Industry and the Federal Government Ignore Safety Needs of Older Children; a Disturbing Legacy for the “Forgotten Child”
NHTSA’s recent proposed rulemaking to improve the Ease-of-Use rating system was more notable for what it omitted. The agency said that it would not widen the scope of the program to include built-in child safety seats – which require no special knowledge to use and provide a much better fit for children who are too small for adult seat belts, but too large for most child safety seats. But the decision is consistent with a long history of failure among auto and policy makers to address the specific safety needs of these children, despite the knowledge that children’s developing bodies are substantially different from a mature physique and require appropriate restraints.
The automotive and safety community rightly dubs this population: “the Forgotten Child.” Generally, these children are between 4 and 8 years old, and weigh more than 50 pounds. This age group has been “forgotten” for nearly 40 years. Until very recently, children of this age group were absent from federal motor vehicle safety standards. Many child seat manufacturers did not make products geared for older, heavier children not yet large enough to fit an adult seat belt properly. The legacy of this indifference is that children of this age group are frequently graduated prematurely to seat belts, leaving them vulnerable to serious injuries and death – even in low-speed crashes from which more appropriately restrained occupants emerge unharmed.
Booster seats have been available in the U.S. since1979. But today, boosters are still widely underused by parents and caregivers of the children who might benefit from them the most – 4-8 year-olds. Recent statistics estimate that only 20-38 percent of children who are between child safety seats and adult seat belts are riding in boosters. Why? For one, the message to parents about which children should ride in booster seats has been incoherent and inconsistent. Secondly, despite various campaigns by the National Highway Traffic Safety Administration and vehicle manufacturers, neither has actually done much to effect booster seat use.
NHTSA was slow to require manufacturers to install rear-seat three-point belts – without which boosters are useless. The agency still does not require dynamic testing of boosters designed for older, heavier children. And from the earliest efforts to establish a child safety seat standard, the agency has largely given automakers a pass – there are no regulations to require vehicle manufacturers to build child safety into their designs.
Manufacturers have been remiss in building rear-seat safety into their vehicles in the U.S. Until regulations required them to do so, lap-only belts were installed in the rear seats of most vehicles. Many vehicles still on the road today have lap-only belts in the middle rear-seat position – the position recommended as the safest for children. Some automakers’ own testing has shown the efficacy of integrated child seats over after-market restraints, but few have actually installed them. Instead, major manufacturers such as Ford and GM have spent millions promoting the use of aftermarket boosters, after initially offering their own branded child safety seats that were specifically designed to fit their vehicles. This contrasts to their approach in Europe and Australia, where regulations are more stringent. As far as back as 1978, Volvo, for example offered belt-positioning boosters.
The results of this inaction are found in the motor vehicle fatality rates for the Forgotten Child. While motor vehicle deaths among other age groups have decreased, According to NHTSA estimates that between 1982 and 1998, there was a 23% increase in motor vehicle deaths among 5- to 9-year-olds. The occupant fatality rate per 100,000 population for children between the ages of 0 to 4 has decreased significantly over the past couple decades, from 4.68 in 1977 to 2.84 in 2000. The fatality rate for children between the ages of 5 and 9 has stayed roughly the same in the past 25 years, and in 2000 was actually higher than it was in 1982.
Rulemaking and the Forgotten Child
The regulatory history is, in many ways, key to understanding the disconnect between true automotive safety for the Forgotten Child and what is offered to parents – in both advice and equipment. NHTSA knew, long before it established any pertinent regulations, that the rear center seat was the safest location for children; that older children were unprotected; and that three-point belts offered better occupant protection than lap belts. Nonetheless, it promulgated rules that were later shown by testing to be wholly inadequate or did not support the use of the child seat products in the marketplace. Progress was slow because neither the agency nor the private sector developed dummies representing older children that could be used in compliance tests. But most significant problem was that the agency needed to align four different standards in order for all children to be properly secured. All of these failures had a direct impact on the design and sales of child safety seats.
Since child restraints are used in conjunction with seat belts and tethers, the history of child seat regulations is closely tied to the history of seat belts and seat belt anchorages. From the 1970s through the mid-1980s, the design of seat belts was in flux. In the 1970s, the agency pushed hard for the installation of passive restraints, (i.e. airbags and automatic seat belts), to improve occupant protection in the face of poor seat belt usage rates. During this period, much of NHTSA’s attention was focused on airbags. Improving seat belt usage by improving the comfort, fit and accessibility of seat belts was given short shrift.
