Introduction

Over the past several years, the National Highway Traffic Safety Administration (NHTSA) and its partners in the private and public sectors have made a concerted effort to promote the use of child safety seats through public education, enforcement, and strong legislation. As a result, the Nation has seen a dramatic increase in child restraint use for infants and toddlers, a reduction in fatalities and injuries, and the saving of countless lives.

Without State occupant restraint laws requiring drivers to place children younger than the age of 4 years in child safety seats, these increases would not have been as great. Unfortunately, most of these laws do not address the need to place children ages 4 to 8 years¹ (who are too big for child safety seats, yet too small to ride safely in adult seat belts) in booster seats. In many instances, loopholes in State laws allow children to ride unrestrained in the back seat.

The greatest risk to child passengers 4- to 8-years of age is the lack of any restraint use in a motor vehicle. In 1999, more than 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 restraint would reduce the number of children killed or seriously injured. Providing additional protection to these children using belt-positioning booster seats would enhance their overall safety.

Therefore, as the public is educated about the importance of age/size appropriate belt-positioning booster seats, it is imperative that they are aware of the dangers children face when they ride unrestrained. Societal norms must change, making it socially unacceptable to place children at unnecessary risk by allowing them to ride unrestrained in a moving vehicle.

The passage of the Transportation Recall Enhancement, Accountability, and Documentation (TREAD) Act provides the U.S. Department of Transportation with a new opportunity to educate the public about the dangers children face when they ride unrestrained, and the importance of having all appropriate-size booster-seat-age children protected by belt-positioning booster seats when they are passenger vehicle occupants.

National Participation in Plan Development

On June 6, 2001, NHTSA published a Federal Register Notice announcing a Public Meeting and Request for Comments To Address the Development of a Booster Seat Education Plan (www.access.gpo.gov/su_docs/fedreg/a010606c.html). NHTSA conducted a public meeting on July 10, 2001, which brought together nearly 100 participants and speakers to provide a forum for sharing viewpoints, information, ideas, and recommendations to increase booster seat use. The attendees and presenters represented the general public, industry, government, child advocacy groups, and child restraint manufacturers. Comments also were received at the public docket (http://dms.dot.gov, docket number 9785). The information gleaned from these two forums was the starting point for the strategic plan.

Additional Contributions to Plan Development

NHTSA reviewed recommendations and goals from other arenas during preparation of the plan, including the following:

• November 1999 report of the Blue Ribbon Panel II, Protecting Our Older Child Passengers (http://www.actsinc.org/whatsnew_6.cfm)

• Child Restraint System Safety Plan of November 27, 2000 (http://dms.dot.gov docket number 7938)

• December 2000 National Transportation Safety Board (NTSB) Booster Seat Use: Government and Industry To Announce New Child Safety Initiatives recommendations (http://www.ntsb.gov)

• Association for the Advancement of Automotive Medicine (AAAM) April 23-24, 2001, meeting on Booster Seats for Children: Closing the Gap Between Science and Public Policy (www.carcrash.org)

• Child Passenger Protection Act of 2001 (S. 980), introduced by Senators Peter G. Fitzgerald (R-IL) and Byron Dorgan (D-ND) on May 26, 2001 (http://thomas.loc.gov)

A Summary of the Issues Raised for Inclusion in Plan Development

NHTSA solicited and received national input, reviewed salient documents addressing child passenger safety, and conducted meetings with individuals involved with child passenger safety at the national and local levels. Combining this information with the Agency's expansive research capabilities and years of experience in child passenger safety, NHTSA identified several recurring issues:

• A large percentage of fatalities in this age group are unrestrained;

• The lack of public awareness of the risks to child passengers 4- to 8-years of age and the use of age/size appropriate restraints;

• The need to reach numerous audiences, such as parents, caregivers, enforcement officers, health care providers, and other influencers (e.g., child care providers and teachers);

• The need to develop outreach and educational programs that have clear, consistent messages and address multilingual/multicultural audiences; and

• The importance of strong, enforceable laws and support for enforcement.

Within the above mentioned issues, specific recommendations included: (1) tailoring messages for high-risk populations; (2) establishing a best-practices approach for all outreach and programmatic activities; (3) passing laws requiring lap and shoulder belts in all seating positions in motor vehicles; and (4) informing the public that when a booster seat is unavailable, a child should be placed in a seat belt in the back seat. There was also strong support for NHTSA to continue providing incentive grants to States to increase age/size appropriate restraint use.

A Blueprint for the Nation

The purpose of the national strategy is to provide a blueprint for increasing the number of children ages 4 to 8 who are secured in booster seats. The proposed framework of the strategy 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. 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.

This plan is divided into five sections:

• Reformulating the TREAD Objective

• The Challenge of Getting Children Placed in Booster Seats

• A Strategic Approach Built on the Successes of the BUA Campaign

• Work in Progress

• A National Movement for Change—Implementing the Strategic Approach

¹ The term "4 to 8 years" refers to children who are 4, 5, 6, and 7 years old.

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