Electric Bike Safety: What Parents Need to Know! – PediaCast 612
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Show Notes
Description
Dr Mikhaila Layshock and Dr Phyllis Agran visit the studio as we consider electric bike safety. E-bikes are becoming popular with kids and teens. But when is a young rider ready, which bike and helmet should you choose, and what ground rules are important before taking that first ride? Tune in for answers to these questions and more!
Topic
Electric Bike Safety
Guests
Dr Mikhaila Layshock
Pediatric Resident
Nationwide Children’s Hospital
Dr Phyllis Agran
Professor Emeritus
University of California Irvine School of Medicine
Links
Are Electric Bikes (E-Bikes) Safe for Kids?
Fast Wheels, Safe Skills: E-bike Safety
E-Bike Readiness Checklist for Parents and Teens
Ohio Bicycle and Pedestrian Law Guide
CPSC Micromobility Information Center
Episode Transcript
[Dr Mike Patrick]
This episode of PediaCast is brought to you by trainees for Child Injury Prevention and Pediatric Emergency Medicine at Nationwide Children’s Hospital.
[MUSIC]
[Dr Mike Patrick]
Hello, everyone, and welcome to another episode of PediaCast. We are a pediatric podcast for moms and dads.
This is Dr. Mike coming to you from the campus of Nationwide Children’s Hospital. We’re in Columbus, Ohio. It’s episode 612.
We’re calling this one Electric Bike Safety, What Parents Need to Know. I want to welcome all of you to the program. We are so happy to have you with us.
You know, bikes give kids and teens freedom, exercise, and a way to get where they need to go. But add a motor, a rechargeable battery, extra weight, and higher speeds, and the safety conversation changes. Electric bikes are increasingly popular, and many families are wondering, when is a rider ready?
At what age? At what developmental level? How do I know if my kid’s ready?
Which bike and helmet should they choose? And you’ll notice I didn’t say, should they wear a helmet? Yes, they should wear a helmet.
But how do you know what is a good one? We’re going to talk about that. And what rules should come before the first ride?
Rules and training. So today we’re going to explore the risks, the recommendations, and the practical steps that can help kids and teens ride safely. Of course, in our usual PediaCast fashion, we have two terrific guests joining us to discuss the topic.
One brings a resident’s perspective from the front lines of pediatric care. The other brings decades of leadership in childhood injury prevention. Dr. Mikhaila Layshock is a PGY2 pediatric resident at Nationwide Children’s Hospital. And Dr. Phyllis Agran is a professor emeritus at University of California, Irvine School of Medicine, and chair of the American Academy of Pediatrics Orange County Committee on Injury and Violence Prevention. Before we get to them, I do want to remind you the information presented in every episode of our podcast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals.
If you’re concerned about your child’s health, be sure to call your health care provider. Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at PediaCast.org. So, let’s take a quick break.
We’ll get Mikhaila and Phyllis settled into the studio. And then we will be back to talk about electric bike safety. It’s coming up right after this.
[MUSIC]
[Dr Mike Patrick]
Dr. Mikhaila Layshock is a PGY2 pediatric resident at Nationwide Children’s Hospital. And Dr. Phyllis Agran is professor emeritus at the University of California, Irvine School of Medicine, and chair of the American Academy of Pediatrics Orange County Committee on Injury and Violence Prevention. She’s also a fellow of the American Academy of Pediatrics, a former member of the Executive Council on Injury, Violence, and Poison Prevention, and a 2025 to 2026 trainees for Child Injury Prevention Facilitator.
Together, they are here to help families understand e-bike risks, recognize rider readiness, and make every ride a safe one. Before we dive in, let’s offer a warm PediaCast welcome to our guests, Dr. Mikhaila Layshock and Dr. Phyllis Agran. Welcome, both of you, to the podcast.
[Dr Mikhaila Layshock]
Thank you so much for having us both here today. This is a really great opportunity for us and the whole T4CIP program.
[Dr Phyllis Agran]
And from my perspective, I so appreciate this opportunity because what we’re doing is addressing an epicenter of e-bike crisis that started in California and is spreading across the country.
[Dr Mike Patrick]
Thank you both for being here. And I know, Phyllis, it is early in the morning out on the West Coast, and we appreciate you being the early bird and joining us on the podcast. Mikhaila, I wanted to start with you.
We’re talking about electric bikes and scooters. I guess a good place to start is just what exactly are those? Are these the things that we see kids, you know, motoring down the sidewalk and the streets and they’re not pedaling?
Is that right?
[Dr Mikhaila Layshock]
Yeah. So, there’s a couple of different ways that we talk about e-bikes. Just at the really basic level, an e-bike has a battery-powered motor, which can provide either pedal-assisted speed or throttle-assisted speed.
And we have three classes of e-bikes. The first one is Class 1. That will assist pedaling up to that 20 miles per hour.
Class 2 will use a throttle up to the 20 miles per hour. And Class 3 will go via pedaling up to that 28 miles per hour.
[Dr Mike Patrick]
And these bikes, you don’t need a particular driver’s license like you do a traditional motorcycle. Like anybody can just get on one and go. Is that correct?
