PEDIATRICS Vol. 111 No. 1 January 2003, pp. 75-79
Community Norms on Toy Guns
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,,¶
* Department of General Pediatrics and Adolescent Medicine, Children’s National Medical Center, Washington, DC
Children’s Research Institute, Washington, DC
George Washington University School of Medicine, Washington, DC
|| National Institutes of Child Health and Human Development, Bethesda, Maryland
¶ Department of Emergency Medicine, Children’s National Medical Center, Washington, DC
# Coleman, Sachs, and Thillairajah Pediatrics, Rockville, Maryland
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ABSTRACT |
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 TOP ABSTRACT INTRODUCTIONMETHODSRESULTSDISCUSSIONREFERENCES |
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Objective. Toy gun play has been associated with aggressive behavior, and it has been suggested that child health professionals counsel families on limiting exposure. Effective violence prevention counseling requires an understanding of norms regarding parental attitudes, practices, and influencing factors. Both theories of reasoned action and planned behavior emphasize that subjective norms and attitudes affect people’s perceptions and intended behavior. Few normative data exist on this issue from a cross-section of families. By establishing behavioral norms and understanding the spectrum of parental attitudes, community-sensitive and community-specific interventions for violence prevention can be developed. The objective of this study was to assess community norms on the topic of toy gun play from the perspective of parents.
Methods. An anonymous self-report assisted survey was administered to a convenience sample of parents/guardians who visited child health providers at 3 sites: an urban children’s hospital clinic, an urban managed care clinic, and a suburban private practice. The parent questionnaire included questions on child rearing attitudes, practice, and sociodemographic information.
Results. A total of 1004 eligible participants were recruited for the study; 922 surveys were completed (participation rate 92%). The 830 (90%) respondents who were parents and had complete child data were the focus of additional analysis. Regarding toy guns, 67% of parents believed that it was never "OK for a child to play with toy guns," and 66% stated that they never let their children play with toy guns. Parents who thought that it was okay for children to play with toy guns and allowed them to play with toy guns were more likely to be male parents, have male children, and be white.
Conclusions. There is variability in norms regarding toy gun play among parents, with most discouraging toy gun play. Norms varied based on gender of the child, gender of the parent, and race. Understanding norms is a first step in designing effective community-sensitive interventions.
Key Words: toy gun play • violence prevention • anticipatory guidance, parental norms
Abbreviations: OR, odds ratio • CI, confidence interval
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INTRODUCTION |
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The American Academy of Pediatrics has encouraged child health professionals to be proactive in addressing violence prevention in child health supervision. The policy statement entitled "The Role of the Pediatrician in Youth Violence Prevention in Clinical Practice and at the Community Level" suggests that health providers have an emerging role in youth violence prevention and management.1 Anticipatory guidance regarding toy gun play is an example of this role, and some have suggested that health professionals advise parents to limit toy gun play.2,3
Effective violence prevention counseling requires an understanding of norms regarding parental attitudes, practices, and the factors that influence norms. The theory of planned behavior4 evolved out of the theory of reasoned action,5 and both focus on intentions to act as important predictors of behavior. Both theories emphasize that subjective norms and attitudes about what others think are critical to understand and are associated with intended behavior.6 Few normative data exist on the violence prevention issue of toy gun play from a cross-section of families. By establishing behavioral norms and understanding the spectrum of parental attitudes and behavior, community-sensitive and community-specific interventions for violence prevention can be developed.
Although controversy exists,7,8 toy gun play has been associated with aggressive behavior. Observational studies have found that when toy guns are introduced into play settings, levels of aggressive behavior increase.9,10 Others have found that toy gun play and parental physical punishment were associated with a higher level of aggression.11 There is a paucity of data on parent attitudes and behavior regarding toy gun play.
The purpose of this study was to accumulate normative data on the views and practices of parents regarding toy gun play from a cross-section of families. In addition, we wished to determine whether norms varied on the basis of practice setting and sociodemographics of the family. The objective of this study was not to judge the appropriateness of certain norms and behaviors but to determine what is commonly practiced and believed to be socially acceptable.
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METHODS |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONREFERENCES |
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An anonymous self-report assisted survey was administered to a convenience sample of parents/guardians who visited child health providers in January 1999 to July 2000. Three very different settings were chosen for the survey: an urban children’s hospital clinic, an urban managed care clinic, and a suburban private practice in the metropolitan Washington, DC, area. All English-speaking parents in the waiting room were invited to participate in the 10-minute survey. The study was approved by the Children’s National Medical Center’s institutional review board.
The questionnaire included questions on child-rearing attitudes and practice as well as sociodemographic information. Results presented here are part of a larger survey on child-rearing practices. The questionnaire included measures of discipline, including questions from Socolar and Stein’s12,13 measures of disciplinary belief and practice. Questions regarding toy gun play were structured similar to questions on discipline. The survey underwent extensive pretesting before administration, including interviews with parents on their interpretation of the questions and a pilot survey (N = 65).
