There has been a historic surge in U.S. traffic fatalities over the last four years as more drivers use their phones to respond to texts or scroll through Instagram feeds. Even parents can’t keep keep their hands on the wheel and their eyes on the road, new research shows.

Half of all parents use their cellphones while driving with young children in the car, according to a study released Thursday by the Children’s Hospital of Philadelphia and the University of Pennsylvania School of Nursing. About a third of parents reported reading text messages, one in four sent text messages and one in seven used social media over the last three months while driving children between the ages of 4 and 10 in a moving vehicle.

The study was conducted in 2017 from a national sample of 760 parents and caregivers of children aged 4 to 10.

It’s not a surprise, given that American adults use smartphones “almost constantly” throughout the day. Seventy-seven percent now own a smartphone, according to the Pew Research Center.

“Engaging with a cellphone inherently takes our attention away from the roadway,” said Catherine McDonald, a senior fellow at the Children’s Hospital of Philadelphia who co-authored the study. “As technology rapidly changes and accelerates, we need to intervene.”

Parents who reported using their phone while driving young children in a moving vehicle were more likely to have demonstrated other risky behaviors, including driving under the influence, not using a seatbelt and not using proper child restraint systems, according to the study.

“Deterring cellphone use while driving is going take a multi-pronged approach,” McDonald said, pointing to increased law enforcement, insurance penalties and health-education counseling as possible solutions. But thus far, insurance companies and police departments have been fairly lenient in terms of identifying and punishing distracted drivers. Laws banning the use of hand-held phones have also had little effect.

Beyond the immediate consequences, McDonald said she’s worried that parents who text and drive may encourage their children to model that behavior when they eventually take the wheel.

“We want to help parents understand the risk associated with these behaviors,” McDonald said. “Parents want to keep children safe, but this behavior places their children at crash risk.”