The American Academy of Pediatrics published a new study titled “Firearm Storage in Homes with Children with Self-Harm Risk Factors.” The conclusion of this article was that parent’s decision to have firearms in the home as well as their storage practices were not influenced by the presence of a child with a mental health condition in the home. The study was comprised of a web-based survey, which was completed by parents of 3,949 households in the US. The results showed that approximately 42% of households that contained children confirmed having a firearm in the house. This percentage did not change when comparing household in which children with mental health reside to those whose children had no mental health issues. The study also showed that of those parents/ caregivers who own firearms only 1 in 3 stored all firearms locked and unloaded. This ratio did differ between households that contained children with mental health issues versus those that did not.

This study led me to question the role of pediatrics in determining the ownership and storage of firearms in homes with children. At every well child visit for children above a certain age we ask if there are any firearms in the house and if so, how are they stored. I found myself wondering “Have studies shown a decrease in injury by firearms following pediatrician intervention and education?” A study published in 2000 concluded that “a single firearm safety counseling session during well child care combined with economic incentives to purchase safe storage devices, did not lead to changes in household gun ownership and did not lead to statistically significant overall changes in storage patterns.” However a randomized controlled trial published more recently, in 2008, concluded that a brief office-based violence prevention approach resulted in increased safe firearm storage.

The American Academy of Pediatrics first issued guidelines in 1992 noting that the safest home for a child is one without firearms. These guidelines also note that if firearms are going to be in households they should be locked and unloaded with ammunition stored separately. I grew up in a house of avid hunters and gun owners and I can just hear them saying, “What good is a gun in the case of an intruder if it is not immediately accessible?” One study in the Journal of Trauma found that “guns kept in homes are more likely to be involved in a fatal or nonfatal accidental shooting, criminal assault, or suicide attempt than to be used to injure or kill in self-defense.” This article claims that the benefit of having a gun in the house for self-defense does not outweigh the risk of accidental injury by that same “protective” weapon. Other’s who advocate for firearm use and ownership claim that if children are properly educated and trained in gun safety there would be less accidental shootings. However, one study published in 2002 had children participate in a weeklong firearm safety program on reducing children’s play with firearms. Following this training period the children were exposed to an unloaded firearm. 53% of the children played with the gun as if it was a toy gun. This study cast doubt on the effectiveness of skills-based gun safety programs for children.

I recognize that it would be naïve of me to think that every gun owner with children in the house is going to forfeit his or her right to their firearms because of this data. That is why there are important organizations such as Project Childsafe (http://www.projectchildsafe.org/parents-and-gun-owners) that cater towards gun owners. This organization provides comprehensive information about gun safety in the home and offers free resources such as cable-style gunlocks to further protect children in their homes.

Jocelyn Rathbone PA-S

References:
Scott J, Azrael D, Miller M. Firearm Storage in Homes With Children With Self-Harm Risk Factors. Pediatrics 2018 March; 141(3): e20172600. Retrieved March 11, 2018.
Kellermann AL, Somes G, Rivara FP, Lee RK, Banton JG. Injuries and deaths due to firearms in the home. J Trauma. 1998 Aug; 45(2):263-267. Retrieved March 11, 2018.
Barkin SL, Finch SA, Ip EH, Scheindlin B, Craig JA, Steffes J, Weiley V, Slora E, Altman D, Wasserman RC. Is office-based counseling about media use, timeouts, and firearm storage effective? Results from a cluster-randomized, controlled trial. Pediatrics. 2008; 122(1): e15. Retrieved March 11, 2018.
Grossman DC, Cummings P, Koepsell TD, Marshall J, D’Ambrosio L, Thompson RS, Mack C. Firearm safety counseling in primary care pediatrics: a randomized,  controlled trial. Pediatrics. 2000; 106(1 Pt1): 22. Retrieved March 11, 2018.
Hardy MS. Teaching firearm safety to children: a failure of a program. J Dev Behav Pediatr. 2002;23(2):71. Retrieved March 11, 2018.
Gill AC, Wesson DE. Firearm Injuries in Children: Prevention. UptoDate. Literature review current through Feb 2018. Last updated March 14, 2018. Retrieved March 11, 2018.