Is toddler skateboarding too risky?

[orthodoxjay1]

I looked online and several website reference the AAP, and in particular a brief article published in Pediatrics in 2002. The article is attributed to a committee comprising maybe a dozen doctors. A brief search reveals a handful of other articles on skateboards and scooters; due to time constraints I picked just one other article to read, a 2018 article in Research in Sports Medicine. (Since this is not my field, I don't know the quality of either of these journals.)

1. Committee on Injury and Poison Prevention 2001-2002. 2002. “Skateboard and Scooter Injuries.” Pediatrics 109 (3): 542–43.
2. Feletti, Francesco, and Eric Brymer. 2018. “Pediatric and Adolescent Injury in Skateboarding.” Research in Sports Medicine 26 (1): 129–49.

I'll try to report the most relevant findings, and I'll cite statistics with locutions such as, "maybe / it seems like x% of injuries involve F." The 'maybe,' etc., is because typically the statistics are reported in the papers, citing one or more other studies and varying quality.

Pediatrics

Several websites reference the AAP article (1), and in particular,

Young children may be at high risk of injury from skateboards and scooters because their judgment of their own skills and strength is often poor, as is their ability to judge foot or vehicular traffic. Their center of gravity is higher than that of older children and adults, their neuromuscular system is not well developed, and they are not sufficiently able to protect themselves from injury. For these developmental reasons, children younger than 5 years should not ride skateboards... (p. 542)

I'm surprised by the bolded part; other activities requiring strength, balance, and coordinations, such as bicycling, are fine for toddlers, as far as I know. The recommendation that all children under 5 refrain from skateboarding cites 'Retsky J, Jaffe D, Christoffel K. Skateboarding injuries in children. A Second wave. Am I Dis Child. 1991;145:188–192' (I did not follow up). It looks like, around the time of writing, most reported injuries were to the ankle, wrist, and face, and about one-third of those involved fractures or dislocations. Among injuries involving hospitalization, 25% were caused by motor vehicles (p. 542).

The abstract for (1) says that many of the skateboard- and scooter-related injuries in children and adolescents "can be avoided if children and youth do not ride in traffic, if proper protective gear is worn, and if, in the absence of close adult supervision, skateboards and scooters are not used by children younger than 10 and 8 years, respectively" (p. 542).

Research in Sports Medicine

The abstract for (2) includes,

This paper reviews scientific literature on the features, outcomes and risk factors related to skateboarding injuries. Findings suggest that while skateboarding injuries can be severe, skateboarding is not as dangerous as it might appear if appropriate risk management steps are taken. Skateboarding should be encouraged as a worthy physical activity and local communities should consider providing specialised, supervised spaces for young people to practice this sport. (p. 129)

According to (2), most injuries (of the data considered) occurred to upper and lower limbs, e.g., hand and wrist. Head injuries might occur in 3-10% of injuries and be more commong in children under 10 (p. 132). Fractures account for 29-61% of all (presumably, all pediatric) injuries; and it looks like concussions account for 3-5% (p. 139). The paper suggests that fractures have worse outcomes for younger children due to skeletal immaturity (e.g., they disrupt growth) (pp. 139-140). Maybe 2-3% of skateboarding injuries in pediatrics require hospitalization (p. 140). Fatality is exceedingly rare among young children; 'moderate' to 'severe' injury occurs in maybe 17% of injury cases (p. 140). Also, one study reports that "children 11–14 years of age represented the majority (44.9%; n = 13,825) of children/adolescents treated in EDs for skateboarding related injuries. This group were also more likely to require hospitalisation compared to younger children" (p. 141).

Despite the (highly plausible) assumption that protective gear descreases likelihood of injury, "reports suggest that 17-87% of children and teenagers... do not use helmets or other protective equipment" (p. 142). Also noteworthy: "The results of several studies indicate that between 38% and 62.5% of skateboard-related injuries result from activities in spaces shared by motor vehicles" (p. 138).

After reading these two papers, I'll carefully consider whether to let my toddler try a skateboard in a controlled setting, with full protective gear, with my direct supervision, and while maintaining slow speeds only.

Any 'scholarly' thoughts (i.e., thoughts that are not purely anecdotal but have something to do with data or studies) are welcome!

 

[alger]

@orthodoxjay1 I will say, as a parent to a 4 year old that is on a skateboard occasionally, what we did was start as young as possible with a balance bike, always wore a helmet, that progressed to pedal bike with no training wheels ever needed. I think establishing balance early on is important in a young kids active development! Also, get them comfortable with the skatepark area, respecting the rules and all that jazz.

 

[orthodoxjay1]

@alger How well can your 4-year-old balance on the board? Can your child push and, e.g., foot-brake?

 

[epiphany777]

@orthodoxjay1 Sounds like it's better to start young in a safe way so they can handle it when they are older better.

 

[orthodoxjay1]

And for those of you with scooters, do look into that. The AAP article made scooters sound fairly dangerous, too!

 

[faithangel2017]

@orthodoxjay1 The AAP make sleeping sound dangerous

 

[orthodoxjay1]

@faithangel2017 They seem risk-averse, anyway.

 

[knotty]

@orthodoxjay1 I cannot even remotely imagine letting my under 5 ride a skateboard. I challenge your assertion that there are other activities that require the same amount of strength and coordination that people allow other under 5s to do. I do not know any under 5s that ride bikes without training wheels, but even so, I think riding a normal bike requires a lot less coordination than a skateboard, and reasonably a child could demonstrate proficiency before being given a bike without training wheels in a way that is not possible with skateboarding.

 

[orthodoxjay1]

@knotty Thanks for your input. Perhaps bicycling requires less coordination, etc., than skateboarding, but I don't have a good reason to believe that. Bicycling with training wheels requires less coordination, but it is not good preparation for pedal-bicycling, but many children these days use balance bikes when very young (e.g., 1-2 years old). Typical balance bikes do not have brakes and permit (downhill) speeds faster than I would permit on skateboards.

 

[kenniel]

@knotty I do know a number of under-5s who can use a pedal bike without training wheels, and 2-year-olds who can go at quite a clip on scoot bikes. All that said, skateboards were always beyond my abilities. If I do let my kiddo use them young, it'll be with the supervision of someone who knows what they are doing.

I also agree with the other commenter who noted that training wheels teach habits that are counterproductive to skilled riding. For example, they keep you from properly leaning into a turn. I think a kid can reach maximum proficiency for training wheels and still be unprepared for two-wheel biking.

 

[knotty]

@kenniel Yeah, that’s not my forte, so I’ll take your word for it. I still think children can demonstrate proficiency (walk along with parents, balance bikes, etc) in ways that you cannot with skateboards. Also the main reason kids want to do skateboard is to do tricks - much less of a temptation with bikes.

 

[kenniel]

@knotty The point about tricks is a good one. Currently my kiddo seems interested in them mostly from a locomotion standpoint, so I hadn't thought about that aspect.