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 THE DEVELOPMENT OF AN EDUCATION PROGRAM EFFECTIVE IN REDUCING THE FIRE DEATHS OF PRESCHOOL CHILDREN

By

Sharon Gamache, National Fire Protection Association Center for High-Risk Outreach,
Don Porth and E. Diment, Portland (OR) Fire & Rescue

S. Gamache, D. Porth, (2001). "Human Behaviours in Fire: The development of an education program effective in reducing the fire deaths of preschool children." Proceedings from the 2nd International Symposium on Human Behaivour in Fire, March 26-28, 2001. Massachusetts Institute of Technology, Cambridge, Massachusetts.

SUMMARY

To address the problem of fire deaths among young children, the NFPA Learn Not to Burn® Foundation, now known as the Center for High-Risk Outreach, created the Learn Not to Burn Preschool Program for children ages 3 to 5. The program was evaluated among children in Head Start programs in North Carolina and showed a 37% knowledge increase from the pre-test to post-test. In addition, several states and localities have implemented the program, including Portland, Oregon, which experienced a reduction of the number of child-set fires.

INTRODUCTION

Since its earliest days, NFPA has emphasized fire safety education as a way to reduce fire deaths, injuries, and property loss. Over the years, NFPA’s efforts have evolved into a national program of fire safety awareness and education called the Learn Not to Burn Program, which stresses teaching positive, practical fire safety behaviors.

After several years of development, testing, and evaluation, NFPA introduced its Learn Not to Burn Curriculum in 1979 in an effort to reduce fire deaths and injuries to school-aged children. By the late 80’s, the curriculum, which helps classroom teachers convey positive messages children can take with them into adulthood, had reached more than 50,000 elementary school classrooms nationwide and was credited for saving more than 100 lives. The curriculum’s 25 key fire safety behaviors were divided into three levels for children in kindergarten through the eighth grade.

Because of the higher rate of preschool children who were dying in fires, however, it became obvious by the late 1980s that there was a great need for a program that targeted younger, preschool-aged children. Children ages five and younger need different kinds of educational materials and messages than older children, since they are less able to control their environments, are more dependent on adults, and are less likely to have received formal instruction or understand fire safety. NFPA’s Learn Not to Burn Foundation, which became known as the Center for High-Risk Outreach in 1995, took on the challenge of developing a curriculum addressing the needs of children aged three to five.

The result was the Learn Not to Burn Preschool Program, which the Learn Not to Burn Foundation developed as part of a multidisciplinary approach to reducing fire deaths and injuries among young children. The program is intended to take its place among other methods for reducing injuries, including legislative and engineering methods, such as those advocating the development and adoption of child-resistant lighters, and educational programs that teach caregivers to keep matches and lighters out of the hands of children.

NFPA emphasized several basic approaches during the development of the Learn Not to Burn (LNTB) Preschool Program. Among these were:

1. Teaching young children the necessary fire safety awareness and skills in a non-threatening way, without the use of props such as burned toys or pictures of burned people. It says "Don’t Scare children—Teach Them What to Do."

2. Using a variety of activities to get behaviors across to young children, who learn best when they use all their senses. Activities should vary and be participatory, and the lessons should be short but repeated to reinforce the concepts.

3. Introducing new adults, such as firefighters, into the child’s environment.

4. Encouraging parents to know what their children are learning and asking them to reinforce the fire safety concepts at home.

KEY BEHAVIORS

The Learn Not to Burn Preschool Program emphasizes eight key behaviors:

1. Stay away from hot things that can hurt.
2. Tell a grown-up when you find matches and lighters.
3. Stop, drop, and roll if your clothes catch fire.
4. Cool a burn.
5. Crawl low under smoke.
6. Know the sound of the smoke alarm.
7. Practice an escape plan.
8. Recognize the firefighter as a helper.

Each of the eight lessons contains goals and objectives, information for the teacher, a lesson plan, a song lesson plan with an original song, and additional learning/play activities.

Among the goals and objectives are knowledge objectives and action objectives. An example of a knowledge objective is, "The child will state that matches and lighters are hot and can hurt children." An example of an action objective is "The child will tell a grown-up immediately whenever the child finds matches or lighters."