The agency established specific child restraint standards nearly 40 years ago. For the first half of that history, older, heavier children were not included in the rulemakings. In March 1970, the National Highway Safety Bureau (NHTSA’s precursor) established FMVSS 213 Child Seating Systems. The early versions of the standard were limited to seats for children weighing no more than 50 pounds. In 1974, Australia’s Motor Transport Department actually criticized one of NHTSA’s proposals for its failure to protect older children and sent the agency a copy of its report “Crash Protection for the Sub-Teen Child,” the results of simulated car crashes designed to evaluate the child restraints on the Australian market specifically for children described as old enough to sit up unaided but too small for adult belts.
Other agency decisions during this period would actually discourage the use of boosters. The first boosters on the market used a lap belt and a tether that restrained the upper portion of the child’s body. But the tether usage rate was very low – mainly because automakers didn’t provide – nor were they required to provide – anchorages to secure the tethers. But, instead of attacking the problem as one of vehicle design, NHTSA first approached it as a usage issue. In 1978, NHTSA mandated that Child Safety Seats requiring a lap belt and a tether would be tested without the top tether at 20 mph, and with the tether at 30 mph. The agency reasoned that a 20-mile-an-hour test without the tether would assure children a minimum level of protection.
In 1980, the agency finally attempted to shore up tether use by proposing to amend FMVSS 210 to require manufacturers to either provide pre-drilled holes for tether anchorages or to require manufacturers to install tether anchorages as standard equipment in all rearmost seating positions. This rulemaking was the agency’s first official recognition of the plight of older children: “For some time, the NHTSA has been concerned that children in the age group 5-12 years are being transported essentially unprotected in automobiles. These children are too big to fit into child restraints and may be too short to use shoulder belts designed for adults.”
Nonetheless, the agency followed up with two actions that killed the most effective booster seat design of that era. In 1985, it terminated the tether anchorage rulemaking, because about half of all manufacturers had started to voluntarily install tether anchorages and because, save for booster seats, “there had been a shift in the marketplace away from tethered restraints.” In 1986, NHTSA amended FMVSS 213 to require child seats with tethers to be tested at 30 mph without the tether attached. None of the boosters on the market could pass the compliance test under that condition.
In the 1990s, protection for older children would take a leap forward. First, automakers were finally required to install three-point belts in rear outboard seats effective in 1990. The regulation was instigated by Congress, which, in a series of hearings in the mid-to-late 1980s excoriated NHTSA for failing to promulgate such a rule and the industry for providing rear three-point belts in overseas models.
Second, Congress included a provision in the 1991 Intermodal Surface Transportation Efficiency Act (ISTEA) directing NHTSA to initiate a rulemaking on child booster seat safety. Congressional interest in booster seat safety arose from a May 1988 NHTSA-commissioned study performed by Calspan on the effectiveness of shield boosters for older children. Shield boosters rose in popularity after NHTSA drove the tethered booster design out of the marketplace. Shield boosters were backless, affixed to the vehicle by the lap belt across a plastic shield that went over the child’s mid-section. Evaluation of the Performance of Child Restraint Systems subjected all types of boosters on the market to 30-mph sled tests using nine-month-old, three-year-old and six-year-old dummies and measured the crash forces on the dummies’ abdomens. The study also looked at head injury criterion and head excursions. The results showed that many of the boosters failed miserably-especially with the six-year-old dummy.
As a result, NHTSA mandated new compliance test procedures. Belt-positioning booster seats would be dynamically tested when restrained to the test apparatus with a lap/shoulder belt rather than a lap belt only. The Final Rule also added three new dummies: a newborn infant, a nine-month-old and a six-year-old. In 1999, the agency also established FMVSS 225 Child Restraint Anchorages, which added requirements for child restraint anchorage systems to ensure their proper location and strength for the effective securing of child restraints. This ushered in the era of LATCH: Lower Anchors and Tethers for Children, a universal anchorage system. By this time, however, the tether was irrelevant to boosters because the newer booster designs were the belt-positioning type and were used in conjunction with shoulder/lap belts.
In this decade, Congress has continued to direct NHTSA to better regulate boosters. The Transportation Recall Enhancement Accountability and Documentation (TREAD) Act of 2000 required the agency to initiate a rulemaking to improve the safety of child restraints, including minimizing head injuries from side impact collisions. It also directed the agency to initiate a child seat safety rating program that would give consumers easily understood information on the efficacy of child seats on the market. In 2002, Public Law 107-318, popularly known as “Anton’s Law,” required that NHTSA mandate lap/shoulder belts for all rear designated seating positions and to expand the weight ranges for children in booster seat to 85 lbs. The law also designated that a phase-in for center rear lap/shoulder belts begin no later than 12 months after the regulation was prescribed.
In 2003, the agency revised FMVSS 213 to expand its applicability to child restraint systems recommended for use by children weighing up to 65 pounds. And in December 8, 2004, NHTSA issued a Final Rule requiring three-point belts in all rear seating positions (other than side-facing seats).
