The topic of keeping children safe is only partly about policies, rules, and oversight. Those things are important. But most important of all, this is about staff, the people who work directly with children and families. Those people must be supported with opportunities for reflection, professional development, and chances to think about the work they do and why that work is so important. What is challenging in that work, and what comes to them easily? It's the ability of programs to recognize and analyze challenging conditions and be able to make improvements.
Programs must make sure that staff have that sense of commitment and responsibility, and that they have the ability to ensure children are thriving is critical. They have to help make sure staff remember why we do the work, to be curious about children's interests, needs, and ideas, to have the opportunity to be creative, to enjoy children and each other's humor every day. These things, in addition to the policies and procedures, will allow staff to be fully present with children. Adults who can be fully present will keep children physically and emotionally safe and thriving.
The first step to doing this is to create a culture of safety. In this context, culture means the set of shared attitudes, values, goals, and practices that characterize a program; the way things work in that program and in that community. Experts and researchers have demonstrated that the culture of an organization plays a key role in all successful safety initiatives.
This is done by involving every staff member and committing to safety at all levels. Programs shouldn’t assume that nothing will ever go wrong. In fact, they should plan that something is going to go wrong. The goal is to create environments where there is zero harm, making it as hard as possible for things to go wrong.
Directors, managers, staff, and families must all embrace the belief that children have a right to be safe. All the adults in the program, the program leaders and staff, know that they are responsible for every child, all day, every day. People understand their roles and responsibilities in keeping children safe and embrace each of the 10 actions outlined in Table 2.1, that together support a culture of safety. This approach is holistic. It's integrated and community-centered. It isn't an add-on. It's not a burden. It's a way of doing business so children don't get hurt (DHHS, 2018).
Use Data to Make Decisions: Program and incident data serve as an important resource to help managers and staff evaluate children’s safety.
Actively Supervise: Children are never alone or unsupervised. Staff position themselves so that they can observe, count, and listen at all times.
Keep Environments Safe and Secure: Programs create, monitor, and maintain hazard-free spaces.
Make Playgrounds Safe: Regularly inspected, well-maintained, age-appropriate and actively supervised outdoor play spaces allow children to engage in active play, explore the outdoors, and develop healthy habits.
Transport Children Safely: Programs implement and enforce policies and procedures for drivers, monitors, children, and families using school buses, driving to and from the program, or walking.
Transport Children Safely: Programs implement and enforce policies and procedures for drivers, monitors, children, and families using school buses, driving to and from the program, or walking.
Be Aware of Changes that Impact Safety: Staff anticipate and prepare for children’s reactions to transitions and changes in daily routine, within and outside of the program.
Model Safe Behaviors: Staff establish nurturing, positive relationships by demonstrating safe behaviors and encouraging other adults and children to try them.
Teach Families about Safety: Staff engage families about safety issues and partner with them about how to reduce risks to prevent injuries that occur in the home.
Know Your Children and Families: Staff plan activities with an understanding of each child’s developmental level and abilities, and the preferences, culture, and traditions of their families. This includes everything from maintaining current emergency contact information to understanding families’ perceptions about safety and injury prevention.
Specific Risks for Injury
Child injuries are preventable, yet 8,110 children (from 0-19 years) died from injuries in the US in 2017.52 Car crashes, suffocation, drowning, poisoning, fires, and falls are some of the most common ways children are hurt or killed. The number of children dying from injury dropped nearly 30% over the last decade. However, injury is still the number 1 cause of death among children.53
Children during early childhood are more at risk for certain injuries. Using data from 2000-2006, the CDC determined that:
For children less than 1 year of age, two–thirds of injury deaths were due to suffocation.
Drowning was the leading cause of injury death between 1 and 4 years of age.
Falls were the leading cause of nonfatal injury for all age groups of less than 15 years of age.
For children ages 0 to 9, the next two leading causes were being struck by or against an object and animal bites or insect stings.
Rates for fires or burns and drowning were highest for children 4 years and younger.54
Injury in Early Care and Education/Child Care
Families “are naturally concerned for their child’s safety, particularly when cared for outside of the home. However, children who spend more time in nonparental child care have a reduced risk of (unintentional) injury. This may be because child care centers and family day homes provide more supervision and/or safer play equipment. Nevertheless, injuries in child care settings remain a serious, but preventable, health care issue" (Lang et. al, 2009).
