Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Dr. Amy Damashek

Second Advisor

Dr. Ron VanHouten

Third Advisor

Dr. Galen Alessi

Fourth Advisor

Dr. Helen Pratt


Caregiver supervision, unintentional childhood injuries, teaching caregiver supervision, young children, safety, teaching, scanning, predictine behavior


Unintentional injuries account for a significant number of child deaths and visits to the emergency department. Although increased supervision is routinely shown to be an effective method of preventing unintentional childhood injuries, few interventions systemically teach caregivers behavioral skills to supervise their children appropriately. The present study utilized a multiple baseline design to pilot test an intervention designed to increase caregiver supervision and decrease unintentional childhood injuries by training caregivers how to provide appropriate levels of supervision for their young children (ages 6 to 36 months). Specifically, caregivers were taught in the present study include: (1) scanning the environment (for potential hazards, including child behavior), (2) identifying potential hazards, (3) predicting potential hazardous interactions their child may have with his or her environment and (4) deciding whether to modify their child’s immediate environment or intervene on their child’s behavior in order to prevent their child from contacting a potential hazard or hazardous event. A total of eight caregiver- child pairs were recruited through the Homer D. Stryker Western Michigan University School of Medicine Family Medicine Clinic; four caregiver- child pairs completed the study. The intervention took place within each participant’s home and consisted of a total of six in-home sessions: consent session, four one-hour weekly skill-training sessions, and a follow-up session, which occurred one month after the final skill-training session. Results show that caregiver frequency of scanning their child’s environment increased after training and persisted throughout the intervention phase; the increases displayed by most participants were not maintained at follow-up. Caregivers did not engage in more appropriate responses to potential hazards following the intervention. Additionally, the effect of direct skill training on participants’ hazard identification skills varied across participants. Child injury rate was low throughout the study and did not change as a result of the intervention.

Access Setting

Dissertation-Open Access