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Current recommendations for restraining child occupants are based on biomechanical testing and data from national and international field studies primarily conducted prior to 2011. We hypothesized that analysis to identify factors associated with pediatric injury in motor-vehicle crashes using a national database of more recent police-reported crashes in the United States involving children under age 13 where type of child restraint system (CRS) is recorded would support previous recommendations. Weighted data were extracted from the National Automotive Sampling System General Estimates System (NASS-GES) for crash years 2010 to 2015. Injury outcomes were grouped as CO (possible and no injury) or KAB (killed, incapacitating injury, non-incapacitating injury). Restraint was characterized as optimal, suboptimal, or unrestrained based on current best practice recommendations. Analysis used survey methods to identify factors associated with injury.

This paper describes the design and development of a family of surrogate child restraints that are intended for use in developing and testing occupant sensing and classification systems. Detailed measurements were made of the geometry and mass distribution characteristics of 34 commercial child restraints, including infant restraints, convertibles, combination restraints, and boosters. The restraints were installed in three test seats with appropriately sized crash dummies to obtain data on seat-surface pressure patterns and the position and orientation of the restraint with belt loading. The data were used to construct two surrogates with removable components. The convertible surrogate can be used to represent a rear-facing infant restraint with or without a base, a rear-facing convertible, or a forward-facing convertible. The booster surrogate can represent a high-back belt-positioning booster, a backless booster, or a forward-facing-only restraint with a five-point harness.

The effects of child safety seats have been well documented in the medical literature. Scattered throughout the medical literature are individual case reports of cervical injury to children restrained in child restraint systems. A review of the literature is provided identifying previous documented cases. The authors also provide new case details of children with cervical spine injury without head contact. An overview of the growth of the infant and specific details in the cervical spine that may contribute to significant cervical injury without head impact is presented.

As a result of improved educational opportunities, handicapped children have increased exposure to transportation related risks. Many of these children require specialized orthopedic seating and posture control devices and must remain in them while riding in a vehicle. The lack of impact protection features in these seating devices introduces an unnecessary level of risk. The emphasis of this program was to demonstrate that proven restraint principles could be applied to handicapped seating without compromising the medical requirements of these units. Efforts were concentrated on two such systems: a molded-shell orthotic seat and a stroller-type Travel Chair. Sled impact tests at 30 mph and 20 g's were used to assist in the evaluation of the upgraded restraints. The results have been encouraging and have shown that handicapped seating can supply the same level of crash protection provided by conventional child restraint systems.