1. National Standardized Child Passenger Safety Training Program May 2004
Misuse and Compatibility Issues

2. 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
Misuse and Compatibility - 2

3. Misuse Rates 1996 NHTSA study of 6000 children in four states in 1994
Most CRS installed without the use of instructions
Misuse and Compatibility - 3

4. Misuse Rates August 2002 National SAFE KIDS study: 81.6% misused
Average of three errors per seat
Misuse and Compatibility - 4

5. Misuse Rates
Informal checkup events consistently record at least 90% misuse rates
Misuse and Compatibility - 5

6. Why Are Misuse Rates So High?
All economic and education levels represented
Many different child restraints and vehicles available
Caregivers don’t read instructions
Misuse and Compatibility - 6

7. 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
Misuse and Compatibility - 7

8. Types of Misuse Selection errors Harnessing errors Installation errors
Often observed in combination
Misuse and Compatibility - 8

9. Selection Errors 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.
Using crash-involved CRS or safety belt
Misuse and Compatibility - 9

10. Harnessing Errors 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
Misuse and Compatibility - 10

11. Installation Errors 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
Locking clip
Not used when needed
Incorrectly placed, or
Used when not needed
Misuse and Compatibility - 11

12. Installation Errors
Vehicle safety belt or lower anchorage belt routed incorrectly
Tether not connected properly or too loose
No tether used if required
Incorrect use of LATCH anchors
Using two belts, or belt and LATCH together
Using "add-ons" not approved by the CRS or vehicle manufacturer
Misuse and Compatibility - 12

13. Consequences of Misuse
Deaths and injuries attributed to misuse
Misuse and Compatibility - 13

14. Misuse of Safety Belts Child too small Lap belt too high
Belt too loose
Shoulder belt under arm
Shoulder belt behind back
Misuse and Compatibility - 14

15. Classroom Hands-On Exercise
Identify specific CRS errors. Look at:
Seat selection
Harness placement
Seat orientation
Recalls and instructions
Parts
Misuse and Compatibility - 15

16. Vehicle Compatibility Issues
Can be serious or fatal
Some vehicles not designed to transport children
Misuse and Compatibility - 16

17. 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

18. 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
Misuse and Compatibility - 18

19. 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
Misuse and Compatibility - 19

20. 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
Misuse and Compatibility - 20

21. 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
Misuse and Compatibility - 21

22. Vehicle Compatibility Issues
Fixes can cause complications
KEEP IT SIMPLE!
Parent MUST be able to reproduce correct installation
Misuse and Compatibility - 22

23. 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

24. 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

25. 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
Misuse and Compatibility - 25

26. Some Solutions Short term: Educate Long Term: Technology advancements
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

27. Classroom Exercise: “What’s Wrong With This Picture?”
Examples of misuse and compatibility issues
Determine what is correct and incorrect about each scene
Misuse and Compatibility - 27

28. What’s Wrong With This Picture?
Misuse and Compatibility - 28
National Standardized CPS Training Program - May 2004

29. What’s Wrong With This Picture?
Child too upright
Needs some type of support under front of CRS
Misuse and Compatibility - 29
National Standardized CPS Training Program - May 2004

30. What’s Wrong With This Picture?
Misuse and Compatibility - 30
National Standardized CPS Training Program - May 2004

31. What’s Wrong With This Picture?
Harness straps too loose and off shoulder
Harness retainer clip out of position
Misuse and Compatibility - 31
National Standardized CPS Training Program - May 2004

32. What’s Wrong With This Picture?
Misuse and Compatibility - 32
National Standardized CPS Training Program - May 2004

33. What’s Wrong With This Picture?
Harness straps too loose and twisted
Harness retainer clip out of position and not threaded correctly
Misuse and Compatibility - 33
National Standardized CPS Training Program - May 2004

34. What’s Wrong With This Picture?
Misuse and Compatibility - 34
National Standardized CPS Training Program - May 2004

35. 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
Misuse and Compatibility - 35
National Standardized CPS Training Program - May 2004