Predictor variables included the practice setting; age, gender, and number of children; and age, marital status, educational level, socioeconomic status, race, religiosity, and gender of parents. The main outcome variable used in our analysis were attitudes and parenting practices regarding toy guns. Because these outcome variables had sparse counts for certain categories of responses, outcome variables were dichotomized into the "never" or "ever" categories. Because parental experience may influence attitudes and behaviors regarding toy gun play, questions regarding toy guns included responses of parents with at least 1 child older than 1 year.
The 
2 test (or Fisher exact test when mandated by sparse data) was used to compare the distribution of categorical variables for different levels of the outcome variables. For dimensional variables, the t test was used to perform the 2-group comparisons when the data were normally distributed and the Mann-Whitney U test when assumptions of normality were not met.14 Multivariable logistic regression models were used to identify characteristics that predicted the outcomes of interest.15 Variables that were statistically significant in crude bivariate associations were included as confounders in the regression model. Association between the characteristics and outcomes was expressed as odds ratios (OR) obtained by the exponentiation of regression parameter estimates. Confidence intervals (CIs) of the adjusted odds ratios were computed using test-based methods. P < .05 was considered to be statistically significant, and all P values were interpreted in a 2-tailed manner.
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RESULTS |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONREFERENCES |
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A total of 1004 eligible participants were approached for the study, and 922 surveys were completed (participation rate: 92%). The 830 respondents (90%) who were parents and had complete child data were the focus of additional analysis. By site, 39% were from an urban hospital setting, 38% were from an urban managed care practice, and 23% were from a suburban private practice. Demographic characteristics of participants by practice site are presented in Table 1.
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Table 2 presents responses to questions on parenting attitudes and practice regarding toy guns and data by age of child. These results include respondents with at least 1 child older than 1 year (N = 735). Regarding toy guns, 67% of parents believed that it was never "OK for parents to let their children play with toy guns," and 66% stated that they never let their child(ren) play with toy guns. Parents with younger children were more likely never to allow toy gun play.
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Table 3 presents multiple regression results regarding toy guns. Parents who thought that it was okay for children to play with toy guns were more likely to be white (OR: 4.10; CI: 2.22–7.58), be male (OR: 2.55; CI: 1.58–4.09), and have male children (OR: 1.82; CI: 1.20–2.75). Factors that were independently associated with parents’ allowing their children to play with toy guns included having at least 1 male child (OR: 3.16; CI: 1.95–5.11), being of white race (OR: 2.76; CI: 1.65–4.62), being a male parent (OR: 2.76; CI: 1.65–4.62), and older age of their youngest child (P = .011). We assessed possible interactions among significant predictors and found no effect.
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DISCUSSION |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONREFERENCES |
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We found that there is variability in attitudes and parenting practices regarding toy gun play, with two-thirds not allowing their children to play with toy guns. Attitudes and practice varied on the basis of sociodemographics of the family, including gender of the child and parent and race.
Several important limitations must be considered. Data may not be generalizable to other populations, including other regions of the country. Although we attempted to recruit a cross-section of families from 3 sites, we surveyed convenience samples of parents in 1 geographic area. However, demographics of participants in the survey were similar to demographics of the practice populations. Second, the sample included parents’ bringing their child to a health visit. We cannot be certain that the participating parent was the primary parent for the child. In addition, only a relatively small fraction of fathers brought their children in for care, and we cannot be certain that their attitudes or practices reflect those of all fathers of children in our study sites. Third, this study involved self-report data. Before administration, the study instrument underwent extensive pretesting and had face validity. Families were assured that their responses would not be shared with their health care providers. However, it is likely that there existed social desirability bias in parent reports. Despite these limitations, we were able to survey a relatively large, diverse sample of parents and had a high participation rate.
This is the first known study in the pediatric literature to assess parental views and reported practice regarding toy gun play. Although toy guns are unregulated in the United States, antisocial toys have been banned in many schools, as well as in some other countries (eg, Sweden, Greece, Norway, Malta).3 Sanson3 noted that considering the prominence of toys in our society, a huge toy industry, and the importance of play in child development, it is surprising that there is not more research on the effect of different types of toys. Whereas there has been a vast amount of research on issues such as television and child behavior, there is a dearth of research on toys and toy guns.
Toy gun play has been associated with aggressive behavior but is not the only or the major predictor for aggression.11 The Victorian Committee of Inquiry into Antisocial Toys (Australia) placed antisocial toys into 3 categories: 1) "victim toys," which portray human figures suffering from gruesome injuries, deformities, and disabilities; 2) "war toys," which include weapons, vehicles, and personnel from past and future wars; and 3) "violent toys," designed to inflict real or imagined harm on others (cited in 3). The committee surveyed psychology experts on the behavior, attitudes, and emotional adjustment of young children. The consensus was that antisocial toys could exert strong to moderate detrimental effects, especially on attitudes, and none of the experts believed that there were any positive effects. Literature on the impact of antisocial toys and toy guns is limited, and more research is warranted. Additional study of the influence of parenting practices on child behavioral outcomes is essential.
