Almost all members of the parent/caregiver subgroup reported that the selected child used a car seat either “all of the time” (71%) or “never” (22%). Only 6% said that the child was a car seat user, but not all the time. If the child never used a car seat, it usually was because the child reportedly had graduated to seat belt use (see page 68).

 

Virtually all parents/caregivers (99%) said the selected child always used a car seat when riding with them if the identified child weighed less than 20 pounds. The finding was similar (95%) when the selected child weighed from 20 to 29 pounds. The percentage then declined to 76% for children weighing 30 to 39 pounds, and to 38% for children under age 6 who weighed 40 pounds or more.

 

The data summarized in Figure 25 suggests that discontinuation of car seat use by most children occurred when the child was 3 or 4 years old. More than 9-out-of-10 children age 2 or younger reportedly used car seats all of the time. The percentage then declined to 80% for 3-year-olds, and to 46% for 4-year-olds. At 5 years of age car seat use was a relative rarity as only 22% of parents/caregivers reported that the child used a car seat all of the time when riding with them.

 

Research on adult seat belt use has found that some drivers will report wearing seat belts “all the time” but admit on a follow-up question that they did not use their seat belt recently. In 1998, 10% of drivers who said they used their seat belt “all the time” later stated that they had not worn their seat belt in the past day or week (see Volume 2 of this series: Seat Belt Report). Figure 26 examines whether this discrepancy also occurs for reported car seat use. Among drivers who said that the child always used a car seat when riding with them, 4% also said the child had not ridden in a car seat at least once in the past day or week when the respondent was driving the child.

Parents/caregivers who reported car seat use for the designated child were asked to identify the type of seat and how it was being used. From the information provided, the survey determined that 25% were using booster seats (based on responses to questions asking strap locations on the child; readers are cautioned that some respondents may have made errors in reporting this). Of the remainder, 60% were operating in a front-facing (toddler) position, 14% in a rear-facing (infant) position, and 1% did not provide information from which the car seat could be determined.

Infants who have not reached their first birthday should always ride in a rear facing position in a car seat regardless of the child's size. Most infants who used car seats (58%) did indeed ride in a rear facing position. But about one-third (32%) rode in a front facing position in a toddler seat, with another 10% in booster seats. Front facing toddler seats predominated among one-year-olds (87%) and two-year-olds (78%). Booster seats accounted for 18% of car seat users among two-year-olds, then more than doubled to 39% at age 3. Booster seats increased as a percentage of car seat users at ages 4 and 5, though far fewer children rode in car seats at those ages.

Slightly more than two-thirds (69%) of children weighing less than 20 pounds rode in a rear facing position. A portion (14%) appeared to be using booster seats although, as mentioned earlier, at least some respondents may have made mistakes in describing the seat. Others (17%) provided information suggesting that the child usually rode front facing in a toddler seat. Front facing toddler seats predominated at 20 to 39 pounds. Past 40 pounds, there was a relatively close split between children in booster seats (the majority) and those in front facing toddler seats. Readers are cautioned that some respondents may have been guessing at children's weights.

Children should ride rear facing until at least 20 pounds and one year of age. Children who reach 20 pounds before one year of age should ride rear facing in a child safety seat approved at a higher weight. Keeping a child rear facing as long as possible helps protect the fragile baby from spinal cord injuries. Figure 30 uses the above criteria to identify what percentage of children who should be riding rear facing (those not yet one year old; those not yet 20 pounds) actually were doing so. While most (57%) were riding in the correct rear facing position, many (43%) were not.

Some car seats are reversible, where they can be used in both a front facing and a rear facing position. Thus the same seat could be used for a child who has grown from infant (rear facing) to toddler (front facing), or could revert back to a rear facing position for an infant when an older child has outgrown the seat, or could be used for both infants and toddlers if the driver interacts with children of multiple ages. In cases where the car seat was not a booster seat, almost half of parents/caregivers (46%) reported that the seat was reversible. Among infants riding in a rear facing position, 44% were known to be using a reversible seat.

As noted in Chapter 1, the safest seating position for a child in a motor vehicle is the back seat. The vast majority of parents/caregivers (90%) stated that the child usually sat in the back when riding in a car seat in a vehicle they were driving, typically behind the front passenger (39%) or in the middle of the back seat (36%). Nine percent reported that the car seat was usually placed in the front.

The dominant location for placement of the child car seat was the back seat of the vehicle regardless of whether the child was riding in a rear-facing infant seat (89%), a front-facing toddler seat (92%), or a booster seat (86%).

Proportionally fewer parents/caregivers permitted the child car seat to be placed in the front if there was an air bag installed for the front passenger side. If there was no air bag in the respondent's primary vehicle, then 14% of the parents/caregivers said that the child seat was usually in the front. If the primary vehicle had an air bag for the front passenger side, then 4% said the car seat was usually in the front. If the primary vehicle had an air bag for the driver side but not the front passenger, then the percentage fell between the two figures at 9%.

Almost all parents/caregivers (98%) considered the back seat the safest location to place a child car seat in a vehicle. One percent incorrectly believed that the front seat was safest, while somewhat fewer answered that it depended on the type of child car seat or else that they did not know (less than 0.5% each). The 1% who thought the front seat was safest contrasts with the 9% who said that the child car seat was usually in the front seat when they drove (see page 38).

