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TRANSCRIPT
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Housekeeping Details Please put your phones on MUTE in order to minimize background noise, as the presentation is being recorded so that we can archive the slides & audio on our website.
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Happy Children in Safe Seats: Not As Easy As It Sounds
Webinar: July 17, 2013
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Happy Children in Safe Seats… Not as Easy as it Sounds
Considerations every safety advocate needs to know to solve car seat challenges
Caroline Langrall, CCLS, CPST
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ObjectivesObjectives
Identify key phases of a child's psychosocial and cognitive development that may create challenges regarding safe travel in the car.
Identify developmentally appropriate strategies to encourage and enable caregivers to use car seats properly.
Explore ways to address the transport of children with special needs and developmental delays.
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What are the challenges?What are the challenges?CryingTantrumsRefusalUnbuckling
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Challenging behaviors… Challenging behaviors… leading to leading to dangerousdangerous “solutions”“solutions”Excessive
crying/screaming?◦Loosen straps◦Front seat◦No seat use
Escaping◦Altering seat◦Compromising
Vomiting/Motion sickness◦Early forward facing
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First Step: Check the use…
◦ Age/size appropriate?
◦ Straps snug and routed right?
◦ Buckles functional?
◦ Installation correct?
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Infant development & Infant development & interventionsinterventions
Bonding, attachment, trust.Sensorimotor & object
permanence.◦Blanket with familiar smell◦Adult in back seat◦Rock/sway the seat◦Pacifier◦Soothing music◦Convertible for older infant?
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Infant development & Infant development & interventions, continued…interventions, continued…Physiological Immaturity
◦Allow an hour for digestion◦Different seat with a different angle◦Overheated◦Swaddle/boundaries
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Toddler development (1-3)Toddler development (1-3)Autonomy EgocentricLack of reasoningSeparation AnxietyImproving dexterity
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Toddler challengesToddler challengesUnbuckling/escaping
378 caregivers: 50% reported child unbuckled self. Majority = boys < 3 (Yale University,
2011)
Tantrum/screaming◦Driver distraction
http://www.parenting.com/blogs/show-and-tell/melanie-parentingcom/new-car-seat-safety-study-toddlers-can-unbuckle-seatbelts
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Improper harness use injury Improper harness use injury patternspatterns
http://www.youtube.com/watch?NR=1&feature=endscreen&v=akGpsPyhDdk
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Interventions for toddlersInterventions for toddlersConsistent, simple messages from all
cg’sReinforce good behavior frequently. Ignore ‘bad’ behaviorCalm voice, empathy, don’t get angry.Pull over and wait…or time-outOffer choicesKeep hands busy: Cheerios, cling
stickers.Special rotating bag of soft ‘car toys’Divert attentionMusicCoat tricks
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Preschooler development Preschooler development (3-6)(3-6)InitiativeWant to please othersLiteral interpretationsLack abstract thoughtDramatic play and magical
thinking
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Interventions for Interventions for PreschoolersPreschoolers
“Write” a story togetherBe clear and consistent
with expectationsDramatic playGive a “job” or “role”Sticker chart for
behaviorChoose car seat or
decorate.Seek & find booksGame for long car rides
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School age development School age development (6-12)(6-12)Spelling and languageDevelopment of scientific methodMoral development: good vs. badUse feedback to judge their
competencyAcceptance by peer group
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Interventions for School Interventions for School Age Age Be clear with rules
Run an ‘experiment’Praise for good behaviorEmpathize Low back booster…
choices
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Without booster With booster
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Adolescent development Adolescent development Abstract/higher-level thinkingCritical thinking emergenceIndependenceInfluence of peersRisk taking behaviors
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Adolescent challenges Adolescent challenges MVC’s = 40% of deaths
◦Age 16-24 = lowest seatbelt use (CDC, 2006)
Driving under the influence Reckless or careless drivingTexting while driving
◦>50% of teens >16 yrs admitted to TWD
◦Less likely to wear seatbelt,◦More likely to drive while intoxicated
or with someone who is intoxicated (Balin
et al., 2013)Bailin, A., Adesman, A., & Sunday, S. R. (2013). 134. Texting While Driving Among High School Students in the United States: Analysis of 2011 Data From the National Youth Risk Behavior Survey (YRBS). Journal Of Adolescent Health, 52(s1), S85-6
National Center for Injury Prevention and Control (CDC). Web-based injury statistics query and reporting system (WISQARS). http://www.cdc.gov/ncipc/wisqars/: 2006
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Adolescent interventionsAdolescent interventionsMakes rules and consequences
clearFollow-through on consequencesProvide choices when possibleDemonstrate expected behaviorReward
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Dealing with motion Dealing with motion sicknesssicknessNo reading, video gamesMiddle seat I Spy games to look outsideOpen window Ice pack to back of neckCool washclothSaltine crackers or ginger snapsPeppermint/ginger
aromatherapy (Lua,& Zakaria, 2012)
“Sea bands”/acupressure (Hunt, 2011)
BreathingFrequent stopsTravel at night/naps
Hunt, K., & Ernst, E. (2011). The evidence-base for complementary medicine in children: a critical overview of systematic reviews. Archives Of Disease In Childhood, 96(8), 769-776.
Lua, P., & Zakaria, N. (2012). A Brief Review of Current Scientific Evidence Involving Aromatherapy Use for Nausea and Vomiting . Journal Of Alternative & Complementary Medicine, 18(6).
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Special NeedsSpecial NeedsPDD/Autism spectrum/Cognitive
delay◦Seat options decrease with age/size◦Difficulty with reasoning◦Need for routine & difficulty with
change◦Sensory processing challengesBe kind; for everyone you meet is
fighting a hard battle. –John Watson
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Interventions for Children Interventions for Children with Special Needswith Special Needs
◦Anticipatory guidance to prepare for seat change
◦Consider other seats.
◦Refer to http://www.preventinjury.org or search Safe Kids website for a CPST trained in Special needs.
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Special needsSpecial needsEZ-On floor mounted vest and
tether◦Vehicle modification◦Seat bight
http://www.ezonpro.com/
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Special needsSpecial needs
http://eztether.com/index.php/product-info/roosevelt
Roosevelt by Merritt Manufacturing◦35-115 lbs & 33.5-62”◦Harness cover & EZ Buckle guard
NOT for use with other seats
◦Not compatible in all vehicles
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Thank you for your Thank you for your attention!attention!
ANY QUESTIONS?ANY QUESTIONS?
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Thank you for participating today!
Final Instructions:Evaluation form is available on our website:
http://www.miemss.org/EMSCwww/CPSHome.htm; alternatively, we can email it to call participants.
Return your completed evaluation along with the contact info page.
The full presentation with audio will be available on our website in a couple of weeks, in case you wish to re-visit it, or refer a colleague to it.