; http://www.cdc.gov/nceh/lead/; http://www.epa.gov/lead/.

[7] http://www.cpsc.gov/en/Recalls/2013/Fisher-Price-Recalls-to-Inspect-Rock-N-Play-Infant-Sleepers-Due-to-Risk-of-Exposure-to-Mold/

[8] World Against Toys Causing Harm, Inc. (WATCH), Press Release November, 2012 (http://toysafety.org/worstToyList.shtml)

The Roots of Concern about Kids

I agree with Lenore Skenazy: there are lots of examples of overblown fears about child safety. Certainly many of her examples illustrate officious do-gooding by bureaucrats. Nonetheless, I do not share her conviction that the primary cause of these fears is excessive government.

My interest in threatened children began with the stories about Halloween sadists who distribute poisoned candy and razor blades in apples to trick-or-treaters. This contemporary legend is widely known, but it has spread by word of mouth. Halloween sadism has received minimal news coverage: there’s nothing to cover, because serious incidents are virtually unknown, and it has gotten next to no government attention.[1] Some of the most prominent child-protection campaigns—such as the missing children movement in the 1980s or Mothers Against Drunk Driving—were launched by activists, not officials.

People’s anxieties about children’s safety need to be understood within their larger cultural context, as do the responses—governmental and otherwise—to those concerns.

Part of this context involves demographic shifts. One hundred years ago, life expectancies were much lower, primarily because lots of infants and young children died from infectious diseases. In 1912, about 28 percent of those who died were younger than 15 years old; in comparison, in recent years, young people account for just over one percent of all deaths.[2] This is an astonishing transformation. A century ago, children lived in a relatively hazardous world; everyone would have known people who had lost a child. In contrast, we inhabit a world where childhood death is quite rare.

At the same time, people now have fewer children than in the past. One hundred years ago, the typical woman bore more than three children; in recent years, the average has been hovering around two. This means that today’s parents probably have a bigger emotional stake in each child than their counterparts in the past. I’m not suggesting that people didn’t used to love their kids as much as we now do, but they were more likely to view losing a child as a terrible but real possibility, rather than as something remarkably rare and perhaps completely avoidable.

The evolution of the media is another element in way the cultural context has changed. The past century witnessed the emergence of radio, TV, cable, and the Internet. News now travels further, faster, in greater volume, and along far more channels. It has never been easier for an individual to make claims about some putative problem and to gain an audience for those claims. Of course, not all claims have equal chances for success. It helps to tap into widely shared cultural understandings—such as concern for children. There is general agreement that children are vulnerable and deserving of protection, and campaigns for children’s welfare have a long history. The media share those understandings and are interested in publicizing claims that address threats to children.

The modern media are a key element in our social problem-producing apparatus. Beginning with the successes of the civil rights movement in the 1960s, electronic media coverage has been vital in relaying emotionally compelling claims to mass audiences. On TV, this involves not only news coverage, but talk shows and other infotainment genres, and even dramas that feature plots “ripped from the headlines.” The endangered child often figures into this coverage; in fact, almost any concern about what the future might hold—nuclear proliferation, climate change, economic uncertainty, epidemic disease, whatever—can be packaged in terms of the uncertain future that confronts our children and grandchildren.

Activists learn from this coverage; anyone who has logged even a few hours watching news programs or talk shows can come away with a sense of how to arouse concern about a new social problem. With hundreds of TV channels and millions of websites competing for attention, the media have a colossal appetite for fresh material. It is a poorly packaged cause that cannot command at least some coverage.

In short, concern about kids—even exaggerated concern—has its origins in the broader culture: in helicopter parents and tiger moms determined to steer their offspring onto the fast tracks to success; in those parents who have suffered tragic losses and remade themselves into activists, campaigning to make people aware that something needs to be done; in the media that use endangered children for compelling stories; and so on. While it is possible to rattle of lists of government child-protection programs (mandatory education, child-labor laws, etc.), plenty of claims—and most of those programs—have their origins in private calls to do something to protect kids. Obsessing about child safety doesn’t always—or even usually—start with petty bureaucrats.

The dramatic drop in the proportion of deaths involving young people over the last hundred years reflects a lot of important changes, many of which we’ve come to take for granted, such as purifying the milk supply; vaccinations (typhoid fever, diphtheria, whooping cough, and measles were all significant causes of death in 1913); and antibiotics.[3] But notice that there is what we might call the paradox of proportion: solving your biggest problem turns what used to be a smaller problem into a big problem.[4]

Consider how this works. Early in the twentieth century, contaminated milk was viewed as a big problem, responsible for many childhood deaths, and this led to a successful effort to improve the milk supply.[5] Bad milk went from being a big problem—let’s say, just for purposes of argument, that it was the biggest single problem—to being under control, so that people can take it for granted that the milk they buy is not likely to kill their children outright. But eliminating that #1 problem means that some other problem is now the biggest problem. Over time, as bigger problems get solved, smaller ones come to the fore, so that having antibiotics to treat infections lets attention shift to requiring seat belts or child-proof bottle caps on medication. And, incrementally, childhood death becomes less common.