Information for the teacher is the technical background on the subject or the severity of the problem, while the lesson plan explains how to teach the lesson and the materials needed. The song lesson plan includes a cassette tape of songs that reinforce each behavior in the program, with the words and instructions on teaching the song, as well as activities to be used with the song. Additional learning/play activities are more ideas on how to teach the behavior.

FIELD TEST AND PRE- AND POST-TEST EVALUATION

The original pilot test of the LNTB Preschool Program was carried out at the Frances L. Hiatt Child Care Center in Worcester, Massachusetts. A teacher’s guide with lesson plans and activities was field-tested by more than 460 day-care teachers, firefighters, and members of the National Association of Insurance Women in teacher workshops in New England and in Pennsylvania, New York, New Jersey, and Maryland. The songs, written by folksinger Jim Post, were field-tested and modified over a year’s time to ensure that their message was accurate and that the songs held the children’s attention.

Both the lesson plans and the songs were then tested in Head Start programs in North Carolina in January 1991 to determine the level of fire safety knowledge among preschool children and to document and measure the curriculum’s effectiveness. Evaluation instruments addressing four separate fire safety behaviors were developed specifically to measure verbal skills and to differentiate between hot and cold and psychomotor skills in demonstrating certain behaviors.

The Foundation chose to test the program in North Carolina because it is part of the "burn belt" , southeastern states where people are at higher risk of fire death than they are in many other areas of the United States. In addition, NFPA had good relations with the Insurance Commission and the North Carolina Burn Center, two organizations that cooperated in the testing.

The Crosby Head Start Center in Raleigh, and the Bynam and Mitchell Chapel Head Start Centers in very rural areas in North Carolina were chosen for the pre- and post-test evaluation. Head Starts, government-supported educational program targeting preschoolers from low-income communities, were chosen because the Learn Not to Burn Foundation’s mission was to reduce fire deaths and injuries among those at highest risk.

The evaluation team met with the Crosby Head Start Center on January 17, 1991 and the Bynam and Mitchell Chapel on January 18 for approximately two and a half hours. During the first portion of the session, the team met with the teachers and their assistants to explain the program and discuss the lessons they would teach over the following weeks. The LNTB teacher’s guide was written in such a way that teachers would be able to teach the program with a minimum of outside instruction.

In the second portion of the session, the evaluation team met with the students. Using pre-lesson survey evaluation forms, the team members asked the children questions designed to elicit both knowledge and performance-based responses. Each child was interviewed individually while his or her teacher observed in the background, and the child’s responses were recorded on a previously designed form.

During the two weeks following the interviews, the teachers presented the lessons provided in the curriculum. The evaluation team then revisited the Centers on February 5 and 6, 1991, and, using the format established in the initial session, interviewed the children individually, asking the same questions they had for the pre-lesson survey. The responses were again recorded.

There were 39 preschool-aged children in the pre-lesson survey and 51 children in the post-lesson survey, including 37 of the original 39. Eighteen of the children in the pre-lesson survey were boys and 21 were girls; in the post-lesson survey, 24 were boys, and 25 were girls. The children represented a mix of ages, although most were four years old. Most of the children were also African-American.

The four behaviors tested were "Don’t touch hot things," "Tell a grown-up when you find matches and cigarette lighters," "Stop, drop, and roll when your clothes catch fire," and "Crawl low under smoke to get out." Each child was rated as "Able to articulate or perform all of the behavior," "Able to articulate or perform part of the behavior," and "Unable to answer or gave wrong answer."

An example of a related question for the behavior "Crawl low under smoke to get out" is "I want you to tell me. You wake up at night and see a lot of smoke in your room. What do you do?" An acceptable answer would be, "I crawl low under smoke to get out." If the child answered only one part of the question, such as "I get out" or "I crawl low under smoke," the child would be rated as "able to articulate or perform part of the behavior." If the child couldn’t answer or gave the wrong answer, he or she was rated as "Unable to answer or gave wrong answer."

Between the pre-test and the post-test, the increase in performance and knowledge among children at Bynam was 22 percentage points. At Mitchell Chapel, the increase was 49 percentage points, and at Crosby, it was 43 percentage points.

