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

2. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 Misuse Rates 1996 NHTSA study of 6000 children in four states in 1994 - 79.5% misuse - Most CRS installed without the use of instructions Misuse and Compatibility - 3

4. Standardized CPS Training Program - Winter 2004 Misuse Rates August 2002 National SAFE KIDS study: - 81.6% misused - Average of three errors per seat Misuse and Compatibility - 4

5. Standardized CPS Training Program - Winter 2004 Misuse Rates Informal checkup events consistently record at least 90% misuse rates Misuse and Compatibility - 5

6. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 Types of Misuse Misuse and Compatibility - 8 Selection errors Harnessing errors Installation errors Often observed in combination

9. Standardized CPS Training Program - Winter 2004 Selection Errors 1.Using a CRS with shield for small infant 2.Using outgrown CRS 3.Child too small/young for CRS 4.Using non 213 certified device 5.Using recalled & unrepaired CRS. 6.Using second-hand CRS with missing history or parts. 7.Using crash-involved CRS or safety belt Misuse and Compatibility - 9

10. Standardized CPS Training Program - Winter 2004 Harnessing Errors 1.Not using harness at all 2.Routed through wrong slots 3.Not doubled back if needed 4.Knotted or pinned or incorrectly routed 5.Too loose 6.Not placed on child correctly 7.Frayed or damaged 8.Metal adjuster not flush with slot or out of position 9.Retainer clip not at armpit level 10.Crotch strap too long or wrong position 11.Using "add-ons" not approved by the CRS manufacturer Misuse and Compatibility - 10

11. Standardized CPS Training Program - Winter 2004 Installation Errors 1.CRS not anchored to the vehicle at all 2.RF CRS in front of active air bag 3.Turned FF too early 4.RF only CRS facing forward. 5.Incorrect recline angle 6.Vehicle safety belt or lower anchorage belt too loose or not locked 7.Locking clip a.Not used when needed b.Incorrectly placed, or c.Used when not needed Misuse and Compatibility - 11

12. Standardized CPS Training Program - Winter 2004 Installation Errors 8.Vehicle safety belt or lower anchorage belt routed incorrectly 9.Tether not connected properly or too loose 10.No tether used if required 11.Incorrect use of LATCH anchors 12.Using two belts, or belt and LATCH together 13.Using "add-ons" not approved by the CRS or vehicle manufacturer Misuse and Compatibility - 12

13. Standardized CPS Training Program - Winter 2004 Consequences of Misuse Deaths and injuries attributed to misuse Misuse and Compatibility - 13

14. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 Vehicle Compatibility Issues Can be serious or fatal Some vehicles not designed to transport children Misuse and Compatibility - 16

17. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 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 CRS vs. Vehicle Seat Design: Possible Fixes

20. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 Vehicle Compatibility Issues Fixes can cause complications KEEP IT SIMPLE! Parent MUST be able to reproduce correct installation Misuse and Compatibility - 22

23. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 Some Solutions Short term: Educate - 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. Standardized CPS Training Program - Winter 2004 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 - 28Standardized CPS Training Program - Winter 2004

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

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

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

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

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

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

35. Locking clip incorrectly placed 13” from correct position Locking clip bent and ripped seat belt allowing extreme forward excursion of child’s upper body What’s Wrong With This Picture? Misuse and Compatibility - 35Standardized CPS Training Program - Winter 2004

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

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

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

39. 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 What’s Wrong With This Picture? Misuse and Compatibility - 39Standardized CPS Training Program - Winter 2004

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

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

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

43. 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 What’s Wrong With This Picture? Misuse and Compatibility - 43Standardized CPS Training Program - Winter 2004

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

45. 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. What’s Wrong With This Picture? Misuse and Compatibility - 45Standardized CPS Training Program - Winter 2004

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

47. 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 What’s Wrong With This Picture? Misuse and Compatibility - 47Standardized CPS Training Program - Winter 2004

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

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

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

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

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

53. 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 What’s Wrong With This Picture? Misuse and Compatibility - 53Standardized CPS Training Program - Winter 2004

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

55. 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 What’s Wrong With This Picture? Misuse and Compatibility - 55Standardized CPS Training Program - Winter 2004

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

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

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

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

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

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

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

63. Lap and shoulder belt not correctly placed on child Shoulder belt cuts under arm and up behind head Child should be in BPB What’s Wrong With This Picture? Misuse and Compatibility - 63Standardized CPS Training Program - Winter 2004

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

65. 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 What’s Wrong With This Picture? Misuse and Compatibility - 65Standardized CPS Training Program - Winter 2004

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

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

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

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

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

71. 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 What’s Wrong With This Picture? Misuse and Compatibility - 71Standardized CPS Training Program - Winter 2004

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

73. Front facing only CRS used rear facing Too upright for rear facing Harness too loose Belt used for installation too loose What’s Wrong With This Picture? Misuse and Compatibility - 73Standardized CPS Training Program - Winter 2004

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

75. 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 What’s Wrong With This Picture? Misuse and Compatibility - 75Standardized CPS Training Program - Winter 2004

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

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

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

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

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

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

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

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

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

85. CR placed on top of back seat that is lowered for access to the trunk Harness falling over edge of shoulders What’s Wrong With This Picture? Misuse and Compatibility - 85Standardized CPS Training Program - Winter 2004

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

87. Too upright for infant Harness too loose Retainer clip out of position Safety belt not through belt path slots Belt too loose What’s Wrong With This Picture? Misuse and Compatibility - 87Standardized CPS Training Program - Winter 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. Standardized CPS Training Program - Winter 2004 Communicating with Parents Accurate & thorough assessment - Weight, height, age - Developmental or physical limits - Type of CRS - Type of vehicle Misuse and Compatibility - 89

90. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 Communicating with Parents Awareness and Attitude: - Body language/facial expressions - Interaction not lecture - Encouraging attitude - Patience Misuse and Compatibility - 91

92. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 Communicating with Parents Don’t ignore the child - Include in conversation - Teach how to buckle up Misuse and Compatibility - 94

95. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 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. Standardized CPS Training Program - Winter 2004 Parent’s Role “Tough Choices” are made by the parents and caregivers Misuse and Compatibility - 98