[Dr Mikhaila Layshock]
Yeah, that’s where the legislation stands right now is that really anybody can get one of these bikes. I think one of the really interesting things is in a lot of communities, in a lot of cities, they have the e-bike rentals. So, you can just go downtown, go to a spot where they have a whole bunch of them and just run an e-bike.
And I think the biggest thing there is they often don’t include the helmets, which we think are one of the most important things with these e-bikes.
[Dr Mike Patrick]
So, these electric bikes, you don’t have to have a license. And they’re heavy and they go fast. And we’ve known for a really long time that bicycles can be particularly dangerous for kids if they’re not wearing a helmet.
Because if you crash, there’s a lot of energy and your head is going to hit something hard. And that’s going to be a problem. But these things go even faster, are even heavier.
You have more momentum and velocity. So, it is just going to be so important to wear a helmet with these electric bikes. Is that correct, Makayla?
[Dr Mikhaila Layshock]
Yeah, that’s absolutely right. I think one of the really big things that we emphasize through our trainees for child injury prevention is that higher speed really does mean higher risk for kiddos. And with the popularity of these rising so quickly, increasing four times the amount of people who have e-bikes from 2019 to 2022 and really just exponentially going up from there.
We want to just really emphasize the importance of safety in the realm of e-bikes.
[Dr Mike Patrick]
Phyllis, let’s say you have a child who has expressed an interest in one of these. What do parents need to know before you embark on purchasing an e-bike? What’s the checklist they should run through from a safety standpoint?
[Dr Phyllis Agran]
Well, thanks for asking the question. And I just want to emphasize what Dr. Layshock said. These are not conventional bicycles.
They have a motor and they have a rechargeable battery, and that throws them into the category of a motorized vehicle or a motorcycle. So, they’re heavier. They go faster.
They’re harder to manipulate. The stop time is faster. And young children just don’t have the motor skills and the ability to manage these e-bikes.
And so, for parents, when we go back to the Consumer Product Safety Commission recommendation that a child between 9 and 12 years of age should not ride any motorized vehicle that goes faster than 10 miles an hour. Well, these Class 1 e-bikes, as Dr. Layshock mentioned, can go up to 20 miles an hour. So right there, it says to us as pediatricians, no child under 12 should be riding an e-bike.
And then just to carry it a little further, 12 to 15-year-olds, I personally wouldn’t recommend it. It’s like a motorcycle and the injury patterns are similar to motorcycles, but we know they’re out there. And I come from a community in Southern California, which is an epicenter of the youth e-bike crisis.
So basically, they are riding them. So, there’s several things that we want to emphasize to parents. Is your child ready?
One, can they ride a regular bike? If they can’t ride a regular bike, an e-bike should be a no. If they can ride a regular bike, you have to assess your own child.
And so often as pediatricians, we say, you know best what your child’s developmental skills are, what your child does, is your child a risk taker? We want parents to be aware of the risks and make careful decisions. And I’d like to add, and we’ll put it in the resource file, Trainees for Child Injury Prevention focused on e-bikes earlier this year.
And we created Is Your Child Ready? which is a checklist to determine should you get your child an e-bike? Then 15- or 16-year-olds, the same principles apply. Again, do they know how to ride a regular bike?
Do they have hazard awareness? Are they risk takers? Do they know the rules of the road?
You know, some of them are riding on the streets. Should they have a driver’s license before we allow them to ride an e-bike? So, I’d like to refer families to Is Your Child Ready?
And then one other thing I’d like to mention in California, which our law enforcement says is insane. In California, as well as in other states, in order to ride an e-scooter, which is lighter and goes slower, you have to have a driver’s license.
[Dr Mike Patrick]
That’s a loophole that should not exist, right? Correct. There’s got to be legislation and hopefully in progress to fix that.
But until that happens, and even if, you know, it’s illegal, kids will still do it. So, parents really still need to be aware of the risks and know what’s going on. But let me just reiterate just how important this is.
These are heavy machines that go fast, and you don’t need a driver’s license at this point to ride on them. But just because you can do it without a license doesn’t mean it’s automatically safe. And we are seeing a lot of kids with significant injuries because they are not ready to ride something that can cause this significant of a trauma if they were to crash.
Is that correct?
[Dr Phyllis Agran]
That’s our messaging. Thank you for emphasizing that.
[Dr Mike Patrick]
We’ll put a link in the show notes for folks over at pediacast.org for this episode 612 that has the checklist, that ready checklist. It’s going to be so important for parents to check out. And we’ll put, again, a link to that so you can find it easily over at pediacast.org in the show notes for this episode. So, let’s talk a little bit about these classes of e-bikes again, Mikhaila. Can you remind us what are those different classes and why do families need to be aware of the different classes, especially before they purchase one?
[Dr Mikhaila Layshock]
Yeah, so with the classes specifically, there’s three of them that we talk about. That class 1 is that pedaling up to pedal assist up to 20 miles per hour. Those are not recommended for any kid under 12.