But this also means that our biggest problems become smaller. As this happens, the tradeoffs become more apparent, as in Skenazy’s example of rules for crib designs, where the benefits don’t seem to outweigh the costs. And we can also suspect that officials will continue to attack the newest big problem, even after things improve to the point that that problem ain’t all that big.

In other words, it helps to view child safety more broadly. Overreaching officials cannot be held responsible for all our anxieties about endangered kids; they are merely part of a larger cultural context. It also helps to consider how we got where we are, to remember all of the things that had to improve before we could have the luxury of focusing on our current concerns.

Notes

[1] Joel Best, “Halloween Sadism: The Evidence” (http://www.udel.edu/soc/faculty/best/site/halloween.html).

[2] U.S. Bureau of the Census, Statistical Abstract of the United States, 1913. Washington: Government Printing Office, 1914, p. 70; Donna L. Hoyert and Jiaquan Xu, “Deaths: Preliminary Data for 2011,” National Vital Statistics Reports 61, no. 6, October 10, 2012.

[3] Susan B. Carter, et al., Historical Statistics of the United States: Earliest Times to the Present, Vol. 1, Part A (Population). Cambridge: Cambridge University Press, 2006, pp. 463–64.

[4] Joel Best, “Social Progress and Social Problems: Toward a Sociology of Gloom,” Sociological Quarterly 42 (2001): 1-12.

[5] E. Melanie DuPuis, Nature’s Perfect Food: How Milk Became America’s Drink New York: New York University Press, 2002.

The Conversation

In Regulation We Trust

Let’s start exactly where Anthony Green of Safe Kids USA would have us start:

Dylan Bjorkman was days short of three years old when he let himself into his family’s unlocked car during his sister’s birthday party on an 86-degree day in West Virginia and died of heatstroke. Tragedies like this one explain why Safe Kids Worldwide, a 25-year-old organization, advises parents to keep their cars locked in the driveway, just as we urge parents to never leave a child alone in a car.

Keeping your car locked seems to make sense for any number of reasons, including theft. But how do we leap from “don’t forget to lock” to “never leave a child alone in a car”? Especially when we all know that we spent at least a smidgen of our own childhoods waiting in the car while mom ran into pick up the prescription, or dad paid for the gas?

The leap is made by the heart. Mine sinks, too, as it imagines the boy’s death and the parents’ grief. That heaviness is so unbearable, the struggling heart makes a leap of faith not to God’s great, unknowable plan, but to a more modern belief: The belief that if we just pass enough laws, we can prevent anything bad from ever happening again.

Regulation is the new religion.

Not that some regulations don’t make a lot of sense. They do. In fact, back in the 1960s, when Ralph Nader was pointing out that some cars roll over too easily, even as scientists were showing us that smoking can cause cancer, it made sense to reassess the products and procedures all around us. As a nation we went on the hunt for hidden dangers, found them all around, and demanded change. Afterward, cars became safer and cigarettes carried warnings, for which I am grateful.

But in the half century or so since then, we have cast an increasingly skeptical eye at increasingly safe things. As Joel Best points out in his amazing essay, the safer our society becomes, the more we obsess about small or even miniscule dangers.

And so now if you look at the list of “unsafe” toys that product liability lawyer James A. Swartz publishes on his website each year, you’ll find items like the Dark Knight Batman Action figure, whose bat-ears ostensibly pose a danger because “[t]oddlers may fall on these inflexible protrusions, with the potential for penetrating and blunt-force injuries.”

Holy frivolous lawsuit, Batman! I suppose that if a child were to leap out of a plane and land directly on top of this action figure—and if the action figure was standing bolt upright at the time, out on the lawn—this could indeed cause a “blunt force injury.” But it seems a bit delusional, even hallucinatory, to worry about a tragic toddler/plastic ear impaling. And to go so far as to say this Batman figure is a toy all decent parents should W.A.T.C.H. out for (Swartz’s website is called “World Against Toys Causing Harm” or W.A.T.C.H.) well, we’ve come a long way from warning folks about exploding Pintos.

But what of the other regulations Swartz and Green stand up for, including Green pressing for more laws prohibiting parents from letting their kids wait in the car for even a minute? He cites 31 children dying in cars last year (the majority of whom were forgotten there, not simply waiting out a short errand). That’s heartbreaking. But a debate rule of thumb holds that you want to scare someone, use numbers. If you want to put things in perspective, use percentages.

So, if there are 40,000,000 children under age 10 in America (and there are), and if they take an average of, let’s say, 10 car rides a week, we are talking about 20,800,000,000—that’s more than 20 trillion—kid car rides a year. And 1 in every 670,967,742 of those errands could prove fatal—that’s 0.000000149% of them. Should we really be regulating parental choice based on percentages like these?

If you talk about a specific child who died this way, most people will instantly say yes. They will be making that leap of the heart from sorrow to salvation-by-regulation. They may even name the new law after the child, as a form of consecration.

