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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Section Five: A National Movement for Change—Implementing the Strategic Approach

Section Five: A National Movement for Change--Implementing the Strategic Approach photoCitizens from across the country contributed their ideas for this strategic plan in public meetings and through written comments. As described previously, considerable activities, funding, and resources have already been committed to increase awareness and promote the use of booster seats. This section contains specific efforts that individuals representing a variety of public and private sector organizations and groups can undertake.


To assist citizens, communities, and States to increase awareness and booster seat use rates, members of Congress can:

  • Support State legislation aimed at closing gaps in child occupant protection laws, especially legislation aimed at older children in age/size appropriate child occupant restraints.
  • Continue to support the occupant protection portions of the Department of Transportation's fiscal year budget requests.
  • Advocate booster seat use publicly and with constituents.
  • Actively support and participate in coalitions comprising businesses and national organizations that advance occupant restraint education, legislation, and enforcement.
  • Encourage governors and State legislators to pass legislation that requires all children to be placed in age/size appropriate child restraints.
  • Place their children in age/size appropriate child occupant restraints.

Federal Government Agencies

The Department of Transportation currently oversees a department-wide initiative to promote seat belt use among all its employees and customers. Agencies throughout the Department regularly disseminate passenger safety messages and support programs that encourage the use of seat belts, child safety seats, and booster seats. Although the mandate for child passenger safety clearly falls under the purview of the Department of Transportation, numerous opportunities exist for other Government agencies to participate in activities to promote the correct progression for child restraint use. The following list, which focuses on the Department of Transportation, includes activities that all Government agencies can undertake (including State and local agencies):

  • Implement this plan as a priority program within the agency and all of its regional and district offices.
  • Provide assistance to States seeking to enact or strengthen protection for older children in age/size appropriate child occupant restraints.
  • Provide financial support and technical assistance to States to support their efforts to actively and visibly enforce their child occupant protection laws.
  • Encourage increased participation by private and nonprofit partners to work with NHTSA, or as part of a coalition, to increase booster seat use.
  • Encourage health and safety officials in school districts to include the proper use of child restraint systems, especially booster seats, in their health and wellness programs.
  • Make training available to public health officers, law enforcement officers, and insurance agency representatives on proper restraint use and appropriate restraint systems.
  • Include child passenger safety messages in other child health-related programs and campaigns.
  • Encourage Tribal Governments to adopt and actively enforce mandatory child safety seat use laws that include the use of booster seats.
  • Support Operation ABC mobilizations and National Child Passenger Safety Week.
  • Conduct annual observational and attitudinal surveys to assess public perception of and changes in booster seat use.
  • Encourage Medicaid funding and reimbursement for age/size appropriate child restraints.

State and Local Agencies and Organizations

National change takes place at the local level. State and local leaders, along with State Highway Safety Offices, must work together to support legislative change and programs that encourage 4- to 8-year-olds to be placed in booster seats, make booster seats available to all children, and educate parents and other caregivers on the correct progression of occupant restraint use for children. To this end, State and local leaders should work to accomplish the following objectives:

  • Educate State leadership about the importance of legislation that requires age/size appropriate occupant protection.
  • Adopt comprehensive child occupant protection laws to encourage coverage of all children up to age 16 in all seating positions.
  • Assess meaningful penalties for child safety and booster seat violations.
  • Build public-private partnerships to develop and execute statewide strategies for raising public awareness and increasing booster seat use.
  • Provide resources for the enforcement of all child occupant protection laws.
  • Support and coordinate public information and education programs.
  • Establish motor vehicle crash databases that capture the use/non-use/misuse of booster seats and measure success.
  • Ensure the availability of booster seats for every child.
  • Provide technical assistance to ensure that children are properly positioned in correctly installed booster seats.
  • Mandate awareness training on child occupant protection for State boards of education.

National Organizations and Coalitions

Many national organizations and coalitions currently support child passenger safety. NHTSA will continue its work with current partner organizations and identify new ones. These organizations share information with members and other constituent groups, develop materials on child passenger safety tailored to the needs of its members, voice public support for child passenger safety, and stimulate grassroots activity on child passenger safety, including booster seat use. This network includes, but is not limited to, the following types of organizations:

  • Health and medical organizations and professional associations;
  • National and community-based organizations serving various racial and ethnic populations;
  • Law enforcement organizations;
  • Associations representing lawyers, judges, and prosecutors;
  • National traffic safety organizations;
  • Faith-based organizations; and
  • Industry-related organizations focused on promoting traffic safety among employees and customers.