36. What’s Wrong With This Picture?
Misuse and Compatibility - 36
National Standardized CPS Training Program - May 2004

37. What’s Wrong With This Picture?
Locking clip on wrong side of belt system, next to door
Misuse and Compatibility - 37
National Standardized CPS Training Program - May 2004

38. What’s Wrong With This Picture?
Misuse and Compatibility - 38
National Standardized CPS Training Program - May 2004

39. 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
Misuse and Compatibility - 39
National Standardized CPS Training Program - May 2004

40. What’s Wrong With This Picture?
Misuse and Compatibility - 40
National Standardized CPS Training Program - May 2004

41. What’s Wrong With This Picture?
Safety belt tied in knot to hold CRS in place
Misuse and Compatibility - 41
National Standardized CPS Training Program - May 2004

42. What’s Wrong With This Picture?
Misuse and Compatibility - 42
National Standardized CPS Training Program - May 2004

43. 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
Misuse and Compatibility - 43
National Standardized CPS Training Program - May 2004

44. What’s Wrong With This Picture?
Misuse and Compatibility - 44
National Standardized CPS Training Program - May 2004

45. 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.
Misuse and Compatibility - 45
National Standardized CPS Training Program - May 2004

46. What’s Wrong With This Picture?
Misuse and Compatibility - 46
National Standardized CPS Training Program - May 2004

47. 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
Misuse and Compatibility - 47
National Standardized CPS Training Program - May 2004

48. What’s Wrong With This Picture?
Misuse and Compatibility - 48
National Standardized CPS Training Program - May 2004

49. What’s Wrong With This Picture?
Harness adjuster bar missing
Using rope or cords to hold straps in place
Misuse and Compatibility - 49
National Standardized CPS Training Program - May 2004

50. What’s Wrong With This Picture?
Misuse and Compatibility - 50
National Standardized CPS Training Program - May 2004

51. What’s Wrong With This Picture?
Rear facing seat forward facing
CRS too small for child
Misuse and Compatibility - 51
National Standardized CPS Training Program - May 2004

52. What’s Wrong With This Picture?
Misuse and Compatibility - 52
National Standardized CPS Training Program - May 2004

53. 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
Misuse and Compatibility - 53
National Standardized CPS Training Program - May 2004

54. What’s Wrong With This Picture?
Misuse and Compatibility - 54
National Standardized CPS Training Program - May 2004

55. 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
Misuse and Compatibility - 55
National Standardized CPS Training Program - May 2004

56. What’s Wrong With This Picture?
Misuse and Compatibility - 56
National Standardized CPS Training Program - May 2004

57. What’s Wrong With This Picture?
CRS reclined too far in rear seat
Misuse and Compatibility - 57
National Standardized CPS Training Program - May 2004

58. What’s Wrong With This Picture?
Misuse and Compatibility - 58
National Standardized CPS Training Program - May 2004

59. What’s Wrong With This Picture?
Cargo tie down used in addition to safety belt
Tie down secured to vehicle seat frame
Misuse and Compatibility - 59
National Standardized CPS Training Program - May 2004

60. What’s Wrong With This Picture?
Misuse and Compatibility - 60
National Standardized CPS Training Program - May 2004

61. What’s Wrong With This Picture?
Wood added under rear facing CR to obtain correct angle for newborn
Misuse and Compatibility - 61
National Standardized CPS Training Program - May 2004

62. What’s Wrong With This Picture?
Misuse and Compatibility - 62
National Standardized CPS Training Program - May 2004

63. 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
Misuse and Compatibility - 63
National Standardized CPS Training Program - May 2004

64. What’s Wrong With This Picture?
Misuse and Compatibility - 64
National Standardized CPS Training Program - May 2004

65. 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
Misuse and Compatibility - 65
National Standardized CPS Training Program - May 2004

66. What’s Wrong With This Picture?
Misuse and Compatibility - 66
National Standardized CPS Training Program - May 2004

67. What’s Wrong With This Picture?
Too small for safety belt – lap belt too high
Belts twisted
Misuse and Compatibility - 67
National Standardized CPS Training Program - May 2004

