Transporting Children with Special Health Needs
Important Considerations when Choosing the Right Car Seat
Mar 27, 2009
Children with special needs include infants and children with short-term and long-term physical, developmental, or severe behavioural health conditions (e.g., autism). In some cases, a conventional car seat may remain the appropriate choice of product; while in other cases, a conventional car seat could aggravate a pre-existing health condition or would not offer the best protection in a crash.
Guidelines for Selecting an Appropriate Protection System
In the 2007 American Academy of Pediatrics report “Car Seat Shopping Guide for Children with Special Needs,” the following guidelines were suggested when selecting an appropriate protection system for a child with special needs:
- Standard child restraint devices may be used for many children with special health care needs, and, whenever possible, a standard child restraint is the preferable choice. Use of a "special" child restraint system for a child with health care needs often maybe postponed until a child exceeds the physical limitations of a car safety seat.
- Car restraint systems should not be modified or used in a manner other than that specified by the manufacturer.
- Infant-only car safety seats with capacity to recline are useful for infants with many medical problems, especially respiratory conditions. These restraints may be especially useful for children with poor head and neck control.
- A roll of cloth can be wedged in the vehicle seat crease and under the car safety seat base at the child's feet, so that the child reclines at no more than a 45° angle
- Premature and small infants should not be placed in car safety seats with a harness-tray/shield combination or an armrest that could directly contact the infant's neck or face during an impact.
- Car safety seats with five-point harnesses anchored at both shoulders, both hips, and between the legs, can be adjusted to provide good upper torso support for many children with special needs.
Use of Special Occupant Restraint Systems
When a child has outgrown a car safety seat, other choices are available for proper and secure occupant restraint. Some systems provide for full support for the child's head, neck, and back and accommodate children up to 47.2 kg (105 lb). Others, such as the conventional E-Z-On Vest can be used to provide additional trunk support for a child who already has stable neck control.
Some older children with disabilities can be transported in a special needs belt-positioning booster. The booster seats help to position the shoulder and lap belt across the child's chest and pelvis.
Conventional lap-shoulder belt systems may also be useful in providing chest restraint of some children with special needs. Lap belts should below and flat across the child's hips, and the shoulder belt should be snug across the chest.
A child with a tracheostomy (breathing tube in the front of the neck) can usually sit comfortably in a regular child seat or booster. Use a child seat with a five-point harness.
Children with cerebral palsy and other neuro-muscular conditions may not be able to sit up well without support. Regular child seats give enough support for many until they outgrow the seats.
For head and body support, several specialty child seats have been designed and tested for use in motor vehicles. These specialty seats for children from 50-100 lbs. must be anchored with a tether strap as well as the seat belt.
Important considerations should be taken in order to provide safe seating for children with disabilities and for transporting children with special health care needs. Also, make sure that all caregivers who transport your child in their vehicles know how to buckle up your child appropriately. Car travel is one of the most risky tasks that they have.
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