And then for both the class 2 and 3, they are not recommended for kids under 16. Class 2 uses that throttle to go up to 20 miles per hour. And class 3 uses pedal assist to go up to 28 miles an hour.
I think it’s so interesting to think about when we look at a traditional bike versus an e-bike, looking at the speed that kids will typically ride a regular bike. For adolescents, looking into the research, they usually only go about 8 to 9 miles per hour. And then for younger kiddos, they’re really only going 5 to 7 miles per hour.
So going from that traditional e-bike or traditional bike over to an e-bike could be up to a 3 to 5 times increase in speed. And as Phyllis has said before, as we’ve been talking about, being able to ride that regular bike does not automatically mean that you are ready to ride an e-bike.
[Dr Mike Patrick]
Yeah, yeah. So very important. Phyllis, a couple of questions come to mind.
First, where do kids – where are you supposed to ride these? It seems like you’re not going fast enough to be out with the rest of motor vehicle traffic, I wouldn’t think. But at the same time, you’re going too fast for sidewalks.
And is it appropriate on paved walking paths? Where do you do this?
[Dr Phyllis Agran]
Well, that’s a really good question and it’s problematic. So, first of all, just yesterday I was out walking and a young kid on an e-bike on the sidewalk and our pedestrian paths where traditional bikes are allowed, you don’t hear them. They’re quiet.
Without warning, she was going into a family walking their baby in a stroller. And that was problematic. And at the last minute, you could see the family react.
So, I’ve had that happen to me. But we don’t want to put young kids 8 to 10, 8 to 12 on the street. And that’s why, you know, this is problematic.
And in my own city, which again I mentioned is an epicenter and we have a crisis, we’re trying to figure out what’s appropriate. So that’s why we talk about ages. Older kids and faster speeds have to go on the streets.
The class 3 are for the streets. So, the same issues when you ride a regular bike on the street are even worse when you ride an e-bike on the street. So, our environment isn’t set up for e-bikes, much less for regular bikes in some communities.
So, in my own city, we’ve established bike lanes for e-bikes, bike lanes for traditional bikes and trying to reduce the speed that you’re allowed to use an e-bike on the pedestrian walkway. So, it’s problematic. Every state, every municipality is dealing with this.
And again, you know, that’s why we have the discussion. Young kids shouldn’t be riding essentially motorcycles. And we don’t want to put them in the streets.
So, the advice may be held off.
[Dr Mike Patrick]
Yeah, yeah. This is an opportunity, I feel like, for parents and community members to really engage with your community leaders, the folks who are in elected positions, because communities really need to keep up with the technology and what’s available for kids to use and make sure that they can do it in a safe way and that they’re legislating, you know, what ages and, you know, when are people developmentally ready. And really becoming active, just like you would for motorcycles and cars and other, you know, vehicles that go fast that can hurt you if you crash.
So, it’s going to be really important, I think, for communities to get on top of this. Now, in terms of helmets, I think that would be an issue too, because there’s definitely a difference between bike helmets and motorcycle helmets. But I’ve never seen an e-bike helmet like specifically for that.
So, what should kids wear if they are deemed safe to ride one of these things?
[Dr Phyllis Agran]
Well, first of all, as Mikhaila pointed out, the traditional bike helmet is a significant factor in reducing head trauma, head injuries. So, and that’s for a bike that goes, you know, under 15 miles an hour, maybe 8 to 10 miles an hour. The e-bike goes faster.
And a traditional helmet is not as protective. Any helmet is better than no helmet. The Virginia Tech Institute does research on all kinds of helmets.
And they opened up a webpage whereby they’ve shown e-bike helmets that they’ve tested. So, I would suggest that as one resource to look at the helmet for an e-bike. The e-bike helmet offers facial protection and neck protection.
And we’re seeing facial injuries. Like one of our recent cases, a child lost control, went into a parked vehicle, and lost her front teeth and had facial fractures. So, the traditional helmet is not as protective.
And then the other thing we’re seeing, you know, I encourage parents, look around your schools, look on your streets. You know, in our community, it must be the thing to do to wear the helmet unstrapped, not fastened. Or wear the helmet on your handlebars.
Okay? So, it’s sort of a joke. That’s really not helping.
It’s not a joke, really. But it’s really not protecting your head unless you wear a properly fitted helmet, fastened and designed for the sport. In this case, the e-bike.
The child, or any adult for that matter, is riding.
[Dr Mike Patrick]
Yeah, yeah. Is there a particular certification that folks should look for in their helmet? And this is not something that folks, you know, if you’re listening to this podcast and driving, you’re probably not going to write this down.
So, we’ll put links in the show notes on how to find a safe helmet. But just in general, is there something people should be looking for?
[Dr Phyllis Agran]
There’s several. There’s an ASTM F1952, which as you pointed out, no one’s going to remember or write it down. Don’t be a distractive driver if you’re listening to this podcast.
Okay? There’s NTA 8776 or DOT, which is Department of Transportation Certification. So basically, we’re saying everyone, not just kids, should wear a helmet appropriate to the speed and the specifications that have been established.
[Dr Mike Patrick]
Yeah, yeah. So very important and can not only save your child’s life but could potentially also prevent lifelong neurological conditions that arise from a very severe head injury. So, it’s really something that’s very preventable, but much more difficult to take care of after the fact and after you have a significant head injury.
Mikayla, you know, for a lot of folks, they’re going to say, well, we see folks, you know, riding on these electric bikes and scooters, and we’ve never seen anyone have an accident. We’ve never heard of anyone having an accident. So, these things must be safe.
But those of us in emergency medicine know different. What sort of injuries are emergency providers seeing from electric bikes and how common are these injuries? Yeah.
[Dr Mikhaila Layshock]
So, I am obviously so really early in my career as an early second year pediatric resident. But I’ve had experiences in the emergency department, in the ICU, primary care settings, even just on our hospital peds floors. And I myself have seen my fair share of injuries related to e-bikes at this point.
And I’m sure you guys both have as well in the emergency department. What the data is showing us is that nearly 5,000 e-bike injuries are reported in just the United States every year, and 11 percent of those require hospitalization. So, these are really dangerous and really high-cost injuries for these kiddos.
And I think one of the most important things going off of us just talking about helmets is that around 90 percent of the kids who come into the emergency department or a trauma center after an e-bike injury were not wearing helmets at the time. The most common types of injuries that we’re seeing, as Phyllis already had touched on, is we see brain injuries. We see bleeding, those facial fractures, injuries to like the chest and to the abdomen.
And then typically those like broken arms, broken legs come in very often as well. We’re not saying that the injury injuries can’t happen on regular bikes, but these are happening at a four to five times more likely rate compared to traditional cycles and have a really increased severity and multiple injuries that are happening. Because of the higher speed, the greater mass effect of these bikes, they produce multiple injuries that are really more representative of what people in the healthcare community see with like motorcycle accidents or higher speed vehicle accidents, as opposed to what we typically see with most regular traditional bicycle accidents.
Yeah.
[Dr Mike Patrick]
You know, 90 percent, I want to make sure I heard you correctly. So, when you see someone in the emergency department with injury from an e-bike and you ask them, hey, were you wearing a helmet? 90 percent of them were not wearing a helmet.
Is that correct?
[Dr Mikhaila Layshock]
Yeah. And even in my own experience living in the Columbus community, I know in my neighborhood, Phyllis was talking about seeing the kids with the straps of their helmet down. So, the second they move their head too quick, that helmet’s coming off.
And then talking about the micro mobility in the city itself, where a lot of those e-bikes don’t even have the option for you to have a helmet. I think it’s a really devastating statistic, but I definitely feel like that is what I have seen and what I have heard from my colleagues and peers who are in those settings. Yeah.
[Dr Mike Patrick]
You only have to see one really bad head injury in the emergency department for this to really sink in of how important this is. And that’s not something that a lot of parents have the opportunity, thankfully, to be exposed to. But it’s just, I mean, 90 percent.
I mean, that just means that we’re not doing a good enough job getting the word out. And parents aren’t necessarily doing a good enough job supervising what their kids are doing and making sure that they’re doing it in a safe way. And I guess, you know, the big issue here is that these are so preventable.
I know, Phyllis, that you guys advocate for a family e-bike riding agreement where kids and parents sit down and lay down the ground rules and, you know, together decide what’s important. Can you tell us about that riding agreement?
[Dr Phyllis Agran]
Sure. You know, just like in most states, graduated driver licensing laws have been very impactful in reducing youth trauma of new drivers. We picked up on this and said, you know what, if you’re going to get an e-bike for your child and permit your child to ride it, you need to have an agreement.
So, it’s kind of patterned after, and I have to hand it to the American Academy of Pediatrics, graduated driver licensing agreement to talk about what are the rules, when can you ride it, I need to give you permission to ride it, where are you going to ride it, you’re not going to wear earbuds, you’re not going to have passengers, you’re not going to be a distracted e-biker, you’re not going to be on your iPhone, and just set the rules straight. And it’s difficult to enforce, but having an agreement is really critical. And I think every community, you know, we’re dealing with youth who are under peer pressure, some are risk takers, some more than others, and they’re doing what are called wheelies.
I don’t think I ever did a wheelie as a kid, because I don’t think I had the skill set to, and I would have been chastised by my parents. But they’re doing wheelies, they’re traveling in herds, they’re traumatizing our pedestrians, and this isn’t all kids. Most kids follow the rules of the road and are responsible, but there’s a group of them that put other road users at risk.
And so, the more the parents are involved, and the more you provide the child with the safety equipment, and the more you’re able to monitor the child, and maybe check out, are they really wearing the helmet, or are they wearing it and then taking it off and strapping it around the handlebars. And then, you know, we have to, you mentioned about community partnerships, and maybe you want to talk about that a little bit later, but we’re all accountable. We’re accountable as pediatricians, parents are accountable, our communities are accountable, our public elected officials are accountable, and by way of disclosure, I have access to the mayor of our city, same Larry Aiken, my husband.
