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Child restraint misuse: Incorrect and inappropriate use of restraints by children reduces their effectiveness in crashes.
It is well known that restraining children in cars reduces their risk of injury in a crash. However, sub-optimal restraint use reduces restraint effectiveness. While the most common form of sub-optimal use is inappropriate use, incorrect use of a restraint has potential for more severe outcomes. This paper draws on field data and studies injury mechanisms through laboratory simulations. Field data is drawn from a dataset of children aged 2-8 in crashes. Laboratory simulations of a number of these crashes were used to study injury mechanisms. Only a small proportion of children in the field sample (5%) were incorrectly using a restraint system, however most of these children (5 out of 7) sustained moderate to severe injuries. This was significantly different to what occurred in the children correctly using restraints. Most incorrect use was seen in children under 5. Most cases involved misuse of the internal harness system of forward facing restraints or the adult belt (with or without a booster). The laboratory study showed an increased injury potential resulting from excessive head and torso excursion in incorrectly used restraint systems. This paper discusses these findings with respect to current restraint system design and calls for an increase in the amount of attention paid to this issue.