3: Creating Safe Indoor Environments

Designing an Effective and Safe Classroom Environment

There are all sorts of classrooms. They differ by size and shape, amount of light and wall space, placement of sinks and counters, and amount of storage. Figuring out how to design the physical space and to maximize children's interactions within the space will take some time. Make a floor plan. Move things around. Take a look at other classrooms and see what works.

Here are a few things to think about when designing your space and making it as workable as possible. Think about the number of interest areas or centers that you want or need for the group of children. Arrange the space so that noisy areas are separated from quiet areas. Locate centers next to needed storage or equipment. Use furniture or other items to provide boundaries. But, make sure that the adults can see all of the areas of the room.⁷⁹

Factors to Consider

Space and boundaries:

• Are the centers clearly defined with furniture, rugs, or shelves?
• Is there enough space for all children to easily move about the room?
• In each defined area, is there adequate space for the number of children using it?

Proximity and distance:

• Are the quiet and noisy areas in proximity or separated?
• Are centers located near things that children need to complete projects (art center near sink, puzzle or game shelves within reach of tables, etc.)?
• Are teachers able to view children in all centers?

Home and culture:

• What home-like features are included in the classroom?
• How is(are) the culture(s) of the local community reflected in the classroom?

Flexibility and permanence:

• How does the space accommodate gross motor activity?
• What aspects of the physical space cannot be changed (cost or structural issues) and are challenging to overcome (e.g., limited access to natural light, cumbersome cubbies, etc.)?

Engagement and challenging behaviors:

• Are there areas of the classroom where challenging behaviors are more likely to occur?
• Are there areas where typically children are positively engaged in classroom activities?

Traffic patterns:

• Can children move easily from space to space?
• Is running and wandering discouraged?

Material selection:

• Are materials chosen to support development and learning?
• Are they culturally relevant and meaningful to the children?
• Is there is a sufficient variety and quantity (without overwhelming children)? ⁸⁰

Pause to Reflect So far, we haven’t specifically called out safety much in our discussion of environmental design. Look at some of the listed items and brainstorm how they each might be related to safety? For example, why is looking at areas of the classroom where challenging behaviors are more likely to occur a safety consideration?

Tips for Environmental Design Traffic patterns need to discourage running. Use furniture, rugs, and similar items to define boundaries. Ensure that teachers can see what is happening in all areas of the classroom. Cultural and home-like features are present in the room. Use spaces with as much flexibility as possible. Quiet and noisy centers are spaced appropriately. Ensure interesting classroom content selection is balanced with appropriate stimulation versus overstimulation. Each center provides enough information about what to do there and how to play.81

 

Grouping of Children

Teachers want to be intentional about how they group children, whether it's a decision made in the moment or as part of lesson planning. Match the size of the group with the purpose of the activity. Think about the children who will be in the group. Young children need opportunities to participate and learn with the whole group, small groups, and they will thrive with a bit of one-on-one time with an adult.⁸³

Large groups are good for:

• Introducing concepts
• Building community
• Conducting routine activities

Small groups are good for:

• Maximizing back and forth interactions
• Peer modeling of skills
• Guiding instruction

One-on-one interactions are good for:

• Tasks requiring complex skills
• Instance when a child needs specific direction and assistance⁸⁴

Pause to Reflect How is considering group size related to safety? What might teachers need to observe for to determine if the group sizes are working well for the children?

Every early childhood environment is full of pros and cons; it is how educators work with the many characteristics of a classroom that can make a tremendous difference. Teachers can be surprised by the results when they:

• Assess the spaces for both limitations and strengths.
• Strategize how to optimize what they have to work with in their classrooms.
• Try a different arrangement, see what happens, and then modify based on what is working and what is not.

might need to be made to meet the needs of the children and keep them safe?⁸⁵

Sometimes a modification can be minor (raising or lowering a shelf, “stop” signs over unavailable areas, masking tape to better define a space, etc.). This highlights the “work-in-progress” nature of early childhood environments. As the needs of children change, the room may need minor changes or have to be rearranged completely to meet those needs.⁸⁶