And so, by generating a group, we’re advocates as pediatricians, and we know that we have to, and we’re trained in this, and Dr. Mike, you’ve helped us so much with T4CIP and presenting to us, so it’s our responsibility to take our clinical experiences to the community and to the politicians or the publicly elected officials and the schools and collaborate to come up with reasonable policies.
[Dr Mike Patrick]
Yeah, because if we don’t do it, who will? And kids suffer, and you know, in the meantime, and we’re just really trying to get out the word because ultimately, it’s the parents who have the biggest influence over their kids and their kids’ safety. And I think that when you do have it as a written agreement, like even though, you know, your kids may not follow it, they know that you’re serious when you have a written agreement about something.
This is a big deal. We don’t have written agreements about many things. And so, this is one of those that we’re going to take really seriously.
And then you mentioned the peer pressure thing. I think kids, you know, when you’re with your parent, it’s easy to say, well, I’ll always wear my helmet, and even if my friends are not wearing theirs, I’m going to put mine on. But then when they’re with their friends and their friends aren’t wearing one and you feel that pressure, do you advocate like role playing or like how do you give your kids the tools to stick with wearing a helmet?
Does that make sense?
[Dr Phyllis Agran]
Yeah, good point, because it’s very difficult to deal with the peer pressure. So, this is, again, where parents are accountable and parents need to get together and say, you know, we’re going to monitor this. And the other thing, too, we talked about bringing this to the community.
The schools have a big role. So, you know, one of the reasons that we hear as to why parents are purchasing e-bikes is that they can get to and from school easier. And they’re using climate change as one reason.
And they’re using the, you know, go visit your school during, and many parents here have driven their kids to and from school. You know, it’s crowded. It’s a dangerous situation.
So, this alleviates traffic. It helps parents. Like we have some parents that said, I got three kids.
I can’t get them all to school on time and get to work on time. What do I do? Well, in one part of our community, we helped fund a school bus, which is far safer than an e-bike.
But I think parents have to band together, set the rules, and have these conversations with the kids and the schools. If a kid comes to school unhelmeted on an e-bike, what’s the responsibility of the school? They have some responsibility in safe transportation from the time the kid leaves home until the kid returns home.
And then, you know, my own community, we have a whole division of law enforcement police officers who are e-bike specialists and who are doing education and classes and so forth.
[Dr Mike Patrick]
Yeah, yeah. No, that is fantastic. And especially, I would suspect for the younger kids, like if you, there is a, as you get a little bit older and maybe a little more cynical and a little more jaded, less respect for law enforcement.
I mean, but those little kids like, oh, a police officer is telling me this. I’m going to take that seriously. And this like so many things, the earlier you start talking about it and start, you know, your prevention efforts at a young age, that hopefully, you know, the hope is that that’ll carry through into their teenage years and help to keep them safe by having those conversations early.
And I can see where law enforcement, you know, would be a big influence on those young kids.
[Dr Phyllis Agran]
You know, you hit a really important point. So, we have many schools have school resource officers, which are basically police officers. So, in our community, they started partnering with the schools and they’re offering an e-bike training class at the middle and high schools.
And we’re saying, go down to the elementary schools as well. And the leverage is the parents have to attend with the kid, and they have to sign that they’ve attended. And the schools are saying, in some communities, and I think this is a good policy, the schools are saying, if you want to ride your e-bike to school and you want to park it on the premises, you need to attend this class with your parents.
Okay. And then I’m just going to add something else. I audited; we have a violators class.
And my friend, Dr. Burris, a trauma surgeon, doesn’t like to call it violators class. She said Saturday class. So, Saturday at 8 a.m., when our officers ticket and most of the tickets or citations are for lack of helmet use or speeding, parents and the kid have to attend this Saturday morning class. And we audited it and the parents are not happy that they have to show up at City Hall at 8 o’clock in the morning. The kids are half asleep. And Jason Schaefer, our lead e-bike trainer across the state and who was on the T4CIP webinar, which you could put into the resources, leads the class and shows videos and so forth.
So, that’s another mechanism. If they don’t attend the violators class, then they can go to court and pay the fine. So, these are mechanisms where we as clinicians are out in the community.
It’s our responsibility. And as the President Mark Del Monte of National AAP said, it’s built into our DNA. We need to be out there partnering with schools, with law enforcement and the parents.
[Dr Mike Patrick]
Yeah, yeah. And that’s a creative solution, you know, to say the parent has to go on Saturday morning, early in the morning with your kid. And this could have been prevented.
You could have slept in on this Saturday. But no. So, you know, have these conversations with your kids so they don’t get those citations for sure.
Mikayla, I think it’s really important, the age ranges that we were talking about. And we do know that kids, you know, there are some kids that may be a little younger that are more mature. And there’s plenty of kids who are older and less mature.
And so, as Phyllis said earlier, you know, parents know their kids. But if we’re thinking about generic age ranges for these things, can you remind us again what age tends to be appropriate for these bikes?