But if you tell a mom that she should be arrested for letting her 7-year-old read Mad while she runs in for milk because he could easily have died, she might ask you to mind your own business. And rightly so.

Laws exist to make society reasonably safe. They cannot make us completely safe without making us completely unreasonable.

I trust my kids around Batman’s ears. I trust them to wait in the car while I run an errand. I don’t trust anyone telling me those activities are so dangerous that there oughta be a law.

Halloween Myths Vanish with Facts

I confess that I am old enough to remember coming home with a bag full of candy on Halloween, and how my mother would examine all of the unpackaged goodies for razor blades and items that could have been poisoned. Thankfully, M&Ms in their bags were okay. Whether there were covens of evildoers trying to commit murder by Halloween treats, I don’t know.

I do know, however, that parents can do a little safety homework to make sure Halloween is the fun night that we all want it to be. The vigilance is important because, according to a study by State Farm Insurance, a kid is on average twice as likely to be hit and killed by a car on Halloween than any other day (or night) of the year.[1] More broadly, we at Safe Kids Worldwide conducted a study on pedestrian safety, supported by FedEx, showing that each day, an estimated 61 children in the United States aged 19 and under are injured as pedestrians—more than 425,780 children in the last 15 years. It also showed that there has been a shift in injuries from younger kids to older ones.[2]

This is why we at Safe Kids Worldwide provide parents and caregivers with tips on pedestrian safety for everyday walking and getting around on Halloween night. It’s all common sense, like walking on sidewalks and paths and crossing at corners: Research shows that 70% of the Halloween crashes occur when children cross in the middle of the block.[3]

The key here is that real child safety efforts are based on research and facts and data, and not myths and exaggerated news stories, as Mr. Best suggests.

I salute Mr. Best, because his article was reasoned, without a reliance on sarcasm and fictions. However, I disagree with his analysis that child injuries and deaths, and remedies for them, are trickle-down crises, in which the risks get smaller and smaller. He suggests that as “bigger problems get solved, smaller ones come to the fore.” He cites seat belts and child-proof bottle caps for medications.

It’s not right to say that auto crashes (resolved by seat belts and booster seats) is a smaller problem. Car crashes have been and remain the number one cause of unintentional death in kids 19 and under, though it is true that there has been good progress over the past ten years.[4] In 2010 there were 4,077 motor vehicle-related fatalities among children ages 19 and under.[5] A smaller problem? I don’t think so.

That gets us to the question Mr. Swartz wisely asks, “How many children need to be sacrificed to make a product safer or remove a product from the market?”

Safety minded parents are on duty every day—and those of us engaged in child safety are here to help them. Not with helicopters, but with common sense based on real research. We are part of the community of care because that means that a happy Halloween leads to a happy Thanksgiving and the next set of holidays. As I said, I remember the days of razors in Halloween apples, and Halloween remains my favorite holiday.

Notes

[1]”Halloween is ‘Deadliest Day’ Of The Year For Child Pedestrian Fatalities,” State Farm, press release, October 23, 2012, http://www.multivu.com/mnr/56790-state-farm-halloween-pedestrian-child-safety.

[2] Mickalide AD, Rosenthal KM, Green A, Baker JM. “Walking Safely: A Report to the Nation.” Washington, DC: Safe Kids Worldwide, August 2012, http://www.safekids.org/assets/docs/safety-basics/safety-tips-by-risk-area/Walking-Safely-Research-Report.pdf.

[3] Op cit. Halloween is ‘Deadliest …”

[4] “National Action Plan for Child Injury Prevention,” Centers for Disease Control and Prevention, April 12, 2012, http://www.cdc.gov/safechild/NAP/toc.html.

[5] National Highway Traffic Safety Administration Fatality Analysis Reporting System (FARS) Encyclopedia. http://www.nhtsa.gov/FARS.

Children’s Lives Are More Than “Percentages”

It is an unfortunate truth that those who oppose efforts to protect children from known and preventable hazards often resort to sarcastic banter in an attempt to make their points, rather than focusing on facts.

It is one thing to oppose government regulation in certain (or even most) circumstances, and quite another to conjure up a child leaping from a plane and landing on a toy. For me, as well as parents of children who have been maimed or killed and countless other concerned citizens, holding accountable those who manufacture and sell defective playthings for our nation’s children is no laughing matter. Such inexcusable lack of concern for safety has caused scores of deaths and catastrophic injuries over the course of decades.

I find it remarkable that, in Ms. Skenazy’s view, speaking about individual children, or numbers of children, who have lost their lives as a result of a preventable hazard is not appropriate because it might “scare” people. Naturally, it is easier and more comfortable to discuss loss of life in terms of “percentages,” in much the same way many manufacturers attempt to justify placing a product into the streams of commerce that causes death or severe injury. The preventable losses of these children are marginalized, the data fed into a machine that spits out a percentage number which we are told represents an acceptable risk. Acceptable to whom? Certainly not to the parents who have to bury their child, or the child who has to live the remainder of his or her life with physical and often psychological damage. Certainly not to those of us who believe we can and must do better.