A Few More Considerations for Environmental Design When designing classroom environments, there are some other considerations to keep in mind: Rotations: Avoid grouping the same children together all the time, especially when pairing skilled with less skilled children. Consider limiting the number of children per center and creating a system for rotating children through favorite areas. Regularly rotate some of the toys and materials to generate a sense of newness. Instruction can be tailored within small groups to meet educational goals. For example, one group of children that is working on learning numbers can read a counting book; another group working on fine motor skills can do beading; still another group of children working on social skills can practice joining play. Emphasize cooperation by choosing toys and activities that require it (e.g., large appliance boxes, games that need two or more players, balls for throwing back and forth, etc.). Whenever possible keep the design elements simple (both for the teacher’s sake and because simple tends to be longer-lasting). Also, some aspects of designing can be done spontaneously and quickly (spur of the moment) and still be effective. 87

 

Forms and Functions of Behavior

There are many reasons a child might use specific behaviors. This is why it is important for adults to carefully observe children, pay attention to their cues, get to know them, and know what part of the schedule gives them a hard time to better understand what they are trying to tell us through their behavior.⁸⁸

Each behavior has a:

FORM = the behavior the child is using to communicate

AND A FUNCTION = the reason or purpose the child is using that behavior⁸⁹

Here are some examples of form and functions of infants, toddlers, and preschoolers:

Form and function are also shaped by culture. Children are socialized to express their feelings in culturally acceptable ways. It is important to talk with families so you can look for acceptable ways that children express themselves in a culturally respectful way.

As you have probably already experienced—it is not always easy to figure out the meaning of a child’s behavior. To add to the complexity of understanding the meaning of behavior:

• A single form of behavior may serve more than one function. For example, a toddler might use biting (form) for different functions (“I want the toy you have.” “I want to play with you but don’t know how to let you know.” “I’m tired.” “I’m frustrated because you don’t understand what I am trying to tell you.” “I want some attention.”)
• Several forms of behavior may serve one function. For example, a child’s purpose (function) may be to build with their favorite blocks, but they use different forms of behavior (biting, yelling, grabbing, running away with the blocks, sharing) based on how they feel that day, who is playing in the block area, or based on their cultural expectations.
• The meaning of behavior is shaped by culture, family, and the unique makeup and experiences of the individual child. For example, some cultures may express sadness by crying or by having a nonchalant facial expression. Some cultures may express happiness by laughing and being exuberant, while others may expect more restrained behaviors.

Some of these functions of communication become a concern for children’s safety (of the child communicating, the other children, and other people in the environment). Early childhood educators must take the time to understand a behavior’s meaning so that they can help the child replace unsafe forms of communication with forms that don’t hurt others or harm the environment. Pausing to try to figure out the meaning behind a child’s behavior—instead of just reacting to the behavior—can change the way we see a child, the way we respond to a child, and the way we teach a child. Becoming a “behavior has meaning” detective who is always on the lookout for the meaning of behavior will help you keep children safe.⁹² Take a look at the following example of an unsafe behavior, what it might mean, and what an educator might do to support the child.

Emilia and Sarae Teacher Emilia says about a child Sarae, "I have to watch her like a hawk or she'll run down the hall or go out the gate, down the street, and I don't know where.” What This Might Mean So, we could reframe this to: Sarae is an active child. She may naturally be a kinesthetic learner, who needs to move and shake, has extra energy. What the Teacher Might Do A teacher can give Sarae positive ways to exercise the way she loves to be. So, whether that's during choice time, that there is an opportunity for her to dance, for example. Or, there' s an obstacle course set up for her to maneuver through. out the function of their behavior/communication.93 When they are outdoors, the teacher can create opportunities for structured play so that is running with an intention; such as part of a game with her peers. If it's hard to get her back inside, give her a leadership role. Maybe she's the one who has the bell that cues everybody that it's time to line up. So now she's going to make sure she finds her friends and is the one responsible for bringing the whole group together to go inside. The Potential Result Reframing the behavior and provide positive outlets will not only keep Sarae safe, but it will also communicate to her that how she feels is okay and that she's being supported, acknowledged, and encouraged.94

