Installation & Use of Child Car Seats and Booster Seats: “Am I doing this right?”

By Kathleen West, B.S. (J.D., expected ’15)

 As the world watched Prince William place the new royal baby, reluctantly snug in his car seat, into a vehicle a few weeks ago, my thoughts were not limited to, “Oh, how cute!” After two months researching and collecting a dataset to capture the U.S. laws and regulations for child passenger restraint systems, I also thought, “I wonder if he took a class and knows how to do that correctly?” Perhaps an odd thought, but misuse and faulty installation of child restraint systems is actually a major concern.

According to the CDC, proper restraint use can reduce the risk of death or injury by more than 50 percent. Yet, ongoing studies by the National Highway Traffic Safety Administration (NHTSA) are finding that as many as 20 percent of drivers with child passengers are not reading any of the instructions regarding proper installation, while 90 percent of drivers of child passengers are reporting that they are confident that they are properly installing and using child restraint systems.

In addition, the NHTSA’s preliminary report finds at least five significant and common ways in which child restraints are being improperly installed or used. The troubling thing is that these over-confident and under-informed drivers are unlikely to seek out information about child restraint guidelines and proper use of these devices, meaning many child passengers, although placed in an appropriate child restraint, may actually be in as much or more danger if they are not being used properly.

As a result of these concerns, the NHTSA continues to try to find ways to educate the public on to the problem of improper use of child restraints. In addition to their own marketing, they also encourage parent advocates by providing a “toolkit” on their website and advice on how to share the valuable information with other parents.

More public health law research would be needed to determine whether or not these educational programs are as effective as they could be at the national level. Hawaii completed a study that compared new parents who were only given information about proper installation of child restraints to new parents who were given both information and completed hands-on demonstrations. Both sets of parents were brought back for observation a few months later, and the observations showed that there were approximately 33 percent fewer errors among those who participated in a more hands-on approach. The study suggests that the most effective methods would require more than simple information dispersal. Notably, both of these groups would have been better prepared just by having been given basic information than the average public, who are not required to seek out information or instructional programs and are expected to learn proper use from manufacturer instructions or self-help.

Approximately eight states, as well as the District of Columbia, incorporate education programs into their laws for those who are in violation of child restraint laws. They may be required to attend educational programs instead of paying a full fine, or in some cases, the laws require class attendance in addition to the fine.

Although thorough research on the best approaches for improving proper use of child restraints is still needed, hopefully increased exposure and awareness will hopefully result in safer driving and better outcomes for our child passengers. And role models like new dad Prince William certainly can’t hurt.

Kathleen West is an intern with the Public Health Law Research program. Her summer work has included researching and creating a comprehensive dataset on child restraint systems across the United States using the LawAtlas content management system. The dataset is now available online at https://www.lawatlas.org/preview?dataset=child-restraint. West is entering her second year at Temple Law School. 

Temple University Center for Public Health Law Research

Based at the Temple University Beasley School of Law, the Center for Public Health Law Research supports the widespread adoption of scientific tools and methods for mapping and evaluating the impact of law on health. It works by developing and teaching public health law research and legal epidemiology methods (including legal mapping and policy surveillance); researching laws and policies that improve health, increase access to care, and create or remove barriers to health (e.g., laws or policies that create or remove inequity); and communicating and disseminating evidence to facilitate innovation.

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