The way I arrived at E was:
1.Studies have shown wearing helmets reduces head injuries
2. Subsequently, law has been passed requiring children under 12 to wear helmets
3.Surprising result: Large amount of kids do wear helmets, but head injuries are actually higher than expected
For me, 'Large amount of kids do wear helmets' is the crucial part.
A) Incorrect because paragraph states that large amount of kids actually do wear helmets.
B) Tempting, because there have been plenty of questions where the answer 'because more of event A will create an environment conducive to consequence B happening' was the right one. However, B didn't sit right with me because it doesn't address the spike, particularly when, if anything, rate should be going down due to increased usage of helmets.
C) Cost of helmets never mentioned in paragraph, and besides the paragraph states that large amounts of children actually do wear helmets.
D) Again, it doesn't actually explain or address a spike of head injuries when the rate was expected to decline.
E) This works because it acknowledges that actually more children do wear helmets, and provides an explanation within that new paradigm: although more kids do wear helmets which, as studies have shown, do reduce head injuries, they are being improperly secured by the parents - implying that they won't end up providing adequate protection in an accident and thus explaining the surprising spike.
That's just my thought process!