Since the evaluation team did not monitor the classroom lessons, it is difficult to know whether the teaching in the Bynam school differed from that of the other schools. However, the evaluation team was informed that the Bynam teacher did not have a cassette player and so did not use the fire safety songs to enhance the lessons.

For all questions in all three of the schools, the increase in performance and knowledge between the pre-test and the post-test was 40 percentage points for the boys and 36 percentage points for the girls. Overall, the increase was 37 percentage points.

Once the evaluation was completed, NFPA finished production of the Learn Not to Burn Preschool Program and the implementation of the program began in the United States and Canada.

IMPLEMENTATION IN PORTLAND, OREGON

One of the early adopters of the program was the city of Portland, Oregon, which believed that, although it is important to measure the knowledge gain accomplished by a fire safety education program, it is even more important to measure the effectiveness of the program in reducing fire deaths and injuries in the target population.

As a result of this philosophy, Portland Fire and Rescue has long embraced education as one of the keys to reducing the fire problem. Unlike engineering and enforcement, education can affect all facets of the fire problem, particularly those over which there is little or no regulatory authority.

During the mid-1980’s, fire death data showed that the fire death rate for children in Portland was at or above the national average. But more disturbing was the fact that children were at even greater risk of death in fires set by children. Upon further review, it was found that almost all of the child-set fire deaths occurred within the preschool-age group.

Along with existing educational programs, Portland launched a focused effort to address youth firesetting in January 1986 and has monitored the data on child-set fires very closely ever since (see Figure 1). One of the original goals of the program was to intervene in the firesetting child/family to prevent on-going firesetting behavior. A secondary goal was a clearer picture of the children’s firesetting activity that would lead to the development of educational strategies to help reduce such firesetting behaviors.

Of the 17 victims who died in fires started by children from 1986 to 2000, 14 were children within the preschool-age range. The other three were adults. Sixteen of these fire deaths occurred during the eight years before the program was implemented during fiscal years 1992-1993 and 1994-1995. During the six years following the implementation of significant educational strategies targeting preschool age children, only one such death was recorded.

To utilize the information gained in the juvenile firesetting intervention program, it became necessary to understand child-firesetting motivations. These fall into three basic categories: curiosity, reactionary, and extreme concern.

Curiosity is a term that means a child’s firesetting will most likely be resolved by the presentation of educational intervention. The child’s firesetting behavior is most likely a result of a lack of information about fire and its consequences.

Reactionary is a term describing the firesetting behavior as a reaction to some type of stress or crisis occurring in the life of the child and/or family. Educational intervention, while important, will not likely resolve the firesetting behavior. Some type of behavior modification is more often necessary. This need may require mental health intervention, medical treatment, parental intervention/training, or other such assistance.

Extreme Concern represents children who have an immediate need for some type of intervention beyond education. When a child presents a behavior profile that, coupled with the firesetting behavior, makes it appear likely that the firesetting behavior will continue before the family can access qualified assistance, they are categorized as Extreme Concern fire setting. Urgency is the key criteria for this category.

Children most often engage in firesetting behavior because they are curious about it or are reacting to some type of stress or crisis. Of primary concern is the motivation of the curious child. While all child-set fires are preventable, those motivated by curiosity are particularly preventable since the behavior is driven by a lack of knowledge or information about fire. The limited learning opportunities most preschool age children have, coupled with their high risk of death in child-set fires, make them a prime target for life-saving education.

Figure 2 shows how the 14-year history of Portland’s program has categorized the motivation for child firesetting. The category "Extreme Concern" was not used until 1992-93.

Overall, two-thirds of the preschool children seen in the juvenile firesetting intervention program were referred for reasons of curiosity. In theory, the likelihood that they would have set the first fire would have been greatly reduced if these children had possessed some understanding of fire and fire safety. The challenge was reaching them most effectively with this proactive education.

Preschool-age children have few formal learning opportunities on which to draw. They develop most of their knowledge by watching the adults in their lives, primarily their caregivers, perform tasks that are often unsafe or inappropriate, although the adults do not realize that they are. Adults light cigarettes, use charcoal barbecues, and light candles for birthdays, all of which may appear to preschool-age children as simple, meaningless tasks performed without any thought—simple, meaningless tasks that they can perform, too. Adults’ actions will always speak louder than the words they use to try to dissuade children from the same behavior. In the end, children usually behave like their caregivers.