National organizations and coalitions can participate in this effort to raise awareness about the dangers children face when they ride unrestrained. They can help promote booster seat use in the following ways:

  • Join coalitions with other national organizations to advance child safety and booster seat education, legislation, and enforcement.
  • Contact private sector businesses and other local, State, and national organizations to provide information and recruit their involvement.
  • Identify needs among members and partners for child passenger safety training and education, provide training and education materials as needed, and establish delivery mechanisms.
  • Identify target groups, determine outreach methods, and produce appropriate resource materials. (NHTSA will provide technical assistance, as needed.)
  • Develop and support outreach programs and events that provide culturally appropriate information for racial and ethnic populations known to have low rates of child restraint use.

Health and Medical Providers

Health and medical providers play a vital and continuing role in providing counseling to parents and children on many matters of health and safety. Physicians and nurses (especially in pediatric practices), attending hospital staff, emergency room medical staff, school nurses, and others see most children from birth through their immunization periods. During this time, these health care providers are in a unique position to educate parents and other caregivers on the importance of using the appropriate safety restraint system for their children, including the importance of placing 4- to 8-year-olds in booster seats. The health and medical community can support the use of booster seats by adopting the following suggestions:

  • Discuss the risk of death and injury in motor vehicle crashes for this age group with parents and other caregivers.
  • Discuss the importance of securing children in booster seats with parents and other caregivers.
  • Display posters and other information about booster seats and child passenger safety in waiting areas.
  • Give parents and other caregivers' educational materials about booster seats and child passenger safety.
  • Talk to children about the benefits of booster seats, how "cool" it is to see out the window when in a raised seat, and comfortable because the seat belt fits properly.
  • Offer testimony and background information to the media and legislature on the benefits of booster seats.
  • Integrate information about booster seats and child passenger safety into developmental examinations as a childhood milestone (e.g., when you bring your child in for his/her 4-year checkup, we will measure him/her to see if it's time for you to purchase a booster seat).
  • Collect and analyze emergency room data on injuries caused by the premature graduation of children into adult seat belts.
  • Participate in media events as credible spokespersons for child safety.

Child Safety Seat Manufacturers/Automobile Manufacturers/Retailers

Child safety seat manufacturers, automobile manufacturers, and retailers are critical to the success of all national efforts to promote the use of booster seats. They can support the use of booster seats by considering these suggestions:

  • Provide booster seats that accommodate children up to 8 years of age, and up to 4 feet 9 inches tall.
  • Design and produce booster seats that are comfortable for children.
  • Consider styling that would make booster seats attractive to older children.
  • Encourage the inclusion of integrated child safety seats in vehicles typically used for transporting children.
  • Combine efforts to address the physical compatibility of all child restraints with motor vehicle seating.
  • Provide, stock, display, and promote a variety of booster seats for use with lap and shoulder and lap-only seat belts that are affordable for all income groups.

Child Passenger Safety Technicians

More than 32,000 certified child passenger safety technicians have been trained to educate parents and other caregivers about the correct use of child safety seats and booster seats and to ensure their proper installation. Recognizing the low usage rate for booster seats, child passenger safety technicians can help increase their use by carrying out the following activities:

  • Remind parents of younger children that when their children reach age 4, they should properly use booster seats.
  • Talk to children about the benefits of booster seats and how "cool" it is to be able to see out the window when they are in a raised seat.
  • Offer testimony and background information to the media and legislature on the benefits of booster seats.
  • Provide community presentations on the imperative for placing children in booster seats.
  • Educate daycare and after school providers about booster seats and the appropriate progression of occupant restraint use.
  • Work to integrate information about booster seat use into law enforcement outreach programs that discuss safety for elementary school children.
  • Work with existing and new partners to establish fitting/inspection stations.


