A Heads Up on Bike Safety

Newswise — Joshua May turned 11 years old Jan. 2. He has had more than 17 surgeries, but he is one of the lucky ones.

On Aug. 3, 2002, Joshua was riding his bike with his grandfather when an older woman driving around the corner didn't see Josh and hit him with her vehicle. Instead of slamming on the brake, she pressed the gas, throwing Josh completely under her vehicle and dragging him into the neighbor's yard.

He severely fractured both legs in several places. He had an open fracture on his left femur and on his right tibia, and an open wound in his scalp. But Josh had been wearing a helmet—which saved his life.

Biking is a fun way for kids to be active and get outside, but danger lurks beneath those tire spokes. Each year, bike-related crashes kill about 900 people and injure 567,000 others. About 30 percent of those deaths were children, and 60 percent of those taken to the emergency room were children.

According to Elaine Ledwon-Robinson, director of speech language pathology and Pediatric NeuroRehabilitation at the University of Michigan Health System, statistics show that 67,000 of these injuries are head injuries" and most of them, 80 percent to 85 percent, would have been less severe or prevented altogether if the rider had been wearing a helmet.

Even though more people than ever before report using bike helmets, only half of the 80 million riders wear them all the time; and about 43 percent of riders never put on the protective headgear.

According to Robinson, the brain injury or head injury that can occur when a head hits the ground or a car in a bike accident is the most serious danger riders face. Broken bones may be uncomfortable but typically will heal. Brain injuries can have lifelong effects on many of the important things we do automatically everyday, like walking, talking and remembering.

The littlest victimsRobinson says brain injuries are especially critical in children because their brains are still developing. If nerves and neurons in the brain are impaired, they may not be able to fully develop. These injuries have lifelong effects, and we may not see the full effect of injuries until a child is much older when he or she may have difficulty making good decisions or completing complex activities.

After the injuryRehabilitation technology has grown far more sophisticated in recent years to help children who experience serious brain injuries. There are many therapies that centers like U-M's Pediatric NeuroRehabilitation Program can provide to children entering rehab programs. Many therapies can really improve their abilities or compensate for residual differences, explains Robinson.

As part of rehabilitation, therapists often use games to help children work on these much-needed skills. "We often use a variety of games and really fun-filled activities, so in a sense the kids are having fun, but they're also working on the skills they need," explains Robinson. The types of therapy used in rehab vary according to the type of injury. Some children have significant motor problems and need to relearn how to walk or use their hands effectively for fine motor skills.

Many children who endure brain injuries may have difficulty with their vision systems after the accident. Because of the brain injury, they may only be able to see part of their visual field and need to be trained to scan the whole visual field again"something that would have occurred naturally before.

Communication issues also arise with significant brain injuries. Robinson says children may have difficulty thinking of the words they want to use, or may have difficulty reading how their speech affects others and understanding cues. "For example, if someone frowns at them, they may have trouble understanding the meaning behind the expression and how to change their communication to suit the situation," Robinson explains.

Memory problems also commonly result from significant brain injuries. Children may have difficulty remembering something they just did, or may store it in their memories but need help to retrieve it. "We teach them the tricks that will help them pull these memories out. It's kind of like storing something in a file cabinet and they can't find the file. As part of therapy, we help them figure out how to do that search," Robinson explains. However, the problem is that it is impossible to predict how much a child will be able to improve and how often residual problems from the injuries will occur down the road. According to Robinson, although children may be able to compensate very well for their problems, they are not necessarily going to have the same potential that they had before the brain injury—which is devastating news to families and can mean significant implications for the rest of these children's lives.

Safety first"Bike helmets are absolutely amazing," says Rachel May, who knows that if her son Josh had not been wearing the protective headgear, he would not have survived his accident. "The helmet was able to take the impact of what happened to him under that car."

Joshua May agrees, "I want kids to know that wearing a bike helmet is very important and saved my life. Maybe it will save theirs too."

Bike helmet tipsWhen buying a bike helmet, parents should look for a few key things and most bike stores are happy to help with fitting: