Buckle Up KC Special Needs Child Passenger Safety

Special Needs
Child-Passenger Safety

All children deserve to be protected in motor vehicles in restraint systems appropriate for their size and development. However, some children who have certain medical conditions require special consideration when selecting restraints.

Regardless of whether or not a child's medical condition presents short-term or long-term challenges, a child should travel in a restraint system that provides optimum protection. Often, a conventional child-safety seat will meet the safety and positioning needs of a child with special health care needs. Other times, an adaptive or specialized restraint will be necessary.

Premature and Small Babies:

Premature and small babies weighing less than 5 pounds may require special positioning aids in order to ride securely and safely in the car seat. Premature infants are those less than 37 weeks gestational age of birth. According to American Academy of Pediatrics (AAP), small and premature infants should have a child-safety seat that will safely restrain them and fit their smaller size. If an infant has difficulty sitting upright in a car seat, then a car bed could be the best option for the baby.

Dorel Dreamride Car Bed
Weight limit: 5-20 pounds
Height limit: 19-26 inches

AngelGuard car bed
AngelGuard Car Bed
Weight limit: Birth to nine pounds
Height limit: Up to 21.5 inches

Hope Car Bed
Hope Car Bed by Merritt Manufacturing
Weight limit: 35 pounds
Height limit: Up to 29 inches, longer if legs can bend

Behavioral Conditions:

Frequently, children with autism have behavioral conditions that do not allow them to be restrained safely. The children are able to get out of their child restraint or unbuckle their seat belt. There are several solutions that can fix this according to www.preventinjury.org. Purchase information for vests can be found at www.ezonpro.com.

  • Use EZON vest with a vehicle floor-mount tether. Special hardware will be required to be placed in the vehicle when using this option.
  • If possible, have a passenger sit next to them in the back seat of the car.
  • If the child gets out of booster seat or seat belt then look at car seats that have higher maximum weight limits so the child is still restrained in a harness.


Orthopedic Conditions:

Casts immobilize the body and can sometimes make it difficult to properly restrain a child in a safety seat. It may be necessary to support the casted extremity with blankets, foam or pillows. Many times casts will not allow a child to fit in their regular child-safety seat.

Britax Hippo Car Seat
Britax Hippo Child Restraint
RF weight limit: 35 pounds
FF weight limit: 65 pounds

For patients with hip spica casts who cannot fit into their regular child-safety seat, the Hippo car seat is an appropriate restraint. Some institutions may provide a loaner child-safety restraint. Once the cast is removed, Hippo should be returned to facility and infant/child should use their regular child-safety restraint.

Modified E-Z-On vest
Modified E-Z-On vest
XS: 20-65 pounds
SM: 20-100 pounds

For patients with casts or medical conditions requiring a child to lie down in the vehicle, the modified E-Z-On vest is an appropriate restraint. This vest and many more vest restraint options are available at www.ezonpro.com.

Broomstick Cast- Since the broomstick cast makes the legs so wide spread it can be difficult to fit a child in a standard convertible safety seat, many times a safety seat with low sides works well and can be used for this type of cast.

Long Leg Cast- Often the long-leg casts are very thick and can interfere with the buckling device of a shield harness. Instead, consider using a child-safety seat with a five-point harness.

If there is no way to safely restrain a child in the family vehicle, non-urgent medical transport should be considered. Please consult your healthcare provider for more information.

Wheelchair Guidelines for Safe Transportation:

Wheelchairs are not designed for transportation purposes and if possible, occupants should use an appropriate child restraint. If transferring the child out of the wheelchair is not possible, use a wheelchair with transit option:

  • That performs well in a crash test
  • That has an optional lap belt
  • For which there are clearly marked points on the frame for attachment of tie downs
  • That complies with ANSI/RESNA WC/19

There are many advantages to transit chairs:

  • The provide increased protection for riders
  • They are easy to use
  • The provide improved stability during normal driving
  • They are more compatible with seat belts

If it is not possible to use a transit chair then:

  • Use a wheelchair with an accessible metal frame
  • Attach tie down straps at the frame junctions
  • NEVER attach the tie downs to moveable parts

Buckle Up Clinic for Children with Special Needs-
Parents and caregivers may call for an appointment: (816) 234-1607

Copyright © 2018 The Children’s Mercy Hospital