Taking a Closer Look at Behavior

You may also find it valuable to examine behavior much the way you would injuries and traffic patterns. Gather data about unsafe behaviors:

• When are they happening? Are there specific times of day that children are finding it more challenging to behave/communicate in safe ways?
• Where are they happening? Are there hot spots for challenging behavior? What in the environment might be the focus of the unsafe behavior/communication?
• Why they are happening? What happened before the led up to the behavior? What happened after?
• Who are the behaviors happening between? All children will have times where they communicate with unsafe behavior, but some children may need more adult support in certain contexts (time of day, activity, groupings of children, etc.).

Look for patterns. Reflect on what can be changed in the physical environment, schedule/routine, groupings, and supervision to help prevent children from hurting themselves or others when trying to communicate their needs.

Safe Toys

Protecting children from unsafe toys is the responsibility of everyone. Careful toy selection and proper supervision of children at play are still—and always will be—the best ways to protect children from toy-related injuries.⁹⁷

It is important that educators consider both safety and durability when choosing toys for children. Toys should be constructed to withstand the uses and abuses of children in the age range for which the toy is appropriate.

The U.S. Consumer Product Safety Commission (CPSC) has safety regulations for certain toys. Manufacturers must design and manufacture their products to meet these regulations so that hazardous products are not sold (see Table 3.3).

In addition to the mandatory standards, many toy manufacturers also adhere to the toy industry’s voluntary safety standards (see Table 3.4).⁹⁹

Toys should be chosen with care. Teachers should look for quality design and construction. Safety labels to look for include “Flame retardant/Flame resistant” on fabric products and “Washable/hygienic materials” on stuffed toys and dolls. Watch for the hazards listed in Table 3.5¹⁰².

Check all toys periodically for breakage and potential hazards. A damaged or dangerous toy should be thrown away or repaired immediately.

Age Appropriate Toys

Teachers must keep in mind the ages of children they are choosing toys for, including their typical interests and skill levels. The manufacturer’s age recommendation is a good starting place to ensure that toys are age-appropriate. Warnings such as “Not recommended for children under 3” should be followed.¹⁰⁴ See Table 3.6 for some age-appropriate toys to consider. Please note that toys appear on the list when they become appropriate and are not repeated in later ages.

Table 3.6 – Age Appropriate Toys¹⁰⁵

Age	Some Age Appropriate Toys
From 6 weeks to around 4 months these toys become appropriate	Simple rattles Teethers Light, sturdy cloth toys and dolls Squeeze toys Texture and soft squeeze balls
Between 4 to 6 months these toys become appropriate	Soft blocks Keys on rings Interlocking plastic rings Small hand-held manipulatives Toys on suction cups
Between 7 to 12 months these toys become appropriate	Rubber or rounded wood blocks Push toys (simple cars, animals on wheels, etc.) Squeeze-squeak toys Roly-poly toys Activity boxes and cubes Containers with objects to empty and fill Transparent, chime, flutter, and action balls Large rubber or plastic pop beads Simple nesting cups Stacking rings Graspable unbreakable mirror toys Simple floating toys Paper and large crayons for scribbling Cloth, plastic, and board books
These toys become appropriate for 1-year-olds	In addition to above Push toys with large handles Toys to push on the floor Doll carriages and wagons Stable ride-on toys with no pedals Small stacking blocks Unit blocks Hollow blocks Large plastic bricks to press together Simple puzzles (at 1, 2-3 pieces and 1½, 3-5 pieces) Pegboards with large pegs Hidden object toys Simple pop-up toys Simple shape sorters Pounding and hammering toys Simple matching toys Simple lock boxes and toys Large beads for stringing Funnels and colanders Small sand toys Dolls and simple accessories Rhythm instruments operated by shaking and banging Simple dress-up clothes and role-play toys Child-sized dramatic play equipment Picture books More detailed toy vehicles Trains with simple coupling systems
These toys become appropriate for 2-year-olds	Pull toys Small, light-weight wheelbarrows Push toys that look like adult equipment (lawnmower, vacuum, etc.) Small tricycles 4 to 5 and then 6-12 piece puzzles Magnetic boards with shapes, animals, and people Fit together toys Large balls Smelling jars Feeling bags Lacing cards Frames for buttoning, lacking, snapping, and hooking Small boats Water/sand mills More realistic dolls Small hand puppets All rhythm instruments Non-toxic paints Clay Markers Blunt-end scissors Chalk and chalkboard Costumes and dress-up clothing Realistic dramatic play props Larger trucks and construction vehicles Pop-up books Hidden picture books
These toys become appropriate at around 3 years of age	Fit in frame puzzles up to 20 pieces Simple jigsaw puzzles Number boards with smaller pegs Frames to tie Large sandbox tools Realistic dolls Stuffed toys with accessories Music box toys Simple sock, mitten, and finger puppets Toy telephone, camera, doctor kit Cash register and equipment to play store Xylophone Paintbrushes Paste and glue Simple block printing Simple board, lotto, and card games
These toys become appropriate around 4 years of age	Mosaic boards Felt boards Matching toys Geometrical concept toys Sand molds Wood-working tools Audio equipment
These toys become appropriate around 5 years of age	Simple weaving loom Simple sewing kit (with a blunt-tipped needle) Paper dolls Dramatic play equipment that works Watercolor paint Science materials Toy typewriter

