Becca and Jason Keen Cunningham are careful parents. They got Mr. Yuk stickers from the Washington Poison Center and put them on anything that might be poisonous to drink, even though the cabinets are locked. They covered outlets, bought side-impact car seats and installed mesh between the deck and its railing so their three young kids can't fall through.
But in 2010, when then 3-year-old Thomas fell out of his second-floor bedroom window, landed on concrete and cracked his skull, the couple realized they overlooked a critical safety device.
"It's a pretty sad irony," said Jason, who is a firefighter and EMT with the Portland Fire Bureau at Station 7.
In observance of National Window Safety Week, the Keen Cunninghams are helping spread the word about what parents can do to prevent these falls — especially as the weather warms up.
Thomas loved to sit in his window seat and was fascinated by the window blind cords. On Oct. 20, 2010, Jason wrapped up the cords, putting them where he thought Thomas couldn't reach, and stressed the dangers of playing by the window; the screen keeps bugs out, but it doesn't keep kids in. Thomas seemed to comprehend what his father told him, at least, in the way that a 3-year-old can.
"It's not enough," Becca said. "Kids don't understand danger. That's why it's our responsibility as parents to protect them."
The next day, just six days shy of his fourth birthday, Thomas was playing quietly in his room while Becca was downstairs. She heard a moaning noise and went up to her son's room, where she found the blinds up and the screen pushed out. Outside, Jason and Becca found their son lying on the back patio semi-conscious with a fractured skull.
Medics rushed him to Legacy Emanuel Medical Center in Portland. Thomas couldn't move or talk.
"I remember asking the ambulance driver whether he was going to live or not," Becca said. She watched her son's eyes flutter close.
The driver didn't know and neither did doctors as they performed an MRI and measured his inner-cranial pressure.
Thomas spent his birthday in a medically induced coma and was paralyzed on his left side. For five weeks he did in-patient rehabilitation at Emanuel to regain mobility and spent another year out of the hospital doing occupational, speech, physical and vision therapy. Today, he is proud to tell people he fell out of a window, was paralyzed and after a lot of hard work, got better.
On the surface, he appears like an average, hyperactive 6-year-old, who loves to play and learn. However, he will never fully recover from his fracture.
"That part of his brain is damaged forever," Becca said. "We'll never know what he would have been like. He's definitely altered."
"I destroyed my son's potential life. It will scar me and it will scar him," Jason said. "I lie awake at night thinking how easily it could have been corrected."
When Thomas hits adolescence, his frontal lobe and executive functions will fully develop. Until then, the Keen Cunninghams won't know if he's lost any abilities in that area of his brain. As a kindergartner at Hearthwood Elementary School, he performs well above grade level and attends an advanced reading class.
Thomas can't play any contact sports, but regularly takes tennis lessons with his twin brother, Zane; the incident rate of concussion while playing tennis is very low.
"We are very lucky, but that's not the point," Becca said. "That's probably not what would happen to the next kid or the next."
In the U.S., about 3,300 kids younger than 6 fall from windows each year, according to the STOP at 4 campaign; 70 percent of those falls are from second- and third-story windows.
"Even falls from first-floor windows can pose safety risks," said Anne Johnston, public health nurse and Safe Kids Clark County coordinator.
So far this year, three children have fallen out of windows, including a 1-year-old boy who fell last month from a second-story apartment window and landed on soil. The boy was crying and alert when emergency crews arrived.
In 2012, at least seven children fell out of windows, Johnston said. Clark County Public Health is working with American Medical Response to gather data and follow trends on window falls.
Children younger than 4 are most at risk because they're short and top heavy, said Sandy Nipper, registered nurse and Child Safety Coordinator at Emanuel. Young children don't have well-developed impulse control and can't anticipate danger, she said.
If a kid falls onto a bush, they may be able to walk away from a fall with just a scratch. But window falls can result in broken bones, traumatic brain injuries or even death, depending on how and where they fall. The STOP at 4 campaign was dedicated to Parker Reck, a 4-year-old Molalla, Ore., boy who died in 2009 after falling from a second-story window onto concrete.
While at Emanuel, the Keen Cunninghams were introduced to window safety products at The Safety Store in the hospital's atrium.
They bought a pair of KidCo window stops that prevent the window from opening more than 4 inches. They also installed window guards on the twins' bedroom window; these metal bars prevent children from falling out and have quick-release harnesses in case of emergency.
"We take a lot of the fault for having not protected (Thomas)," Becca said. "Other people are still in the position where they can prevent it from happening. We can never erase our guilt and sadness and loss."
At the time of the fall, Becca didn't know about window guards or stops. When she read the window locks section in Washington's Child Profile, she assumed her standard locks worked just fine. She suspects other parents don't understand the difference between window locks and windows with after-market safety features.
To help kids learn about window safety, Becca wrote a children's book. The book, written from Zane's perspective, talks about what the family could have had in the backyard to prevent Thomas from getting hurt. She got the ideas from her kids and their friends. While a bouncy house, a trampoline, an inflatable suit or a backyard full of peanut butter would be great, the book points out that's not real. Zane recognizes that his parents now know what to do and how to keep him safe.
After finding someone to illustrate the book, Becca plans to submit the book to publishers, hoping there's a niche for this topic. She hasn't found a children's book that focuses on window safety.