In addition, preschool-age children are often difficult to reach, unlike children enrolled in school. Fortunately, many children participate in childcare and in early childhood education programs, so working through such programs seemed to be the best, most efficient way to reach the target audience to reduce curiosity-driven firesetting.

Portland chose to address this fire problem using Learn Not to Burn Preschool Program because the city enjoyed a long-standing relationship with NFPA and knew that the LNTB Program was well researched and developed. While the LNTB Preschool Program had been shown to provide educational gain in program participants, the type of behavior changes Portland sought had not yet been shown, however.

In fiscal year 1992-1993, the LNTB Preschool Program was delivered to 29 Head Start Preschool Program classrooms in Portland. The teachers were given a one-hour in-service training which explained the nature of the problem driving the program, as well as the use and delivery of the curriculum. Firefighters specializing in fire and life safety education provided on-going classroom support if the teachers requested it. Anecdotally, the teachers who received the curriculum were enthusiastic about the topic and the product.

The program was not formally evaluated, and teachers were not asked to pre- and post-test the curriculum because Portland was satisfied with the documentation of effectiveness provided by NFPA. The primary means of evaluation would focus on behavioral changes, which would be measured against the history of the juvenile fire problem in Portland.

In 1994-95, it was decided to expand the outreach to a wider network of preschool-age children in group child care facilities, which catered to 12 or more children in a nonresidential setting, registered with the state of Oregon. A similar learning tool, called "Play Safe! Be Safe!" developed by the BIC Corporation for the 3- to 5-year age group, was chosen for this audience. The program, while packaged differently, consisted of the same behaviors and educational philosophies and methodologies as the LNTB Preschool Program.

Over 175 of the program kits were distributed to group childcare facilities in Portland. Again, no evaluation measures were used. Rather, the fire data documenting behavioral changes would provide the evaluation. Positive feedback similar to that resulting from the LNTB Preschool Program distribution was received.

Figure 3 shows the history of referrals to the youth firesetting intervention program for 3- 5-year-olds, the target age group for this effort. These figures represent the percentage of children in the "Curiosity" category, as compared to the total number of referrals to the program in each fiscal year. The "Curiosity" children are those determined to be most receptive to behavioral changes due to appropriate knowledge and education.

As can be seen, the number of children referred to the youth firesetting intervention program in the target age group dropped significantly after delivery of these educational tools. These reductions correspond to the reduced fire death rates seen in Figure 1 and the reduced fire incidents shown in Figure 4. Put simply, the youth fire problem began to decline significantly after the educational programs were implemented for the high-risk audience in the preschool-age group. The overall reduction in fires was also felt to be due, in part, to the knowledge base these children carried with them as they grow older and move out of the preschool age group.

Figure 4 shows not only the number of youth-caused fires in a steep decline, but also a decline in the relationship between youth fires and total fires. While the total number of fires in Portland has dropped, youth-set fires also continue to decline.

As time passes, however, the numbers have slowly begun to climb, so this approach is currently being implemented again.

Portland Fire & Rescue feels that efforts to increase the safety of preschool-aged children are effective when effective and well-designed educational programs, such as the LNTB Preschool Program are used. Death, injury, and the damaging effects of fire can be reduced through such efforts.

IMPLEMENTATION IN OTHER STATES

The Learn Not to Burn Foundation also worked with organizations in several other high-risk southern states to implement the LNTB Preschool Curriculum statewide in an effort to reduce the number of deaths and injuries among the state’s preschoolers and their families, and to rally various fire service and education groups around the issue of fire safety.

Three states in particular—Mississippi, Arkansas, and West Virginia—were the focus of considerable effort.

The Mississippi Association of Fire Chiefs, a meeting of which resulted in the effort to reduce fire deaths in the state by implementing the LNTB Preschool Program, first invited the Learn Not to Burn Foundation into Mississippi in 1993. Mississippi picked the Preschool Program because the cost was low, it reached a high-risk group, and it used interactive materials, songs, and colorful materials, making it both fun for instructors and accessible to children.

