Section Two: The Challenge of Getting Children Placed in Booster Seats

There are numerous challenges to getting 4- to 8-year-old children secured in booster seats, in addition to the many situational factors that affect booster seat use. The first challenge is the lack of information among parents and other caregivers about: (1) the correct progression of restraint use for children; (2) how booster seats work; and (3) the safety benefits of booster seats. The second challenge is the desire of young children to act grown up and not have to sit in any type of child restraint. A third challenge is the inconsistency of State laws pertaining to protecting older children and booster seat use. Without consistent laws, or laws that provide for mandatory booster seat use for the older child, parents and other caregivers will continue to question the need for, and benefits of, booster seats.

Finally, even though lap belts and shoulder belts for front-seat occupants have been required in cars for more than 30 years, NHTSA did not require combination lap and shoulder belts in the rear outboard seating positions until 1989 (vehicle model year 1990). While the presence of lap-only belts did not preclude manufacturers from offering various restraint systems for older children, shield booster seats (designed for use with lap-only belts) were the only type of booster seat available at the time. Once NHTSA required shoulder belt restraints for the rear seating positions, child safety seat manufacturers responded by developing belt-positioning booster seats. Hence, belt-positioning booster seats have only recently been available.

The need to educate parents and caregivers on the correct progression of restraint use is illustrated in NHTSA research conducted by the Children's Hospital of Philadelphia (CHOP). Researchers found that "while parents generally do a good job of restraining children who are under age 3 and over 8, the number of appropriately restrained children between ages 3 and 8 drops significantly. Instead of using car seats or belt-positioning booster seats, many of these children are inappropriately restrained in adult seat belts (see chart)." ⁶.

In another study conducted by CHOP, parents identified potential barriers to using booster seats, including the child's behavior and discomfort. They also found that, due in part to peer pressure, children often balk at being in a child safety seat as they get older. These studies also note that increasing booster seat use is difficult because parents are confused by a patchwork of child occupant protection laws with inconsistent provisions.

Ultimately, we must rely on parents and other caregivers to take responsibility for placing 4- to 8-year-olds in booster seats when they ride in motor vehicles. To address the many aspects of this challenge, NHTSA and its public and private sector partners must continue to promote passenger safety for all motor vehicle occupants. We must create and maintain a cultural norm that equates children's safety with placing 4- to 8-year-olds in age/size appropriate occupant restraints. In doing so, and recognizing that proper fit of booster seats does not solely depend on age, NHTSA makes the following recommendations about booster seat use: "all children who have outgrown child safety seats should be properly restrained in booster seats until they are at least 8 years old, unless they are 4'9" tall." Children can move to a seat belt when they can firmly place their back against the vehicle seat back cushion with their knees bent over the vehicle seat cushion.

⁶Winston, et al., The Premature Graduation of Children from Child Restraints to Vehicle Safety Belts. DOT HS 809 259, 2001, p.18.

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