Rules, compliance and injuries to preschool children

Purpose: To examine the relationships between maternal rules and child compliance, both self-reported and observed, and medically attended unintentional injuries to preschool children. The primary hypothesis was that rules and committed child compliance are inversely related to injuries among young children. Methods: 278 mothers of three-year-old children were interviewed about the number and nature of rules of conduct for their children, their insistence on compliance and the mothers' assessment of the children's compliance. In addition, the mothers and their children were videotaped in several laboratory settings including one in which the children were permitted to play with only one of two sets of toys. Mothers' follow-through with this rule, their socialization and disciplinary strategies, and the children's compliance were all coded. Children's injuries were identified by comparing the mothers' report of child injuries and the abstraction of the children's medical record. Results: Mother's observed follow-through with the established rule and observed children's committed compliance were significantly and inversely related to the children's medically attended injuries even after controlling for education, socioeconomic status and race. In contrast, the self-reported measures of rules and assessment of children's compliance were not related to child injuries. Conclusions: While there was substantial variance in the mothers' reports of the number of rules, rule insistence and compliance, it was her actual follow-through that was protective of injuries. Similarly, only observed committed compliance, neither maternal reported compliance, nor observed situational compliance, while common at this age, were protective.