According to journalist Cathy O’Leary’s article for the West Australian on Friday 26th January, “A Third of PMH (Princess Margaret Hospital – Perth) Admissions Caused By Falls’, almost 18,000 children were treated for injuries at PMH emergency department this last financial year.   With more than one third of that number being the result of falls.  This trend is replicated in all Australian States.  Kidsafe Victoria commented in May, 2017, that falls are the leading cause of emergency admissions and a study published in July 2017 – ’10 Year Review Of Child Injury, Hospitalisation, Health Outcomes and Treatment Costs in Australia’ Mitchell, R.J, Curtis, K., Foster, K. also reflecting these patterns.

O’Leary goes onto to note findings by Kidsafe WA’s childhood injury report that injuries have been steadily increasing in numbers for the past 5 years.  That breaks down to 49 children per day being treated for falls or blunt force injuries at WA’s children’s hospital.   Children under five years of age are at a greater risk of injury and account for 36% of injury presentations.  O’Leary’s article mentions that “Children at these young ages are becoming mobile, however lack the cognitive ability to navigate the world safely, relying on adults to look out for their safety and well being.”Kidsafe Victoria stated that many of the falls in the under five age group where from change tables, high chairs, baby walkers, cots, prams, bikes, scooters and skateboards, many of these are preventable falls.

As parents and carers, we have a responsibility to our children to keep them as safe as possible, whilst still encouraging them to explore, physically navigate their environment and expend energy.  A tough one, as a parent, I know just how difficult this can be.  With love and guidance we try so hard to keep our kids safe, and yes, accidents do happen.  But what about the situations that, as parents and carers we could control a little better?  O’Leary’s article states that ‘Only one per cent of children brought in with injuries, had reportedly used safety equipment.”  I was shocked to hear that this statistic was as low as this. If we focus on the under five year olds, this is certainly something that we can be more vigilant with.  That taking time to ensure that safety equipment such as helmets for scooters and bike use are not only available, fitted correctly and used.  As parents we can ensure then that this becomes a regular part of outdoor play and an essential part of the activity.  In turn, building habits for our children to follow during their lifetime.

It is very easy to encourage parents to use safety equipment with their under five year olds.  However, the challenge of a toddler can be fierce when they refuse to wear the offered equipment.  Or that after a day of asking, pleading, yelling, bribing is just plain exhausting. Toddlers seem to have endless energy and know which buttons to push in order to flatten even  the toughest of parents’ batteries.  They know how to wear us down, to get to the point that we just say “Fine, then just do it your way!”.  To take the path of least resistance as we are only human too and can only take so much.    As exhausting as our loveable but ferocious toddlers are, our responsibility comes down to keeping them safe.  To be worn down is one thing, to keep them safe is another.     So after a day of keeping up with  a toddler or two in your life, heated exchanges and mixed messages from the parent to the child can be common.  There is an easier way, yes you heard me correctly, there are a few tools for your parenting toolkit that can assist you with these every day life.

Rule Setting

Make some time to sit with your parenting partner and come up with a list of things that your toddler does that is unsafe, and things that are important to you both as parents.  Then set about looking at how you can set a rule for your child to help them understand how they fit into their world and what is expected of them in a calm, learning manner rather than just teaching them what not to do.   Let’s look at an example.  You spend half the day yelling at your child to stop jumping on the couch. You spend the other half of the day checking if they are ok after they have fallen off the couch by nearly taking out an eye on the coffee table corner on the way down, or landing awkwardly on a limb that doesn’t usually face that direction.  You hate that you are yelling all day, that you can’t understand why your toddler is not listening to you and learning from you that this behaviour is not tolerated, as well as wondering how long it will be until you are statistic at your local children’s emergency department.  You with me?  Ok so the first thing to do is set the rule in positive tense.


  • RuleCouches are for sitting on.


