Booster seat use and reasons for nonuse

Background. Many children 4 to 9 years old are inappropriately restrained in vehicles and are at risk for injury in crashes. Objectives. This study was undertaken to determine the rate of booster seat use and the reasons for nonuse. Methods. Observations were conducted at a random sample of day care centers, and drivers of unrestrained children 4 to 8 years old were interviewed to determine the reasons for lack of booster seat use. Results. Observations were conducted on 149 children. Shoulder belt use significantly increased with the age of the child; 28.3% of 4-year-olds and 70.0% of 6- to 8-year-olds used lap-shoulder belts. Overall, 27.7% of children in the target age group used booster seats; only 10% of children 6 to 8 years old were restrained with booster seats. Booster seat use decreased when there were 3 or more passengers in the vehicle. The most common reason for lack of booster seat use was that parents thought the child was large enough to use the regular lap-shoulder belt system, or problems with attempting to use the seat in the vehicle. More than one half of parents who were not using booster seats at the time of the survey reported owning seats. Conclusion. This study indicates that parental misconceptions about size and safety of regular restraint equipment are the most common reason that children are not appropriately restrained in vehicles. This information can be used to guide community intervention programs.