[Dr Mikhaila Layshock]
Absolutely. So, national recommendations say that children under 12 should not ride on a vehicle that is capable of going more than 10 miles per hour, which obviously includes e-bikes that we talk about, also might include ETVs, motorcycles, scooters, e-scooters, mopeds, all those different types of things. And then, as we talk about in the context of, yes, we have an age cutoff that says nothing below here, but it also takes into account looking at the developmental readiness.
If you find that your kid is developmentally ready from age like 12 to 15, they show that they’re ready, they have the skills, they have the safety in place, it is appropriate to potentially start with a Class 1 e-bike. And just a reminder for everyone, the Class 1 e-bike is the e-bike that is a pedal assist motor that goes up to 20 miles per hour. Riders older than 16 that, again, are showing those skills, those safety practices, all the things that we look for to show that somebody is ready to ride an e-bike, we say that they should still even start with that lower speed, that Class 1 e-bike, and then as they build their skills, show that they are ready, you can move to a faster e-bike, to one of the Class 2 or Class 3 e-bikes.
But again, it’s all in the context of, are they ready? Are they showing they’re safe? Are they showing they’re responsible?
And are they going to wear their helmet every time? That’s what we’re going to keep saying.
[Dr Mike Patrick]
Yeah, so very, very important. Phyllis, in addition to gear that you can wear to protect yourself, like a helmet, this is also a mechanical thing that may need some maintenance. And if you don’t maintain them correctly, that could add danger because maybe you’re more likely to crash if there’s a problem with the bike.
So, what do parents need to know about the batteries and routine maintenance and that sort of thing?
[Dr Phyllis Agran]
Yeah, these are lithium batteries, and they can catch fire, cause fires, and they need to be recharged frequently. So, the parent needs to, first of all, read the owner’s manual, just like you read the owner’s manual when you put a kid in a car seat, read the owner’s manual for the e-bike, and no charging in the bedroom. They need to have the appropriate equipment to recharge the battery and don’t do it when you’re asleep, because there have been examples of explosions and serious burns and serious injuries.
Furthermore, they need maintenance, and probably more so than a traditional bike. So again, reading the owner’s manual, following the maintenance guidelines, and seeking professional help to, you know, are the brakes working? Is everything working?
It’s critical, just like you take care of your car. You got to take care of these e-bikes.
[Dr Mike Patrick]
Yeah, yeah. Where do you take them? Like if you want to get it checked out, I guess where you purchased it?
[Dr Phyllis Agran]
Well, yeah, yeah, that’s one option. I would personally take it to my police officer, who knows these bikes inside and out, but if we don’t have experts in our community, they need to become experts. I mean, this is like an infectious disease traveling across the country.
So, the more people that are trained and the more we, you know, we haven’t talked about how they’re marketing. We haven’t talked about who’s selling them. Are they informing parents?
And most important to you parents, you know, I ask the kids and the parents, do you know what class of e-bike you have? And they don’t. So, this is a multi-pronged approach involving all of us.
So, I guess I would take it where I purchased it. I would probably take it to, you know how we have car seat checkups and we have a police officer in our department that does car seat checkups? When my kid was little and my grandkids, I used to take the car seat to her and is it installed properly?
You know, I think to law enforcement, if they have the skill sets and I think most do is a great idea.
[Dr Mike Patrick]
Yeah. Or they may know a resource in your community that specifically does this. They would be on top of that, hopefully.
Because, you know, even lawnmowers, right? You can take your lawnmower to get a tune-up at the shop, but, you know, maybe the motorcycle mechanic folks should delve into e-bike, you know, and offer that as a service. And do a checkup of it, you know, not to have it once a year, whatever we decide is going to be a safe, you know, to make sure that everything is checking out.
[Dr Phyllis Agran]
You know, you’re bringing up a liability issue. So, it’s a liability of the seller. And also, one thing we didn’t mention that I think is important is your communities vary in the laws and the regulations.
So, you have to check your state, you have to check your municipality, your city. But some, and New York has a good model law, you know, what’s your liability insurance? Say your child is injured, injured another person.
Do you have insurance to cover the medical costs? Do you have insurance to cover a potential litigation or a lawsuit if your child injures somebody else? This happened in our community where a retired teacher was hit by a youth e-biker and eventually he died.
So, this opens up another can of worms. And then one other point I wanted to mention, you know, Mikhaila talked about the classes of e-bikes, but these can be altered. There are apps out there where a parent or a child could alter and make that e-bike go faster.
So, the classes become meaningless in a sense, because we don’t know if that bike has been altered to go faster. And in our case, our district attorney opened up a special office dealing with e-bike safety, and they’re beginning under child endangerment to prosecute parents who knowingly helped their child alter the e-bike to go at a faster speed than how it was designed.
[Dr Mike Patrick]
Don’t do that, parents. Please don’t do that. It’s dangerous for your kids and dangerous for your community, for sure.
Mikhaila, let’s say you’ve determined that your child’s ready and it’s going to make transportation easier, and you’ve made the decision that you’re going to purchase an e-bike. You want to start with a low class, I would imagine. And what sort of training then?
