ANN ARBOR, MI – Safe Kids Washtenaw County reminds parents and caregivers that children with special health care needs are subject to the same hazards as any other child when they are a passenger in a vehicle.

That's why Safe Kids and experts at the University of Michigan C.S. Mott Children's Hospital recommend that parents work in collaboration with their child's specialty health care provider and nationally certified child passenger safety technicians to select the best car seat or special restraint option for their child.

“Special needs aren't limited to chronic conditions, such as cerebral palsy and spina bifida,” says Lori Brinkey, physical therapist, Mott Hospital, and coordinator, Safe Kids Washtenaw County. “Any child could have temporary special needs. A child in a cast after a sports injury has special needs, and there are special restraints available for kids who are immobilized. Even behavioral disorders may need special consideration on the road.”

The most common situation that requires special consideration on the road is premature birth, notes Brinkey.

“Most infant seats aren't designed for babies under five pounds,” she says. “A premature baby needs to be placed in a car seat and evaluated by a medical professional before leaving the hospital. Some premature babies may need to be transported in special car beds instead of car seats until they are more fully developed.”

When a premature baby is cleared by his health care provider to ride in an infant car seat, a certified child passenger safety technician should work with the child's caregivers to adjust the harness straps in the infant seat and show them how to place rolled blankets or towels in the seat safely to limit movement.

Health care providers, safety equipment manufacturers and child passenger safety technicians have work together to identify the best child restraint systems for kids who cannot use standard car seats, booster seats or seat belts, which include:

• Car beds: Some children, on the advice of a physician, should travel lying down. Crash-tested car beds secure them to the vehicle seat with the child's head toward the middle of the car and his feet toward the side.
• Vests: Children over 2 years of age can ride in crash-tested vests that provide upper-body and crotch restraint similar to the harness of a forward-facing car seat. Most vests are designed for children who can sit upright, but vests are available for children who must ride lying down on a vehicle's seat. Not all restraint vests are tested to the same safety standards as car seats; only vests labeled to indicate that they meet the Federal Motor Vehicle Safety Standards should be used in place of car seats.
• Adaptive car seats: Specialized car seats are available to provide extra support according to a child's specific needs, identified by a physical therapist or specialty physician. Some larger seats can accommodate children who weigh 100 lbs. or more.
• Transit wheelchairs: Although it is preferred that children ride in an approved child safety seat, sometimes it is not practical to transfer them to a car seat. In those cases, it is highly recommended that families speak to their medical supplier and health care providers about obtaining wheelchairs that have been crash tested and meet certain transportation standards.

In addition, the Automotive Safety Program of the Indiana University School of Medicine has developed a supplementary course entitled “Safe Travel for All Children: Transporting Children with Special Health Care Needs.” For details, visit www.preventinjury.org.

Mott Hospital frequently hosts this course, in collaboration with health care providers and registered participants from the automotive and insurance industry, school programs and law enforcement agencies. It is primarily funded by a grant from the Office of Highway Safety and Planning.

Brinkey's advice to caregivers of children with special needs: “Make sure you're getting up-to-date information. Devices with new capabilities are being developed, tested and introduced all the time.”

Several larger adaptive seats suitable for small adults have been developed recently, and wheelchair manufacturers are working to increase the number of transit ready products.

To have your child evaluated for a special needs restraint, contact the Department of Physical Therapy Mott at (734) 763-2554, or have your child's physician fax a physical therapy referral for an adaptive car seat evaluation to them at (734) 936-9552.

Written by Lori Brinkey

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