The role of proximal circumstances and child behaviour in toddlers' risk for minor unintentional injuries.

BACKGROUND Much of the research on child injury risk has focused on trait-like factors (eg, hyperactivity, child gender) that influence injury risk rather than state-like factors (eg, environmental circumstances, child behaviour). Additional research is needed to better identify the proximal risk factors for children's risk for unintentional injury. OBJECTIVES The present study examined the antecedents to minor unintentional injury events and whether unusual circumstances and child behaviour predicted injury risk. METHODS The study used archival data that were collected via biweekly in-person interviews with 170 mothers of toddlers (15-36 months) for 6 months. A case crossover design was used to predict children's risk for injury from proximal risk factors. RESULTS Children were at a higher risk for injury when circumstances were unusual and when they were engaging in an unusual behaviour. When a child was engaging in an unusual behaviour, higher levels of maternal supervision predicted lower injury risk. Children were more likely to be injured in a new environment, in an environment with animals or other people, in an environment with hazards or when engaging in a new activity or in a familiar activity performed in an unfamiliar way. CONCLUSIONS The results indicate that toddlers may be at a greater risk for minor unintentional injury when environmental circumstances are outside of the norm or when a child is engaging in unusual behaviours. The findings also indicate that higher levels of caregiver supervision may be especially beneficial when children are engaging in new or unfamiliar activities.