January 13, 2014
News Review From Harvard Medical School -- Study Tallies ER Trips for School Assaults
Assaults on children at school lead to about 88,000 emergency room visits each year, a new study estimates. Very few of the assaults involved guns or required a hospital stay. About 40% of the injuries were bruises and scratches. The study was based on a survey of 66 hospitals. It covered the years 2001 through 2008. Researchers estimated nationwide totals based on this limited sample. An estimated 7 million ER trips occurred during those years because of injuries in schools. About 92,000 visits each year resulted from deliberate injuries. Nearly all (96%) were assaults rather than self-injury. Middle-school kids, non-whites and boys were more likely than others to be assaulted at school. Researchers called for better prevention strategies. Injuries that occurred outside of school were more likely to be severe. About 3% involved guns, compared with 0.08% of injuries at school. Outside of school, kids also were more likely to harm themselves or to be harmed by strangers or parents. The journal Pediatrics published the study online. HealthDay News wrote about it January 13.
By Henry H. Bernstein, D.O.
Harvard Medical School
What Is the Doctor's Reaction?
It is one of a parent's worst nightmares if a child at school is ever sent to the emergency room. Even worse is if the child has been hurt at school on purpose.
Intentional (done on purpose) injuries to children are usually related to bullying and other violence. Apparently, they happen all too often at school.
A study just published in the journal Pediatrics looked at the facts and trends of intentional injuries to children. Children in the study were school age, 5 to 19. Information was collected from a sample of 66 hospitals in the National Electronic Injury Surveillance System -- All Injury Program. The years studied were 2001 through 2008.
During those 8 years, there were more than 7 million visits to the emergency room for injuries that happened at school. About 1 out of 10 was described as intentional.
The researchers noticed differences in visits related to intentional injuries based on gender and age:
- Boys were more likely to have an intentional injury at school.
- Girls were more likely to have an intentional injury outside of school.
- Middle-school-aged children (10 to 14) had the highest risk of intentional injury at school.
- Children aged 15 to 19 had the highest risk of intentional injury outside of school.
There also were differences found based on race and ethnicity:
- African-American, American Indian and Hispanic youth were linked with higher risks of intentional injuries compared with accidental injuries.
- These groups' risks of intentional injury were higher in the school setting.
The most common types of intentional injuries at school were bumps and bruises, cuts, and broken bones. A child was more likely to be admitted to a hospital after an intentional injury than after an accidental one. This suggests that intentional injuries tend to be more serious. The researchers concluded that more prevention strategies are needed.
What Changes Can I Make Now?
Too many children are being hurt on purpose at school. Bullying is a big part of the problem. Bullies can frighten a child. They can lower his self-esteem. They also might seriously hurt the child.
You can help your child stay safe from bullies. Use these ideas recommended by the American Academy of Pediatrics:
Teach your child how to:
- Look the bully in the eye.
- Stand tall and stay calm in a difficult situation.
- Walk away.
Teach your child how to say in a firm voice:
- "I don't like what you are doing."
- "Please do NOT talk to me like that."
- "Why would you say that?"
At first, it might be hard for your child to do and say these things. Practice is very important. This will help make it easier to do and say these things if any bullying does happen.
Teach your child when and how to ask for help. Your child should not be afraid to ask an adult for help if he is being bullied. Let your child know that bullying is not his fault. He should not be embarrassed.
Encourage your child to make friends. Children who are loners are more likely to be bullied. Help your child form strong friendships, either in school or at an outside activity.
Support activities that interest your child. Your child will be more confident by taking part in activities like team sports, music groups or social clubs. When children feel good about how they relate to others, they are less likely to be bullied.
Let school officials know if there is a problem. Work with them on solutions.
- When school officials know about bullying, they can help stop it. Talk with the principal, guidance counselor, playground monitors and your child's teachers.
- Write down and report all cases of bullying to the school. By knowing when and where the bullying occurs, you and your child can come up with a plan for the next time it happens.
What Can I Expect Looking to the Future?
More research is needed to understand the link between bullies and victims. I hope that improved ways to prevent intentional injuries will be found.
We all need to do a better job of preventing violence and bullying. New approaches must meet the needs of all children, especially at-risk groups. Once these problems are addressed, schools will be safer places for children -- as they should be.