 

Pause to Reflect Look at these toys that might be given to children. Do you know enough about them to know whether or not they are safe? If not, what would you need to know and do to make sure they are safe? How would you determine what age of children they are safe for?

Safety Risks from Art Materials

For certain chemicals and exposure situations, children may be especially susceptible to the risk of injury. For example, since children are smaller than adults, children’s exposures to the same amount of a chemical may result in more severe effects. Further, children’s developing bodies, including their brains, nervous systems, and lungs may make them more susceptible than adults. Differences in metabolism may also affect children’s responses to some chemicals.

Children‘s behaviors and cognitive abilities may also influence their risk. For example, children under the age of 12 are less able to remember and follow complex steps for safety procedures, and are more impulsive, making them more likely to ignore safety precautions. Children have a much higher chance of toxic exposure than adults because they are unaware of the dangers, not as concerned with cleanliness and safety precautions as adults, and are often more curious and attracted to novel smells, sights, or sounds. Children need regular and consistent reminders of safety rules, and there is no substitute for direct supervision.

Guidelines for Selecting Art and Craft Materials

Here are some helpful reminders about choosing art materials for children:

• Note that even products labeled ‘non-toxic’ when used in an unintended manner can have harmful effects.
• Products with cautionary/warning labels should not be used with children under age 12.
• Avoid solvents and solvent-based supplies, which include turpentine, paint thinner, shellac, and some glues, inks, and a few solvent-containing permanent markers.
• Avoid products or processes that produce airborne dust that can be inhaled (including powdered tempera paint).
• Avoid old supplies, unlabeled supplies, and be wary of donated supplies with cautionary/warning labels and that do not contain the statement “Conforms to ASTM D4236.”
• Look for products that are clearly labeled with information about intended uses.
• Give special attention to students with asthma or allergies, which may elevate the students’ sensitivities to fumes, dust, or products that come into contact with the skin.¹¹⁸
• Gather your supplies beforehand so that you can continue to supervise their use without needing to step away.
• Instruct children on safety practices before you begin (such as, modeling how to cut safely with scissors).
• Do activities in well-ventilated areas.
• Use protective equipment (such as smocks).
• Assume that anything you use should be safe enough that it won’t harm children if it gets on their skin or in their mouths and/or eyes.¹¹⁹

Technology can be a Tool for Learning

What exactly is developmentally appropriate when it comes to technology for children? In Technology and Interactive Media as Tools in Early Childhood Programs Serving Children from Birth through Age 8, the National Association for the Education of Young Children (NAEYC) and the Fred Rogers Center state that “appropriate experiences with technology and media allow children to control the medium and the outcome of the experience, to explore the functionality of these tools, and pretend how they might be used in real life¹²⁰.”

