Forgotten Child

	Over 500 children a year are killed because they are either unrestrained or effectively unrestrained because of poor belt fit and improper restraint.

Most parents allow their children to stop using any form of child seat after age four. These parents are making a potentially life altering mistake. Unless your child can meet the following criteria, they need to stay away from adult seat belts:

• They are tall enough so that their legs bend at the knees at the edge of the seat when seated;
  
  
• They are mature enough to remain seated with their backs flat against the back of the seat (no slouching);
  
  
• The lap belt sits high on the thighs or low on the hips;
  
  
• The shoulder belt crosses the shoulder and chest;
  
  
• The latch plate is as far as possible from the occupant center line; and
  
  
• The buckle is close to the child’ship.

Adult seat belts do not protect children properly because the seat belt fails to fit them correctly. As a consequence, children are maimed or die. Why do adult seat belts not fit children properly?

	Consequences of Improper Seat Belt Fit Submarining Rollout Mis-Positioning Belt Behind Back

A 1996 NHTSA study showed that only 6.1 percent of the children who were weight eligible were actually restrained in a booster seat. This small percentage could be explained by state laws.

Even though adult seat belts do not fit children four to eight properly, as of 2002, 26 states allowed parents to place children in an adult seat belt after the child reached age four. Four allowed children to use an adult seat after age three. Two allowed children to use an adult seat belt after age two.

Knowing that 32 states allow parents and caregivers to place four year old and younger children in adult seat belts, vehicle manufacturers have advocated the use of booster seats for children ages four to eight. In April 2000, former Ford CEO Jacques Nasser touted the safety benefits of booster seats in announcing Ford's Boost America campaign:

A year later in front of a Senate Subcommittee hearing, Ford's Director of Automotive Safety testified about the safety benefits of booster seats:

However, when faced with litigation, these same vehicle manufacturers argued in court that booster seats were not safety related items at all but were used merely to improve comfort. In fact, Ford's retained experts argued in a Florida trial that booster seats are a matter of comfort and convenience, not safety. CEO Nasser testified, contrary to his Boost America comments, that booster seats were intended to increase seat belt use based on comfort issues, not safety issues.

So, are four to eight year old children adequately protected by adult seat belts or do they need booster seats? Vehicle manufacturers for years have recommended that the shoulder portion of the belt be placed behind the back of a child if the seat belt did not fit properly. In short, they encouraged belt mispositioning.

Once the shoulder portion of the restraint system is defeated, the restraint system is rendered dangerous since the upper torso is no longer restrained. Without the upper torso restraint, the child will hyperflex over the lap belt and sustain paralyzing injuries because the 3-point belt has become a lap belt only design.
Further, by placing the shoulder belt behind the back, the injury producing consequences of submarining are increased. Submarining injuries devastate the internal organ injuries and can cause lower spine fractures.
         Lap Belt Only Kinematic Sequence

In September 1996, the NTSB issued a safety report recommending that the NHTSA revise FMVSS 213 to create a performance standard for child seats for children up to 80 lbs. Until 2002, the only safety standard designed to protect children limited its protection to children up to 50 lbs. By June 2003, the revised FMVSS 213 extended protection to children who weigh up to 65 lbs. However, the NHTSA acknowledges that "children must weigh approximately 80 lbs. to fit properly in a safety belt without a booster seat." Why not protect children between 65-80 lbs.? Don’t they deserve protection?

What injuries are four to eight year old children exposed to even when they properly use an ill-fitting adult seat belt? If the lap belt fails to properly restrain a child's pelvis, the forces of the crash will be distributed into the abdomen rather than the bony pelvis. Abdominal tears, paralysis and death are common injuries when a child submarines under the lap belt. Because so much space exists between the lap belt anchors, a child can literally be ejected from under the lap belt. Because the shoulder belt anchor is so high and so far forward, the shoulder belt can literally strangle a four to eight year old child or create a fulcrum causing spinal injuries. Other times, the child will slip out of the shoulder belt and be exposed to lap belt only type injuries.

Knowing that vehicle manufacturers were taking inconsistent positions on the need to protect four to eight year old children and knowing that the safety of four to eight year old children remains ignored, Public Citizen, in April, 2002, urged the vehicle industry, NHTSA and Congress to require integrated, built-in child restraints for children four to eight.

Public Citizen's request is well-founded. Various integrated child seats have been available since the 1980's. In fact, Ford has indicated in internal engineering notes that for children between four to eight, the integrated child seat with 5-point harness is the "safest form" of restraint system to use because it is both "safe" and convenient."

Despite decades of research that demonstrate that four to eight year old children are not adequately protected by adult seat belts, only a handful of vehicle manufacturers have provided integrated child seats.

	2002 Model Year Vehicles with Standard Built-In Child Seat Chevrolet Venture

The time is now to protect children age four to eight from the ill-fitting consequences of adult seat belts. four to eight year old children who are using adult seat belts are being maimed and killed at a staggering rate. In 1997 alone, over 10 times the number of children who were ever killed by airbags were killed while using an adult seat belt. Adult seat belts and children four to eight are a deadly combination. As long as four to eight year old children remain a forgotten priority, deaths and catastrophic injuries will continue to rise at epidemic proportions.

Hope may be on the horizon however. The NHTSA announced its 2003-2006 Rulemaking Priorities and Supporting Research recently. One of the special populations the NHTSA intends to focus on is the protection of children. This is certainly well overdue. Unfortunately, it could be another 10 years before any meaningful required legislation is adopted. In the meanwhile, safety advocates will have to keep encouraging manufacturers to implement safety features even before legislation requires them to do so.