68. What’s Wrong With This Picture?
Misuse and Compatibility - 68
National Standardized CPS Training Program - May 2004

69. What’s Wrong With This Picture?
CRS and child restrained by only a lap belt
Misuse and Compatibility - 69
National Standardized CPS Training Program - May 2004

70. What’s Wrong With This Picture?
Misuse and Compatibility - 70
National Standardized CPS Training Program - May 2004

71. 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
Misuse and Compatibility - 71
National Standardized CPS Training Program - May 2004

72. What’s Wrong With This Picture?
Misuse and Compatibility - 72
National Standardized CPS Training Program - May 2004

73. 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
Misuse and Compatibility - 73
National Standardized CPS Training Program - May 2004

74. What’s Wrong With This Picture?
Misuse and Compatibility - 74
National Standardized CPS Training Program - May 2004

75. 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
Misuse and Compatibility - 75
National Standardized CPS Training Program - May 2004

76. What’s Wrong With This Picture?
Misuse and Compatibility - 76
National Standardized CPS Training Program - May 2004

77. What’s Wrong With This Picture?
Getting too tall for CRS
Harness through lower slots
Harness too loose
Retainer threaded incorrectly
Misuse and Compatibility - 77
National Standardized CPS Training Program - May 2004

78. What’s Wrong With This Picture?
Misuse and Compatibility - 78
National Standardized CPS Training Program - May 2004

79. What’s Wrong With This Picture?
Handle left up
Note: Shoulder belt around back of CRS is allowed on this model
Misuse and Compatibility - 79
National Standardized CPS Training Program - May 2004

80. What’s Wrong With This Picture?
Misuse and Compatibility - 80
National Standardized CPS Training Program - May 2004

81. What’s Wrong With This Picture?
Resting flat on the back of the CRS rather than semi-reclined
Harness on edge of shoulders
Misuse and Compatibility - 81
National Standardized CPS Training Program - May 2004

82. What’s Wrong With This Picture?
Misuse and Compatibility - 82
National Standardized CPS Training Program - May 2004

83. What’s Wrong With This Picture?
Infant bundled before harnessing
Misuse and Compatibility - 83
National Standardized CPS Training Program - May 2004

84. What’s Wrong With This Picture?
Misuse and Compatibility - 84
National Standardized CPS Training Program - May 2004

85. 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
Misuse and Compatibility - 85
National Standardized CPS Training Program - May 2004

86. What’s Wrong With This Picture?
Misuse and Compatibility - 86
National Standardized CPS Training Program - May 2004

87. 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
Misuse and Compatibility - 87
National Standardized CPS Training Program - May 2004

88. Hands-On Exercises 1. Identify CRS misuse in vehicles
Do not change scenarios
2. Role play effective Communication
Practice advocacy skills
Misuse and Compatibility - 88

89. Communicating with Parents
Accurate & thorough assessment
Weight, height, age
Developmental or physical limits
Type of CRS
Type of vehicle
Misuse and Compatibility - 89

90. Communicating with Parents
Circumstances determine approach:
Solicited help
Checkup event
Safety fair display
Telephone inquiry
Be cautious when providing unsolicited advice or comments
Misuse and Compatibility - 90

91. Communicating with Parents
Awareness and Attitude:
Body language/facial expressions
Interaction not lecture
Encouraging attitude
Patience
Misuse and Compatibility - 91

92. 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
Misuse and Compatibility - 92

93. Communicating with Parents
Real issue vs Original Question
“Which car seat is escape proof?”
“When can I turn him around?”
Misuse and Compatibility - 93

94. Communicating with Parents
Don’t ignore the child
Include in conversation
Teach how to buckle up
Misuse and Compatibility - 94

95. 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
Misuse and Compatibility - 95

96. 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…”
Misuse and Compatibility - 96

97. CPS Technician’s Role Listen and assess Interpret issues and teach
Be an accurate, credible source
Instill confidence
Recognize your limits
Misuse and Compatibility - 97

98. “Tough Choices” are made by the parents and caregivers
Parent’s Role
“Tough Choices” are made by the parents and caregivers
Misuse and Compatibility - 98