Let your child know what the purpose of that piece of furniture is for and what the behaviour that is expected of them when using it.  Rather than – Don’t jump on couches, which is set in a negative tense, couches are for sitting is on – the positive. tense.  A good start.   When you find a moment, start to let your toddler know this rule.  You may find them sitting nicely on the couch, and you can let them know – “You are sitting so comfortably/snugly on our couch, do you feel nice a comfy on the couch?”

You have been very clear about parts of the body that are used to sit on a couch and let your child know in a calm and praising manner.  We all love a bit of praise.  Some of you might be waiting quite some time before you find your toddler sitting quietly on a couch – yes some toddlers can actually do this! If it is not your toddler, don’t worry, let them know the rule in the act.  You look across and see your child jumping furiously on your couch.  You go to yell, stop.  Instead, a calm but firm voice, point out what the problem is.  “Liam, couches are for sitting on, please show me how you sit on a couch, bottoms only on our couch.” (It would also help if you have eye contact with your toddler at the same time, then they are more likely to hear you.  Also, consider touching them and showing them what you expect)

There, you said it, clearly stated and with not a hint of anger or frustration, well done.  Your child is more likely to listen to what you have to say in this tone.  This is your warning for the behaviour.  Wait and see what your child does with this clear statement.  If Liam is compliant, then praise him very quickly.  “Great listening Liam, thank you for sitting on the couch / for stopping jumping on the couch.”  You have praised Liam for understanding the request and what part of what he did that makes you happy.   Fantastic outcome and you have just avoided one less fight for the day.  Toddlers are challenging boundaries all the time as they should, this is their job at this age and they are very good at it.   When we are not telling them what to do, they will often be more receptive to participating in our request.   Another outcome may be that Liam continues to jump on the couch despite your request.  He may be testing you out to see what you are going to do about this.   His body may also be overwhelmingly be wanting him to jump, move and develop because he has been sitting inside for a good few hours now.  He can’t keep still any longer.  You need to enforce this rule.  Telling him ten times what the rule is won’t get you anywhere and then you are likely to lose your temper on the eleventh request, to which you mumble to yourself, that this rule stuff doesn’t work!   Be patient, it is a learning goal for both of you.    Go over to Liam and calmly get him down off the couch, if he is receptive, let him know the rule again – ‘Couches are for sitting on, I can see that you are not sitting on the touch, now please get down.”

The next step is to distract or divert his attention.  If it is appropriate you could take him to an area where he can jump in safety where you are present and on an appropriate object.  alternatively distract him onto another activity.   Distraction takes time, young children are described as ‘single channelled’.  This means they can get very focused on one activity and it can take up to 10-15 minutes where you may need to stop and help your child engage with another activity without them constantly returning to the undesirable activity.

Be consistent.  If you see your child returning again to a behaviour you are trying to stop remind them quickly of the rule each time.  It shows that you are watching and what you expect.  Be prepared to act quickly.  Remind your child of the rule, distract or divert to an appropriate activity.  In some cases, you may action a consequence.  For example, your child refuses to put their bike helmet or knee pads on, however, they want to ride their bike.  Simple!  The rule alters to “When you have your helmet on we can get your bike out of the garage”.   If they take their helmet off, remind them the rule, guide them to put their helmet on, remove the bike for a period of time if they aren’t cooperative or let them know how wonderful it is that they are getting to ride their bike (with their helmet on).

Child Health Nurse, Caroline Radford is currently running the Caroline’s Angels Perth Toddler Seminar Series.  This is a three part series focusing on toddlers and how as adults we can guide them through this tricky age whilst supplying parents with tips, strategies and most of all understanding for their own unique toddler.

The next seminar in the series is Toddlers and Tantrums which will be held on Tuesday 6th February, 2018 7.15pm at the Telethon Speech and Hearing Centre’s Auditorium.  Guiding toddler behaviour, rule setting, why tantrums occur and how to manage them will all be part of the discussion on Tuesday night.

If you would like to attend our Toddlers and Tantrums session, details are below with further information and ticketing.  The $55 ticket price includes your parenting partner or one grandparent to attend with you.


Happy Toddler Days

Caroline and Caroline