1. Child Passenger Safety and Occupant Protection Conference Call 8-20-09

2. Extending 5-point Harnessing: Forward Facing Seat Options for Heavier Children Caroline Langrall, CCLS, CPST Mt. Washington Pediatric Hospital

3. Outline ★ Challenges ★ Crash Dynamics ★ Seat Options ★ Special Needs

4. Challenges Lack of research Historically, majority of affordable seats offered FFing harnessing to 40lbs. Rise in Obesity 3+y/o male,90th percentile for weight= 40lbs. (CDC, 2000) Maturity for booster use.

5. Challenges Child must be mature enough to sit in a booster 40lb, 4 year old Dislodged belt from belt guide.

6. Challenges 4 year old. 42 lbs Low back booster

7. Challenges 3 years, 9 months. 48lbs Not overweight (No booster)

8. Crash Dynamics A five-point harness system makes contact with the strongest parts of the body – the hips and shoulders, and transfer crash forces over those strong parts of the body...and into 5 points on the seat. (Britax USA) The Iliac Crest (hip bones) isn’t fully developed until age 6-10. This crest keeps the lap belt in position. Poor belt fit increases the risk of abdominal injuries.

9. Crash Dynamics Booster vs. 5-point harness

10. Crash Dynamics A forward facing, top- tethered seat reduces head excursion: Weber, Kathleen; Crash Protection For Child Passengers: A Review of Best Practice. UMTRI Research Review, July-September 2000 Tethered Not Tethered

11. Seat Options Many new seats offer rear-facing 35-40lbs and forward facing harness limits of 50+lbs Tall children: look for high top harness slots. Conventional seats for Special Needs

12. Graco MyRide 65 RF to 40lbs, FF to 65lbs head pillow to 40lbs infant insert: 1st harness slot top harness height=16” natural recline FFing

13. Safety 1st Complete Air “Air Protect” Technology RF: 40lbs, FF: 50lbs 10.5” lowest slot 17” top slot

14. Radian XT RF: 40lbs (retroactive on 65/80/XT, Sept 1, 2008+) FF: 80lbs (top harness slots: 17”) EPS foam headwings (can’t use on 1st and 2nd harness slots) Can tether RF Removable Harness

15. Britax Roundabout 50 RF: 35lbs, FF: 50lbs Same harness dimensions as Marathon (16.5”) No belt lock-offs, no HUGS. Can tether RF Can recline FFing to 33lbs

16. True Fit Premier RF:35lbs, FF: 65lbs Rebound Energy Management System Must use “upper seatback” headpiece after 22lbs. (not shown in picture below) Has built-in belt lockoffs

17. Britax Frontier Minimums: 2 years, 25 lbs. Max harness: 80lbs. 18.25” top harness slot. Booster can be used beyond 100lbs assuming: appropriate belt fit, ears below top of seat, and expiration (9 yrs booster).

18. Graco Nautilus 20-65lbs 5-point harness 30-100 HBB 40-100 LBB 100% of the base must be on vehicle seat Debate about buckle being under child.

19. Additional Seats Apex 65 20-65lbs harness booster to 100lbs *vehicle headrest Evenflo Triumph Advance 5-50lbs Britax Regent 20-80lbs Discontinued?

20. Special Needs A child may need 5-point harness beyond conventional seat offerings: behavioral issues muscle tone medical condition search safekids.org for a local CPST trained in special needs.

21. Other Seats Available for download on saferidenews. com Missing some new seats

22. Caregiver Education Top tethering Reminder about vehicle LATCH limits Child may reach height limits before weight. Harness at or ABOVE shoulders for Forward Facing. Child’s torso proportion is key.

23. Thank you for your time! Questions?

24. phomiak@miemss.org