Safety in Numbers

Digital Wizardry Helps Kids Escape Danger

By Cary Estes

 

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UAB engineers Bharat Soni (left) and Alan Shih (right) helped researchers led by Russ Fine (center) realize their dream of producing a new model for analyzing childhood injury.

Last fall, a very unusual six-year-old child was born at UAB. This incredibly ill-fated tyke has already experienced a great deal of trouble, including dozens of car crashes. And now researchers at UAB are lining up for the chance to cause more mayhem; if they get their way, the kid will be pushed down stairs, take nosedives off of playground equipment, and run into other unfortunate situations.

These calamities are all part of the Digital Child project, a sophisticated computer simulation created by UAB’s Southern Consortium for Injury Biomechanics (SCIB), the biomechanics research arm of the UAB Injury Control Research Center (ICRC). Lessons learned from the Digital Child could lead to better lives for thousands of real children around the world.

“The Digital Child responds to impacts—changes in force and energy—just like a real kid,” says Russ Fine, Ph.D., M.S.P.H., the founding director of the ICRC and SCIB. “It will approach the most accurate kind of laboratory tool or environment that we can have.”

Researchers at the SCIB worked with teams from the UAB Department of Mechanical Engineering and Wayne State University in Michigan to produce what is basically a crash-test dummy for the digital age, says Fine. But the project—and several other intriguing research ventures at the ICRC—could evolve into an even more important weapon in the war on childhood injuries.

Youth Movement

The ICRC’s mission is to help reduce injuries among people of all ages, but it places a special emphasis on children, since injuries are by far the leading cause of death and disability in the United States for people between 1 and 20 years old.

In 2006, unintentional injury accounted for 52.8 percent of the deaths in the United States for that age range, according to the National Center for Injury Prevention and Control. Homicides were a distant second, at 15.8 percent, while 9.5 percent of deaths were due to suicide. In other words, more than three-fourths of the childhood deaths that year were due to factors other than disease.

Nevertheless, the ICRC approaches unintentional injuries much the same way that physicians approach cancer and heart disease, says ICRC Senior Scientist John Waterbor, M.D., Ph.D. Namely, there is an underlying reason why injuries occur, he notes, and with enough research, the causes can be diagnosed and potential preventative measures found.

“Injuries are not accidents,” Waterbor says. “We don’t say ‘accident’ in the world of injury control, because they’re not. There are a few that you cannot predict, but for the most part, like diseases, they can be predicted and prevented.”

Modeling Twisted Metal

The Digital Child is an injury waiting to happen—and ready to change the ruling paradigm of crash research. “Traditional crash-test dummies have enormous limitations,” says Fine, including high costs and an extremely simplified depiction of human anatomy. “With the Digital Child, our computer gurus have taken all the data about the body and turned it into a mathematical model.”

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In fact, there are three models, representing the anatomy of a three-year-old, a six-year-old, and a 10-year-old. A team led by Bharat Soni, Ph.D., chairman of the Department of Mechanical Engineering, worked with colleagues at Wayne State to build a composite model from a vast quantity of medical imaging data. The Digital Child approach could be used to replicate any age and body size, says Fine.

Meanwhile, scientists at Wayne State have been supplying their UAB colleagues with data from actual car crashes to help set the stage for a virtual demolition derby. The data are so comprehensive that researchers will be able to re-create nearly any crash scenario—determining the precise fate, for example, of a passenger in the back seat of a 1998 Ford Taurus after it is struck in the right rear by a 2004 Honda Civic at 45 miles per hour. “Astronauts train on simulators, and that’s essentially what this is,” Fine says. “It’s a crash simulator.”

The immediate objective is to help auto makers design safer cars—especially for children, since motor-vehicle crashes account for nearly half the unintentional-injury deaths in that age group. The long-range goal is to use the technology to study nearly any injurious situation.

“The potential of the Digital Child is not limited to car crashes,” says SCIB Associate Director Jeffrey Foster, M.P.H. “You could design a football helmet and shoulder pads that are as safe as possible. You could simulate a child falling off playground equipment and determine what surface materials could best absorb some of the force.”

Fine even foresees a time when Digital Child technology could be used in real time to improve treatment for young crash victims. Paramedics could transmit specific information about the crash to hospital personnel, including the age and weight of the victim, where the car was struck, and, if known, where the victim was seated.

“If you feed that information through the computer model, you can get a good idea about what is wrong before a child ever hits the emergency room,” Fine says. “You can have the pediatric neurosurgeon upstairs scrubbing in, and at that point all you have to do in the emergency department is stabilize and confirm what the model has predicted.”

One-Stop Shopping

Comprehensive data are crucial to the success of the Digital Child and most of the ICRC’s other projects. But pediatric injury records are often less than precise, and the research that has been conducted is scattered throughout technical papers and journals around the world.

In an effort to consolidate the latest and best data, the SCIB is working with Washington, D.C.-based biomechanical research firm BioInjury to produce the Pediatric Injury Biomechanics Data Archive and Textbook. “The archive will house everything needed to conduct top-flight pediatric biomechanics research,” says Foster. “It’s one-stop shopping.”

BioInjury founder Salena Zellers Schmidtke, M.S., B.M.E., who earned a master’s degree from UAB in 1992, is coordinating the project. “We don’t know a great deal about pediatric injuries, especially in the motor-vehicle crash environment,” Schmidtke says. “Most of the regulations and standards, as well as the testing done currently, are based on scaled-down versions of adults—and the research that has been done is scattered throughout many institutions and publications.” The archive and textbook will bring all pertinent data together, helping avoid duplication of previous research and identifying gaps that need further study.

Schmidtke says the database, which also will be available online, should prove to be a valuable resource for automakers, child car-seat designers, government safety agencies, and other pediatric-injury researchers. “We’re very excited about getting this project out there.”

To Cross or Not to Cross?

Elsewhere at the ICRC, psychologist David Schwebel, Ph.D., is examining the cognitive factors behind childhood injury. In other words, why did the child cross the road?

“Children often overestimate what they think they can do, and that overestimation is related to injury risks,” says Schwebel. “So children who overestimate to a larger degree also get hurt more often.” One of the most common, and dangerous, examples of childhood over- and underestimation happens at street level. Pedestrian injuries are second only to car crashes as the leading cause of death for children ages five to nine.

In order to study pedestrian injury and teach safe crossing techniques, Schwebel collaborated with Iowa-based Digital Artefacts, LLC, to create a virtual-reality environment that replicates the crosswalk in front of a local elementary school.

Children stand on a special curb that is placed in front of three 21-inch video monitors. When they believe it is safe to cross, they step off the curb, which then triggers the computer to show a digital version of the child crossing the street. “The computer records all the actions that occur, so we can understand the size of the gap that children cross within, how long they hesitate before crossing, and so on,” Schwebel says. This information can then be used to better understand other areas of children’s decision-making.

Schwebel also has used virtual technology to study the changes that take place when students cross a street while carrying a heavy backpack or while talking on a cell phone. “Injuries to children are a major public health problem.” he says. “The more we know about them, the better we can be at preventing them.”

In the end, says Fine, that is the ultimate goal for all projects at the ICRC. But its goal will not be achieved with a single scientific breakthrough, he notes. “There’s no silver bullet. You can’t vaccinate against injuries like you can against communicable diseases. It takes teaching, training, research, and continuing education.” Plus the help of an extremely cooperative Digital Child.