Since then, NHTSA has proposed expanding booster seat safety standards to those children weighing 80 lbs. and increasing the weight limit, federalizing and testing with HIII 10 year-old dummy, but many gaps remain in securing occupant protection for the Forgotten Child. The immediate work undone: NHTSA has yet to issue a final rule to extend the dynamic testing requirements to cover child restraints recommended for up to 80 pounds. Nor has the agency developed the dynamic performance rating system for child safety seats or a plan to address the safety of child seats in side impacts. A larger concern is the lack of any significant requirements for rear-seat occupant protection. There are nominal standards for seat belts and seats, but there is no requirement to crash-test dummies of any size in the rear seat.
U.S. Automakers and The Forgotten Child
Despite marketing their products to families – users of various sizes and physical development requiring effective crash protection systems – automakers have largely ignored safety for older child occupants. After a few stabs at offering integrated boosters and an earlier effort to carry their own line of child safety seats, automakers have left boosters to the aftermarket. A recent recommendation by Ford Motor Company on its Boost America website illustrates to what degree vehicle manufacturers have disconnected themselves from protecting the Forgotten Child: “Never use a booster seat with a lap belt only unless permitted by the booster seat manufacturer.” (Automakers know from their own research that using a lap belt only with a booster seat is unsafe and can leave a child vulnerable to serious head, neck and spinal injuries in a crash.)
U.S. automakers do not work with aftermarket child seat manufacturers to develop a range of child safety seats that work specifically with their vehicles. They do not routinely test aftermarket child safety seats in their vehicles, nor do they advise parents on what aftermarket products fit the geometry of their seats. Parents are left to figure it out on their own. And as former NTSB Chairman Jim Hall pointed out in a 1999 speech, it isn’t easy:
“For model year 1999, there are more than 200 different cars and light trucks on sale in the US. In addition, there are about 68 different models of child car seats on the market today. This results in nearly 14,000 potential combinations of cars and car seats, each with their own unique compatibility issues. That’s just for this year.”
Throughout the regulatory history, automakers have mounted a series of excuses for failing to take the lead role in designing automobiles that are safe for children. Even in the early years, when major automakers actually marketed their own brand of child safety seats, they complained that the regulations were too complex, stringent and would be unacceptable to the public:
U.S. automakers began to offer branded child safety seats as early as 1965. Both GM and Ford sold child safety seats in the late 1960s – the Ford Tot Guard and the GM Love Seat. Chrysler offered the Chrysler Safety Infant Carrier for infants weighing up to 20 pounds and the Chrysler Child Safety Seat for children weighing between 20 and 50 pounds. Automakers continued to offer their own branded child seats to U.S. customers at least through to the mid-1980s. Ford finally discontinued the Tot Guard in the early 1990s.
As the purveyors of seats, designed for infants and children up to about age five, these automakers were heavily involved in the development of their products, as they explained to NHTSA in various rulemakings.
Despite that, automakers products did not fair well in other crash tests. The early versions of the Love Seat and the Tot Guard would not have passed the first proposed compliance tests, according to GM and Ford. The Australian Department of Motor Transport crash-tested the GM Love Seat as part of its crash-test research into the efficacy of child safety seats for children over the age of five, called “sub-teens,” and found that it would not make the agency’s list of approved seats. The Tot Guard performed so poorly when Ford crash tested it for use in the 1992 Aerostar, its engineers recommended against its use in that vehicle. Ford put language in the 1992 and 1993 Aerostar owner’s manual advising against using low shield booster or a Tot Guard in that vehicle.
While automakers had ignored the needs of older child occupants in their vehicle designs, they were well aware of their presence in the rear seat and of the incompatibility between adult three-point belts and older children. In 1987, when NHTSA began a rulemaking to require shoulder/lap belts, Ford and Honda argued for revisions based on the presence of children in the rear seat. And, an examination of the child restraint language in the owner’s manuals of the early 1990s indicate that many manufacturers were well aware of the belt-fit issues for children who had outgrown child safety seats – but did nothing in their designs to address this safety gap. Their solution was, most often, to place children in the center rear lap belt.
After surrendering the child safety seat business entirely to the juvenile products manufacturers, some automakers turned to the possibility of installing integrated child safety seats. In Europe, automakers such as Saab and Volvo had been offering them to consumers since, but this development wouldn’t reach U.S. consumers until the early 1990s. In the U.S., integrated child seats with booster cushions were first introduced in family vehicles such as the 1990 Volvo 900 series; the 1992 Dodge Caravan; the 1994 Saab 900; and the 1997 Dodge Cirrus.
