The development of fatal outcome was reviewed based on crash data including all fatally injured 0–14 year old car occupants in Sweden during 1956–2011 and put in relation to general improvements in vehicle and road safety and implementation of restraint systems.

The review revealed a substantial decrease in crash‐related fatalities among 0–14 year old car occupants during the past three decades, representing a significant drop of 83% compared to the highest scores in the 1960s–70s. During 1992–2011, a total of 194 crash‐related fatalities were registered;​ the majority occurred on high‐speed roads. Head injury was a primary cause of death, in a total of 54% of all cases. Two fifths of the crashes involved a single car, while three fifths involved other vehicles. In total, 24% of the children were unrestrained, and 59% of those were ejected during crashes. Among the restrained children, 56% were considered to be appropriately restrained according to Swedish recommendations. Crash severity, complex crash situation, fire and drowning were factors that contributed to the fatal outcome, even though the restraint usage was considered to be optimal.