Since 1993, the Center for High-Risk Outreach has run teacher training workshop on the LNTB Preschool Program in all regions of the state. The Head Start Association and the Mississippi Department of Public Health/Early Childhood Unit were both involved in the organizing and training efforts, and nearly 2,000 Head Start and preschool teachers have been trained on the Program. The Program materials have been donated by the Foundation, the Mississippi Insurance Council, and the Mississippi Association of Fire Chiefs.

The Center for High-Risk Outreach has also run two train-the-trainer sessions for local fire-safety educators so that they could continue to train preschool teachers in their communities and other areas of the state. In conjunction with these efforts, fire safety educators formed the Mississippi Association of Public Fire Safety Educators.

In 1994, a West Virginia project funded by the Learn Not to Burn Foundation, the Northeastern Area State and Private Forestry, and the USDA Forest Service and coordinated by the West Virginia Fire Marshal’s office, set out to reach every day-care provider in the state. With the assistance of local fire department personnel, nine training sessions were conducted for fire service personnel, forestry personnel, and facilitators from the West Virginia University Cooperative Extension Fundamental Program. The Fundamentals Program facilitators train in-state child-care workers in a variety of skills. The program reached about 1,000 day-care centers and 25,000 preschoolers in the state.

The following year, eight West Virginia preschools participated in a LNTB Preschool Program pre- and post-test evaluation of 51 students, who ranged in age from 3 years, one month to 5 years, 9 months, using the testing instruments that were used in North Carolina. The students exhibited a 44.1 percentage increase in knowledge and performance between the pre-test and the post-test.

In Arkansas, leadership for statewide implementation came from the Arkansas Early Childhood Commission, the Arkansas Fire Fighters’ Association, the Arkansas Fire Chiefs’ Association, the governor’s office, and the Department of Public Health. Training took place in day-care centers throughout the state, reaching hundreds of day–care providers.

LEARN NOT TO BURN PRESCHOOL PROGRAM IN FRENCH AND SPANISH

The LNTB Preschool Program has also been translated into French and Spanish. The French program, Protegez-Vous du Feu, was completed in 1994 and distributed to every French-speaking child-care center in Canada. The Spanish-language program, Mis primeros pasos en prevencion contra incendios, was completed in 1997 for Spanish-speaking children in the United States.

The guides for both these programs were translated directly from the English guide, although the fire safety songs were written from scratch in French and Spanish by native-speaking composers and musicians. In both cases, the songs were tested in childcare centers to ensure that children understood the message. The French program was tested in Montreal and the Spanish songs were tested in centers in several U.S. cities with large Latino communities. The artwork in both programs is also original.

Preschool teachers taught the lessons over two weeks using the drafted songs and the lesson plans, then filled out surveys to give the development teams feedback. The survey questions included "How many times did you practice the song before the children could sing the words and know the melodies?" and "Were there any words that were new to the children?"

Various musicians incorporated the recommended changes into the songs.

The Spanish-language program has proven popular in Latin America, as well as the United States, because little has been done there previously to teach fire safety to young children. The program, which was reviewed by a team of native-speakers to ensure that the translations of all the materials was correct and appropriate to the various countries, is now being implemented in Mexico, Puerto Rico, Costa Rica, and Argentina.

Conclusion

An educational program, such as the Learn Not to Burn Preschool Program, can be effective in teaching children fire safety behaviors and can have an impact on the numbers of child-set fires that can lead to deaths among young children. This educational program is best used in the context of engineering changes, such as the child-resistant lighter, as well as educating caregivers--parents, older siblings, and others to never leave children unattended and to properly store matches and lighters.

More evaluation such as the pre-and post testing and impact studies such as those done in Portland should be conducted, especially as the Learn Not to Burn Preschool Program is being adapted for international use. As the rate of deaths among preschoolers continues to be much higher than the deaths of other ages, attention to the fire safety needs of preschoolers should not be lost as deaths go down in the general population. Programs should continue to be developed and existing ones improved. New programs for the caregivers should be developed and tested. Messages and programs for a variety of cultural groups should be studied and evaluated.

The information presented in this paper, while compelling, is very limited. Much more must be done to increase the fire and life safety of children everywhere. The evaluation of such programs receives too little attention and, subsequently, too little support. Fire frequency, fire injuries, and fire deaths to, and among, children remain too high. It is time for all of the disciplines affected by the international fire problem to come together to develop solutions.

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