During my two decades of practice in Philadelphia, I have been happy to see parents pay increased attention to protecting their "precious cargo" in their cars – their children. Sadly, however, the same diligence is missing when children are on their own – walking or biking.

And the experience of the region's largest pediatric trauma center at CHOP backs this up. More children are admitted annually to CHOP with injuries sustained by being struck by a motor vehicle than as an occupant in a motor vehicle crash, according to CHOP Trauma Program's record of all patients admitted for injury treatment.

During a five year span (Jan 1, 2010- December 31, 2014), CHOP treated 343 children admitted for significant injuries suffered as pedestrians struck by a vehicle and 62 children, for significant injuries while riding their bikes and struck by a vehicle. These were spread pretty evenly across age ranges. Of note, during this same time, we treated 163 children admitted for significant injuries suffered as occupants in a motor vehicle crash.

It's time to give the same attention to protecting our children when they are walking and biking as when they are riding in a car. Most of these injuries can be prevented.

We want to make sure our kids are active – biking and walking are great forms of exercise – but we need to be smart about it. While young children have the motor skills to cross the road, it is not until late in elementary school that children typically know how to scan and anticipate the actions of other road users and respond in safe ways. They need parents who are honest and accurate about their child's "street smarts" to teach them these skills.

You might want to consult with your child's pediatrician about whether your child is developmentally ready to manage traffic without supervision. Once you determine that your child is ready to go out alone, start slow on familiar streets with little traffic and slowly increase exposure to more complicated situations.

Just like we teach defensive driving, we need to teach and model defensive biking and walking for our children. We cannot assume others will follow the rules of the road or that they see you just because you see them. Likewise, we should behave as predictably as we can. Here are four tips to share with your kids:

1. Be Aware. Be attentive to what is going on around you. Anticipate what other road users might do.

If you are biking or walking on path or road that you share with bikes and motorized vehicles, do not listen to or look at a phone/device. Step to the side and out of traffic to look at your device. You need to regularly scan your environment for hazards using your eyes and ears. When you tune into your music and tune out the world, you may not hear that the engine of a car running the red light and people telling you to watch out, or see that the light changed and you're walking into traffic.

Note, pedestrians walking on a path or stepping into a cross walk can and do get struck by bicyclists. You need to look for that bike riding through the yellow light or stop sign.

Read more practical pedestrian safety tips for pre-teens and teens from National Highway Traffic Safety Administration

2. Be predictable and follow established rules. As bicyclists and pedestrians, we all need to be predictable to vehicle operators (drivers, other bicyclists), so that they have time to react and avoid colliding with you. This needs to be taught to older children who previously relied on their parents to look out for them. We are most predictable when we follow established rules for bicyclists and pedestrians.

Pedestrians are expected to be in cross walks at intersections and crossing the street with the traffic light. They are not expected to cross or suddenly dart out in the middle of a street. Try to cross an intersection with a group of pedestrians  – safety in numbers.

Use sidewalks when available. If you must walk in the street, walk as far to the left, and facing traffic. Make eye contact with the vehicle operators to make sure they see you.

All bicyclists riding in traffic are expected to follow the traffic rules as a vehicle operator – such as riding with traffic (not against or facing oncoming traffic) and obeying traffic signals and stop signs. They should use hand signals to let drivers know what they plan to do next, such as turning.

Here is a review of Philadelphia bike laws from the Philadelphia Bicycle Coalition

3. Be highly visible. Pedestrians and bicyclists benefit from wearing brightly colored clothing during the day, at dusk and dawn. At night, we should have reflective clothing and bike equipment. Reflective tape works in a pinch. Pedestrians walking at night should have a flashlight and cyclists need a front light and rear light or reflector. We should assume drivers cannot see us and act accordingly.

4. Bicyclists – wear helmets. I've saved the most obvious for last. Use bicycle helmets always – parents and children. This is a no-brainer, no pun intended. People of all ages should always wear properly fitted helmets – and ride properly fitted bikes as well. I frequently ride on our region's amazing bike paths and am shocked to see a number of adults and children still not wearing helmets.

Mobility for teens is so important. They love the freedom and the exercise. For kids in the city, this is especially so. It's how many of them get to school and socialize  – using bikes and going on foot. Just remember to review the relevant safety rules and review their route before they head out.  Are their potential hazards to avoid? Is there a safer route? Are they practicing "defensive" walking and cycling?

And don't forget that safety goes beyond traffic safety. Your child needs to think about interpersonal safety. The good news is that the tenets of defensive walking and cycling can also protect against being a victim of violence as well. Walk or bike in safe areas at safe times of day and keep aware of your surroundings.

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