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Safe Travels, Part One: Transporting Your Child with Special Needs in the Family Vehicle

Question: 

Safe transportation for children and adults of all ages is an extremely important topic.  Children who are medically fragile/technology dependent are at an even greater risk of injury during travel.   This is the first in a series of three articles, discussing equipment and techniques designed to protect children and adults with disabilities and chronic illnesses during travel.

 

My son Nathan, age five, has low muscle tone, global developmental delays, and receives most of his nutrition through his G tube.   He is very small for his age (weight 30lbs, length 36in.) He uses a Britax convertible car seat at home.  What is the safest way for me to transport Nathan in our family vehicle?  ~Jane in NJ

Answer: 

The Right Seat

All 50 US states have laws regarding the use of car seats for infants and young children.  However, state laws alone may not provide maximum support for infants, toddlers, and children, especially those with disabilities.  For example, Texas car seat laws state that infants must be secured in a rear-facing car seat until one year old and up to 35 pounds, and children between one and four years of age weighing 20 to 40 pounds must ride in a forward-facing car seat.  Children over 40 pounds can be transported in a booster seat until they are at least eight years old age of eight and weigh more than 40 pounds, unless they are already more than 4’9” tall. ( Source)

In 2014, the American Association of Pediatrics amended their car seat recommendations for all children, stressing the safety benefits of continuing the use of car seats and booster seats as long as possible.    When both age and weight limits are stated, the AAP recommends that the parent follow the guidelines that permit the child to stay in that particular car seat as long as possible.  For example, the AAP states the following:

 

“The AAP recommends that all infants should ride rear facing starting with their first ride home from the hospital. All infants and toddlers should ride in a rear-facing car seat until they are at least 2 years of age or until they reach the highest weight or height allowed by their car seat's manufacturer.”

 

Your son is five years old, but has not yet reached the weight or height limit for his rear-facing convertible car seat.  Since he is well within the manufacturer’s guidelines for using his car seat in the rear-facing position, he should stay rear-facing until he reaches the maximum height or weight for his current seat, as specified by the manufacturer. 

Register your car seat with the manufacturer in order to receive gamely notification in case of a recall.  You can find the contact information for all car seats manufactured in the United States here.

The right position

Several convertible and 3-in-1 car seats can accommodate children up to 50lbs in the rear-facing position.   According to the National Center for the Safe Transportation of Children with Special Healthcare Needs, use of a rear-facing seat for as long as possible provides the best protection and positioning angle for a child with most disabilities.  Most young children are able to safely use a commercially-available car seat in a family car rather than a special seat specifically designed for children with disabilities, especially if it is used in the rear-facing position.  (Note: Exceptions to this statement can be found here.)

 

The Right Installation

Car seat installation is critical to the safety of everyone present in the vehicle.  Here are several resources to assist you in locating a nationally certified child passenger safety technician in your community.

The Right Family Support

Child safety seat recommendations have changed dramatically over the past several decades.  Sometimes it can be challenging to convince friends and family members, especially older individuals, that a rear-facing car seat is the safest place for your child.  It is extremely important for your child to be properly restrained in an appropriately installed car seat every time he travels in any vehicle.   These resources can help  one-page information sheet created by the  National Child Passenger Safety Board provides position statements from several sources, along with links to their respective websites for more detailed information.  

 

 

 

Financial Assistance for the purchase of rear-facing, convertible, and 3-in-1 car seats:

In most states, families that qualify for WIC and/or Medicaid are eligible to receive a voucher for a free 3-in-1 or convertible car seat.  In order to access these programs, dial 211 from a “land line” telephone in your home state, or go to http://www.211.org and select the resource page for your state.