Mod I Misuse Winter04wppq

Standardized Child Passenger Safety Training Program Winter 2004

Misuse and Compatibility Issues

Objectives • Recognize and correct vehicle and CR compatibility issues • Determine best practice for incompatibilities • Recognize and correct misuse of CR • Discuss and demonstrate effective parent communication strategies

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Standardized CPS Training Program - Winter 2004

Misuse Rates 1996 NHTSA study of 6000 children in four states in 1994 - 79.5% misuse - Most CRS installed without the use of instructions

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Standardized CPS Training Program - Winter 2004

Misuse Rates August 2002 National SAFE KIDS study: - 81.6% misused - Average of three errors per seat

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Standardized CPS Training Program - Winter 2004

Misuse Rates

Informal checkup events consistently record at least 90% misuse rates

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Standardized CPS Training Program - Winter 2004

Why Are Misuse Rates So High? • All economic and education levels represented • Many different child restraints and vehicles available • Caregivers don’t read instructions

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Standardized CPS Training Program - Winter 2004

Why Are Misuse Rates High? • Instructions are not read • Some instructions are complicated and contradictory • Hand-me down seats missing parts or instructions • Misunderstanding about crash dynamics

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Standardized CPS Training Program - Winter 2004

Types of Misuse • Selection errors • Harnessing errors • Installation errors • Often observed in combination

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Standardized CPS Training Program - Winter 2004

Selection Errors 1. 2. 3. 4. 5. 6.

Using a CRS with shield for small infant Using outgrown CRS Child too small/young for CRS Using non 213 certified device Using recalled & unrepaired CRS. Using second-hand CRS with missing history or parts. 7. Using crash-involved CRS or safety belt Misuse and Compatibility - 9

Standardized CPS Training Program - Winter 2004

Harnessing Errors 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

Not using harness at all Routed through wrong slots Not doubled back if needed Knotted or pinned or incorrectly routed Too loose Not placed on child correctly Frayed or damaged Metal adjuster not flush with slot or out of position Retainer clip not at armpit level Crotch strap too long or wrong position Using "add-ons" not approved by the CRS manufacturer

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Standardized CPS Training Program - Winter 2004

Installation Errors 1. 2. 3. 4. 5. 6.

CRS not anchored to the vehicle at all RF CRS in front of active air bag Turned FF too early RF only CRS facing forward. Incorrect recline angle Vehicle safety belt or lower anchorage belt too loose or not locked 7. Locking clip a. Not used when needed b. Incorrectly placed, or c. Used when not needed Misuse and Compatibility - 11

Standardized CPS Training Program - Winter 2004

Installation Errors 1. Vehicle safety belt or lower anchorage belt routed incorrectly 2. Tether not connected properly or too loose 3. No tether used if required 4. Incorrect use of LATCH anchors 5. Using two belts, or belt and LATCH together 6. Using "add-ons" not approved by the CRS or vehicle manufacturer

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Standardized CPS Training Program - Winter 2004

Consequences of Misuse

Deaths and injuries attributed to misuse

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Standardized CPS Training Program - Winter 2004

Misuse of Safety Belts • Child too small • Lap belt too high • Belt too loose • Shoulder belt under arm • Shoulder belt behind back

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Standardized CPS Training Program - Winter 2004

Classroom Hands-On Exercise Identify specific CRS errors. Look at: -

Seat selection Harness placement Seat orientation Recalls and instructions - Parts

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Standardized CPS Training Program - Winter 2004

Vehicle Compatibility Issues

• Can be serious or fatal • Some vehicles not designed to transport children

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Standardized CPS Training Program - Winter 2004

Vehicle Compatibility Issues: CRS vs. Vehicle Seat Design • • • • • •

Deep contours Side-facing Steep slopes Center seat humps Short and/or narrow seats Space in vehicle - RF CRS and small rear

seat - Multiple CRSs side by side may not be possible - Limited roof height

• Vehicle seat back height Misuse and Compatibility - 17

Standardized CPS Training Program - Winter 2004

CRS vs. Vehicle Seat Design: Possible Fixes • Try another seating position. • Tightly rolled towel or a foam noodle (only for rear-facing seat). - Must not raise or move the CRS forward - Should not be of a size to change the length of the lap belt securing the RF CRS