Automaker’s principal communications with consumers on child restraints have been confined to owner’s manuals. Here, the advice for children weighing more than 50 pounds has ranged from contradictory to so-general-as-to-be-useless, to dangerous, to non-existent. For example, the 1987 Jeep Cherokee owner’s manual has no instructions regarding children who have outgrown child safety seats. The 1994 Mitsubishi Montero suggests that parents put children who have outgrown “child restraints” to wear a lap/shoulder belt in a rear seating position. It makes no mention of boosters. In the early and mid 1990s, many advised consumers to put children who had outgrown safety seats in an adult belt, provided the belts fit properly which was defined loosely by how the lap and shoulder belt fell across the child’s body – or seat them in the lap belt in the middle. Some went so far as to warn consumers about lap belt injuries to children.
In 1999, Chrysler informed owners of the Dodge Stratus that a booster seat was for children weighing more than 40 pounds and mentioned the shield variety fastened to the seat by a lap belt – more than a decade after the Calspan tests showed that shield boosters performed poorly in dynamic sled tests. It offered no other instructions regarding the restraint of the Forgotten Child.
Often, the automaker put the onus on the correct fit of any child restraint on the child or the vehicle seat on the parent and the aftermarket manufacturer or, in one case, a doctor. The 2000 Ford Focus Owner’s manual recommended that parents trying to find a booster seat for an older child “may wish to discuss the special needs of your child with your pediatrician.”
Recent inquiries to four automakers – Ford, Chrysler, GM and Honda – about what child seats appropriate for a six-year-old might best fit the back-seat geometry of a 2001 sedan-type vehicle elicited no useful information, and in one case, misinformation. Not one customer service phone representative had any information at the ready. All had to check their resources and none offered any answers. A Ford customer service representative, for example, suggested to check the owner’s manual, but then added that she doubted that the information would be there. She then said that “car seats were pretty much standard” and would fit any vehicle and then suggested trying different seats in the vehicle. “I would think that you would find it on the (child seat) box.” The Honda representative said that Honda did not offer any advice “because of the many variations” in child safety seat designs. Chrysler and GM customer representatives suggested the customer call the dealership. “The dealership really knows the vehicle best,” the GM representative said. (Better than the company that designed and manufactured the vehicle?)
In other developed nations, older children are not an after thought. The transportation agencies of both Australia/New Zealand and the EC have tougher standards for child occupant protection, began research efforts into crash protection and promulgated rules pertaining to the children who fall in the gap between child safety seats and adult seat belts much earlier.
In 1974, Australia was actively researching crash protection for children too big for child safety seats and too small for adult belts and commented to the NHTSA docket establishing FMVSS 213 that the agency had failed to consider children between 50 and 80 pounds, called “sub-teens.” In 1976, Australia required pre-punched holes for upper tether anchorages. In Australia, child safety seats were also tested in rear, lateral and frontal collisions in sled tests. Further, its department of motor transport defined a new child booster seat that used a lap and shoulder belt and would be suitable for children weighing more than 80 pounds (38 kg). Canada proposed a simple booster cushion standard in 1982, requiring that it work with the adult seat belt and not deflect more than 1 inch under a vertical load of 500 pounds. As far back as 1981, the ECE standards covered booster seats capable of restraining children of up to 80 pounds.
These standards first appeared decades before American regulations, in part, because three-point seat belts were required in rear seats much earlier, making belt-positioning boosters possible. Some countries, such as Sweden and Australia have required three-point belts in rear seating positions since the early 1970s. As a result, belt-positioning boosters entered those markets in 1978. In addition, as part of their New Car Assessment Program, Europe and Australia crash test child restraints with instrumented dummies in the rear seat of the vehicle in a frontal and side impact tests.
The more proactive regulatory environment overseas has forced automakers in those markets to offer child safety products specific to their vehicles, to accommodate the needs of children 5-8 years old or to provide more specific information to consumers about restraints for older children.
For parents, the sum of this history has been misuse and confusion over how to restrain older children. In February last year, U.S. Secretary of Transportation characterized the latest booster seat use statistics – fewer than one in five children, ages 4-8, is riding in a booster seat – as a sign of “failure” and must be addressed immediately. This has been the case, borne out by a series of studies carried out by the government and others over the last 15 years.
In 2004, NHTSA released data showing that only one in five young children were riding in booster seats. In that same year, Partners for Child Passenger Safety issued a report on “The Forgotten Child,” which noted that despite affordable options, approximately 62 percent of children ages 4 to 8 in the United States remained restrained in only adult seat belts, putting them at unnecessary risk of injury and death. In 2005, the Journal of the Society of Professional Nurses published a paper noting that motor vehicle crashes continued to be the leading cause of death in children ages 5-9 and that many of the injuries suffered by crash victims in this age group were caused because the children were restrained improperly.