National and local media organizations have shown strong support for child passenger safety programs. It is time to build on that support by educating the media and obtaining their buy-in (even in States that have gaps in their existing laws) for placing 4- to 8-year-olds in booster seats. The access that broadcast, print, and out-of-home media have will be critical to getting the word out about the risks associated with children riding unrestrained. In addition to requesting publicity through their broadcast, print, and out-of-home channels, NHTSA will make a point of requesting the placement of information about booster seats and child passenger safety on their Web sites. Suggestions for media activities supporting booster seat use are as follows:

  • Cover special events and press conferences during CPS Week and Operation ABC mobilizations.
  • Air video and audio news releases on child passenger safety and booster seats.
  • Develop feature stories for health and style magazine sections.
  • Run editorials on the need for upgrading child occupant protection laws to protect 4- to 8-year-olds by placing them in booster seats.
  • Conduct call-in shows and interviews with local experts on child passenger safety.
  • Publish consumer advisories on new NHTSA publications on booster seat use.
  • Feature child safety seat checkpoints and fitting/inspection stations and list on community calendars.
  • Include child safety seat and booster seat public service messages throughout programming.
  • Take advantage of high-quality Ad Council media kits.
  • Air a radio broadcast from a fitting/inspection station.


The community of public and private school educators encompasses preschool and elementary school teachers and their assistants, school administrators and their staff, boards of education, and other professionals and volunteers. Individually and collectively, members of these groups can help prevent death and injuries by participating in and initiating activities that promote the use of child occupant restraints. Opportunities for involvement are as follows:

  • Display posters about booster seats in classrooms and at the entrances to school buildings.
  • Integrate information about booster seat use into discussions on health and safety.
  • Invite child passenger safety technicians to speak to children about booster seats.
  • Host presentations on booster seat use during parent-teacher activities and school fairs.
  • Support legislation that upgrades child occupant protection laws to include booster seats.

Law Enforcement

Law enforcement agencies and professional associations have actively supported child passenger safety through enforcement, training, and public education. Additional and expanded activities for their involvement are presented below:

  • Train additional officers as child passenger safety technicians so they can educate others within their agencies and drivers on the correct use of child restraints and booster seats.
  • Continue to enforce all occupant protection laws.
  • Initiate new outreach activities to educate parents and other caregivers about appropriate child restraint use.
  • Work with the media to publicize information about crashes in which children are not restrained or not properly restrained
  • Serve on local child passenger safety advocacy task forces and coalitions.
  • Actively participate in Operation ABC mobilizations.


As responsible corporate citizens, businesses know that safe, healthy families are good for business. Through internal and external communications, businesses can help educate employees, customers, and the public at large. Businesses can promote the use of booster seats and child occupant protection in many ways:

  • Support comprehensive child occupant protection laws.
  • Support enforcement of all occupant protection laws.
  • Communicate child safety seat use messages to customers and employees.
  • Join in coalitions with other businesses and national organizations (or affiliates) to advance child safety seat education, legislation, and enforcement.
  • Contribute resources (both direct funding and in-kind services) to support outreach activities and public information and enforcement efforts.
  • Join Safe Communities coalitions.
  • Post and distribute information to customers and employees about booster seats.
  • Request that health insurance representatives talk to employees about booster seats when they present information about company health insurance plans.
  • Host a child passenger safety checkup event for employees.

Private Citizens

Because young children are unable to protect themselves, parents and other caregivers must take responsibility for placing them in age/size appropriate occupant restraints, and seating them in the back seat where they are the safest. However, as children get older, parents and other caregivers can begin educating them about the importance of occupant restraints and should involve them in selecting a booster seat. All adult citizens can promote child passenger safety by doing the following:

  • Always wear a seat belt and serve as a role model.
  • When children ride in a motor vehicle, secure them properly in a child safety seat, booster seat, or seat belt depending on their age, height, and weight.
  • Place children in the safest part of the vehicle—the back seat.
  • Never start the vehicle until everyone is buckled.
  • Seek assistance if you are unsure about the correct way to secure a child in a child safety seat or booster seat or about their proper installation in a motor vehicle.
  • Encourage elementary schools to include information about booster seats and seat belts when they talk about health and safety.
  • Let children help select a booster seat.
  • Talk to children about the increased comfort and ability to see out the window when they sit in a booster seat.

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