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Standardized CPS Training Program - Winter 2004

CRS vs. Vehicle Seat Design: Possible Fixes • Use CRS with different base, belt paths, high back, etc. • Tether attachment • Remember how to say "I don't know of a safe way

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Standardized CPS Training Program - Winter 2004

Vehicle Compatibility Issues: Vehicle Equipment Issues • Anchors forward of bight or asymmetrical • Automatic safety belts • Buckles too large • Safety belts too short • Anchors too close • Buckle stalk too long • No shoulder belts

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Standardized CPS Training Program - Winter 2004

Vehicle Equipment Issues: Possible Fixes • • • • • • • • •

Another seating position Additional buckle attachment Manual lap belt added Belt shortening clip Tether attachment CRS with different belt path If allowed, semi-recline FF CRS Twist belt webbing at buckle stalk Shoulder belt, Y-harness, or vest added

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Standardized CPS Training Program - Winter 2004

Vehicle Compatibility Issues • Fixes can cause complications • KEEP IT SIMPLE! • Parent MUST be able to reproduce correct installation

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Standardized CPS Training Program - Winter 2004

Compatibility Issues:

Air Bags and Rear-Facing CRSs • Impact delivered to infant’s head during inflation • Must install in back seat if no on/off switch is available • Side air bag systems interactions unknown • Follow NHTSA recommendations Misuse and Compatibility - 23

Standardized CPS Training Program - Winter 2004

Compatibility Issues:

Air Bags and Forward-Facing CRSs • If child MUST ride in front: - Should be child who » Can be correctly restrained and » Stay farthest away and » Have the best upper body protection

- Vehicle seat must be moved back as far as possible - On/Off switch recommended for frequent, routine front seat installation Misuse and Compatibility - 24

Standardized CPS Training Program - Winter 2004

Compatibility Issues: Air Bags and Children in Safety Belts • Both lap and shoulder belt must fit correctly • Child must stay “in position” • Children under 13 safest in the back • Side air bag interaction unknown at this time • Follow NHTSA recommendations

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Standardized CPS Training Program - Winter 2004

Some Solutions • Short term: Educate - Consumers - Technicians - Advocates • Long Term: Technology advancements - CRSs more user friendly - Compatibility of CRSs & vehicles - TREAD Act • Ongoing efforts have been successful Misuse and Compatibility - 26

Standardized CPS Training Program - Winter 2004

What is a possible option if a CRS and the vehicle seat you are installing it in are not fully compatible? A) Saying “I don’t know a safe way to install this here.” B) Using a different CRS C) Using a different vehicle seating position D) All of the above

Standardized CPS Training Program - Winter 2004

What is a possible option if a CRS and the vehicle seat you are installing it in are not fully compatible? • • • •

Saying “I don’t know a safe way to install this here.” Using a different CRS Using a different vehicle seating position All of the above

Standardized CPS Training Program - Winter 2004

Classroom Exercise: “What’s Wrong With This Picture?”

• Examples of misuse and compatibility issues • Determine what is correct and incorrect about each scene

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Child too upright • Needs some type of support under front of CRS

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Harness straps too loose and off shoulder • Harness retainer clip out of position

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Harness straps too loose and twisted • Harness retainer clip out of position and not threaded correctly

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture? • Locking clip incorrectly placed 13” from correct position • Locking clip bent and ripped seat belt allowing extreme forward excursion of child’s upper body

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

Locking clip on wrong side of belt system, next to door

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture? • Infant forward facing • CRS in RF recline position • RF belt path used for FF position • <80% of CRS base supported by vehicle seat • Locking clip hanging off of the belt system

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

Safety belt tied in knot to hold CRS in place

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture? • No (or out of position) harness retainer clip • Loose harness straps off shoulders • Child forward facing should be rear facing • Harness in lower slots in forward facing seat • Hard toys attached to shield

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Two safety belts (one from front seat center & one from right rear) used to install CRS • Both belts in rear facing belt path on forward facing seat. • 10 month/19 lbs child should be rear facing.

