Data from a household survey and from three car seat clinics, carried out in the same community in 1996 were used to assess appropriate use of car seats for children aged 1-4 years. From surveys from 203 families restraint use appeared high: 90% of families had a car, and 95% reported using occupant restraints for their children, with tether straps bolted in 69%. From 90 cars tested at car seat clinics 70% were not installed correctly. Based on weight and proper tethering (as reported), 112 (55%) were appropriately restrained. This is likely to be an overestimate due to over-reporting of tether strap use. Sex of the child, and the family's use of a baby walker (banned from sale in Canada) were significantly associated with appropriate use, when confounders were controlled. The perception of the danger of traffic crashes for children was significantly lower in families with appropriate use. The data from car seat clinics demonstrated a number of technical problems with the installation and use of car seats that are unlikely to be influenced by family characteristics or perception of risk.