Investigation of Child Restraint System (CRS) Misuse: Passive and Active Educational Interventions

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URL: http://rave.ohiolink.edu/etdc/view?acc_num=osu154505928327915

Abstract

Motor vehicle crashes (MVCs) are a leading cause of death in children. Child restraint systems (CRS) are effective at protecting children in MVCs. Unfortunately, the majority of CRS on the road today are being misused, which limits the amount of protection they can offer. For example, caregivers often install CRS too loosely into their vehicle, neglect to attach the top tether to the anchor in the vehicle, or do not tighten the harness tightly enough around their child. Most CRS users are not aware they are making these potentially dangerous errors. Better education is necessary for caregivers who rely on CRS to protect their children in vehicles. The literature suggests that passive CRS instructions and features are inadequate for reducing misuse, but hands-on educational methods with real-time feedback are more effective.

The studies presented here aim to explore several different approaches to understand and reduce CRS misuse. Targeted passive interventions were evaluated for top tether attachment and lower anchor (LA) tensioning. Active intervention in the form of a novel automated feedback system was also evaluated.

The passive interventions examined in these studies were not effective in reducing CRS misuse. The data suggest that small changes to the visibility of different CRS features do not improve their usage. Additionally, simple repetition of installation tasks resulted in the repetition of similar errors instead of improved outcomes due to learning effects.

Active interventions, however, were successful in improving CRS installation outcomes. Subjects who completed a practice installation with automated feedback from a display monitor were less likely to commit errors during a follow-up CRS installation compared to subjects who practiced without any feedback. The active educational system offers more critical learning steps necessary for acquiring new psychomotor skills compared to passive instruction resources. Thus, learning from step-by-step automated feedback may prove to be a powerful tool for the reduction of CRS misuse.

Cited Works (12)

Year	Entry
1997	Legault F, Gardner B, Vincent A. The effect of top tether strap configurations on child restraint performance. In: Proceedings of the 2nd Child Occupant Protection Symposium. November 12, 1997; Orlando, FL.93-122. SAE 973304.
1995	Brown J, Kelly P, Griffiths M, Tong S, Pak R, Gibson T. The performance of tethered and untethered forward facing child restraints. In: Proceedings of the 1995 International IRCOBI Conference on the Biomechanics of Impact. September 13-15, 1995; Brunnen, Switzerland.61-74.
2005	Arbogast KB, Ghati Y, Menon RA, Tylko S, Tamborra N, Morgan RM. Field investigation of child restraints in side impact crashes. Traffic Inj Prev. December 2005;6(4):351-360.
2011	Skjerven-Martinsen M, Naess PA, Hansen TB, Rognum TO, Lereim I, Stray-Pedersen A. In-depth evaluation of real-world car collisions: fatal and severe injuries in children are predominantly caused by restraint errors and unstrapped cargo. Traffic Inj Prev. 2011;12(5):491-499.
2011	Tai A, Bilston LE, Brown J. The cumulative effect of multiple forms of minor incorrect use in forward facing child restraints on head injury risk. In: Proceedings of the 22nd International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 13-16, 2011; Washington, DC.
1997	Hummel T, Langwieder K, Finkbeiner F, Hell W. Injury risks, misuse rates and the effect of misuse depending on the kind of child restraint system. In: Proceedings of the 2nd Child Occupant Protection Symposium. November 12, 1997; Orlando, FL.165-180. SAE 973309.
2003	Lalande S, Legault F, Pedder J. Relative degradation of safety to children when automotive restraint systems are misused. In: Proceedings of the 18th International Technical Conference on the Enhanced Safety of Vehicles (ESV). May 19-22, 2003; Nagoya, Japan.
2002	Arbogast KB, Cornejo RA, Kallan MJ, Winston FK, Durbin DR. Injuries to children in forward facing child restraints. In: 46th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 30–October 2, 2002; Tempe, AZ.
2011	Bohman K, Arbogast KB, Boström O. Head injury causation scenarios for belted, rear-seated children in frontal impacts. Traffic Inj Prev. February 2011;12(1):62-70.
2007	Menon R, Ghati Y. Misuse study of latch attachment: a series of frontal sled tests. In: 51st Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 15-17, 2007; Melbourne, Australia.129-154.
2006	Elliott MR, Kallan MJ, Durbin DR, Winston FK. Effectiveness of child safety seats vs seat belts in reducing risk for death in children in passenger vehicle crashes. Arch Pediatr Adolesc Med. June 2006;160(6):617-621.
2007	Lesire P, Cuny S, Alonzo F, Tejera G, Cataldi M. Misuse of child restraint systems in crash situations: danger and possible consequences. In: 51st Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 15-17, 2007; Melbourne, Australia.207-222.