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Child restraint misuse: Do parents properly install car seats?
David C Schwebel1, Morag MacKay2, T Mark Beasley3
1Department of Psychology, University of Alabama at Birmingham, United States.
Insights
Despite widespread issues, most child restraint components are installed correctly, significantly improving child safety in vehicles. Continued efforts are needed to reduce misuse and ensure complete correct installation for maximum protection.
Area of Science:
- Pediatric injury prevention
- Motor vehicle safety
- Public health research
Background:
- Child restraints significantly reduce pediatric injury risk in motor vehicle crashes.
- Child restraint misuse is prevalent, with 70-95% of restraints installed or used incorrectly in previous decades.
- Recent data is needed to assess current child restraint misuse rates and common errors.
Purpose of the Study:
- To present recent national data on child restraint misuse in the United States.
- To identify the most common types of child restraint misuse.
- To analyze misuse patterns across different installation methods.
Main Methods:
- 1,477 vehicle owners with installed child restraints (excluding booster seats) participated across seven U.S. sites.
- Certified technicians assessed restraint installation using a standardized checklist.
- Data included overall percentage of correct components, individual component scores, and an overall correct installation score.
Main Results:
- 85.25% of child restraint installation/use components were correct overall.
- Rear-facing, LATCH/lower-anchor installations had the highest correct component rate (89.07%).
- Only 11.9% of restraints were installed and used entirely correctly; forward-facing seatbelt installations had the lowest correct component rate (76.50%).
Conclusions:
- Few child restraints are installed and used completely correctly, consistent with past findings.
- A majority of installation components are correct, enhancing child safety compared to being unrestrained.
- Multifaceted, collaborative efforts involving manufacturers, public health professionals, agencies, and parents are crucial to reduce child restraint misuse.
Background:
Child restraints (car seats) reduce risk of pediatric injury in motor-vehicle crashes, but restraint misuse is widely documented, with estimates from the 2000s and 2010s suggesting 70-95% of child restraints are installed or used incorrectly. This study had two primary objectives: (a) present recent data concerning child restraint misuse from a large, national sample in the United States; and (b) explore the types of misuse that are most common, including across different types of installations.
Methods:
As part of a larger study, 1,477 individuals who drove vehicles with installed child restraints participated at seven U.S. sites. Booster seats were excluded. Upon arrival for an initial research appointment, restraint installation was assessed by certified technicians using a standardized checklist that yielded an overall score of the percentage of correct components, as well as individual binary scores (correct vs. incorrect) for each checklist component and an overall binary score (100% correct or not) for the entire installation.
Results:
Overall, 85.25% (SD = 11.91) of restraint installation/use components were correct; that percentage was highest for rear-facing, LATCH or lower-anchor installations (89.07%, SD = 8.57) and lowest for forward-facing seatbelt installations (M = 76.50%, SD = 13.59). Just 11.9% of all restraints were installed and used entirely correctly. Inspection of individual installation/use components indicated most items were correct 95-100% of the time. However, some items had poorer scores, and a handful were correct less than half the time for some installation types.
Discussion:
Replicating findings from years past, few child restraints were installed and used completely correctly. However, a large portion of the installation/use components were correct, and thus children riding in the restraints were considerably safer than if unrestrained. Continued multifaceted efforts to reduce child restraint misuse are advised. These efforts should be shared by vehicle and restraint manufacturers, public health professionals, government and non-profit agencies, and parents themselves.
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