ACCIDENTS TO CHILDREN: IMPLICATIONS FOR HEALTH EDUCATION A Thesis Presented to the Faculty of the School of Social Work The University of Southern California In Partial Fulfillment of the Requirements for the Degree Master of Social Work by Margaret Mcglasson June 1950 UMI Number: EP66350 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. Dissertation Publishing UMI EP66350 Published by ProQuest LLC (2014). Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106- 1346 S 'SO A 0 I 4 ^ This thesisj written under the direction of the candidate*s Faculty Cnm.m.ittee and approved by all its members, has been presented to and accepted by the Faculty of the Graduate School of Social Work in partial fulfilment of the re­ quirements for the degree of MASTER OF SOCIAL WORK Dean Thesis .MCGLASSON Faculty Committee Chairman TABLE OP CONTENTS CHAPTER PAGE I. THE PROBLEM AND EMPHASIS IN THIS STUDY........ 1 II* LITERATURE AND TRENDS IN ACCIDENT PREVENTION . . 9 Education in the elementary schools, 1919-1930 9 Emphasis on nWomtBn responsibility, 1930-1940 13 Beginning recognition that the problem belongs to many institutions and many individuals, 1940 to present time • • • • • • • • • • ♦ * 19 III. PRESENTATION OF CASE FINDINGS ............. 32 General findings • • • • • « • • • • • • • * * 32 Place of occurrence • . • * • • • • . * • • « 33 Age of children 38 Significance of multiple accidents • • • • • • 40 Significance of supervision « . . « • « • • • 42 Excessive concern with supervision 45 Significance of overprotection • • • • • • . * 48 Summary of implications of overprotection and excessive concern with supervision • ♦ » • • 52 Analysis of cases where there was no direct supervision at time of accident • • « • • • 53 1 Analysis of cases where there was no apparent neglect 58 Analysis of cases where there was parental neglect and accident seemed preventable • • 59 ii CHAPTER PAGE Summary of implications relating to supervision . . • • • • • • * • • • • • « • • 60 IV. SUMMARY AND CONCLUSIONS ........... 62 BIBLIOGRAPHY • • • •... ....... 69 APPENDIX 72 CHAPTER I THE PROBLEM AND EMPHASIS IN THIS STUDY In a typical year accidents kill more children, more young men and women than any disease# In 1946, according to figures compiled by the National Safety Council, 99,000 per** sons were killed, 10 million were injured in the United States, and the total cost to our nation was more than five billion out of this ten million injured there were approxi­ d o l l a r s #3* mately 370,000 permanent impairments# No one would deny that here is a grave and menacing problem that must be dealt with in some effective manner# Even more serious, perhaps, are the implications of a study prepared by the Statistical Division of the National Safety Council which reveals that accidents are the leading cause of death in children over one year of age*** Each year some 20,000 children in the Uhited States die from accidental deaths# The tremendous figure for additional ones who are seriously maimed or disfigured for life, if available, would make this a more staggering figure# One of the tragic elements 1 Herbert Yahraes, Make Your Town Safe! Public Affairs Pamphlet #133 (Chicago; Public Affairs Committee, Inc#, 1947), p# 3# 2 National Safety Council, Accident Facts (Chicago; National Safety Council, 1949), p# 4# 2 in this is that it is estimated that approximately 70 to 80$ of these accidents are preventable*^ Many believe also that parents are accomplices in these accidents, and it is through parents that prevention must be accomplished* This problem of accident prevention for children has been of concern to the public for many years* Three main trends can be seen in the programs and methods that have been employed in such prevention* The first planned safety work began in 19T9 under the auspices of the National Safety Coun­ cil in cooperation with the schools* Most of the responsibi­ lity for prevention of accidents was delegated to the schools* About 1930 there was a swing from an emphasis on the school vs part in this program to the part that mothers played* Chtll sometime in the 1940 fs f,mom,s,t responsibility for the child overshadowed that delegated to the school; it was her "fault *•, her negligence, that was the root of any and all accidents to the child* The present trend is away from stressing the part that any one person or institution plays in this total pro­ blem* Accident prevention is being recognized as a complex problem* The responsibility for its solution must be shared by many organizations and individuals interested in the wel­ fare of the child* 3 Etta C* Jeancon, 11 Accidental Injuries in Children, " Annals of Western Medicine and Surgery* June, 1949, p* 226* 3 The Children’s Hospital, Los Angeles, provided the setting for a group of studies on accident prevention for children. It is the belief of the administration of the hos­ pital that many accidents are preventable. Four students from the University of Southern California, School of Social Work, were given the opportunity to study all accident cases requir­ ing hospitalization from November 1, 1949 to December 12, 1949 with a view toward determining the validity of this premise, to ascertain factors in the accident causation, and to sug­ gest ways of reducing the number of these accidents. The hos­ pital has been and is still intensely interested in research in this area. Several leading magazines in this country, in­ terested in presenting material based on faets and research, have also indicated a desire for such research. The four students who undertook this study were doing their field work in either a medical or a psychiatric place­ ment, They were interested in the several problems presented by the hospital authorities and, while the objectives of their studies varied, alX pointed to one use - more under standing of the factors leading to accidents. One student studied the specific constellation of factors in the accident itself, or actually "what happened;19 she thought it might be possible to find a definite correlation between certain external environ^ mental factors and the accident phenomena. Such findings, if valid, definitely could be utilized in accident prevention. These would he concrete, easily Illustrated facts that the public could readily see and accept If presented authentically* A second student believed there was much in the parent-child relationship that could be highlighted in a dynamic way toward health education in accident prevention* She examined the ma­ terial available with the idea of discovering, if possible, "what goes on behind all this**' It was her premise that the child actually is led to have many accidents by reason of un­ healthy relationships with the parent, but that these are often on an unconscious level* The parent is not an ogre; he or she will accept health education in this direction if it can be presented logically without too much emphasis on the guilt of the parent in respect to these accidents, and if the material is based on facts that the public readily can assi­ milate and digest* A third student was interested in the im­ plications for casework services or "what can be done now?" This thesis is not being written concurrently with the other three but will be done after the others have been completed* The present study centers around the kind of publicity currently being used in accident prevention, and the trends that have been followed in attempting to solve this problem* Both the literature and the publicity on accident prevention were examined and studied to learn what was of positive value and what was of negative value* The writer, like the hospital authorities, is familiar with the trauma of guilt feelings and the havoc such feelings bring about in the behavior of an in­ dividual* She questioned, therefore, the trends in publicity that increasingly emphasized guilt of a parent In allowing these accidents* She believes that the accident Is traumatic enough without overemphasis of the natural guilt that any parent feels when his or her child is maimed, disfigured, or cruelly hurt* She was interested in examining the overpro- tectiveness of children as related to the accident phenomena; the amount and kind of responsibility that should be delegated to other institutions such as the school, and the amount and kind of supervision needed* What could be done beyond remov­ ing the physical cause of the accident? What were the more common types of accidents and where did these accidents occur? Were there any vital child-parent areas that were being neg­ lected? In reference to current health education and accident prevention publicity, did this study point up possible changes that would result in a more positive approach? What were these people like, this accident population? Had they been fairly rigid all their lives? If so, what would fixing guilt do to them? Would it be found that the problem was Indeed one of health, but also that it was concerned with mental health? 9 ... nt The writer realized that she did not know what was "normal,* but she did have some idea as to what is implied in the terms overprotectiveness, rejection, guilt reactions, and rigidity* Could this knowledge be utilized in accident prevention? Was