The premature graduation of children from child restraints to vehicle safety belts

Abstract

Belt-positioning booster seats are recommended for children between 40 and 80 pounds, however, usage is estimated at only 5% nationally. The goal of this project was to determine reasons for the premature graduation of children from child safety seats to vehicle seat belts and to suggest strategies for increasing booster seat use.The project utilized multiple methods, including a review of existing literature and programs regarding premature graduation and booster seat use; discussions with parents, children, and experts via telephone or focus groups; and facilitated brainstorming sessions. These qualitative methods were used to gain a broad understanding of the issues relating to the premature use of seat belts by young children and to suggest strategies to increase booster seat use.This research showed that the premature graduation of children from child safety seats to vehicle seat belts occurs for a variety of reasons. Most notably, a parent's perception of risk of their child being injured in a crash plays an important role -parents who used booster seats tended to have a higher risk perception than parents who used seat belts for their children. Parents' knowledge of best practice for child passenger safety and the potential consequences for not following these recommendations played a key role among the subjects studied in this research. Parents identified several potential barriers to optimal restraint for their young children including situational circumstances (e.g., extra adult or child in the vehicle), child behavior, child discomfort, the law, availability of the booster seat, cost, convenience/ ease of use, and perceptions of safer alternatives. This research also identified potential strategies to overcome barriers to booster seat use, and to promote continued booster seat use among parents who use them. ii Executive SummarySeat belts do not properly fit young children. The lap belt rides up around the child's waist and the shoulder belt crosses the face or neck, often causing the child to place the belt behind his/her back or under his/her arm. This reduces the effectiveness and compromises the torso restraint. As a result, the premature use of seat belts can cause significant injury in the event of a motor vehicle crash. In particular, young children restrained using seat belts are 3.5 times more likely to sustain a significant injury and 4.2 times more likely to sustain a significant head injury than children using child safety seats or booster seats (Wnston, et al., 2000). In addition, young children using seat belts are also at risk for seat belt syndrome, which can include serious injuries to the abdomen and/or spine.In order to help prevent these injuries, the National Highway Traffic Safety Administration recommends that children between 40 and 80 pounds be restrained using a belt positioning booster seat.' Unfortunately, however, belt positioning booster seat use is only about 5%nationally. The goal of this project was to determine reasons for the premature graduation of children from chi...