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S.A.F.E. Model can help prevent playground injuries

By Donna Thompson, Susan D. Hudson, and Heather M. Olsen

If you ask 20 people why children get injured on the playground, you may well get 20 different answers. Each person may have a story about how someone they know got injured. While these anecdotes are interesting, they provide no guidelines for those interested in making the play environment safe for all children. What is needed is a framework or conceptual model that helps us visualize the play environment and possible risk factors in that environment.

The model must represent the specific variables in the environment and indicate the possible relationships and interactions of those variables in producing safe play areas. In other words, to build this model, first we must ask the question, "What are the risk factors within the play environment?" Then we must understand how the risk factors might interact with one another to raise the probability of injury.

In 1995, the Centers for Disease Control and Prevention (CDC) funded a project at the University of Northern Iowa, which created the National Program for Playground Safety (NPPS). The mandate of the program was to raise awareness about playground safety and the need for injury prevention. One of the first tasks undertaken by the NPPS was to create a conceptual model for playground safety. The NPPS accomplished this task by calling together leaders in the fields of early childhood, elementary, and physical education; parks and recreation; and safety to answer the following question: What constitutes a safe play area? The conceptual model was published in 1996 in the National Action Plan for the Prevention of Playground Injuries (Thompson and Hudson, 1996), which was released during a national news conference in Washington, D.C. The purpose of the model is to provide a blueprint for the creation of safe play areas.

The model consists of four elements that lay the foundation for safe play areas:
S = Supervision
A = Age-appropriate design
F = Fall surfacing
E = Equipment maintenance

Rather than being hierarchical in nature, these four elements interact with one another to create a safe play environment. In other words, working on one element alone, such as surfacing, will not prevent all injuries unless supervision, age-appropriate design, and maintenance are also considered.

For example, let’s say a 3-year-old child fell from a horizontal ladder onto a grass surface under the equipment and broke her arm. The hard ground under the equipment (inappropriate surface) will be cited as the cause of the injury, but was it really the only cause? Was it not also a lack of supervision, since it is questionable whether a 3-year-old should be on a horizontal ladder? Was the 3-year-old developmentally able to grip the bars of the ladders? What about the lack of maintenance, which resulted in inappropriate surfacing under and around the equipment? It is evident that all four elements contributed to the injury.

These four elements will be completely explained in the succeeding chapters. Chapters 2 and 3 examine the importance of supervision; chapters 4 and 5 discuss how an understanding of children’s developmental needs translates into designing developmentally appropriate play areas; chapters 6 and 7 investigate the latest information about surfacing materials; and chapters 8 and 9 describe maintenance factors that contribute to safe play areas.

We can also see that the four elements depicted in the S.A.F.E. model can also be called risk factors. For instance, if a doctor says that you are at risk for a heart attack, she probably is basing her assessment on the fact that you have certain risk factors such as high blood pressure, too much body fat, high cholesterol, and so on. The more risk factors present, the higher the probability that you will have a heart attack. The same thing can be said about the four elements of the S.A.F.E. model: The absence of proper supervision, developmentally appropriate equipment, adequate surfacing, or proper maintenance raises the probability of injury.

How Playground Injuries Occur

Being aware of risk factors in the environment is only the first step in coming to a complete understanding of how children are injured. These risk factors provide us with a broad understanding of what can contribute to injuries but does not provide us with specific reasons why a child is injured. To further understand playground injuries, we must turn to another model, shown in figure 1.6, for a more detailed explanation of the causes and effects of injuries in the play environment. The components of this injury model are triggers, unsafe actions and conditions, prevention, and consequences.

Risk factors are the triggers that initiate the possibility of injury. For every risk factor, there are unsafe conditions, unsafe actions, or a combination of the two that, unless prevented, will lead to injury. For instance, in the area of supervision, an unsafe condition would be the presence of an industrial trash container on or adjacent to a playground where children play on a daily basis. In a real-life legal case, the lid of such a container blew over as children were lining up at the end of recess. The lid landed on top of a child, causing a severe brain injury. Was the cause of the incident improper supervision by the adult who allowed the children near the container, or was it the existence of an inappropriate condition (trash container on the perimeter of the playground)? In this case, both the supervision and location proved to be the deciding factors in the settlement of the case for the plaintiff.

Unsafe Actions and Conditions
For each of the elements in the model, unsafe actions and conditions might exist. For instance, in the area of supervision, an unsafe behavior would be children playing on equipment without adult supervision. An unsafe condition would be a piece of equipment that lacks viewing holes to show whether a child is present (as in the cautionary tale at the beginning of the chapter).

In the area of age-appropriate design, an unsafe action would be older children inappropriately using equipment meant for younger children. This can lead to two problems. First, the older children might get hurt through unsafe play behavior, and second, younger children may model the inappropriate behavior of older children.
An unsafe condition would be a lack of separate play areas for children aged 2 to 5 years and children aged 5 to 12 years.

An unsafe action in the area of surfacing would be when children leave toys and other equipment under and around elevated playground equipment, which generally occurs at child care centers. When children fall off the equipment, they fall on the toy as well as the surface. An unsafe condition would be a lack of sufficient loose fill material to absorb a fall.

Finally, an unsafe action in equipment maintenance would be a lack of inspections of the play area. If no one routinely checks the equipment, an unsafe condition, such as loose bolts on a swing set, may occur. As a result, the swing hanger may come loose when a child is midflight on a swing.

Injury Prevention
If no preventative measures are taken, unsafe conditions and actions can lead to injuries. While we have been discussing injuries to children, injuries can also occur to the environment. For instance, lack of routine surfacing maintenance (i.e., replenishment of loose fill materials under swings) can lead to the development of holes (see figure 1.7). The hole is not only an unsafe condition that can lead to injuries such as a broken leg, but it also deteriorates the overall integrity of the ground, leading to further erosion and drainage problems.

Prevention comes from awareness of the elements of the S.A.F.E. model. That is why understanding the information in this book is so important. It is through awareness, education, and training that action can be taken to avoid the risks associated with each of the S.A.F.E. elements.


This is an excerpt from S.A.F.E. Play Areas: Creation, Maintenance, and Renovation.

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