Lisa Guernsey, author of Screen Time: How Electronic Media—From Baby Videos to Educational Software—Affects Your Young Child, also provides guidance for families and early educators. For example, instead of applying arbitrary, “one-size-fits-all” time limits, families and early educators should determine when and how to use various technologies based on the Three C’s: the content, the context, and the needs of the individual child. They should ask themselves the following questions:

• Content—How does this help children learn, engage, express, imagine, or explore?
• Context—What kinds of social interactions (such as conversations with families or peers) are happening before, during, and after the use of the technology? Does it complement, and not interrupt, children’s learning experiences and natural play patterns?
• The individual child—What does this child need right now to enhance his or her growth and development? Is this technology an appropriate match with this child’s needs, abilities, interests, and development stage?¹²¹

Early childhood educators should keep in mind the developmental levels of children when using technology for early learning. That is, they first should consider what is best for healthy child development and then consider how technology can help early learners achieve learning outcomes. Technology should never be used for technology’s sake. Instead, it should only be used for learning and meeting developmental objectives, which can include being used as a tool during play.

When technology is used in early learning settings, it should be integrated into the learning program and used in rotation with other learning tools such as art materials, writing materials, play materials, and books, and should give early learners an opportunity for self-expression without replacing other classroom learning materials. There are additional considerations for educators when technology is used, such as whether a particular device will displace interactions with teachers or peers or whether a device has features that would distract from learning. Further, early educators should consider the overall use of technology throughout a child’s day and week, and adhere to recommended guidelines from the Let’s Move initiative, in partnership with families. Additionally, if a child has special needs, specific technology may be required to meet that child’s educational and care needs. And dual language learners can use digital resources in multiple languages or translation to support both their home language and English development.

classroom are using an app to create a “story” with photos of their recent field trip.¹²²

Active versus Passive Engagement

Early childhood educators should understand the differences between passive and active use of technology. Passive use of technology generally occurs when children are consuming content, such as watching a program on television, a computer, or a handheld device without accompanying reflection, imagination, or participation.

Active use occurs when children use technologies such as computers, devices, and apps to engage in meaningful learning or storytelling experiences. Examples include sharing their experiences by documenting them with photos and stories, recording their own music, using video chatting software to communicate with loved ones, or using an app to guide playing a physical game. These types of uses are capable of deeply engaging the child, especially when an adult supports them. While actions such as swiping or pressing on devices may seem to be interactive, if the child does not intentionally learn from the experience, it is not considered to be active use. To be considered active use, the content should enable deep, cognitive processing, and allow intentional, purposeful learning at the child’s developmental level.

Pause to Reflect Do these children look like they are using technology actively or passively? What do you need to see or know to accurately make this determination?

Early childhood educators also need to think of ways they can reduce the sedentary nature of most technology use. Technology can encourage and complement physical activity, such as doing yoga with a video or learning about the plants outdoors with a nature app.

Co-Viewing of Technology

Most research on children’s media usage shows that children learn more from content when parents/caregivers or early educators watch and interact with children, encouraging them to make real-world connections to what they are viewing both while they are viewing and afterward.

is the best way to make technology use effective. ¹²⁶

There are many ways that adult involvement can make learning more effective for young children using technology. Adult guidance that can increase active use of more passive technology includes, but are not limited to, the following:

• Prior to the child viewing content, an adult can talk to the child about the content and suggest certain elements to watch for or pay particular attention to;
• An adult can view the content with the child and interact with the child in the moment;
• After a child views the content, an adult can engage the child in an activity that extends learning such as singing a song they learned while viewing the content or connecting the content to the world.

Causes of Burns

Burns can be caused by dry or wet heat, chemicals, or electricity (both indoors and outdoors).

