Children’s book puts tough message into tiny hands, and it was inspired by one couple’s tragic loss

Thomas Cooper Naramore died tragically on July 24, 2015, but his memory will live on through a new children's board book. Not Even a Minute: A Story About Preventing Hot Car Heatstroke, written by Sarah Tollett and Joe Schaffner, who also did the illustrations, was produced by Arkansas Children's Hospital Injury Prevention Center. The book was dreamed up after Hot Springs Juvenile Court Judge Wade Naramore and his wife, Ashley, called the Injury Prevention Center with the idea of creating a program for hot-car safety. Thomas, their 18-month-old, died after his father accidentally left him in the back seat of his car, forgetting to drop him off at day care. According to statistics by Kidsandcars.org, Thomas was one of 24 children in the United States who died in a hot car in 2015. There have been 17 hot-car deaths in the United States already this year and, worse, there were eight in June. Three of those were in Texas over the course of three days. (Texas has the most hot-car deaths of any state.) Tragically, the number of deaths has grown every year since 2015. In 2016 there were 39 and in 2017, 43. In 2018, 52 children died in hot cars, the highest number in a year on record. Statistically, July is the month when most hot-car deaths occur.

 

IT CAN HAPPEN TO ANYONE

"The Naramores approached the [Arkansas Children's Hospital] Injury Prevention Center specifically asking if we could develop an injury prevention program for hot car safety," says writer-illustrator Schaffner, who no longer works at the center. "There's really nothing out there for hot car safety but some fact sheets and some tips. We decided to create a book meant to be read to children, but while at the same time reinforcing safety messages back to the parent." Schaffner is now assistant director of outreach for the South-Central Telehealth Resource Center with the Institute for Digital Health and Innovation at University of Arkansas for Medical Sciences. Not Even a Minute presents a colorful world with cats as the main characters. It begins with Dad strapping his son into the car seat for the commute to day care. Dad puts his briefcase in the back seat. "Put something in back to keep me on track," he says. Along the way they stop for gas and Dad pays at the pump and keeps an eye on his son through the window. They pick up food at a drive-thru and the next page reads: "Turn around to see if you've fallen asleep." After a trip to the bank, where they again use the drive-thru, they arrive at day care. But with all the stops, they are later than normal and the day care is calling Dad to make sure his son is coming. On the last page, Dad leaves the boy in safe hands. The story is based loosely on Naramore's routine trip to work. About a year after Thomas died, "We began looking for ways that we could help prevent this type of accident from occurring," Ashley Naramore says. There are personal touches in the book. A picture of Thomas on the bottom of the back cover is captioned, "In honor of Thomas Cooper Naramore" and "In partnership with Ashley and Wade Naramore." Inside, Thomas' day-care artwork that once hung on the family's refrigerator is reproduced on the last page of the story. "You can see his name on there, things we had hanging," Ashley Naramore says. "It's really cool the way they were able to bring his life into that book to hopefully save other lives." Schaffner says doing the book was an eye-opener. "I sat across the table from a father who had lost his son and read the story we created to help prevent future tragedies. We shared tears. We shared a common goal of doing our best to prevent other parents from experiencing the same loss.

RUNNING ON AUTOPILOT

The question, then, is how does this happen? Kidsandcars.org safety information says "a change in daily routine, lack of sleep, stress, hormone changes, fatigue and simple distractions are things all new parents experience and are just some of the reason children have been unknowingly left alone in vehicles." Amber Rollins is director of Kidsandcars.org, the organization that the Naramores and other parents who've experienced a hot car tragedy lean on for support and to help educate more people about the problem. She says the brain trick that causes someone to forget a child in the back seat is not unlike the one that lets you leave a cup of coffee on top of a car, or forgetting to take your pills, though those silly actions do not begin to compare emotionally to leaving a baby in a car seat. "Something we can all relate to is being on autopilot. You can get in the car and drive to work blindfolded with your hands tied behind your back because you've ­done it a hundred times. When you go into autopilot mode, the problem with that is, you're brain is not physically able to account for a change in the normal routine. "If dropping a kid off at day care isn't a part of that routine, you know, the learned exact routine that you do every day, then without a disruption or reminder that you're supposed to do that, that action will not be accomplished, it will not happen, because your brain is not able to pull itself out of that routine to do that intended action," Rollins explains. She says most people have probably gotten to work or school and thought, "Did I take my pills?" "You can kind of remember doing it and then you get home and the pills are there. It's these same slips of memory that are happening when a child is left in a car, but unfortunately, our brains aren't able to differentiate between the importance of taking the pills or the baby in the back seat when they're in that mode, autopilot mode." Distractions aren't the only reason that hot car deaths are on the rise. Rollins says the problem has "absolutely" gotten worse since car seats were moved to back seats. Add the fact that they are now rear-facing makes them even more difficult to see. "More than half of kids who die in hot cars are under age 2, which means not necessarily that they were rear-facing but they should have been rear-facing. That tells you right there, that's a big factor," Rollins says.