Parents/caregivers were asked if they thought it was safe to place a rear-facing car seat in the front seat of a vehicle having a front passenger air bag. The correct answer is no, because it could place the child in the air bag's path, with the force of impact being too great for the child. Most parents/caregivers (92%) said it was unsafe while 4% considered it safe. Another 4% responded either that they did not know how air bags worked (0.6%) or that they did not know the answer to the question (3.8%).

Most car seats (85%) were obtained new. About one-in-seven (14%) were acquired used. The remainder of the sample could not say whether the seat was acquired new or used, or else refused to respond (1%).

More than two-thirds of car seats (68%) were purchased, while 27% were acquired as a gift or loaner from a relative or friend. Another 1% obtained the car seat from a loaner program. If purchased, the car seat most often was bought from a retail store (92%).

Almost one-third (31%) of parents/caregivers who said that they received the seat as a gift or loaner from a relative or friend also answered that the seat was obtained used. This is a safety issue as used car seats may contain hidden damage that weaken them; for example, damage sustained from having previously been involved in a crash.

The interviewers asked the parents/caregivers of children using car seats where they had gotten their information on car seats. Six potential information sources were read, one at a time, to respondents. The respondents were asked whether they had ever read or heard of any information, or received any advice, about the need to use child car seats from that source. The respondents were then given the opportunity to volunteer additional sources where they had received car seat information. Most often, the parents/caregivers said that they had obtained information on child car seats from tv or radio (65%), or from books or articles on child care (61%).

Parents and caregivers reported that they had relatively little difficulty installing their children's car seats regardless of the type of seat. Overall, seven out of ten respondents (71%) said it was very easy to attach the car seat to the vehicle they usually drove. An additional 23% considered it somewhat easy.

Those respondents who said that it was only somewhat easy to attach the seat to the vehicle, or not easy at all, were asked what was difficult about attaching the seat. Most often (38%) they answered that the problem was fitting the seat belt through the car seat hole or loop. 

Besides asking how easy it was to attach the car seat to the vehicle, the interviewers also asked the respondents how confident they were that the seat was securely attached. Most (78%) said they were very confident, with the type of seat making little difference in the response.

The results presented on the previous pages suggest that parents and other caregivers generally believe that they are installing child car seats correctly. However, observations in the field have shown some form of car seat misuse for the vast majority of children in car seats, in the form of installation and/or buckling errors. To assess the misuse issue more fully, the interviewers asked the respondents if they had ever driven with the child in the car seat and later found that the car seat was not securely attached. One-quarter (25%) said “yes” while 75% said “no.”

Those respondents who acknowledged driving with the child and later discovering that the car seat was not securely attached were asked why this happened. The responses tended to revolve around rushed behavior or carelessness, unexplained attachment difficulties, children's behavior, or movement of the seat within the vehicle or to another vehicle. 

Most often, the respondents said that they learned how to attach the child car seat to the vehicle by reading the instructions (75%). About one-in-six (16%) figured it out themselves and 8% had a friend or relative show them.

In total, 88% of parents/caregivers had read the car seat instructions. Of these, 70% said the instructions were very easy to understand; 24% said they were somewhat easy. Among those who said they did not read the instructions, 51% conceded that the instructions were available.

As with installing the car seat in the vehicle, most caregivers considered it easy to properly buckle the child into the car seat. Almost all parents/caregivers answered either that it was very easy (74%) or somewhat easy (23%). The percentage who considered it very easy was about the same across type of seat.

Those respondents who said that it was only somewhat easy to buckle the child in, or not easy at all, were asked what was difficult about it. Most often they said it was difficult to buckle the belt (23%), adjust the straps (23%), or deal with an overly active child (19%). 

Nearly all parents/caregivers felt either very confident (88%) or fairly confident (11%) that their child was properly buckled into the car seat. Once again there was little difference across type of seat.

Almost one-in-five parents/caregivers (19%) reported that the child had gotten out of the car seat while riding with them. As expected, this occurred most often among older children who were riding in booster seats (34%).

Parents/caregivers of children who at least on occasion used car seats were asked if the child had ridden in a vehicle in the past 30 days where someone outside of the household was driving. Figure 49 restricts the analysis only to those parents/caregivers who lived with the child. More than two-out-of-five (44%) answered that this had occurred.

Figure 50 compares the frequency that the selected children were driven by persons outside the household to the frequency that the same children were driven by the responding parents/ caregivers (this analysis again was restricted to parents/caregivers who lived in the same household as the child). As expected, the children were transported on a far less regular basis by the non-household members, which is consistent with the findings in Chapter 2 (see page 23). For example, 59% of parents/caregivers said they drove the child 20 or more days in the past 30, whereas only 7% said the child was driven by a non-household member that number of days.

When asked the identity of the driver outside the household who transported the child in the past 30 days, the parents/caregivers most often answered that it was a grandparent (37%) or a parent/step-parent (37%). Fewer than half as many reported that it was a brother/sister (2%) or some “other relative”(16%). The relatively high percentage for parents/step-parents when looking from the vantage point of the child contrasts with the low percentage obtained from the vantage point of the outside driver (see page 24). At least part of the difference may reflect aspects of custody arrangements and related perceptions. The differing time frames specified in the two questions (past month versus past year) may also be playing a role.