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Happy Children in Safe Seats: Not As Easy As It Sounds

Webinar: July 17, 2013

Happy Children in Safe Seats… Not as Easy as it Sounds

Considerations every safety advocate needs to know to solve car seat challenges

Caroline Langrall, CCLS, CPST

ObjectivesObjectives

Identify key phases of a child's psychosocial and cognitive development that may create challenges regarding safe travel in the car.

Identify developmentally appropriate strategies to encourage and enable caregivers to use car seats properly.

Explore ways to address the transport of children with special needs and developmental delays. 

What are the challenges?What are the challenges?CryingTantrumsRefusalUnbuckling

Challenging behaviors… Challenging behaviors… leading to leading to dangerousdangerous “solutions”“solutions”Excessive

crying/screaming?◦Loosen straps◦Front seat◦No seat use

Escaping◦Altering seat◦Compromising

Vomiting/Motion sickness◦Early forward facing

First Step: Check the use…

◦ Age/size appropriate?

◦ Straps snug and routed right?

◦ Buckles functional?

◦ Installation correct?

Infant development & Infant development & interventionsinterventions

Bonding, attachment, trust.Sensorimotor & object

permanence.◦Blanket with familiar smell◦Adult in back seat◦Rock/sway the seat◦Pacifier◦Soothing music◦Convertible for older infant?

Infant development & Infant development & interventions, continued…interventions, continued…Physiological Immaturity

◦Allow an hour for digestion◦Different seat with a different angle◦Overheated◦Swaddle/boundaries

Toddler development (1-3)Toddler development (1-3)Autonomy EgocentricLack of reasoningSeparation AnxietyImproving dexterity

Toddler challengesToddler challengesUnbuckling/escaping

378 caregivers: 50% reported child unbuckled self. Majority = boys < 3 (Yale University,

2011)

Tantrum/screaming◦Driver distraction

http://www.parenting.com/blogs/show-and-tell/melanie-parentingcom/new-car-seat-safety-study-toddlers-can-unbuckle-seatbelts

Improper harness use injury Improper harness use injury patternspatterns

http://www.youtube.com/watch?NR=1&feature=endscreen&v=akGpsPyhDdk

Interventions for toddlersInterventions for toddlersConsistent, simple messages from all

cg’sReinforce good behavior frequently. Ignore ‘bad’ behaviorCalm voice, empathy, don’t get angry.Pull over and wait…or time-outOffer choicesKeep hands busy: Cheerios, cling

stickers.Special rotating bag of soft ‘car toys’Divert attentionMusicCoat tricks

Preschooler development Preschooler development (3-6)(3-6)InitiativeWant to please othersLiteral interpretationsLack abstract thoughtDramatic play and magical

thinking

Interventions for Interventions for PreschoolersPreschoolers

“Write” a story togetherBe clear and consistent

with expectationsDramatic playGive a “job” or “role”Sticker chart for

behaviorChoose car seat or

decorate.Seek & find booksGame for long car rides

School age development School age development (6-12)(6-12)Spelling and languageDevelopment of scientific methodMoral development: good vs. badUse feedback to judge their

competencyAcceptance by peer group

Interventions for School Interventions for School Age Age Be clear with rules

Run an ‘experiment’Praise for good behaviorEmpathize Low back booster…

choices

Without booster With booster

Adolescent development Adolescent development Abstract/higher-level thinkingCritical thinking emergenceIndependenceInfluence of peersRisk taking behaviors

Adolescent challenges Adolescent challenges MVC’s = 40% of deaths

◦Age 16-24 = lowest seatbelt use (CDC, 2006)

Driving under the influence Reckless or careless drivingTexting while driving

◦>50% of teens >16 yrs admitted to TWD

◦Less likely to wear seatbelt,◦More likely to drive while intoxicated

or with someone who is intoxicated (Balin

et al., 2013)Bailin, A., Adesman, A., & Sunday, S. R. (2013). 134. Texting While Driving Among High School Students in the United States: Analysis of 2011 Data From the National Youth Risk Behavior Survey (YRBS). Journal Of Adolescent Health, 52(s1), S85-6

National Center for Injury Prevention and Control (CDC). Web-based injury statistics query and reporting system (WISQARS). http://www.cdc.gov/ncipc/wisqars/: 2006

Adolescent interventionsAdolescent interventionsMakes rules and consequences

clearFollow-through on consequencesProvide choices when possibleDemonstrate expected behaviorReward

Dealing with motion Dealing with motion sicknesssicknessNo reading, video gamesMiddle seat I Spy games to look outsideOpen window Ice pack to back of neckCool washclothSaltine crackers or ginger snapsPeppermint/ginger

aromatherapy (Lua,& Zakaria, 2012)

“Sea bands”/acupressure (Hunt, 2011)

BreathingFrequent stopsTravel at night/naps

Hunt, K., & Ernst, E. (2011). The evidence-base for complementary medicine in children: a critical overview of systematic reviews. Archives Of Disease In Childhood, 96(8), 769-776.

Lua, P., & Zakaria, N. (2012). A Brief Review of Current Scientific Evidence Involving Aromatherapy Use for Nausea and Vomiting . Journal Of Alternative & Complementary Medicine, 18(6).

Special NeedsSpecial NeedsPDD/Autism spectrum/Cognitive

delay◦Seat options decrease with age/size◦Difficulty with reasoning◦Need for routine & difficulty with

change◦Sensory processing challengesBe kind; for everyone you meet is

fighting a hard battle. –John Watson

Interventions for Children Interventions for Children with Special Needswith Special Needs

◦Anticipatory guidance to prepare for seat change

◦Consider other seats.

◦Refer to http://www.preventinjury.org or search Safe Kids website for a CPST trained in Special needs.

Special needsSpecial needsEZ-On floor mounted vest and

tether◦Vehicle modification◦Seat bight

http://www.ezonpro.com/

Special needsSpecial needs

http://eztether.com/index.php/product-info/roosevelt

Roosevelt by Merritt Manufacturing◦35-115 lbs & 33.5-62”◦Harness cover & EZ Buckle guard

NOT for use with other seats

◦Not compatible in all vehicles

Thank you for your Thank you for your attention!attention!

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Thank you for participating today!

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