Strong Child Passenger Safety Laws

From 1978 to 1985 every State and the District of Columbia passed laws requiring child restraints for young child passengers (Kahane, 1986), and most of these laws have since been amended and strengthened to include more children and to close loopholes and exemptions. Still, great variation exists in the requirements and ages covered by State child restraint laws.

There is no consensus on what the ideal CPS law should include. However, research shows the scope and wording of laws can influence restraint use (Benedetti et al., 2017). For example, one study found that children were more likely to ride in the recommended type of restraint if their State’s CPS law followed best practices for child occupant protection (i.e., AAP, 2021; Durbin et al., 2018).

In general, strong occupant restraint use laws should be comprehensive and cover all seating positions equipped with a seat belt in all passenger vehicles (ACTS, 2001; NCUTLO, 2000; NHTSA, 2003). NHTSA and other partners have encouraged States to expand their child restraint laws to include “booster” provisions that cover children until they are big enough for the lap and shoulder belts to fit properly.

Use:

As of May 2023 there were 39 States and the District of Columbia that had enacted child restraint laws covering children through at least age 7. One State (South Dakota) only requires a child restraint or booster seat through age 4, and 6 States have laws that go through age 5 (IIHS, 2023a). However, while there are some similarities in terms of who is covered by CPS laws, a wide variation in age, height, and weight requirements exists (GHSA, 2021; IIHS, 2023b). In 3 States, some children under 16 are covered by neither the child restraint nor the seat belt law (IIHS, 2023a).

Effectiveness:

Several research studies (Fell et al., 2005; Margolis et al., 1996) have found restraint use levels among children and teens covered by restraint use laws are higher than those not covered, and that injury levels among children covered by CPS laws are lower than children not covered. Additionally, research in both the United States and Canada has shown that laws requiring child restraints or booster seats for older children are associated with a decrease in fatalities (Brubacher et al., 2016; Mannix et al., 2012).

Several studies have evaluated the effect of extending a State’s child restraint law to cover older children (often referred to as a “booster provision”) on booster seat use (Gunn et al., 2007). Studies conducted in Washington State (Ebel et al., 2003), Tennessee (Gunn et al., 2007), and Wisconsin (Brixey et al., 2011; Decina, et al., 2008) found increases in booster seat use and child restraint use more generally following expansion of the State’s child restraint law. A broader study looking at 35 years of FARS data (1975 to 2011) found that expanding CPS laws to include more children is effective at increasing the age of children in child restraints (Jones & Ziebarth, 2017). Similarly, an observational study of child restraint legislation in Canadian provinces found that provinces with newly passed legislation saw booster/front-facing restraint use increase from 26% to 54% (Simniceanu et al., 2014). During the same period, provinces with existing legislation saw no increase (31% versus 30%). This suggests that legislation on its own may be insufficient, and that the outreach, education, and enforcement activities associated with new legislation play a vital role in increasing restraint use.

Efforts to extend child restraint laws to include older children gained momentum in the 2000s, with South Carolina and Tennessee becoming the first States to explicitly include a booster seat provision in their State laws in 2001 (Bae et al., 2014). The National Survey of the Use of Booster Seats has been conducted by NHTSA since 2006 with biennial updates beginning in 2009. In 2006 some 58% of children 4 to 7 were appropriately restrained in child restraints or booster seats (Glassbrenner & Ye, 2007). In 2021 some 73.2% of children in this age group were appropriately restrained. Interestingly, while appropriate restraint increased during this time period, the percentage of children 4 to 7 in a booster seat decreased (31% in 2019 compared to 41% in 2006), suggesting the majority of the increase in appropriate restraint can be attributed to children 4 to 7 remaining in forward-facing car seats longer (Boyle, 2023). A change in booster seat use is also evident when looking at the restraint use of older children. In 2006 some 8% of children 8 to 12 were using booster seats (Glassbrenner & Ye, 2007). In 2021 some 12.5% of kids in this age group were using a booster seat (Boyle, 2023, 2021).

Most CPS laws are primary; however, most seat belt laws start coverage before a child reaches 18, so older children and teens might be covered by a secondary enforcement seat belt law in some States. Research has found that teens living in secondary enforcement States are less likely to report wearing their seat belt than teens living in primary enforcement States (Garcia-España et al., 2012).

Cost:

The costs of expanding a restraint use law to include all seating positions in all passenger vehicles are minimal. States can expect costs related to enforcement and publicizing any law changes.

Time to implement:

CPS laws can be implemented as soon as the law is enacted and publicized.