You know, we talked about, you know, to have driver’s training and some schools may offer that, but a lot of schools don’t. And so, what can parents do once you’ve made the decision to get one to make sure that your kids are ready to actually use it on a daily basis?
[Dr Mikhaila Layshock]
For sure. Definitely with doing that continual assessment of making sure that your child is ready to ride one of these bikes, there are often a lot of great community resources, as Phyllis has talked about, but also resources at your primary care office, at your children’s hospital, at schools, and even sometimes through like the Department of Transportation, motor vehicle departments. I know that we’ve included some in our post show notes.
I have some information there. Specifically, I know I’m coming from Ohio, so I put some of the Ohio laws, some of the tips and tricks that they recommend for e-bike safety. And then there’s a really, really great resource coming out of San Diego that goes through an interactive training module for both the riders and the parents, which I think can be super helpful to go through the steps to learn what they need to know to be able to safely ride and to safely go throughout the community on one of these e-bikes.
Specific skills that we recommend parents go through is really just practicing that braking, turning, scanning the environment, making sure that you’re paying attention to all the things that can be around you. I think one of the things that we say is like always just assume that nobody else can see you and making sure that you’re kind of almost on the defense every time you’re driving, but otherwise working on signaling, showing people where you’re going, and then really, really importantly, that speed control, stopping distance, all those types of things. It’s really great to do that in a safe, protected environment.
I think about it, when I was learning how to drive my car back when I was 16, my dad took me to the local abandoned parking lot, and I would practice parallel parking, driving, braking, all of the things in that really controlled, safe environment, not only for me to get comfortable with that, but just to make sure that everybody around me was safe when I was learning all of those things, that there was nobody around me, which I think was really great for everybody involved that I was doing it in an alone parking lot. Yeah, I think really just ensuring those safe spaces to learn, to grow, and always making sure you’re wearing the appropriate protective equipment while you’re doing that. No matter how short, even if you’re practicing in your driveway, in the street, in front of your house, having that helmet is incredibly important.
[Dr Mike Patrick]
Yeah, yeah, yeah, for sure. We can’t say that enough times, that the helmet is very important. And then those just driving behaviors that you were mentioning, you know, obeying signals, watching, you know, being aware of the environment and watching out for potential dangers as you’re going, not doing wheelies, those are all going to be important behaviors to reinforce, right, Phyllis, as you move forward.
It’s not just a one and done, okay, we have our agreement, go for it. You sort of want to monitor and make sure your kids are actually riding these things in a safe way, right?
[Dr Phyllis Agran]
I think it might, you know, we need to talk about how we as pediatricians message this. And, you know, we always say, ask your pediatrician, and in this case, ask your pediatrician. We have the tools now, and we have the knowledge to help guide parents.
But it’s similar to teaching your kid to cross the street, teaching your kid how to swim, and especially teaching your kid how to drive a car. You know, my grandson just got his, or I guess it’s a year ago, got his driver’s license. So, his parents made him be the driver when they were going out as a family so they could critique him.
He didn’t like it, but it’s called, too bad, these are the rules. So similarly with the Z bikes, you know, skills training and knowledge training is important, and that’s why we advocate licensing of some sort. You know, just like you have to have a driver’s license to drive a car, ride an e-scooter in California, some sort of licensing that’s competency, knowledge, hazard awareness, you know, as Mikhaila pointed out, I think would contribute significantly toward the injury reduction.
[Dr Mike Patrick]
Yeah, yeah, absolutely. And we all need to work together, right? And we’ve already given some great examples of creative things communities are doing.
And I think California, it seems, is leading the way because you guys have a lot of folks who are on those e-bikes. And so, the things that you’re doing, we need to all around the rest of the country be paying attention to, like the Saturday morning classes, for example. But this is, you know, just like AI, this is not going anywhere.
And these are going to continue to multiply. And we just, as parents, have to make sure that our kids are doing it safely, even if legislation has not caught up. You know, hopefully there will be a day when, you know, you need a class and you need to get licensed and we need to make sure everyone’s doing it safely because these are motorized vehicles and we are seeing significant injuries from them.
So, we all really do need to work together, right?
[Dr Phyllis Agran]
Absolutely.
[Dr Mike Patrick]
Mikayla, before we go, any last words of safety and prevention that parents should be aware of as we’re thinking about electric bikes?
[Dr Mikhaila Layshock]
Absolutely. So, I think we will say it a million times. Your pediatrician will say it.
Your emergency room doctors will all say it. We definitely should have you require your kiddo to wear a properly fitted, appropriately speed rated helmet every time, no matter how close, how far they’re going. I think that is of utmost importance, as we’ve seen with that statistic of over 90% of kids not coming in wearing a helmet to the hospital.
Otherwise, really just following those age appropriateness, age readiness, all of the things when you’re deciding on whether your kid is ready for a bike and whether they are developmentally appropriate and really just making sure they have the skills, the training, starting slow, using those protected paths, making sure that they are understanding the safety and the laws that are in place to help keep them safe.
[Dr Mike Patrick]
Yep. So very, very important. And our kids are our treasure, and of course we want them to be safe.