Table 9.2.2 – Preventing Injuries
Type of Injury
Prevention Tips
Sudden Infant Death
Always put infants to sleep on their backs
Cribs, bassinets, and play yards should conform to safety standards and be covered with a tight-fitting sheet
There should be no fluffy blankets, pillows, toys, or soft objects in the sleeping area
Don’t allow children to overheat (California Department of Public Health MCAH, 2019)
Choking
Keeping objects smaller than 1½ inches out of reach of infants, toddlers, and young children.
Have children stay seated while eating
Cut food into small bites
Ensure children only have access to age-appropriate toys and materials (American Academy of Pediatrics, 2020; Anderson, 2020)
Drowning
Make sure caregivers are trained in CPR
Fence off pools; gates should be self-closing and self-latching
Supervise children in or near water59
Inspect for any standing water indoors or outdoors that is an inch or deeper.
Teach children water safety behaviors. (California Childcare Health Program, n.d.)
Burns
Have working smoke alarms
Practice fire drills
Never leave food cooking on the stove unattended; supervise any use of microwave
Make sure the water heater is set to 120 degrees or lower61
Keep chemicals, cleaners, lighters, and matches securely locked and out of reach of children.
Use child-proof plugs in outlets and supervise all electrical appliance usage. (McLain et.al, 2016)
Falls
Make sure playground surfaces are safe, soft, and made of impact-absorbing material (such as wood chips or sand) at an appropriate depth and are well-maintained
Use safety devices (such as gates to block stairways and window guards)
Make sure children are wearing protective gear during sports and recreation (such as bicycle helmets)
Supervise children around fall hazards at all times63
Use straps and harnesses on infant equipment. (Mayo Clinic, 2020)
Poisoning
Lock up all medications and toxic products (such as cleaning solutions and detergents) in original packaging out of sight and reach of children
Know the number to poison control (1-800-222-1222)
Read and follow labels of all medications
Safely dispose of unused, unneeded, or expired prescription drugs and over-the-counter drugs, vitamins, and supplements65
Use safe food practices.
Pedestrian
Do not allow children under 10 to walk near traffic without an adult
Increase the number of supervising adults when walking near traffic
Teach children about safety including:
Walking on the sidewalk
Not assuming vehicles see you or will stop
Crossing only in crosswalks
Looking both ways before crossing
Never playing in the road
Not crossing a road without an adult
Supervise children near all roadways and model safe behavior66
Motor-vehicle
Children should still be safely restrained in a five-point harnessed car seat
Children should be in back seat
Children should not be seated in front of an airbag67
Creating a Safety Plan
Early care and education programs have an obligation to ensure that children in their care are in healthy and safe environments and that policies and procedures that protect children are in place. Using a screening tool, programs can identify where they need to make changes and improvements to ensure children are healthy and safe while in their care. A checklist such as the one modified from Head Start’s Health and Safety Screener in Appendix C can be used for this purpose.68
Programs must become familiar with the hazards to children that are specific to their population and location. Considerations for this plan include the type of early education program, ages of the children served, surrounding community, and family environments.
If any hazards are found upon screening, programs can make modifications to remove hazards or use safety devices to protect children from hazards. Care should be taken to ensure that the modifications include children with disabilities and special needs.
It will also be important to use positive guidance to help modify behaviors that put children’s safety at risk. Professionals can use role modeling and communication to teach children how to respond to situations, including emergencies, that put their safety at risk.
Early childhood programs must continue to monitor for safety. This includes regular screening for safety and analysis of data surrounding injuries. Professionals must continuously monitor for conditions that may lead to children being injured and examine both the behaviors of children and adults in the environment (Robertson, 2013).
Documenting Injuries & Injury Prevention
When a child is injured, it is important to document the injury. This documentation is provided to families, typically in the form of an injury or incident report. These should document:
Who was involved in each injury? (child/children; staff, volunteers, family members)
Where did the injury occur?
What happened? (What was the cause?)
What was the severity of each injury?
When did each injury occur?
Who – e.g., what staff were present and where were they at the time of each injury?
What treatment was provided? How was the incident handled by staff?
How could each injury have been prevented? What will be done in the future to prevent similar injuries?
Who was notified in the child’s family? When? How?