• Burns from dry heat can occur from fire, irons, hairdryers, curling irons, and stoves (American Institute for Preventive Medicine, 2012; Leahy, Fuzy & Grafe, 2013).
• Burns from wet or moist heat occur from hot liquids, such as hot water or steam (American Institute for Preventive Medicine; Leahy, Fuzy & Grafe). These types of burns are called scalds. Scalds can occur within seconds and cause serious injury.
• Chemical burns occur from chemical sources and can also cause serious burns when exposed to skin, or if swallowed, whether intentionally or unintentionally.
• Electrical burns can cause very serious injury as they can burn both the outside and inside of the person’s body, causing injury that cannot be seen, and which can be life-threatening.
• Radiation burns can also occur from sources of radiation such as sunlight (American Institute for Preventive Medicine).¹⁴¹

Types of Burns

Burns are divided into first, second, and third degree burns.

First degree burns affect only the outer layer of the skin (epidermis). These types of burns are the least serious as they are only on the surface of the skin. First degree burns usually appear red, dry, and slightly swollen (MedlinePlus, 2014). Blisters do not occur with this type of burn. They should heal within a couple of days (American Institute for Preventive Medicine, 2012). A first degree burn is pictured in the bottom left of Figure 3.20.

Second degree burns affect the top layer of the skin and the second layer of skin underneath (dermis). These are more serious than first degree burns. The skin may appear very swollen, red, moist, (MedlinePlus, 2014) and may have blisters or look watery and weepy (American Institute for Preventive Medicine, 2012). A second degree burn is pictured in the bottom middle of Figure 3.20.

Third degree burns are the most serious burn. A third degree burn affects all layers of the skin and may affect the organs below the surface of the skin. The skin may appear white or black and charred (MedlinePlus, 2014). The person may deny pain because the nerve endings in their skin have been burned away (American Institute for Preventive Medicine, 2012). Third degree burns require immediate medical treatment. If teachers suspect a child has a third degree burn, they should immediately call 911. A third degree burn is pictured in the bottom right of Figure 3.20.¹⁴²

Chemical burns can occur anytime a liquid or powder chemical comes into contact with skin or mucous membranes that line the eyes, nose, or throat. Chemical burns may also occur if a chemical is swallowed. These burns can cause serious injury and emergency services should be contacted. If a person receives a chemical burn, the chemical should be removed from the skin by using a gloved hand to brush it off and then wash the area with plenty of cool water. Electrical burns can occur if a person has been using an electrical appliance and is exposed to water or if an electrical short occurs while using the electrical appliance. Using faulty or frayed cords on electrical appliances can result in electrical burns. Electrical burns are a serious injury. Emergency medical services (EMS) should be immediately activated.

Never use oils such as butter or vegetable oil on any type of burn as this can cause further injury. For first or second degree burns flush the area with plenty of cool (not ice cold) water for about 15 minutes or until the pain decreases and cover with a clean, dry bandage. Using ice or ice-cold water can cause frostbite (American Institute for Preventive Medicine, 2012). For major burns remove any clothing that is not stuck to the skin, cover the burned area with a dry, clean cloth, and seek emergency assistance. ¹⁴⁴

Guidelines to Prevent Burns

• Install and regularly test smoke alarms.
• Practice fire drills. ¹⁴⁵
• Train staff to use fire extinguishers.
• Teach children to stop, drop, and roll.¹⁴⁶
• Never allow children to use electrical appliances unsupervised.
• Never use electrical appliances near water sources.
• Never use electrical appliances in which the cord appears to be damaged or frayed.
• Never pull a plug from the cord. Always remove a cord from an outlet by holding the base of the plug.
• Cover electrical outlets with childproof plugs. Never allow children to put anything inside an electrical outlet.
• Ensure stoves and other appliances are turned off when finished with them.
• Turn pot handles inward so that a person cannot accidentally bump a handle and spill hot liquids.
• Do not use space heaters and other personal heaters.
• Check to be sure the hot water heater is not set too high. To avoid scalds from hot tap water, hot water heaters should be set to 120 degrees or less (MedlinePlus, 2014).
• Keep chemicals, cleaning solutions, and matches and lighters securely locked and out of reach of children.¹⁴⁷