We also want them to experience new things and to enjoy life and have fun, but to do it in a safe way. And so, it’s really important to keep all of these things in mind as we move forward and there’s more of these electric bikes out there. Before we go, I wanted to mention again T4CIP, which is Trainees for Child Injury Prevention.
And Phyllis, this is a group I know you have worked with for quite a while. We have featured them on this podcast as these are future pediatricians who want to keep kids safe. And so, tell us, Phyllis, a little bit more about T4CIP and where you can find more information.
[Dr Phyllis Agran]
This program was founded by a friend and colleague for decades, Gary Smith at Nationwide. And his team has done a remarkable job at recognizing that injuries are the leading cause of death and disability among our youth and addressing it from the standpoint of mentoring our next-gen pediatricians. And I have to tell you, as I round third in my career, it’s critical that we bring on the trainees and give them the skills that they need to carry forward the messages.
I mean, there’s always going to be—who thought this was even an issue five years ago? Except maybe Dr. Ma in Northern California who spotted it. But training us to have the skills and have the resources to advocate for kids, I mean, that’s what we’re about.
Our mission of AAP is to optimize the health and well-being of all children. So, this is our responsibility, and this program has really achieved it. And I was excited when they picked e-bikes as an issue.
And when we started, and I’ll just tell you this, I think Mikhaila and some of the other trainees said, well, we really haven’t seen e-bikes. And then we were interviewed for AAP News, and the interviewer said, what are parents asking you about e-bikes? And I said, I thought about it, I said, they’re not until they get to the emergency room.
So, we want to change the conversation, and we always say, ask your pediatrician. And so T4C-IP has given us the resources to ask your pediatrician, and we have the tools.
[Dr Mike Patrick]
And we are going to share those tools so folks can find them very easily. If you head over to PediaCast.org, and this is episode 612, and just look for the show notes for episode 612, and we will have all those for you. The T4C-IP e-bike safety resource website is a fantastic place to find lots of information, so we’ll put a link to that.
We do have that e-bike readiness checklist for parents and teenagers. We have an example of an e-bike family agreement. We have more information on ride-ready training.
And then for Ohio specifically, just to let folks know, we have the Ohio Bicycle and Pedestrian Law Guide, so you can find out where the state of the law is right now as it relates to motorized vehicles, including electric bikes. And so, lots of information there for you. Just head over again to PediaCast.org, episode 612, and we will have the resources there for you to find pretty easily. So once again, Dr. Mikhaila Layshock, PGY-2 Pediatric Resident at Nationwide Children’s Hospital, and Dr. Phyllis Agran, Professor Emeritus at University of California Irvine School of Medicine and Chair of the AAP Orange County Committee on Injury and Violence Prevention. Thank you both so much for stopping by and chatting with us today.
[Dr Phyllis Agran]
Well, thank you, and I think we’ll save some lives as parents listen to this, as we all listen to it, and thank you so much.
[Dr Mikhaila Layshock]
Yes, thank you for giving us this opportunity to share all this information.
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[Dr Mike Patrick]
We are back with just enough time to say thanks once again to all of you for taking time out of your day and making PediaCast a part of it. We really do appreciate your support. Also, thanks again to our guests this week, Dr. Mikhaila Layshock, Pediatric Resident at Nationwide Children’s Hospital, and Dr. Phyllis Agran, Professor Emeritus at University of California Irvine School of Medicine and Chair of the American Academy of Pediatrics Orange County Committee on Injury and Violence Prevention. Don’t forget you can find us wherever podcasts are found. There might be an easier way for you to subscribe and listen. We’re available in the Apple Podcast app, Spotify, iHeartRadio, Amazon Music, Audible, YouTube, and most other podcast apps for iOS and Android.
Our landing site is pediacast.org. You will find our entire archive of past programs there, along with show notes for each of the episodes, our terms of use agreement, and that handy contact page if you would like to suggest a future topic for the program, or if you just want to say hello. I love hearing from listeners on the contact page.
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Simply search for PediaCast. We do have a program that is similar to this program. We turn the science up a couple notches, and we offer free continuing medical education credit for those who listen.
It’s called PediaCast CME. That stands for continuing medical education, and it’s for physicians, yes, but also nurse practitioners, physician assistants, nurses, pharmacists, psychologists, social workers, and dentists. It’s because Nationwide Children’s is jointly accredited by all of those professional organizations that we can offer the credits you need to fulfill your state’s continuing medical education requirements.
Shows and details are available at the landing site for that program, pediacastcme.org. You can also listen wherever podcasts are found. Simply search for PediaCast CME.
A third podcast that I host is called FAMEcast. This one is a faculty development podcast from the Center for Faculty Advancement, Mentoring, and Engagement at The Ohio State University College of Medicine. If you are a teacher in academic medicine or a faculty member in any of the health sciences, then this is a podcast for you.
You can find FAMEcast at famecast.org, and wherever podcasts are found, just search for, you got it, FAMEcast. Thanks again for stopping by, and until next time, this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So long, everybody.
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