In my view, we as a society owe more to our kids than treating them like lab rats. It is not acceptable policy to allow manufacturers to sell defective products, monitor the death and injury rates, then see if the loss percentages are within an acceptable range. The focus must be on prevention, on proper design and testing in the first instance, so that tragedies can be avoided, rather than merely added into a cost/benefit analysis akin to number crunching at any financial institution.

We can agree that laws exist to make society reasonably safe. However, we have a long way to go when it comes to fulfilling this mission.

The Importance of Proportion

I wrote my initial contribution before those by James A. Swartz and Anthony Green were posted. Their essays confirm a central point that I was trying to make—that the primary impetus for child safety does not come from meddling officials, but rather from private advocates, like Swartz and Green, whose campaigns may call for more governmental action. Earlier campaigns of this sort deserve credit for all those social policies that dramatically cut the death toll among children. So far as I can tell, everyone involved in this conversation approves of improving the milk supply, promoting vaccinations and antibiotics, and so on—policies that probably prevented something like a hundred million Americans from dying in childhood over the last century.

However, I do feel that there is a question of proportion. Talking about the costs and benefits of policies requires facing this. Anthony Green writes, “It is not right to say that auto crashes … [are] a smaller problem. Car crashes have been and remain the number one cause of death [among young people].” The second sentence is quite correct, but the first one is false. In 1966, there were 50,894 traffic fatalities; in 2010, there were 32,788. The actual number of deaths fell, even though the U.S. population grew by 55 percent, the number of drivers more than doubled, and the number of miles driven tripled. The number of deaths per million miles driven dropped from 5.5 to 1.1. Traffic fatalities are a smaller problem. Why? Lots of reasons—safer cars, safer roads, better emergency medical care, and policies to rein in drivers who are teens, elderly, or intoxicated.

I suppose we could cut traffic fatalities to nearly zero—establishing a national 5 mph speed limit might do the trick. But we don’t do that because there are tradeoffs. We accept that being able to travel at the speeds we find convenient will lead to some deaths. Obviously, we continue to try to reduce the death toll, but without destroying the principal benefits of automobility.

Which returns us to the matter of proportion. In general, advocates go after the biggest dangers first—smallpox, dangerous milk, and such. Inevitably, as those policies succeed, the targets become smaller, and the tradeoffs more apparent. While there were initial fears about the safety of smallpox vaccines, their effectiveness soon overwhelmed most opposition. To take a more recent and less obvious case, people with arthritis grumbled about child-resistant caps on aspirin bottles enough that an accommodation was reached (I don’t know if this is still true, but manufacturers used to be allowed to sell one size of bottle without a safety cap).

If we’re now at a point where smart people disagree about the need for the next safety measure, I consider that evidence that earlier campaigns have addressed most of the easy issues, that we have progressed enough that the costs and benefits are more closely matched. On the one hand, James Swartz questions whether it is “acceptable to lose just one precious child”; on the other, Lenore Skenazy argues that saving that last life may involve costs that outweigh the benefits. Such a debate is not between facts and “myths”—it concerns values.

Applying Cost-Benefit Engineering to a Kid’s Life Is Just Wrong

Ms. Skenazy must have fun making these cavernous rhetorical leaps—e.g. that anybody would propose that a mom should be arrested for allowing a child to read Mad magazine—but that’s not what’s disturbing. If even one parent would relax their diligence because of her writing, that’s not good.

What’s really troubling about Ms. Skenazy’s argument is her use of the kind of cost-benefit analysis that industry uses in designing a toaster oven—a company should only make more costly design changes if a certain number of fires are caused or if a certain number of individuals are seriously injured.

Her math is as mind-boggling and as tiresome as her wisecracks. A formula that defines when children can be protected is extreme. The bottom line of it is this: because only 31 kids were left in cars and died of heatstroke, she argues, the problem doesn’t deserve attention. As Mr. Swartz asked in his essay, under “World’s Worst Mom” philosophy, how many kids have to die or suffer serious injury before government can step with its proven, measurable record of success at saving lives?

On the heatstroke danger, no law or regulation over “parental choice” is proposed, as Ms. Skenazy improperly says. Rather, we hope that education and awareness will cut down those fatality numbers, and the unknown number of near misses. Awareness gives parents the choice to be safer.

As I argued in my last post, the trickle-down theory of safety is wrong and cruel. It suggests that when a big, big, big problem is cured, safety educators search for smaller and smaller risks to stay in business. Thus Skenazy jumps from the Pintos of the 1960s to the ears on a Batman toy.

But this is not the path child safety has taken.

  • In 2010, 4,077 kids 19 and under died in motor vehicle–related incidents.[1]
  • In 2010, more than 400,000 children were nonfatally injured in motor vehicle–related incidents.[2]
  • In 2009, 824 children aged 19 and under died from unintentional poisoning.[3]
  • Each year, more than 3.5 million children ages 14 and under receive medical treatment for sports injuries—that includes concussions, a problem causing many parents intense anxiety.[4][5]
  • From 1987 to 2009, suffocation and choking fatalities have risen from 771 deaths to 1,160.

