Do Sleeping Children Respond Better to a Smoke Alarm That Uses Their Mother's Voice?

Acad Pediatr. 2020 Apr;20(3):319-326. doi: 10.1016/j.acap.2019.06.016. Epub 2019 Jul 2.


Objective: Being asleep at the time of a residential fire increases fire-related fatality risk. This study tested whether children awaken from slow wave sleep and perform an escape procedure better to a voice smoke alarm that uses their mother's voice compared with a female stranger's voice or a low-frequency tone alarm.

Methods: Using a randomized, nonblinded, repeated measures design, 176 children 5 to 12 years old were exposed during stage 4 slow wave sleep to 4 smoke alarm signals: 1) the voice of the child's mother, 2) the voice of a female stranger, 3) low-frequency 500 Hz square wave tone, and 4) conventional residential high-frequency tone. The alarms were assessed regarding their ability to awaken the children and prompt their performance of an escape procedure.

Results: Among the 176 subjects, 78.4%, 83.0%, 88.1%, and 49.4% awakened and 78.4%, 81.3%, 85.8%, and 48.3% successfully performed the escape procedure within 5 minutes of alarm onset in response to the mother's voice, stranger's voice, low-frequency tone, and high-frequency tone alarms, respectively; while the median time-to-escape was 23.0, 24.0, 41.5, and >300 seconds for these 4 alarms, respectively.

Conclusions: The 2 voice alarms and low-frequency tone alarm significantly outperformed the high-frequency tone alarm, with the low-frequency tone alarm and female stranger's voice alarm performing best. Compared with the voice of a female stranger, personalizing the alarm message with the voice of the child's mother did not increase alarm effectiveness. These findings provide important information for development of an effective and practical smoke alarm for children.

Keywords: fire; injury; prevention; sleep; smoke; smoke alarm.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child
  • Child, Preschool
  • Equipment Design*
  • Female
  • Fires
  • Housing
  • Humans
  • Male
  • Mother-Child Relations
  • Mothers / psychology*
  • Ohio
  • Protective Devices*
  • Sleep* / physiology
  • Smoke
  • Smoke Inhalation Injury / prevention & control
  • Sound*
  • Voice* / physiology


  • Smoke