It is important to keep these reports to analyze them to:
identify location(s) for high risk of injury.
pinpoint systems and services that need to be strengthened.
develop corrective action plans
incorporate safety and injury prevention into ongoing monitoring activities.71
Hazard Mapping
One such process to do this is hazard mapping, which is an approach to prevent injuries by studying patterns of incidents.
Step One – Identify High-Risk Injury Locations
Create a map of the classroom, center, or playground area. Label the various places and/or equipment in the location(s) that is being mapped. Make the map as accurate as possible.
Place a “dot” or “marker” on the map to indicate where each specific incident and/or injury occurred over the past 3-6 months (or sooner, if concerns arise).
Look at the severity of the injuries.
Identify where most incidents occur.
Step Two – Identify Systems and Services that Need to be Strengthened
Review the information on the injury/incident reports for areas with multiple dots.
Consider what policies and practices are contributing to injuries/incidents.
Step Three – Develop a Corrective Action Plan
Prioritize and select specific activities/strategies to resolve problem areas.
Develop an action plan to correct the problem areas you identified. Include each of the activities/strategies selected in this corrective action plan. Identify the steps, the individuals responsible, and the dates for completion.
Create a plan for sharing the corrective action plan with staff and families.
Step Four – Incorporate Hazard Mapping into Ongoing Monitoring
Determine if any additional questions should be added to injury/incident report forms to obtain this missing information.
When developing corrective action plans, consider prioritizing more serious injuries, even if they have occurred less often.
Make sure there reduction in injuries and/or incidents and the severity of the injuries with a corrective plan.72
Teaching Children about Safety
While it is the adult’s responsibility to keep children safe and children should not be expected to actively protect themselves, teachers should help children develop safety awareness and the realization that they can control some aspects of their safety through certain actions. The earlier children learn about safety, the more naturally they will develop the attitudes and respect that lead to lifelong patterns of safe behavior.
Safety education involves teaching safe actions while helping children understand the possible consequences of unsafe behavior. Preschoolers learn through routines and daily practice and by engaging in language scripts and following simple rules. These scripts and rules may be communicated through voice, pictures, or signs. Children learn concepts and develop skills through repetition, then build upon these as concepts and skills become more complex.
Preschoolers need help to recognize that safe play may prevent injury. Teachers can promote independence and decision-making skills as children learn safe behaviors. Teachers can explain that children can make choices to stay safe, just as they wash their hands to prevent disease, brush their teeth to prevent cavities, and eat a variety of foods to help them grow strong and healthy.
Preschoolers can learn to apply a few simple and consistent rules, such as riding in a car seat and wearing seat belts, even though they are too young to understand the reasons for such rules. For example, four-year-old Morgan says, “Buckle up!” as she gets into a vehicle. Although Morgan lacks the skill needed to buckle the car seat buckle and does not understand the consequences of not being safely buckled into her car seat, she is developing a positive habit. Safety education in preschool focuses on behaviors the children can do to stay safe. It involves simple, concrete practices that children can understand.
The purpose of safety rules and guidance is to promote awareness and encourage developmentally appropriate behavior to prevent injury. Teachers may include separate rules for the classroom, playground, hallways, buses, or emergency drills. Limit the number of rules or guidelines, but foster consistency (e.g., three indoor rules, three playground rules) and base them upon the greatest hazards, threats, and needs in your preschool program and community.
Safety guidance is most effective when teachers have appropriate expectations and safety rules are stated in a positive manner. For example, an appropriate indoor safety rule might be stated, “We walk indoors,” rather than the negative, “Do not run indoors.” On the playground, a rule might state, “Go down the slide on your bottom, feet first.” As children follow these rules, acknowledge them for specific actions with descriptive praise (e.g., “Kevin, you sat on the slide and went down really fast! That looked like fun!”).
State rules clearly, in simple terms, and in children’s home languages; include pictures or icons with posted rules to assist all children’s understanding. Children often are more willing to accept a rule when they are given a brief explanation of why it is necessary. Gently remind children during real situations; with positive reinforcement, they will begin to follow safety rules more consistently. As children develop a greater understanding of safety rules, they begin to develop self-control and feel more secure.
