Child Ssfety Seat Checkups Improve Parental Knowledge, Child Protection

FAYETTEVILLE, Ark. — Any adult who has attempted to install a child safety seat in their automobile knows the effort can quickly become a Chinese puzzle of straps, latches and tabs. But research from the University of Arkansas shows that participation in community-run child safety seat checkups improves parental knowledge and the likelihood that children will be properly protected.

According to The National Safe Kids Campaign, in 2000, 1,654 children under the age of 14 died in automobile accidents. And in 2001, approximately 228,000 were injured as the result of crashes. But Ches Jones, associate professor in the department of health sciences, kinesiology, recreation and dance, reports that restraining a child can reduce the risk of death more than 70 percent.

Use of child safety seats has increased over the years, but many parents fail to install these seats correctly or to select seats appropriate for their child’s age and weight, Jones said. As a result, many parents believe they have protected their child when they’ve inadvertently placed that child at risk.

"A number of factors make safety seat installation difficult. There are three main types of car seats: infant seats, convertible seats and boosters. Each is suitable for a different weight range," Jones said. "Add onto that the variety of vehicles out there — SUVs, two-seaters, vans, sedans — all with different standard restraint systems. That makes three variables to coordinate when buying and installing a safety seat — the size of the child, the type of seat and the car."

In fact, the process is so complicated that technicians who perform child safety seat checkups must first complete a lengthy training program — five full days, learning to install the various seats into every model of vehicle. Fortunately, that hard-won expertise can benefit parents who seek quick, individual instruction at community-run checkups.

In the December 2002 issue of The Journal of the Arkansas Medical Society, Jones and colleagues Ashley Herring, a registered nurse, and Casandra Nunez, a UA graduate student, reported that 90 percent of subjects who had attended child safety seat checkups in the past year retained a high degree of knowledge about protecting their children. Further, many of these subjects reported high levels of self-efficacy in installing safety seats in their vehicles.

The researchers collected their data through telephone surveys, identifying 101 parents and caregivers who had participated in safety seat checkups in Northwest Arkansas. The 70 subjects who agreed to participate answered a 20-item questionnaire, which gathered demographic information and tested knowledge of child vehicular safety. Safety questions included, "Should a car seat be used after it has been in a crash?" and "When is it permissible to move a baby from rear-facing to forward-facing seats?"

The researchers write: "The results of this study were promising and clearly show that child safety seat checkup events make an impact." Because checkups provide one-on-one instruction, they not only provide vital information to parents, but they also give researchers a glimpse into common mistakes that can jeopardize children’s safety, Jones said.

For example, research at checkup events in Louisiana found that of 266 safety seats examined, 250 — or 94 percent — had been incorrectly installed. The researchers cited that, among other mistakes, safety seats weren’t tightly belted into the vehicle and harness straps were not fitted snugly around the child.

Car seat manufacturers are attempting to reduce installation mistakes by developing tether and latch systems that are easier to understand and operate. But without proper instruction, the new seat designs represent just one more variable that can confuse parents.

"One thing our research suggests is the importance of individual instruction from trained professionals," Jones said. "With so many variables complicating the process, you can’t necessarily rely on advice from other parents. They may not have the same car or the same type of safety seat. In those cases, people trying to be good samaritans may be the source of dangerous mistakes."

Jones recommends that parents contact public safety organizations such as police departments, hospitals and health departments to find out when and where safety seat checkups will be held. The events typically coincide with baby fairs, held several times each year, and occur in public areas like shopping malls.

In addition, Jones offers tips that may help parents avoid common mistakes in selecting and installing child safety seats:

• Check the owner’s manual of your vehicle. Car manufacturers may specify the safest place to position a car seat in the vehicle.
• Do not place young children in the front seat. Even when riding in safety seats, children face grave injury and possible death from airbags that may deploy during a crash.
• Never buy a used car seat. Garage sales and flea markets may seem like an ideal place to acquire safety seats inexpensively, but Jones cautions that used seats may be damaged in ways that compromise their ability to protect a child. Even hairline fractures from a past accident could place children at risk of injury. Know the history of any car seat before you trust it with the safety of your child, he advises.
• Never use a car seat that has previously been in a crash.
• Children must be 20 pounds AND one year old before they can advance to a forward-facing safety seat.
• Laws that ensure child vehicular safety vary between states. In Arkansas, state laws require that children 6 years old and 60 pounds or lighter be placed in child safety seats. Jones recommends parents become familiar with state guidelines that pertain to child safety.