They are big numbers, but it’s not all bad news. From 1987 to 2009, there has been over a 53 percent decrease in the unintentional injury death rate among children ages 19 years and under in the United States.[6] This doesn’t mean that our concern about child safety should be relaxed. It means that twenty-five years of action based on data and research has made kids safer. And that the journey is far from over.

I don’t like statistics, which may seem surprising given the number of numbers in the foregoing post; I prefer to put a face on the numbers. On Christmas 2011, embers from a fireplace started a house fire in Stamford, CT. The mother of the house was able to get out through a window, and screamed for help. Her parents and three daughters, a set of 7-year-old twins, Grace and Sarah, and Lily who was 9, were trapped behind a wall of flames. All five died, including the grandfather who tried to rescue at least one of them. Because the home was undergoing renovations, there were no smoke detectors in the home, and firefighters said they could have prevented this Christmas tragedy. We at Safe Kids work with firefighters on education across the nation on the need for smoke detectors. The Kidde Fire Sentry smoke and fire alarm is $7.99 on amazon.com. Do the math on that.

Notes

[1] National Highway Traffic Safety Administration. Fatality Analysis Reporting System (FARS) Encyclopedia. http://www.nhtsa.gov/FARS.

[2] National Highway Traffic Safety Administration. Personal communication with Lorenzo Daniels. Washington, DC: U.S. Department of Transportation; June 2012.

[3] Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS), http://www.cdc.gov/injury/wisqars/index.html.

[4] American Academy of Orthopedic Surgeons. “Play It Safe.” Rosemont, IL: American Academy of Orthopedic Surgeons, 1999.

[5] American Academy of Orthopaedic Surgeons. A guide to safety for young athletes. American Academy of Orthopaedic Surgeons Website, http://orthoinfo.aaos.org/topic.cfm?topic=A00307.

[6] Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). http://www.cdc.gov/injury/wisqars/index.html.

The Audacity of Seeking to Prevent the Preventable

The core philosophy of Safe Kids is that the overwhelming majority of the risks in which we engage are preventable.

  • Deaths from car crashes can be reduced if people wear seat belts and properly place their young children in a correctly installed car seat. Other ways to minimize deaths from car crashes are through graduated drivers licensing schemes and interlock brakes.
  • Kids are much less likely to be poisoned by getting into medication if a parent keeps them out of reach and out of sight.
  • And if they do get into medications or dangerous substances, the harm is likely to be resolved much more quickly by calling a poison control center—1-800-222-1222—our health care system’s secret weapon.
  • If a kid wears a bicycle helmet, he is less likely to suffer a serious concussion and other injuries.
  • If parents, coaches, and kids follow the common sense protocol for when a young athlete might suffer a traumatic brain injury, kids playing on football fields, soccer fields, and basketball courts will be much safer. Parents anxious about this danger because of the ubiquitous news about sports concussions will be able to breathe some relief.

Further, sensible prevention measures save society tax dollars.

  • Every dollar spent on a booster seat saves society $71.
  • Every dollar invested in a smoke alarm saves $28.
  • A helmet on the head of a younger bicyclist saves $580
  • Each federal dollar spent to support poison control centers saves $38.74.
  • As much as the child safety deniers would like to think otherwise, those of us engaged in child safety do think about cost-benefit in the spirit of a holistic formula leading to what works. We think about what’s the surest cure we can prescribe in the most cost-effective way possible, because resources are limited and the caffeinated media world in which we live can sustain only so many messages. It’s unhelpful when Mr. Best resorts to “World’s Worst Mom” talk with his 5 mph speed limit hypothesis.

    Here’s a real example. I have spoken in this debate about the horror involving a child dying of heat stroke, left alone in a car by a parent or caregiver. What’s the remedy? In addition to education, technological answers were considered. The National Highway Traffic Safety Administration (NHTSA) commissioned the Center for Injury Research and Prevention at Children’s Hospital of Philadelphia to conduct a study to determine if technology or engineering could provide an answer. It was determined that no current technological remedy would be effective or reliable. Until there’s a real technological remedy for this problem, education is our most effective intervention. Though NHTSA is a leader in the effort, the predominant awareness work is being conducted by safety professionals in the non-profit world.

    Reminding parents about common sense responses to risk has great benefit and little cost. Another example just hit my screen: The Florida Orlando-Orange County Expressway Authority has launched an education campaign urging drivers to have a “designated texter,” building from MADD’s success on designated drivers. A Harvard study estimated that between 1988, when it was launched, and 1998, the designated driver campaign saved 50,000 lives.

    Mr. Best seems to suggest that safety professionals are constantly shopping for problems as “larger ones” are resolved. I imagine Mr. Best would identify distracted driving as another “smaller” problem which consumer safety advocates have dreamed up.