 

CHUNKY, CHEWABLE PAGES

Not Even a Minute is not only colorful to look at, it's made with babies in mind. The book was designed for children's hands — and mouths. It has thick pages with rounded corners that are safe if a child chews on them. On the back are facts about hot-car deaths and tips for preventing them. "We want the children to want to have this book, and it's something their parents read to them so that their parents get that message. That was the goal with it. That parents would be able to use it as part of their library for their young children to reinforce the safety message every time they read it," says Dr. Mary Aitken, director of the Injury Prevention Center at Arkansas Children's Hospital. The book has been met with praise far and wide. At the Safety 2018 World Conference in Bangkok, the 16-page book received a silver award from the International Safety Media Awards. "It was really nice to hear that it spread that far. The whole goal was to just spread awareness. We've said a thousand times that if it could save one life it will have meant the world to us. The book is very special and we were very delighted with the way the book turned out," Naramore says. Aitken says the book is sold at the Children's Hospital gift shop and she hopes to have it in more stores soon. "We're looking at a new arrangement with a small publishing house. We have it in our gift shop here and we'd like to see it in gift shops across the country. I think there would be a real interest in it." In a pilot project, copies of the book were given to six day care centers in the state. A thousand families ended up with books and a toolkit with prevention tips and materials. Aitken knows more families in the state could benefit from the book. "Arkansas has had 17 of these deaths that have been documented between 1998 and 2017, so our rank is No. 18 in the country," Aitken says. "These deaths occur in any state, any climate, but we have more hot days during the year and I think that is probably the reason. We just have more days that the temperature is that warm. But, some of these deaths have occurred when the temperatures are in the 60s and 70s. "Obviously, the hotter it is, the faster it happens. But most of the heat increase happens within just a few minutes and it can be deadly under any weather conditions," she says. In addition to cases where children were forgotten in cars, Aitken says other scenarios include when children gain access to a parked car and get trapped inside or in the trunk. Sometimes, parents have been known to leave their children in cars intentionally. "Parents say, 'I'm just going in the store for a minute,' so they think they can leave their child safely. And that's a myth. There's no period of time where it's safe," Aitken says. According to statistics from noheatstroke.org, when it is 85 degrees outside, the temperature inside a car can reach 104 degrees in 10 minutes. After 30 minutes, the temperature is a blazing 114 degrees. On a 95 degree day, the inside of a car can reach 124 degrees in 30 minutes. Kidsandcars.org statistics show that cracking the windows does not help slow the heating process, nor does it lower the maximum temperature.

 

MORE TO COME

Aitken's Injury Prevention Center's purpose is to educate the public about not only hot-car deaths, but anything that can harm a child. Not Even a Minute may not be the last book the center publishes. "I think there are certainly a lot of opportunities to develop material like this, but some things lend themselves better to baby books than others," Aitken says. Other possibilities include books on playground and water safety. "We're recognizing more and more that actually for 1- to 4-year-olds, the leading cause of injury-related death used to be motor vehicles, but we've been working so hard on that problem that we realize now that drowning has overtaken it and there are things we can do there, like making parents aware of the importance of supervising their kids all the time around water," Aitken says. For now, though, there is much left to do about kids and cars and safety. The focus right now is on reducing the number of hot-car deaths in Arkansas and beyond. No one wants that more than the Naramores, who say they will keep working to prevent more tragedies, painful as it is. "It is a hard story to share, but something we feel called to do. Our tragedy is part of who we are. Yes, it is painful. But it is our hope that by sharing our experience with others and taking steps to further public education and awareness, we can save lives. If we save one life, we have accomplished our mission," says Ashley Naramore.