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This is a template for noon conference/morning report

Please download and update it (add/remove/edit/reorder slides) �as you see fit

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��Child Passenger Safety�May 22, 2024

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Overview

Landscape of child passenger safety
[insert current state] legislation
Choosing the correct type of seat
Children with special transportation needs
Additional safety tips
Where do doctors fit in?
Resources (for patients and providers)
#CheckBeforeYouChange Day of Action

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Landscape of�Childhood Passenger Safety

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Child MVC Fatalities: 1975-2021

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The Facts

In 2020, 607 children 12 years and younger were killed in car crashes
Over 63,000 were injured
38% were not buckled up

CDC, 2022

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Child Restraint Effectiveness

Child restraints reduce risk of injury in crashes by ~75%
Child restraints reduce fatalities by:

71% for infants younger than 1 year old
54% for children 1 to 4 years old in passenger cars

Belt-positioning boosters reduce the risk of serious injury by 45% compared with seat belts alone for children 4 to 8 years old

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[Insert your state] Legislation

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[State] Legislation

[Find them here: Car Seat Laws | Booster Seat Requirements | SafeRide4Kids]

*Remember that state laws do not always match what is the safest way for children to ride in the car.

Ohio Law:

Every driver and front seat passenger must wear a seat belt.
Infants and young children must ride in a child safety seat until they are 4 years old AND weigh at least 40 pounds.
Every child* under 8 years old must ride in a booster seat or other appropriate child safety seat** unless the child is 4'9" or taller. Every child* from 8-15 years old who is not secured in a car seat must be secured in the vehicle's seat belt.

*Unless there is a life threatening situation, the parent has an affidavit signed by a licensed physician exempting the child from the law due to a physical impairment, or the vehicle is a taxicab, a public safety vehicle, is regulated under Ohio Revised Code 5104.011 or was manufactured without seat belts.

**Includes infant seats, convertible seats, forward-facing seats, booster seats and other federally-approved safety seats.

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Choosing the Correct Type of Seat

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Some caveats…

The next few slides will give the basics

Certified Child Passenger Safety Technicians (CPSTs), go through a 3-to-4-day course and are required to log a certain number of hours installing seats every year. Unless you have taken this course, you can give general advice, but it is best practice to refer families and caregivers to a CPST for more detailed advice and to check their seats.

Link to CPST training manual,2020

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One size does not fit all

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Infants and toddlers should ride in a rear-facing car seat

as long as possible, until they reach the highest weight

or height allowed by their car seat

Info from: https://www.nhtsa.gov/vehicle-safety/car-seats-and-booster-seats

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Children who have outgrown the rear-facing weight or height limit for

their car seat should use a forward-facing car seat with a harness for

as long as possible, up to the highest weight or height allowed

by their car seat or manufacturer.

Info from: https://www.nhtsa.gov/vehicle-safety/car-seats-and-booster-seats

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Children whose weight or height is above the forward-facing

limit for their car seat should use a belt-positioning booster seat

until the vehicle lap and shoulder seat belt fits properly.

Info from: https://www.nhtsa.gov/vehicle-safety/car-seats-and-booster-seats

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When children are old enough and large enough to use the vehicle seat belt alone, they should always use laps and shoulder seat belts for optimal protection

Info from: https://www.nhtsa.gov/vehicle-safety/car-seats-and-booster-seats

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Is your child ready for the seat belt?

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All children <13 years old should be restrained in the rear seats of vehicles for optimal protection

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Car Safety Seat Installation

General rule of thumb

If CSS can be moved more than 1 inch from side to side or front to back when grasped at the bottom of the seat near the belt or lower anchors and tethers for children (LATCH) attachment points, it is not installed tightly enough

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Child Passenger Safety for Children with Special Transportation Needs

*This section adapted from a presentation by Dr. Marilyn Bull for Riley Children’s Hospital

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Children with Special Health Care Needs

15.2 million (20.8%) children 0-17 have a special health care need
1 in 4 CSHCN (25.0%) had functional limitations
1 in 2 CSHCN (45.4%) are moderately and/or consistently affected in daily activities
1 in 36 children have Autism Spectrum Disorder
1 in 700 births have Down Syndrome
1 in 50,000- 60,000 births are conjoined twins

Some of these children will not be able to use standardly available car seats.

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Challenges

Families try to “fix” or “adapt” conventional options to address the challenges. This is unsafe.
Families are not aware that other options exist.
If you are working with a family in this situation, find a CPST that has been certified to work with children with special transportation needs (this requires additional training beyond the base CPST training).