    Further, in many cases, education and awareness are hugely successful interventions. Education is not an imposition; not a law, regulation or mandate. We pick and choose what we listen to. As I have said before, awareness is part of the DNA of freedom.

    If the work we’re doing gets to the point that we run out of genuine risks to resolve, I am happy to look for another job. There’s an audacity in getting to zero, and audacity is a wonderful challenge.

Trying to Outlaw Fate

How I wish Anthony Green could have read my book, Free-Range Kids, in which I write, “I love safety. I believe in helmets, car seats and seat belts.”

I even love his idea of a “designated texter,” and wish I’d come up with it myself! Frankly, anyone against implementing basic safety measures would have to be a little strange.

Anyone against trying to legislate out every last bit of risk in the world, well, that’s another story.

The idea shared by Green and fellow essayist (and injury lawyer) James A. Swartz is that every accidental child death could and should have been prevented. Which means that every accidental death is not an accident at all, but someone or something’s fault, and we must make sure it never happens again. Even if that means outlawing something as generally safe and normal as letting a kid wait in the car while her mom runs in for pizza, or letting a baby sleep in the crib all his older cousins used.

This is how a trial lawyer thinks: Any client who comes to him with a child hurt in even the most unusual and unpredictable manner has a legitimate claim against a practice, a person, or a manufacturer. This leads to situations like the following.

About a month ago, a child in Alberta, Canada, somehow nearly strangled to death on his hall pass lanyard. Immediately afterward, all 2,000 schools in the province declared lanyard hall passes a danger and banned them. But what if the student had tripped over a shoelace and fallen down the stairs? Should we outlaw lace-up shoes? Or stairs? Or what if he’d choked on an apple slice? From now on, only applesauce allowed at lunch?

Emotionally, to hear the story of the lanyard boy—it’s wrenching. No one could deny it. I certainly don’t. But I think we CAN deny that hall passes are inherently dangerous. They have been used for decades by I’d guess hundreds of millions of children, and here we have one child who almost died.

In an article about the incident, a local police spokesman was quoted as saying, “If [we] had any information ahead of time, this obviously would have been prevented.” But…that’s the point: We CAN’T have information about every accident ahead of time. If I know I’m going to get hit by a car on my way to work this morning, by golly, I’ll take the day off. But we can never know when something unpredictable is about to happen. Hence the word “unpredictable.”

The sad fact is that some of us, including some children, will end up hurt by things that are actually very safe. We used to call this God’s will, or bad luck, or fate.

Now we just call a lawyer. Or a lawmaker.

Or both.

Values and Consistency

If you ask Americans if they value equality, almost all will say that of course they do. And if you ask them if they value freedom, it turns out most value that as well. I’m one of those folks: I value both equality and freedom.

But that doesn’t mean that there aren’t tensions between my two values. Think about it: a perfectly egalitarian society is unlikely to be especially free, just as a perfectly free society is unlikely to be all that equal. Inevitably, there will be tradeoffs, and we have to compromise, to give up a little freedom to insure equality, or sacrifice a little equality to preserve freedom.

In my view, our discussion has arrived at this point. Americans hold that they have rights to life, liberty, and the pursuit of happiness. In her contributions, Lenore Skenazy emphasizes the importance of liberty, while Anthony Green and James A. Swartz stress the importance of life.

So far as I can tell, none of us object to regulations requiring cars to have seat belts and airbags, or houses to have smoke detectors. These are simple technical fixes that have saved thousands of lives at relatively low cost in money and inconvenience. But even Mr. Green, whose most recent contribution notes that about 4,000 young people die in motor vehicle accidents annually, did not pick up on my suggestion that a national 5 mph speed limit would markedly cut that death toll. This leads me to suspect that—rhetoric about priceless lives aside—we all understand that tradeoffs are inevitable. Do the benefits of getting rid of lanyards outweigh the costs? The answer doesn’t seem all that apparent.

We may like to imagine that our values form coherent, consistent philosophies, but imagining doesn’t make it so.

This Is How a Concerned Citizen Thinks

I am proud of my work as a trial attorney, as a consumer advocate, and as an officer of a charitable organization, World Against Toys Causing Harm, Inc., dedicated to the cause of child safety. I am proud that lawmakers over the years, with attorneys and all concerned citizens, have made a difference. Ms. Skenazy herself points to safer cars, seat belts, helmets, flame-retardant children’s sleepwear, and countless other examples of improved safety leading to saved lives. As attorney Gerry Spence so aptly stated, “Without trial lawyers and fair courts and unbiased juries to hear our cases, we will be rewarded with the same justice that people across the world experience – no justice at all, not even the empty promise of it.”

Mr. Green eloquently points out that Ms. Skenazy again makes her points through exaggerations, and she now tries to demonize the messenger: “This is how a trial lawyer thinks,” she writes. Our legal system helps shed light on behind-the-scenes dealings of corporations and others that disregard the safety of our country’s children and all citizens. For example, the true extent of the Catholic Church sex abuse scandal was uncovered only when brave victims, with their counsel, obtained internal documents and testimony under oath, otherwise unavailable to the public.