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Harness retainer clip on rear of CRS holding harness on • Locking clip on end of harness holding the two ends together, not connected to splitter plate

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Harness adjuster bar missing • Using rope or cords to hold straps in place

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Rear facing seat forward facing • CRS too small for child

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture? • Big snow suit not allowing harness to fit properly • Harness straps loose and twisted • Harness retainer clip improperly threaded and low on child NOTE: This photo is from a magazine advertisement

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture? • This is a household carrier • Was being used in car as a CR • No CR labels and a very small sticker stating it is not to be used in a vehicle • No belt paths for vehicle use

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

CRS reclined too far in rear seat

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Cargo tie down used in addition to safety belt • Tie down secured to vehicle seat frame

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

Wood added under rear facing CR to obtain correct angle for newborn

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Lap and shoulder belt not correctly placed on child • Shoulder belt cuts under arm and up behind head • Child should be in BPB

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Harness straps placed under child’s arms rather than over the shoulders • Harness retainer clip too low • Child in background should be in BPB, too small for safety belt

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Too small for safety belt – lap belt too high • Belts twisted

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• CRS and child restrained by only a lap belt

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture? • Improper fit of safety belts • Using one belt for multiple occupants • Using belt from one seating position to restrain an occupant in another position • Lap belt only position used when lap & shoulder belt is available

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Front facing only CRS used rear facing • Too upright for rear facing • Harness too loose • Belt used for installation too loose

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Infant facing the front • Rear facing only CRS installed facing the front • Handle left up • Harness too loose and off the shoulders • No retainer clip

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Getting too tall for CRS • Harness through lower slots • Harness too loose • Retainer threaded incorrectly

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Handle left up • Note: Shoulder belt around back of CRS is allowed on this model

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Resting flat on the back of the CRS rather than semi-reclined • Harness on edge of shoulders

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Infant bundled before harnessing

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• CR placed on top of back seat that is lowered for access to the trunk • Harness falling over edge of shoulders

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

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Standardized CPS Training Program - Winter 2004

What’s Wrong With This Picture?

• Too upright for infant • Harness too loose • Retainer clip out of position • Safety belt not through belt path slots • Belt too loose

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Standardized CPS Training Program - Winter 2004

Hands-On Exercises 1. Identify CRS misuse in vehicles -Do not change scenarios 2. Role play effective Communication -Practice advocacy skills

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Standardized CPS Training Program - Winter 2004

Communicating with Parents Accurate & thorough assessment - Weight, height, age - Developmental or physical limits - Type of CRS - Type of vehicle

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Standardized CPS Training Program - Winter 2004

Communicating with Parents Circumstances determine approach: - Solicited help » Checkup event » Safety fair display » Telephone inquiry

- Be cautious when providing unsolicited advice or comments

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Standardized CPS Training Program - Winter 2004

Communicating with Parents Awareness and Attitude: - Body language/facial expressions - Interaction not lecture - Encouraging attitude - Patience

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Standardized CPS Training Program - Winter 2004

Communicating with Parents Simplify and clarify language: “baby seat” may mean “infant seat”, “convertible”, “booster seat”, “feeder seat” - Define terms and acronyms - Explain concepts in lay terms - Explain why - Use examples

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Standardized CPS Training Program - Winter 2004

Communicating with Parents Real issue vs Original Question • “Which car seat is escape proof?” • “When can I turn him around?”

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Standardized CPS Training Program - Winter 2004

Communicating with Parents Don’t ignore the child - Include in conversation - Teach how to buckle up

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Standardized CPS Training Program - Winter 2004

Communicating with Parents Invest the time to do it right - Don’t rush or talk too fast - Instruct and demonstrate - Ask for return demonstration » Better learning experience » Minimizes liability

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Standardized CPS Training Program - Winter 2004

Communicating with Parents Be comfortable saying: - “I don’t know the answer, but I’ll find out…” - “I can’t tell you a safe way to do that…”

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Standardized CPS Training Program - Winter 2004

CPS Technician’s Role • Listen and assess • Interpret issues and teach • Be an accurate, credible source • Instill confidence • Recognize your limits

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Standardized CPS Training Program - Winter 2004

Parent’s Role

“Tough Choices” are made by the parents and caregivers Misuse and Compatibility - 98

Standardized CPS Training Program - Winter 2004