CAR SEATS FOR CHILDREN WITH SPECIAL NEEDS — TRANSPORTING OLDER CHILDREN

Some children still need the support of a child restraint even after they have outgrown a standard car safety seat. This might include children with cerebral palsy; decreased head, neck and trunk control; skeletal disorders; and various nerve and muscle disorders. There are forward-facing medical seats that fit children who weigh up to 105 pounds. These seats come with extra pads and devices to help position the child in the seat. Work with an occupational or physical therapist to position your child in these types of seats. These child restraints also come with an extra strap called a tether. The tether, along with the vehicle seat belt, must be used to install the restraint correctly.

Children and Upright Vests

If your older child does not need the added support and positioning features of a medical seat but has difficulty sitting still in a vehicle or gets out of his seat belt, an upright vest may be used. It is installed in the car with the vehicle seat belt and a tether. In some cases, a vest can be used on a school bus. Check with your pediatrician and your school transportation director for current information.

Older Children and Belt-Positioning Booster Seats

If your child is able to sit up without help and is too large for a standard car safety seat with a harness or a forward-facing seat/restraint, he should use a belt-positioning booster seat until he is large enough to use a seat belt. Belt positioning booster seats raise a child up so that the lap and shoulder belts fit properly. This helps protect the upper body and head. These seats must be used with a lap/shoulder belt.

Older Children and Seat Belts

Typically, a child is ready to use a seat belt when all three of the following conditions occur:

· The child is tall enough so that when she sits against the vehicle seat back her legs bend at the knee and her feet hang down.

· The shoulder belt lies across the chest, not the neck or throat.

· The lap belt lies low and snug across the thighs, not the stomach.

Children usually do not fit seat belts until they are between 8 to 12 years of age and are about 4 feet 9 inches tall. When your child is ready to wear a seat belt, make sure it fits properly. Shoulder belts should be worn across the chest. Never place a shoulder belt behind a child's back or under a child's arms. This could cause injury to the child.

When a Child Goes to School

When a child with special needs is ready to enter school, federal laws ensure her right to have equal services, including transportation. Any special transportation needs should be noted in the child's Individual Education Plan. The child's parents or caregivers, school representatives, and medical or rehabilitation personnel develop this plan.

Adapted Vehicles

In some instances, families need an adapted vehicle to meet the transportation needs of their children. In general, families should work with a qualified rehabilitation specialist to decide the changes needed to protect everyone in the vehicle. For names of qualified driver rehabilitation specialists, contact a local rehabilitation center or the Association for Driver Rehabilitation Specialists at 1-800-290-2344 or www.driver-ed.org. When choosing a vehicle, families should work with a reputable dealer of adaptive vehicles. Adapting Motor Vehicles for People With Disabilities is a brochure published by the NHTSA to help families learn more about adapting vehicles.