Of course, the argument can always be taken to extremes by alleging “unusual and unpredictable” circumstances, however this is not representative of the ongoing discussion, which focuses on preventable injuries and deaths.

A juror who sat on an important workplace safety case said it best: “It is already difficult enough for ordinary people to take on the corporations that do them harm. Why would anyone ever suggest that … we should take the slingshot away from David and hand it to Goliath?” This is how a concerned citizen thinks.

Preventing Harm Means Challenging Fate

As this debate comes to a close, I just wanted to comment on a few things that Ms. Skenazy wrote in her most recent post.

“I Love Safety.” I am thrilled to hear that Ms. Skenazy loves safety, and believes in helmets, car seats and seat belts. I can’t take credit for the “designated texter” idea—that was the Florida Orlando-Orange County Expressway Authority—but I’d be thrilled to work with her to get the awareness out there about the idea. No law, but education about it.

“Accidental Death.” I never used the word “accident” in relation to the scope of the zone of safety with which we are concerned at Safe Kids. It is simply that most unintentional injuries can be prevented, and we should work together to discover and implement strategies to prevent them from happening when feasible.

Heat Stroke vs. Pizza Pick-ups. Laws are not for every case or risk, and in fact laws are reserved for rare cases, pervasive risks, as a last resort. But in some cases laws do work, like with laws requiring bike helmets, car seats, and seat belts. We have determined that the best measure in heat stroke cases is education, just as it was in encouraging parents on best safe sleep practices for kids.

The Imaginary Anti-Lanyard Law. In the Alberta, Canada example about the child injured when he choked on his hall pass lanyard, Ms. Skenazy makes one of her Olympic-qualifying leaps of absurd faith to say that child safety principles would suggest the need for an anti-hall pass law. What I saw is that schools in Alberta temporarily recommended that schools stop using lanyards pending a full investigation. Another leap is Prof. Best’s national 5 mph speed limit. A fundamental weakness of the cases presented by Mr. Best and Ms. Skenazy is that they don’t offer things that really happen, just exaggerations.

Can’t Deny Fate? Bad things are going to happen to good people, no question. Tragedies are going to visit good parents and their children. Fate cannot be outlawed or litigated, but fate can be challenged.

“Not Predictable?” In many cases, we can predict injury. This happens through data collection and a robust sharing of information. Today, we see statistics showing that there’s been a rise in 16- and 17- year-old driver deaths in 25 states, which means more deaths are predictable and public policy should respond—and we have the tools to do so. When we see a rise in pedestrian deaths among teenagers in a Safe Kids Report—possibly caused by distracted walking while smart phone texting—we can predict more incidents and consider ways to reduce them again. That is why I don’t use the word accident, because its definition involves an unforeseen event.

We Have Challenged Fate and Saved Lives. Lots of them in fact. We have successfully gone beyond the things that Ms. Skenazy likes—child seats, seat belts, and helmets. Experiments in graduated driver’s licensing strategies, measures and technology to deal with drunk driving, inexpensive home safety proofing products, safe cribs, and other steps work in a quantifiable way. The inspiration behind the child safety community is that we can beat fate, and we have. The danger is when we surrender to it without a fight.

Letters to the Editor

Letters to the Editor: Children’s Safety and Liberty

Editors’ Note: We are pleased to print here a selection of letters to the editor in response to this month’s theme of children’s safety and liberty.

Protecting Individual Rights

An important principle to keep in mind when discussing children’s safety is that the government’s only proper purpose is to protect individual rights–those of the parents and of the child. In the case of leaving a child in a car, proper, objective laws exist to punish parents who actually harm their children, thus violating the children’s individual rights, usually through a pattern of negligence of their parental duties (e.g., the New York father of 13 who was convicted of involuntary manslaughter for forgetting his 21-month old daughter in the car for hours.) Improper regulation, on the other hand, punishes parents who have done no harm (e.g., those who get visited by DSS for leaving a child in the car for three minutes while picking up a prescription on a 50-degree day.) Note, in this context, that criminal law differentiates properly between involuntary manslaughter and accidental death: a driver who runs a red light and kills someone would most likely be charged with involuntary manslaughter, but one who drives carefully and hits a child darting into the street most likely would not. The same principle should apply to parents and inform our discussions of children’s safety: not every death of a child in a parent’s care is criminal; accidents do in fact happen, and those parents who suffer from an accidental death should not be treated like criminals. Nor should parents or manufacturers be presumed guilty until proven innocent and prevented from exercising their proper judgment by reams of safety regulations, which in fact violate parents’ and manufacturers’ individual rights and are thus improper.

Heike Larson

Oakland, CA

Give Parents Options

I am raising four children, ages six, eight, ten and twelve. I don’t want Mr. Green to “advocate” for their “safety” if it means eradicating my option to choose when and whether to leave them in a car. I agree whole-heartedly with Mr. Best, and have sensed a wholesale change in our culture’s acceptance of death, loss, and risk. Have antibiotics and seat belts led us to a place in human history where we cannot accept even one child’s death, ever? And if there is a death, under any circumstances, well, as Ms. Skenazy says, then someone or something must be to blame?

