Increasing Booster Seat Use for 4- to 8-Year-Old Children - October 2002Increasing Booster Seat Use for 4- to 8-Year-Old Children - October 2002  
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Executive Summary


Under Section 14(i) of the Transportation Recall Enhancement, Accountability, and Documentation (TREAD) Act, the Secretary of Transportation is required to, "…develop [a] 5 year strategic plan to reduce deaths and injuries caused by failure to use the appropriate booster seat in the 4 to 8 year old age group by 25 percent." While this is a highly desirable goal, the National Highway Traffic Safety Administration's (NHTSA) research shows that a 25 percent reduction in deaths and injuries would not be attainable through the implementation of a program designed solely to increase proper use of belt-positioning booster seats. This view is borne out by the following data:

  • Virtually 100 percent restraint use by booster seat age children would be necessary to achieve a 25 percent reduction in total fatalities for this age group; and,
  • Only about 21 percent of 4- to 8-year-old children are reported as unrestrained in non-fatal crashes. Therefore, the number of unrestrained children is insufficient to produce a 25 percent reduction in the number of injured children, even if all were restrained.

The Agency's research also shows that the lack of any restraint use in a motor vehicle is the greatest risk to 4- to 8-year-old passengers. In 2000, almost half of the 4- to 8-year-old passengers killed in crashes were reported as totally unrestrained. In addition to the high number of fatalities, thousands of children were seriously injured in crashes because they were unrestrained.

Persuading parents who do not restrain their children at all to place them in any kind of occupant restraint would reduce the number of children killed or seriously injured. Providing additional protection to these children from belt-positioning booster seats would further enhance their overall safety. Therefore, NHTSA has broadened the scope of its booster seat program to include increasing restraint use, in general, among 4- to 8-year-old children.

The Strategic Plan

In public meetings and through written comments, citizens from across the country contributed their ideas for this strategic plan. Its purpose is to provide a blueprint for decreasing the number of children who ride unrestrained and promoting the use of booster seats for children ages 4 to 8. In so doing, the plan provides the Agency's recommended guidelines for booster seat use.

All children who have outgrown child safety seats should be properly restrained in booster seats until they are at least 8 years old, unless they are 4'9" tall. Children are large enough for a lap and shoulder belt when they can sit against the vehicle seat back cushion with their knees bent over the vehicle seat cushion.

The proposed framework of this national strategic plan builds on NHTSA's current Buckle Up America (BUA) campaign, which has been extremely successful in increasing the use of child safety seats for children from birth through 4 years of age and reducing fatalities and injuries in this age group. The elements of the BUA campaign are: (1) public-private partnerships; (2) strong legislation; (3) active, high-visibility law enforcement; and (4) effective public education.

The plan contains specific activities that individuals representing a variety of public and private sector organizations and groups can undertake. These activities range from the conduct of public information and awareness programs about restraint use and booster seats, to the upgrading of child passenger safety laws. They address the need for training, technical assistance, and outreach, as well as the need for enforcement and resource allocation in support of child occupant restraint use. Specific activities are identified for groups that fall under the following categories:

  • Congress
  • Federal Government agencies
  • State and local agencies and organizations
  • National organizations and coalitions
  • Health and medical providers
  • Child safety seat manufacturers and retailers
  • Child passenger safety technicians
  • Media
  • Educators
  • Law enforcement
  • Businesses
  • Private citizens

To provide a context for increased activities, the plan highlights the broad base of support for child passenger safety that exists across the country. NHTSA's public and private sector partners have incorporated messages and best practices information about the lifesaving benefits of booster seats throughout their wide-ranging child passenger safety programming and communications activities. States and communities have received funding for some of these programs and activities through a number of highway safety grants that are funded under the Transportation Equity Act for the 21st Century (TEA-21).

Meeting the Challenge

There are numerous challenges to getting 4- to 8-year-old children secured in booster seats. These range from the lack of information among parents and other caregivers about: (1) the correct progression of restraint use for children, (2) how booster seats work, and (3) the safety benefits of booster seats, to the inconsistency of State laws pertaining to protecting older children and booster seat use. Without consistent laws, or laws that provide for mandatory booster seat use for an older child, parents and other caregivers will continue to question the need for, and benefits of, booster seats.

To address the many aspects of these challenges, NHTSA and its public and private sector partners must continue to promote passenger safety for all motor vehicle occupants. However, we must ultimately rely on parents and other caregivers to take responsibility for placing 4- to 8-year-old children in booster
seats when they ride in motor vehicles.

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Reformulated Objectives & Goals for 2006
To measure progress of its expanded program to increase all restraint use among 4- to 8-year-olds, while promoting booster seat use, NHTSA developed the following new objectives and goals for 2006.
Objective 1: Increase restraint use by 4- to 8-year-old passenger vehicle occupants.
2006 Goal: Increase restraint use by 4- to 8-year-old occupants to 85 percent (from 63 percent in 1999).
Objective 2: Reduce the percentage of unrestrained 4- to 8-year-old passenger vehicle occupant fatalities.
Goal for 2006 Reduce the percentage of unrestrained 4- to 8-year-old occupants that die in passenger vehicle crashes to 39 percent (from 63 percent in 1999).
Objective 3: Reduce the severity of injuries to 4- to 8-year-old passenger vehicle occupants involved in motor vehicle crashes [Data to measure this objective comes from two different databases, Crashworthiness Data System (CDS) and General Estimate System (GES); therefore, there are two goals for this objective].
CDS Goal for 2006: Reduce the number of moderate to severe injuries per 100,000 4- to 8-year-old passenger vehicle occupants involved in motor vehicle crashes to 1,050 (from 1,509 in 1999).
GES Goal for 2006:Reduce the number of incapacitating injuries per 100,000 4- to 8-year-old passenger vehicle occupants to 5,700 (from 6,540 in 1999).