America's play grounds: make them safe!

Each year over 200,000 children are injured on America's playgrounds. Despite efforts by concerned professionals like those associated with the National Playground Safety Institute (NPSI), created by NRPA in 1990 to address this problem, the rate of injury has remained relatively stable from 1990 - 1995 (Mack, Hudson and Thompson, 1997). One of the reasons, is that playground safety is a complex issue. For instance, we know that falls to surfaces account for over 150,000 injuries (Mack, Hudson and Thompson, 1997). The simple answer in solving this problem would be to make surfaces safer. However, the deeper issue is why did children fall in the first place? Was it because they were on equipment that was too difficult for their developmental abilities and skills? Was it because two children were using the equipment inappropriately without adult supervision? Was it because the equipment was worn and a piece broke, sending the child tumbling to a non- resilient surface?

Just as we can't solve complex problems with simple answers; the issue of playground safety cannot be solved by one organization or group. Rather, to be successful in dealing with playground safety, partnerships among groups, organizations, and individuals on the national, state and local levels need to happen. How can this be accomplished?

In October 1995, the Center for Disease Control and Injury Prevention (CDC) funded the National Program for Playground Safety at the University of Northern Iowa, Cedar Falls, Iowa. The program established five major goals:

1. to create a National Action Plan for Playground Safety;

2. to disseminate information about playground safety nationwide;

3. to act as a clearinghouse for information concerning playground safety;

4. to create training and curriculum materials on playground safety;

5. to conduct research on impact attenuation of surfaces.

This article discusses the first goal - the National Action Plan for the Prevention of Playground Injuries.

Creation of a National Action Plan for the Prevention of Playground Injuries

In order to define the issues surrounding playground safety, a national advisory board comprised of professional representatives from the NPSI, the National Safety Council, National Safe Kids Campaign, American Association for Leisure and Recreation and the National Association for the Education of Young Children, as well as manufacturers, physicians, nurses, educators, parents, and child-care consultants met in January 1996 to answer the question: How can injuries to children on playgrounds be prevented? The group initially developed 72 items which, through a process of discussion and friendly debate, were pared down to 33 elements. Through a computer modeling technique these 33 elements were placed in a schematic diagram to show their relationship to playground safety. The program staff then analyzed the diagram and developed a rough draft of a national plan for review by the board. Further refinement of the plan was done throughout the summer of 1996, supported by input from the advisory board and other selected groups.

On September 18, 1996 the National Action Plan for the Prevention of Playground Injuries was released during a national press conference in Washington, D.C. with Senator Thomas Harkin (Iowa), CPSC Chair Ann Brown, CDC Director Dr. Mark Rosenberg, and Injury Prevention, and National Program for Playground Safety Director Dr. Donna Thompson. The plan emphasized the need to "protect our children" on the nation's playgrounds.

The National Action Plan for the Prevention of Playground Injuries

The purpose of the National Action Plan for the Prevention of Playground Injuries is to provide a blueprint for playground safety. It is designed to be used by adults who care about children. Recreation and park personnel, teachers, parents, caretakers of children, and other concerned adults all have a role in providing safe play environments.

Early on during the analysis process it was clear that four elements comprise the foundation of playground safety. The elements are: 1. design of age-appropriate playgrounds; 2. proper surfacing; 3. proper supervision of children; and 4. proper maintenance of playgrounds. It was also evident that these four elements interacted with one another in providing a safe play environment (See Fig. 1). Action in one of the areas affects the others; simply making a safer surface will not prevent all playground injuries, unless supervision, maintenance and age-appropriate design are also considered.

[Figure 1 ILLUSTRATION OMITTED]

The plan is divided into four sections, each highlighting an element of playground safety.

The first element described in the plan is the need to design age-appropriate playgrounds. Safe playgrounds match developmental needs of children while offering challenging opportunities. For example, horizontal ladders provide a challenge as well as the chance to develop upper body strength for school-age children. However, preschool children do not have the same physical development. The preschool child who attempts to use a horizontal ladder is exposed to a potentially serious injury.

To achieve this element, the plan Our lines three areas where action can be taken: 1. assess the age-appropriate design of playgrounds; 2. choose age appropriate equipment; 3. advocate that all playgrounds be designed age appropriately.

In addition, the plan suggests action steps that can be taken in these three areas on the national, state and local levels. For instance, it is suggested that professional organizations, like NRPA develop and promote information about the design of age-appropriate playgrounds; create training workshops and seminars concerning how to choose age-appropriate equipment; and help identify and promote information about developmental characteristics of children with regard to the creation of safe playgrounds.

The second element discussed in the national plan is that of providing proper surfacing under and around playground equipment. Research has shown that asphalt, concrete, dirt, and grass are inappropriate surfaces (Ramsey and Preston, 1990). Research also indicates that 80% of current public use playgrounds have these inappropriate surfaces (Thompson and Bowers, 1989). In this section of the plan, the following actions are proposed: 1. evaluate current surfacing situations; 2. select proper surfacing under and around equipment; and 3. improve surfacing for the future.

Action steps that professional organizations such as NRPA can take to help with this goal include: providing ongoing dissemination of information about appropriate playground surfaces; providing educational programs about the importance of playground surfaces; and--through programs like NPSI--train members about the role that proper surfacing plays in creating safe playgrounds.

The provision of proper supervision on playgrounds is the third element in the plan. Children should be allowed to fully explore play environments. Running, climbing, swinging, jumping, and other behaviors occur as children interact with playground equipment. However, the freedom to explore play settings should happen with the presence of adult supervision. It is estimated that more than 40% of playground injuries may be related to inadequate supervision (King, 1990).

Actions to be taken for this element include: 1. appraising current supervision plans; 2. specifying the supervision methods to be used; and 3. enhancing supervision practices. Action steps that can be taken on the national level by organizations like NRPA include: disseminating information concerning good supervisory practices for playgrounds, developing model supervisory plans that can be used on community playgrounds and educating its members as to the importance of supervision on playgrounds.

The fourth element in the National Action Plan is the provision of proper maintenance. Proper maintenance of playgrounds includes scheduled inspections and maintenance of both equipment and surfaces. This should be done by "trained personnel with necessary resources."

In order to achieve this goal, the following actions should be taken: 1. review maintenance policies and procedures and 2. improve maintenance practices. The plan proposes that national organizations like NRPA provide educational programs for risk managers and insurance carriers about the importance of good maintenance policies. It also suggests that organizations provide workshops and seminars using NPSI and it's playground safety inspector certification plan as a model to help promote good maintenance practices on our nation's playgrounds.

Implementation of the National Action Plan

As the plan points out, issues of playground safety can only be solved when people on the local, state and national levels collaborate and cooperate to: 1. promote awareness of the problems; 2. develop possible solutions for the problems; 3. analyze solutions for their effectiveness; and 4. educate people about solutions that work.

The National Program for Playground Safety through the creation of the National Action Plan for the Prevention of Playground Safety has attempted to provide a blueprint for this collaboration. The program will facilitate collaboration and cooperation through dissemination of information on its world wide web site (http://www.uni.edu./coe/playgrnd) and 800 hotline (800-554-PLAY) and by maintaining a national clearinghouse of materials on playground development and safety. However, it is up to other professional organizations--National Recreation and Park Association, American Association for Leisure and Recreation, National Association for the Education of Young Children, National Safety Council and Parent's/Teachers Association--to join us in this undertaking, if playground safety is to become a reality. None of us can do it alone.

All of us working together can achieve the goal of making our nation's playgrounds safe for every child.