There are several reasons that toy gun play has been discouraged: 1) the association with aggressive play and aggression, 2) dangers of toy guns with projectiles or air guns, and 3) potential confusion of toy guns with real guns. In 1987, the American Academy of Pediatrics developed a policy entitled "Injuries Related to ‘Toy’ Firearms," which categorizes both projectile and nonprojectile toys and nonpowder guns such as air guns and air rifles as toy firearms.16 The main hazards discussed included injury and death from projectile or air trauma, substitution of projectiles including live ammunition, hearing damage from peak sound levels >140 dB, and confusion of these toy firearms with real weapons.17–19 This statement recommended that federal regulations specify safety standards and that pediatricians counsel parents concerning the hazards of these toy firearms.
Confusion of toy guns with real guns is problematic in many situations: 1) when children play with loaded firearms that are thought to be toys; 2) when children who are holding toy guns are mistaken to be armed intruders; and 3) when toy guns are used aggressively to threaten others or in perpetration of crimes. Farah et al20 surveyed parents and found that three fourths of gun-owning parents believed that their 4- to 12-year-old child could tell the difference between a toy and a real gun, and 23% believed that their child could be trusted with a loaded gun. However, another study by Jackman et al21 assessed how boys (age 8–12 years) behave when they find a handgun in a presumably safe environment and compared parental expectations of their child’s interest in real guns with observed behavior. In a staged experimental situation, they discovered that 76% of groups of boys found and handled a planted metal .380 caliber handgun, and a child in almost half of these groups pulled the trigger. Approximately half of the boys who found the gun thought that it was a toy or were unsure whether it was real. Parent perceptions of their child’s interest in guns did not predict actual behavior. More than 90% of the boys who handled the gun reported that they had previously received some gun safety instruction.
Distinguishing toy guns from real weapons is a challenge.22 Children who were holding or playing with toy guns have been mistaken for armed intruders with tragic results.23 In the United States, plastic handguns that resemble toy guns were under development in the 1980s until a federal statute prohibited the manufacture of guns that could not be identified by metal detectors (B. Knox, Brady Center to Prevent Gun Violence, personal communication, September 26, 2001).23 Some have suggested that regulations be developed to require toy guns and toy firearms to look distinctly different from real guns.
The direct relationship between toy gun play and risk for intentional or unintentional gun injury is unclear. Does making toy guns "forbidden fruit" decrease or increase chances of toy gun or real gun play in another environment, such as a friend’s house? Can children be instructed about which guns are safe and which are not? Can toy guns be designed in a way that looks distinctly different from real guns? Does limiting accessibility to toy guns decrease the likelihood of toy and real gun confusion and potential injury? These all are areas of needed future study. Some have suggested that anticipatory guidance counseling in well-child care on firearm safety should include discussion of toy gun play. There are few data regarding toy gun play and health outcomes and no known data on the effectiveness of counseling to limit toy gun play or to educate parents about the issue. For firearm safety counseling, a study by Grossman et al24 found that a single 60-second firearm safety counseling session combined with economic incentives to purchase safe storage devices did not lead to statistically significant changes in household gun ownership or storage patterns. Additional study on the effectiveness of anticipatory guidance counseling is needed.
Gender and age of the child, gender of the parent, and race were most influential in affecting parents’ attitudes and practices. Other variables in the model that were not significant included age of parent, number of children, marital status, parent educational level, household income, and religiosity. Parents who were white, were male, and had male children were more likely to have positive attitudes toward toy gun play and allow toy gun play. Although the majority of parents in the survey were mothers, gender differences in attitudes and practice were clear. Like other violence prevention issues (firearm ownership and safety),25,26 additional studies of gender differences in attitudes and decision making in parenting are needed, including interview of both parents and other parent figures (ie, extended family). Interventions to address these issues may need to target fathers and other parent figures, as well as mothers. Because mothers more commonly are present at child health supervision visits, interventions may need to extend beyond the parent who is present. Strategies may include encouraging and involving more family members in child health supervision visits; reaching fathers through mothers’ attending visits; or intervening with families outside child health supervision through home visitation programs, schools, or other venues.
The issue of whether parents should allow toy gun play is not new. Some have recommended that child health professionals discuss this issue in anticipatory guidance. Surprisingly, there is a paucity of research on the impact of toy gun play on child behavior and effectiveness of intervention. We found that there is variability in parental norms on this issue. In addition to study of child behavioral outcomes, understanding community norms about toy guns is a first step in addressing this important parenting issue.
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ACKNOWLEDGMENTS |
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We thank Ellie Hamburger, MD, Kalpna Prasad, MD, and Erin Stewart, MD, for support of this project.
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FOOTNOTES |
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Received for publication Feb 4, 2002; Accepted May 14, 2002.
Reprint requests to (T.L.C.) Department of General Pediatrics and Adolescent Medicine, Johns Hopkins University, 600 North Wolfe St, Park 392, Baltimore, MD 21287. E-mail: tcheng2{at}jhmi.edu
Dr Cheng is currently affiliated with General Pediatrics and Adolescent Medicine, Johns Hopkins University, Baltimore, Maryland.
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PEDIATRICS (ISSN 1098-4275). ©2003 by the American Academy of Pediatrics
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