Child Passenger Safety

What’s the Problem?

In the United States, motor vehicle crashes are a leading cause of death among children.¹

• In 2012, more than 1,100 children ages 14 years and younger died as  a result of motor vehicle crashes.²
• One CDC study found that, in one year, more than 618,000 children ages 0-12 rode in vehicles without the use of a child safety seat or booster seat or a seat belt at least some of the time.³
• Of the children who died in a crash in 2011, 33% were not buckled up.⁴

Who’s at Risk?

Anyone riding unrestrained in a motor vehicle is at increased risk for dying or sustaining serious injuries in the event of a crash.

• Of the children who died in a crash, more black (45%) and Hispanic (46%) children were not buckled up compared with white (26%) children (2009-2010).⁴
• More of the older children (45% of 8-12 year olds) were not buckled up compared with younger children (one-third of 1-7 year olds; one-fourth of infants under 1) in fatal crashes in 2011.^5,6
• Restraint use among young children often depends upon the driver’s seat belt use. Almost 40% of children riding with unbelted drivers were themselves unrestrained.⁷
• Additionally, child restraint systems are often used incorrectly. One study found that 72% of nearly 3,500 observed car and booster seats were misused in a way that could be expected to increase a child’s risk of injury during a crash.⁸

As with all passengers, children riding with drivers who have been drinking are at increased risk for motor vehicle-related injuries. From 2001 to 2010, approximately 1 in 5 child passenger (<15 years old) deaths in the U.S. involved drunk driving; 65% of the time, it was the child’s own driver that had been drinking (BAC ≥ 0.08 g/dl). Most (61%) child passengers (under 15 years old) of drunk drivers were not buckled up in the fatal crash.⁹

Can It Be Prevented?

Yes, many motor vehicle deaths are preventable. During 1975–2012, child restraints saved an estimated 10,157 lives of children aged 0–4 years.² Buckling children in age- and size-appropriate car seats, booster seats, and seat belts reduces the risk of serious and fatal injuries:

• Car seat use reduces the risk for death to infants (aged <1 year) by 71% and to toddlers (aged 1–4 years) by 54%.¹⁰
• Booster seat use reduces the risk for serious injury by 45% for young children (aged 4–8) years when compared with seat belt use alone.¹¹
• For older children and adults, seat belt use reduces the risk for death and serious injury by approximately half.²

All kids under age 13 should sit in the back seat. Airbags can kill young children riding in the front seat. Never place a rear-facing car seat in front of an air bag.

When making sure that children are properly buckled up in a car seat, booster seat, or seat belt, it is vital to know the appropriate stages for age, height, and weight:

• Birth up to Age 2 – Rear-facing car seat. For the best possible protection, infants and children should be buckled in a rear-facing car seat, in the back seat, until age 2 or when they reach the upper weight or height limits of their particular seat.
• Age 2 up to at least Age 5 – Forward-facing car seat. When children outgrow their rear-facing seats they should be buckled in a forward-facing car seat, in the back seat, until at least age 5 or when they reach the upper weight or height limit of their particular seat.
• Age 5 up until seat belts fit properly – Booster seat. Once children outgrow their forward-facing seat, (by reaching the upper height or weight limit of their seat), they should be buckled in a belt positioning booster seat until seat belts fit properly. Seat belts fit properly when the lap belt lays across the upper thighs (not the stomach) and the shoulder belt lays across the chest (not the neck).
• Once Seat Belts Fit Properly without a Booster Seat – Children no longer need to use a booster seat once seat belts fit them properly.  Seat belts fit properly when the lap belt lays across the upper thighs (not the stomach) and the shoulder belt lays across the chest (not the neck). The recommended height for proper seat belt fit is 57 inches tall.

Everyone should ride properly restrained at all times. It can be tempting for parents to not use child safety seats or booster seats, particularly on short trips that are close to home, when they are rushed, or when they are simply exhausted from a long day. Parents may also have to deal with older children who are resistant to the idea of booster seats. But remembering that car crashes can happen anywhere, anytime, and at any speed is important. Saving a child’s life is always worth the time required to buckle up.

Tips for Scripts

• INFORM viewers about the life-saving benefits of child safety and booster seats.
• PORTRAY a car crash in which properly restrained riders are not seriously injured.
• EDUCATE viewers on the proper use of child safety restraints and demonstrate that there are free resources in their communities to help them in this process (e.g., hospitals, fire departments, SAFE KIDS coalitions).
• REMIND viewers to never put their families at risk by driving under the influence of alcohol or other substances.
• HAVE a parent or guardian who has consumed even a small amount of alcohol give the car keys to a friend, spouse, or oldest teenaged driver.
• DEMONSTRATE the use of child safety restraints as smart, routine, every-day behavior.
• SHOW kids 12-years and younger riding properly restrained in the back seat.
• TAKE a few seconds to show parents securing infants and young children in child safety seats and/or belt-positioning booster seats in the back seat.
• HAVE a parent or guardian refuse to start the car until everyone is buckled up.

Case Example

A woman learns that her husband and two children, having survived a bad car crash, are in the emergency room. Her husband and older daughter (age 10) have minor injuries: a broken arm, scratches, bruises and a sore neck. The younger son (age 7) is in surgery and may need to go through weeks of rehabilitation. The woman learns from the doctor that the son was severely injured because he slipped under the seat belt. She corrects the doctor, explaining that their son always sits in a booster seat, but the doctor assures her that the boy was not sitting in a booster seat at the time of the accident. The woman realizes/accepts that her husband wasn’t using the booster seat for their youngest son and the episode focuses on the resulting pressures/issues placed on their relationship within the context of their son’s prognosis.