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Status Report, Vol. 45, No. 9 | September 8, 2010 Subscribe

Need a booster? Question stumps many parents

"Is she still supposed to be in a booster?"

"Tell us about the booster."

"When do they switch?"

The child passenger safety questions arrived in a steady stream on a recent morning in Gaithersburg, Md. A moonbounce and a shiny red engine lured families to the fire department's exhibit, where a row of child safety seats caught the eye of many grown-ups. Before the kids could pet the ponies or board the Tilt-a-Whirl, they first had to buckle up for a fit test in a demo seat.

This display at the Montgomery County Agricultural Fair also features information on restraints for infants and toddlers, but most questions concern belt-positioning boosters for older kids. Boosters seem simple enough. The idea is to raise a child so that vehicle lap and shoulder belts fit properly. But confusion about booster use persists, and surveys show that many children are leaving boosters behind before they get big enough. Adult belts generally don't fit properly without a booster until a child is about 4'9" tall and weighs 80 pounds.

Despite increasing booster use, a 2008 survey by the National Highway Traffic Safety Administration found that 45 percent of children 4 to 7 years old weren't properly restrained in either a forward-facing child restraint or a booster. Though booster use may have increased since then, the survey is considered the most accurate measure because it determined restraint use by observation and obtained ages in interviews.

A January poll by the University of Michigan C.S. Mott Children's Hospital found much higher rates of booster use, though such a result is expected when parents self-report. More important is that the survey confirms a broader trend — the older the child, the less likely he or she is to be riding in a booster or child restraint. Nearly all parents of 4 and 5 year-olds reported using boosters, but use declined to 82 percent for 6 year-olds, 67 percent for 7 year-olds, and down to 40 percent for 8 year-olds.

Every state and the District of Columbia has a child restraint law, but these differ when it comes to booster-age children. In 27 states and DC, the laws cover children until the 8th birthday, with exceptions for kids who are big for their ages. Wyoming and Tennessee require boosters to age 9. The laws can be effective educational measures even when not well enforced.

"There's a portion of the population that just follows laws. If it's a law, it must be the right thing to do," says Kristy Arbogast, who studies child passenger safety at The Children's Hospital of Philadelphia.

Still, there's room for confusion when it comes to older kids. Experts are quick to point out that many 9 and 10 year-olds are small enough to benefit from boosters. Emilie Crown, who manages Montgomery County's car seat program, says no matter how old kids are, "we always talk about proper fit."

Karen Corkery knows Maryland's law allows her 8-year-old daughter, Riley, to use a belt without a booster. But when the family encountered the car seat display at the county fair, she had questions, saying that Riley's "sort of in that in-between stage. She just turned 8, and she's been resisting the booster for the last six months."

A fit test demonstrated that Riley is almost ready to leave the booster behind, but not quite. The belt fit her nicely, but her knees didn't bend at the seat as they should. "She'd probably be more comfortable in a booster," Crown offered. Riley shook her head and made a face.

Resistance from children is one factor that reduces booster use. Some parents are too quick to give in, believing the risk is minimal, safety advocates say. Karen Gay, who runs passenger safety programs for the District of Columbia, says parents often acquiesce to children who complain the seats are babyish. Gay tries to win over kids by having them sit in a car without a booster and asking them to look out the window. Then she has them do it again with a booster.

"They say, 'Oh, I can see!'"

Gay often spots children sitting on boosters but not buckled in.

Parents say " 'I told her to buckle it,' " Gay says. "They're relying on the kids."

It's up to adults to take back control in this area, Gay and other advocates say. A National Highway Traffic Safety Administration study, published earlier this year on getting more children ages 5 to 7 properly restrained, concludes that more vigorous and better publicized enforcement of laws, combined with education campaigns, is needed. The study is based on discussions with child safety advocates and focus groups with adults observed driving with unrestrained kids.

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