Behavioral Needs

Children who may be prone to unbuckle, loosen or re-position their restraints may require a special vest or harness to keep them secure. Parents should not modify the clips and straps on a child’s seat, but rather, try out seats that have different kinds of clips that are more difficult for a child to unbuckle. In these cases, there are safeguards to accommodate these behaviors and keep children safe.

In addition to finding the right restraints, it can be helpful to introduce soothing techniques to relax children while they are in their seats. Some adaptive boosters come with internal speakers to hook into an mp3 player, which can be calming for children with autism and other sensory or behavioral disorders. Many parents also have success using iPads or other tablets to calm and distract their children with games designed specifically for children with special needs.

Autism
Children with autism may face challenges with hyperactivity. Proper restraint is key, because these children often don’t know the danger of roaming around the vehicle. Parents should consider car seats with chest clips that the child can’t push down, as well as models with additional guards to prevent the child from unfastening their straps. There are also upright vests from EZ-ON that zip up the back that may also be used for this purpose.

Restraints can also mean challenges for children with autism who have sensory issues. Some children prefer a tight fit to the lighter touch of straps. A close-fitting vest called a Churchill, which is used with a lap and shoulder belt, is available for older children with sensory issues.

If transporting your child presents its challenges, plan to discuss this with your child’s physician and/or therapist. You may also wish to seek the assistance of a child passenger safety technician who is trained to assist with patients with special health care needs. Contact your local hospital to find a technician near you with this training.

Physical Needs

Children with special needs that are physical in nature may need modifications that cannot be made to standard car seats and safety practices.

Different sizes
Children who are smaller or larger than their peers may also require special accommodations. Small children should remain in a rear- or forward-facing car seat with a five-point harness until they have outgrown the height and weight limits of the seat. Large children may require seats with higher height and weight limits. Many car seats have harnesses that can now be used up to 65 pounds; therefore, look for weight limits that are closer to 80 or 90 pounds if this describes your child’s needs.

Injuries requiring large casts
Children in hip and leg casts may not fit comfortably or safely in a conventional car seat. Depending on their size, they will need to be transported using a car bed, a specialized medical seat, or a modified vest. Ask the doctor when having the cast fitted.

Motor challenges
Many children with motor control challenges need a restraint that helps them sit up straight or stay in place. Large, specialized seats provide extra support to children who have outgrown a forward-facing car seat, but may be unable to use a booster seat.

Cerebral palsy
Children with cerebral palsy who have some trouble controlling their head and upper body often need special solutions. Because forward-facing seats are upright and less supportive of the head, children should stay rear facing in traditional car seats for as long as possible based on manufacturer’s requirements. Once they have outgrown their rear-facing seat, it’s important to find a large car seat or medical seat that will support their entire trunk and can still be reclined while forward facing. In this position, they are able to lean their head back and maintain a clear airway.

Spina bifida
Children with spina bifida are at much higher risk of having hydrocephalus, which means fluid accumulates in the brain. For this reason, many children with spina bifida have larger than average heads, making it more difficult and more important to keep their head supported at an appropriate angle. As an alternative to a traditional car seat, small children may use a car bed, which allows them to lie flat.

If you have questions about transporting your child, plan to discuss this with your child’s physician and/or therapist. You may also wish to seek the assistance of a child passenger safety technician who is trained to assist with patients with special health care needs. Contact your local hospital to find a technician near you with this training.

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