Accident Analysis and Prevention 41 (2009) 670–675 Contents lists available at ScienceDirect Accident Analysis and Prevention journal homepage: www.elsevier.com/locate/aap The role of risk-taking and errors in children’s liability to unintentional injury Richard Rowe a,∗ , Barbara Maughan b a Department of Psychology, University of Sheffield, Western Bank, Sheffield S10 2TP, UK b King’s College London, Institute of Psychiatry, MRC Social Genetic and Developmental Psychiatry Centre, UK article info Article history: Received 21 August 2008 Received in revised form 15 January 2009 Accepted 16 March 2009 Keywords: Children Risk Error Hyperactivity Accident Injury abstract There is likely to be heterogeneity in the processes putting children at risk of injury. This paper exam- ines whether errors may form a dissociable process from risk-taking. We further examine whether these constructs mediate the links between emotional and behavioural problems and unintentional injury. We designed the parent-report Children’s Injury Related Behaviour (CIRB) questionnaire to measure errors and risk-taking in everyday activities. The sample consisted of 499 children aged 4–11 years recruited from the community. Principal components analysis showed that a two factor solution was appropriate and provided scales to measure risk and error with good psychometric properties. Both risk and error scales were independently related to injury history. Errors were associated with conduct problems, emo- tional problems and hyperactivity. Risk-taking was associated with conduct problems and hyperactivity only. Risk-taking and errors accounted for the links of conduct problems and hyperactivity with injury involvement. The distinction between risk and error has implications for research and interventions to reduce childhood injuries. © 2009 Elsevier Ltd. All rights reserved. Identifying the causes of childhood unintentional injury is of great public health importance. During 2003, unintentional injuries were responsible for 37% of deaths in children aged 4–11 years—a rate of 5.8 deaths per 100,000 in the US (National Center for Injury Prevention and Control, 2006). A growing body of litera- ture identifies children’s behaviour problems as risk factors for injury (Lalloo et al., 2003; Rowe et al., 2004). Longitudinal research indicates that behavioural problems, such as aggression and hyper- activity, and emotional problems, such as anxiety, increase risk of injury (Rowe et al., 2007). Given the range of psychopathol- ogy associated with injury, it is likely that more than one type of aberrant behaviour increases risk of injury. Identifying these different types of injury precursor is a crucial step in developing preventative interventions as each may require specifically tailored approaches. A distinction between error and violation has advanced under- standing of precursors to adult accident involvement (Reason, 1990). Errors involve planned actions that do not achieve their intended goals whereas violations are deliberate deviations from practices believed necessary for safe performance (Reason et al., 1990). The distinction has usefully been applied to understand the failures of operators of complex systems during large scale disasters (Reason, 1990). ∗ Corresponding author. Tel.: +44 (0)1142226606; fax: +44 (0)1142766515. E-mail address: r.rowe@sheffield.ac.uk (R. Rowe). The distinction of errors and violations has also been useful in categorizing dangerous driving behaviours (Lajunen et al., 2004). In this context, errors include inappropriate allocation of attention in driving, for example in not observing the trajectories of other vehi- cles. Violations include speeding and driving under the influence of alcohol. Violations have been consistently demonstrated to relate to driving accident involvement while many studies have not found a significant relationship between errors and accidents (Parker et al., 1995; Sullman et al., 2002). Errors have been shown to predict accident involvement, however, in older drivers (Parker et al., 2000) and motor cyclists (Elliott et al., 2007). The present paper examines whether a conceptually similar dis- tinction is applicable to injury-related behaviour in children. In this context violations may be akin to risk-taking. Risk-taking has been identified as a correlate of injury and has been shown to mediate the relationship between problem behaviours and unintentional injury (Bijttebier et al., 2003; Speltz et al., 1990). Morrongiello et al. (2008) found that risky attitudes such as defiance towards safety considerations predict risky behaviours in school age children and were more important than beliefs such as invulnerability and exter- nal locus of control. By contrast, the role of errors in children’s unintentional injury has not been addressed previously. Reason (1990) divides errors into mistakes and attentional slips and lapses. Mistakes involve successful completion of planned actions with failure the result of the plan being inadequate in the first place. Slips and lapses occur when the plan is adequate but the actions are not carried out as intended. Mistakes have been a particularly important component of understanding how a skilled 0001-4575/$ – see front matter © 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.aap.2009.03.004