ATV accidents jump as the weather gets warm, and children are more prone to injuries. Here’s why.
Wearing a helmet while riding an all-terrain vehicle (ATV), a bike or a skateboard should be a no-brainer. Riders are prone to ATV accidents as the weather gets warm and families enjoy the outdoors.
Experts at Monroe Carell Jr. Children’s Hospital at Vanderbilt say wearing a helmet is the best save-the-brain decision anyone can make.
Wearing a helmet while riding an ATV should be a habit, much like putting on a seat belt when you get in a car, said Stacey Pecenka, manager of the Pediatric Trauma Injury Prevention Program at Monroe Carell. Helmets help absorb the shock of impact in the case of an accident. They protect the brain, and can reduce the severity of a head injury.
Monroe Carell care teams treated 97 children injured in ATV accidents in 2025, the same number as in the prior year. Injuries from ATV accidents can be severe, Pecenka said.
Two of the most common situations emergency personnel see about ATV accidents often result in serious injury: riders not wearing helmets; or driving on roads or highways.
“What (families) don’t see is how tough some of the injuries can be,” Pecenka said. “Road rash, facial injuries, traumatic brain injuries, internal organ damage and multiple fractures – their lives could be negatively impacted very quickly if they aren’t wearing protective gear on ATVs/4-wheelers.”
Helmets are the most important gear for ATV riders. And it is also smart to use restraints and wear long sleeves and pants, and appropriate shoes, to prevent or minimize injuries to other parts of the body besides the head.
In Tennessee, state law says only people age 16 and older may driving adult-sized ATVs. The law also require those younger than 18 years old to wear a helmet while riding an ATV. But many people are unaware of these laws, or ignore them. It’s not uncommon for emergency medical personnel to treat children much younger than age 16 who have suffered ATV-related injuries, Pecenka said.
Children are especially prone to ATV injuries because of lack of experience operating motorized vehicles, lack of psychomotor control and coordination, and lack of judgment that can result in risk-taking behavior and poor decision-making.
“It’s certainly a normal response to tell your children to go outside for a bit to get some fresh air, sunshine or exercise,” said Dr. Harold Lovvorn III, a pediatric surgeon and medical director of Pediatric Trauma at Monroe Carell. “But we will probably need to add a caveat to ‘go outside and play.’ Maybe it’s adding the tag ‘and don’t forget your helmet.’
“When we send them outdoors for independent activities, we will need to encourage them to wear protective gear and to practice safe play.”
Lovvorn said most children don’t know how to protect themselves, so it’s up to adults to give the gentle reminders about following safety rules.
Monroe Carell fully supports recommendations by the American Academy of Pediatrics and the American College of Surgeons that children 16 and under should not ride ATVs, because of the high risk of serious injuries.
However, if parents allow their child to ride an ATV despite the known risk that these vehicles pose to children, these safety tips are strongly recommended:
- Always wear protective gear – especially a helmet – when riding ATVs. Head injuries are by far the leading cause of death and disability related to ATV crashes. Helmets are known to reduce head injuries by 85%. Wear a motorcycle or motorized sports helmet and make sure it is certified by the U.S. Department of Transportation or the Snell Memorial Foundation.
- Avoid driving ATVs with a passenger, or riding as a passenger. Most ATVs are designed to carry only one person.
- Take a hands-on safety training course.
- Do not drive ATVs on paved roads, because they are difficult to control. Collisions with cars and other vehicles can be deadly.
- Do not let children drive or ride on adult ATVs. Children are involved in about one-third of all ATV-related deaths and hospital emergency room injuries. Most of these deaths and injuries occur when a child is driving or riding on an adult ATV.
Helping keep children safe
The Injury Prevention Program at Monroe Carell Jr. Children’s Hospital at Vanderbilt is a nationally recognized program that aims to reduce traumatic injuries among children, and promote safe behaviors in the community. Parents can learn more about ATV safety for their children and more at the program’s website.