Adults are fully responsible for children’s safety and compliance with safety rules and emergency procedures. Safety education for children, which includes rules and reinforcement of verbal and picture scripts in children’s home languages (including sign language), is essential for handling emergency situations. Through practice and routines, children are better able to follow the teacher’s instructions and guidance. It is essential that teachers evaluate each child’s knowledge and skill in this area, and provide additional learning activities as needed to ensure that all children can follow emergency routines.
Here are some strategies that teachers can use to help children learn about safety:
Incorporate safety into the daily routine.
Involve children in creating rules
Provide coaching and gentle reminders to help children follow safety rules.
Acknowledge children’s self-initiated actions to keep themselves and others safe (such as pushing chairs in and wiping up spills)
Provide time for children to practice safety skills (such as buckling seat belts)
Introduce safety concepts and behaviors in simple steps.
Role-play safety-helpers.
Define emergency and practice what children should do in emergency situations.
Introduce safety signs.
Incorporate musical activities and safety songs.
Because of their level of cognitive development, many young children cannot consistently identify dangerous situations. They may understand some safety consequences and can learn some scripts. But adults must be responsible for their safety. Children often act impulsively, without stopping to consider the danger. By learning and following simple safety rules (e.g., take turns, wear a helmet) and practicing verbal, visual, or sign-language scripts, children establish a foundation of lifelong safety habits.74
Engaging Families
Share written and visual safety messages with families through newsletters, brochures, bulletin boards, Web pages, and take-home activities in the home languages of the families in the program. Emphasize safety issues that relate to your preschool program and community.
Integrate parent information with children’s learning about topics such as poisoning prevention and traffic safety.
Provide safety information through workshops and during parent meetings; include information on a variety of topics, especially those that involve higher risk in specific communities, such as water safety, gun safety, or lead poisoning.
Invite community safety personnel to participate in workshops and share resources and information about how to access community services.
Address specific safety issues, such as vehicle safety and pedestrian safety, through one-on-one guidance during pickup and drop-off times.
During family conferences, find out what messages family members would like teachers to reinforce at school.
During home visits, offer to help families identify potential hazards in their family environment and ways to reduce possible injury.
Post emergency plans on family bulletin boards and provide families with a written copy of the preschool program’s emergency plan. Include responses to different scenarios (e.g., evacuation, shelters), the location of the designated evacuation shelter, and a number to call if family members cannot reach the preschool.
Encourage families to plan and practice emergency drills for fires, earthquakes, floods, violent encounters, or other situations that could occur in their home or community. Provide families with resources to develop a home evacuation plan and drill.
Invite family members to attend the preschool or to serve as guest speakers as children learn about people who can help in emergency situations. Invited guests may include safety or medical personnel (e.g., firefighters, paramedics) or workers in related professions (e.g., construction workers, electricians, meteorologists, cleaning businesses).75
Summary
Active supervision is critical to keep young children safe. When programs create a culture of safety, they go beyond following regulations and policies, by making a commitment to protecting safety so that children don’t get hurt. There are some common risks to safety that educators should be aware or (and that will be covered in more depth in the next two chapters). When early care and education programs create a safety plan using data they have gathered by documenting and analyzing the injuries children get, they can make changes to help protect children’s safety.
While adults have the ultimate responsibility for safety, children can be taught about and families can be engaged in protecting children’s safety. Teachers must also consider the value of risk play when making decisions about what action to take to keep children safe.
Brussoni, M., Olsen, L. L., Pike, I., & Sleet, D. A. (2012). Risky play and children’s safety: Balancing priorities for optimal child development. International Journal of Environmental Research and Public Health, 9(9), 3134–3148. doi:10.3390/ijerph9093134.
Department of Health and Human Services (DHHS). (September 12, 2018). Creating and enhancing a culture of safety Head Start town hall meeting. Retrieved September 18, 2024: https://eclkc.ohs.acf.hhs.gov/sites/...-of-Safety.pdf
Lang, M., Canadian Pediatric Society, & Community Paediatrics Community. (2009). Health implications of children in child care centres Part B: Injuries and infections. Paediatrics & Child Health, 14(1), p. 40-48. https://doi.org/10.1093/pch/14.1.40
Safety and Injury Prevention by McLain, O'Hara-Leslie, & Wade. In McLain, K.B., O'Hara-Leslie, E.K., & Wade, A.C. (2016). Foundations in Assisting with Home Care. Lumen Learning.