Safe Sleeping

Sudden Infant Death Syndrome (SIDS) is identified when the death of a healthy infant occurs suddenly and unexpectedly, and medical and forensic investigation findings (including an autopsy) are inconclusive. SIDS is the leading cause of death in infants 1 to 12 months old, and approximately 1,500 infants died of SIDS in 2013 (CDC, 2015). Because SIDS is diagnosed when no other cause of death can be determined, possible causes of SIDS are regularly researched. One leading hypothesis suggests that infants who die from SIDS have abnormalities in the area of the brainstem responsible for regulating breathing (Weekes-Shackelford & Shackelford, 2005).¹⁴⁸

This is a very important topic for early childhood educators as one study found that while data suggests that only 7% of incidents of SIDS should occur while children are in child care, 20.4% actually did.¹⁴⁹

Risk Factors for SIDS

Babies are at higher risk for SIDS if they:

• Sleep on their stomachs
• Sleep on soft surfaces, such as an adult mattress, couch, or chair or under soft coverings
• Sleep on or under soft or loose bedding
• Get too hot during sleep
• Are exposed to cigarette smoke in the womb or in their environment, such as at home, in the car, in the bedroom, or other areas
• Sleep in an adult bed with parents/caregivers, other children, or pets; this situation is especially dangerous if:

• The adult smokes, has recently had alcohol, or is tired.
• The baby is covered by a blanket or quilt.
• The baby sleeps with more than one bed-sharer.
• The baby is younger than 11 to 14 weeks of age.

Important Facts About SIDS

• SIDS happens in families of all social, economic and ethnic groups.
• Most SIDS deaths occur between one and four months of age.
• SIDS occurs in boys more than girls.
• The death is sudden and unexpected, often occurring during sleep. In most cases, the baby seems healthy.
• Although it is not known exactly what causes SIDS, researchers know that it is not caused by suffocation, choking, spitting up, vomiting, or immunizations.
• SIDS is not contagious.¹⁵¹

Reducing the Risks

Although the sudden and unexpected death of an infant cannot be predicted or prevented, research shows that certain infant care practices can help reduce the risk of a baby dying suddenly and unexpectedly. Early childhood educators can help lower the risk of SUID for infants less than one year of age by following these risk reduction guidelines.

Sleeping Position

The chance of an infant dying suddenly and unexpectedly in childcare is higher when a baby first starts the transition from home to care. Research shows if a baby has been placed on his/her back by the families, and the childcare provider places the baby to sleep on his/her stomach, there is a higher risk of death in the first weeks of child care. One of the most important things you can do to reduce the risk of sudden unexpected death is to place babies to sleep on their backs.

Healthy babies do not choke when placed to sleep on their backs. By reflex, babies swallow or cough up fluids to keep the airway clear. Since the windpipe (trachea) is positioned on top of the esophagus, fluids are not likely to enter the airway. (See Figure 3.21)

Babies who are able to roll back and forth between their back and tummy should be placed on their backs for sleep and allowed to assume their sleep position of choice. When infants fall asleep while playing on their tummies, move the baby to a crib onto his/her back to continue sleeping.

Indoor Falls

While most falls occur outdoors, and this topic is addressed in Chapter 4, they can also happen indoors. Teachers (and adults at home) can prevent falls indoors by

• Installing stops on windows that prevent them from being opened more than four inches or install window guards on lower parts of windows. Removing furniture from near windows. Screens should not be relied on to prevent a fall.
• Installing safety gates at the top and bottom of staircases. Installing lower rails on stairs that children can reach and use. Making sure the surface of the stairs stays clear.
• Using safety straps and harnesses on baby equipment and furniture. Children should not be left unattended in high chairs or on changing tables.
• Baby walkers should not be used (licensing prohibits these).
• Teaching children to walk where surfaces may be slick. Preventing these surfaces as much as possible, such as wiping up spills.¹⁵⁵

Indoor Water Safety

Small children are top-heavy; they tend to fall forward and headfirst when they lose their balance. They do not have enough muscle development in their upper body to pull themselves up out of a bucket, toilet or bathtub, or for that matter, any body of water. Even a bucket containing only a few inches of water can be dangerous for a small child.

It’s important that early childhood educators follow the safety practices outlined in Chapter 4 for water safety both indoors and outdoors, keep children under active supervision, and be very aware of containers of water.¹⁵⁶