May 13, 2003

BIRMINGHAM, AL — A new study published in the April issue of the Journal of Safety Research suggests that, contrary to popular belief, children who are clumsy are not more prone to injuries than their graceful peers.

University of Alabama at Birmingham (UAB) psychologist David Schwebel, Ph.D., directed the study to determine the link between children’s motor ability and unintentional injuries. The study found no correlation between the children’s motor skills and injuries, even after controlling for injuries related to sports, age and gender.

“This study adds to a small but growing body of literature suggesting motor skills are not directly related to injury risk,” Schwebel said. “Rather, motor skills may play a role in injury risk in conjunction with other factors such as exposure to hazards and temperament.”

Accidental injuries are the leading cause of childhood mortality in the United States, according to the National Safety Council, causing more deaths than all diseases combined. More than 235,000 children, ages 14 and under, were treated in hospital emergency rooms in 2001 for playground injuries alone.

Schwebel’s study involved 50 6-year-old children and 50 8-year-olds who were asked to complete nine tasks to assess their motor ability. The tasks included walking across a balance beam, balancing a block on their head, balancing on one foot, stringing beads, retrieving a ball by hand, retrieving a ball by foot, pouring water, tossing a bean bag and catching a ball.

Researchers evaluated the children’s motor skills based on how well they performed each task. Parents completed questionnaires about the children’s history of injuries. In addition, the children’s families were asked to record any injuries the children sustained during a two-week period.

Using information from the diaries, researchers coded the children’s injuries on a four-point scale: minor injuries requiring no treatment; minor injuries requiring home first aid; major injuries requiring multiple first aid tasks such as washing, ointment and bandages; and injuries requiring professional medical treatment. Researchers also noted whether children received injuries during organized sports since sports can put coordinated children more at risk for injuries than other children.

One explanation for the study’s findings, said Schwebel, could be that coordinated children participate more in sports, bike riding and other physical activities than clumsy children. This fact could therefore increase their opportunity for injury, thereby explaining the results. Behavior may interact with a child’s motor ability such as when a child overestimates his or her physical abilities. Past studies have shown that children who estimate that they can step further or reach higher than they actually can are more prone to injuries than other children. Studies show that impulsive or highly active children are more likely to overestimate their abilities.

Thus, it may be that a child’s motor skills alone are not a predictor of a child’s injury risk, but that poor motor skills, along with other factors like behavior, may make a child more prone to injuries, Schwebel said. Further research is needed to determine if there is a link between motor ability and behavioral factors that leads to injuries.

“Results of the study could have implications to the engineering of children’s toys and playground equipment and to the design of appropriate supervision strategies for children engaging in potentially dangerous activities,” Schwebel said.

Schwebel says playground manufacturers need to develop equipment that allows both coordinated and awkward children to push themselves to their physical limits — helping them develop motor skills, balance and strength — but that will not create an injury risk for even clumsy children.

The study’s co-authors are Jodie Plumert, Ph.D., University of Iowa; Stephanie Binder, Virginia Tech University and Jessica McDermott Sales, M.A., Emory University.