Parenting has morphed into an exercise that my own parents would have completely ridiculed, because as scientists, they fully understood statistical analysis. My mother was an early adopter when it came to seat belts and helmets, and put the poisons up high, even before there was an official admonishment. But she certainly didn’t expect or even want us to be under direct adult supervision every moment of every day, and if it had been insinuated that she would be subject to charges of criminal neglect for leaving us in the car while she went into the dry cleaner’s, she would have protested. Mightily.

I recall as a child in the 70s seeing a PSA on television about old refrigerators, and how we ought not to climb into them. It showed a refrigerator at a dump, and a kid playing hide-and-seek, I think. It was emphatic about the immediate risk of death from these refrigerators, and even though I’d never seen one like that (with a latch that only opened from the outside), I imagined that there was a genuine concern for safety behind this campaign. Likewise with lead paint and the warnings not to eat the chips.

Today, I find nothing helpful or informative about the admonishments that come my way as a parent. The reasoning goes like this: in order to responsibly support my kids’ survival to the age of majority, I must toe the current cultural parenting line, which means my children would not walk anywhere alone, never take public transportation by themselves, not spend time outdoors alone, and never, ever have the choice to wait in the car while I run into the store. What kind of life would that be? Not one that I would want to live—as a child, or as that child’s parent, either.

When my children were preschool age, I regularly left them in the car at the grocery store, because taking them across the parking lot seemed a much greater risk than anything that could happen to them in the car. It’s not that I wasn’t thinking about their safety, it was that I was choosing how to express the value of safety in my own way, in that moment, as their mother.

There is, I believe, a happy medium between the kind of safety consciousness that leads to a profound diminishment in quality of life, and the blind unconsciousness that leads to tragic and avoidable deaths in the hundreds of thousands. To suggest that anyone concerned with quality of life, who is willing to accept a risk factor above zero, is callous or unconcerned about children is painful to me. I want my children to thrive, not just survive. Along with that goes my own thriving as their caregiver. It matters to me to have some measure of autonomy in how I attempt to achieve that thriving.

Mollie Kaye

Information, Not Fear

Have we come far enough in the area of child safety? NO! But not for the reasons listed by listed by Mr. Green and Mr. Swartz. We still have to recognize that times change. We need to stay informed of new technologies and new products.

As a parent of three, I take offense at the fearmongering statistical approach of the authors. To include vehicle accidents in an essay about child safety is extremely misleading. Vehicle safety is vehicle safety. They are comparing apples to oranges in order to scare parents and validate their position. In those numerous incidents where a child was injured in a vehicle accident, how many adults were injured as well? This is not to downplay the injury of a child, but to clarify that vehicle safety and, say, choking hazards do not belong in the same category.

The authors also go on to say the best weapon to protect our children lies with the manufacturer. No it does not. Our society has become one of blame and not responsibility. The “not our fault” generation believes that they live in a perfect world, and when something goes wrong, that they are not to blame. Here are some of the pet peeves of a practical parent—me:

1. Choking hazards. No amount of regulation, no choke tube tester, no label on an item will ever replace or compete with a parent. At least a parent that knows their child. Kids will put things in their mouth; it is a given. My kids played with toys that could possibly cause them to choke, but I never allowed that to happen. Why? They were taught not to put things in their mouths, and they were also watched around such toys. The “not my fault” generation expects the manufacturer and government to do their job for them. And I ask what is next, will public parks and playgrounds have inspectors checking that there is no stone or twig lying around that will fall through that “magic” test hole? Will parents sue the city when their child chokes on a stone they picked up?

2. Design and engineering. Perfection is impossible. There is absolutely no way that a manufacturer can guarantee that any product they produce is going to be 100% perfect. They can and usually do their best, but this is the real world, where accidents happen. Take for example, the drop-side cribs. By the way, all three of mine survived, and my grandkids will survive, because we still have it. The crib is now well removed from the manufacturer, and yet they are still being held accountable by the “not my fault” generation. With our third child, and the crib being older, I took it upon myself to replace the hardware and fasteners. Why? Because anything will wear out over time and with repeated use.

3. Personal Protective Equipment. What was once a personal choice is now a government regulation. Helmets for family skating. Cages on batting helmets. Bike helmets. Helmets for skiing. Elbow pads, knee pads, padded gloves, and so on and so on. When we fought the face cage on the batting helmet rule because my daughter hated how it interfered with her field of view, I had a mother very rudely ask me, “What you want your daughter to get hit by the ball, and hurt?” I told her that no I did not, “but I do want her to learn how to duck.” The more we over-armor people during activities, the more invincible they believe they become. This false sense of power allows them to go further, faster and harder, resulting in different injuries.

Our kids while precious are not delicate little pieces of china. But overprotecting them will make them resemble china, as they will crumble at the first sign of adversity.

Warren Pacholzuk