Unsafe home remedy

Photo credit: Dr. Marilyn Bull

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Examples of some of the seats available for children with special transportation needs

Car bed

Wallenberg seat for use with casts

Lay Down EZ-ON Vest/503

(if child must lie down)

Adaptive booster

(for neuromuscular conditions)

Source: Merritt Car Seat

Travel vest

(can be used in ride share vehicles & on some buses)

Source: Ride Safer

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Resources for Children with Special Transportation Need

National Center for the Safe Transportation of Children with Special Health Care Needs

National Center brochure
Diagnosis specific information and brochures
Safe Travel for All Children course

Find a Tech in your area who has taken the Safe Travel for All Children course
Conventional Restraint Options
Adaptive Restraint Options
Behavior Modification Techniques
Sensory Diet Activities

preventinjury.medicine.iu.edu/adaptive-transportation

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More Child Passenger Safety Tips

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Find a Tech

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Health Disparities in CPS

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Health Disparities

Cost

Culture

Geography

Access to CPSTs

Language barriers

Cost: Families with lower incomes often have less access to quality car seats due to the high cost of car seats and booster seats.
Culture: Some cultures are less likely to be properly restrain their children in car seats or booster seats.
Geographic Disparities: Rural areas often see lower usage rates of car seats and booster seats. This may be due to limited access to purchase points or less exposure to educational programs. Families in urban settings often have different challenges – like more ride sharing, difficulty of carrying seats with them if they don’t have personal vehicles, etc.
Access to CPSTs: The availability of educational resources about car seat safety can vary greatly by community. Areas with fewer resources may have less access to car seat checks and installation help from trained professionals, leading to incorrect usage.
Language Barriers: Non-English speaking populations may face challenges in accessing or understanding information about proper car seat use, as many resources and educational materials may not be available in multiple languages.

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Ways to Address Disparities

Subsidize Cost

Create materials to address specific cultural barriers

Increase number and diversity of CPSTs

Create materials in multiple languages

Reduced price/free programs, voucher systems, loaner programs

May need to address perceptions of safety, generational practices, economic priorities, social norms, religious beliefs, etc.

Trust increases when info comes from someone from your community or that looks or sounds like you

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Where do doctors fit in?

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The impact one doctor can have…

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How to talk about child passenger safety

Ask open-ended questions
Familiarize yourself with community resources and resources at your institution

Know where you can find Child Passenger Safety Technicians near you

Assess every child for risk factors
Know the different types of seats and when they are used

Make families feel like they are doing something wrong
Assume you know everything about child passenger safety
Use statistics as a scare tactic
Stop advocating outside the office

DO

DON’T

DO: Ask open-ended questions around families’ views and experiences around riding safely in the car

DO: Familiarize yourself with resources in your community to connect families and caregivers with CPSTs to help them assess the safest way for their children to ride in vehicles.

DO: Assess every child for risk factors.

DO: Know the different types of seats and when they are used

Don’t: Frame questions so that families feel they must explain themselves or that they did something wrong.

Don’t assumer you know everything about child passenger safety. Child Passenger Safety Technicians must complete a minimum of 40 hours of training to advise families on the safest way for their children to ride in vehicles. There are MANY different types of seats, and many different family travel scenarios. Unless you have been trained as a CPST, know the basics but refer families to an expert for the best travel recommendations for their child and their travel situation.

Don’t: Let your influence as a physician stop when the patient leaves the office.

Don’t: Use statistics as a scare tactic to further your cause.

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Questions to ask families about child passenger safety

”Where does your child sit in the car?”
“What type of car seat does your child ride in and how did you choose that seat?”
“What problems are you having with your car seat?”
“Do you have any problems with your child sitting in their car seat?”
“Are there any times when you don’t use the car seat?”
“Have you had your car seat installation check by a certified technician?” If no, be ready to help them find out how they can find a CPST.

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Resources

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Additional Resources and References

Finding a Child Passenger Safety Technician

Finding a car seat inspection station

Car Seat Laws by State

Becoming a Child Passenger Safety Technician

AAP Child Passenger Safety Policy Statement

CDC. (2022, October 14). Child passenger safety. Centers for Disease Control and Prevention. https://www.cdc.gov/injury/features/child-passenger-safety/index.html

https://bit.ly/T4CIP-CPS-Resources

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Local Resource

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At Our Hospital/In Our Community

Fill this in with local child passenger safety resources/programs, etc.

Do you have a trauma or injury prevention program in your institution? They might have info
What about CPS materials at your institution?

Think fact sheets, blog posts, videos, etc.

Is there a Safe Kids Chapter nearby? They might have resources
What about your public health departments? Many of them have car seat checks, access to low/reduced cost car seats, etc.

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How to Participate in the Day of Action�May 22, 2024

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Day of Action Activities

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Webinar

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X Chat

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Selfie Sign 1

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Selfie Sign 2

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The next slides are on T4CIP in case you want to explain the program to the group you are presenting to

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What is T4CIP?

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Goals of T4CIP

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Why Child Injury Prevention?

Injury is the leading cause of death and acquired disability among children in the United States.
We’ve made progress reducing the rates of injuries among children, but there is much more work to be done – both with known and emerging hazards.
Effective strategies to prevent injury exist but have not been adequately implemented everywhere.
You can make a difference!

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10 Leading Causes of Death in 2020 by Age

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Monthly trainings with leaders in the field coming to teach on topics like message creation, community outreach, topic specific education, and more

Mentorship – we have an amazing group of facilitators that work with small groups of students more in depth on the topics and community outreach

During their time in the program trainees will participate in and help create two days of action, one in May and one in October, each on a different topic.

Local outreach - - to support these days of action, all participants are required to set up and participate in outreach activities at their institution or in their community

Social media outreach – they are also encouraged to share messaging through various social media platforms throughout that day including during a Twitter chat with national topic-specific partners

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Meet the 2023 T4CIP Facilitators

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2024 T4CIP Cohort

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Topics covered

*metrics for first 6 days only

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Interested in Joining T4CIP?