Video Transcript - Dr. Snowdon's research project
[ Press Release 2011-26 ]Dr. Anne Snowdon, PhD University of Western Ontario
Professor, Odette School of Business
What is the subject of your research?
The subject of my research is keeping children safe in vehicles on Canada's roadways. Road crashes are the leading cause of death of Canadian children and they have been for a number of years. We have made very little gains in this area of public health and safety. So the focus of my research is: Why is that? How do we get families to keep their children safe and not loose so many children in these families every year?
How do you perform your research?
We realised fairly early in this program of research that we would have to observe parents in a naturalistic setting like the side of a road to really and fully understand how are kids traveling in vehicles in safety seats or booster seats or nothing at all. So we first had these students on intersections across Canada. Students would see a car with a child in that car and record how they were seated and they would estimate the approximate age of the child and then we knew exactly what age groups are sitting in what kind of seat, in what types of vehicles and how are the parents seated as well, are they using the seat bell or not.
We also interviewed many of these families, as they droved into the nearest parking lot to the intersection where we were observing. So we gain a lot of insight from not just observing, as people went trough the intersections how children were being seated, but then stopping and asking and talking to families about the kinds of information they were looking for, the kind of things they knew or didn't know and how they were making those decision.
Why are safety seats important?
Safety seats generally are very important because they position the child so that the safety features in any vehicle can do their job. In the case of a booster seat, they lift children up and forward so that the lap belt comes right across the top of the thigh, rather then ridding up over the children's abdomen. The reason that is so important is that the lap belt needs to be anchored at the child's hips because that's the strongest part of a child's body and it can withstand impact better than any other part of the child's frame. So booster seats are simply a positioning device that allow that seat belt to do its job very well without hurting children. So one of the very serious injuries we see in children without booster seats is that lap belt cuts straight across the abdomen and severs his spinal cord. You can't repair that injury. The other problem is if children are sitting in a seat belt and put that shoulder strap behind their shoulder what happen is, in a minor crash, is they fly forward, hit their head and their neck snaps back so you have a life threatening if not life ending head injury or neck injury. So the booster seats simply position children so the seat belt does its job in preventing the severity of the injury and preventing injuries where children are killed.
And that's the real critical importance of the booster seat.
What are barriers to booster seat use?
Early findings are crystal clear. Parents are highly motivated to do everything they can to keep their children safe. The most critical issue for them is they simply do not know how. That's very significant in school-aged children. So what we found is parents of school- aged children have an over reliance on seat belts. And that's where the focus of our research needed to drill down and help families understand just how important it is for school-aged children to be in booster seats and to be sure they're in them long enough. So, that parents will often use booster seats for a short time and usually when the children are very young. But as children get a little bit older, age five, age six, little heavier but not heavy enough, not tall enough for a seat belt, then they were assuming a seat belt was safe enough and that's really one of the hallmark findings of the entire program of research.
The second barrier is children. As children reach school age, they are much more influential in pushing back and saying "I am not sitting in a booster seat. I don't like it, it's uncomfortable". So a parent who is not aware of the risk and is not knowledgeable about how important it is, is not highly motivated to push back with the child and negotiate: "You have to sit in the booster seat", because they don't understand the risk.
When can my child get out of a booster seat?
When you look at the research evidence, research evidence defines safe use of child seats and the best evidence tells us that in order for a child to be correctly seated in the safety seat, it depends on the child's height and weight. Infants should be in an infant seat rear-facing in a vehicle until a minimum of one year of age. Because baby's head and neck is too heavy and the muscles are not well enough developed to protect them riding forward. They need to be in that baby seat as long as possible in terms or their height and weight according to manufacturers' directions, but it usually is minimum 22 pounds in weight and 21 inches in height. Once their child is at least 1 year of age, and meets those minimum height and weight requirements, they can be turned forward facing. Forward facing, the easy way to remember how long your child should be in a forward-facing seat is 40/40; forty pounds, forty inches. What Canadian parents often do is go from the forward seat into the seat belt. Children need to be in a booster seat when they are over 40 pounds until a minimum of 80 pounds in weight and a minimum of 57 inches in height. Those heights and weights, as I said, are the minimum. If you talk to trauma surgeons in Canada, they will always say, more is better, but the minimum height and weight together must be met. So if you have children who become real tall and slim because they had a growth spurt, they've got to meet the minimum weight of 80 pounds before they are safe in a seat belt because that is when the bone structure is solid enough for that seat belt to do its job.
How might your research impact health policy?
I think this research and other research like it could lead to and perhaps we should be looking to develop very systematic structured points of intervention that every family, as the child grows into particular heights and weights and age ranges, should be ensuring that the family is well aware what the safety seat needs are for that child. So when babies and toddlers and school-aged children go to their doctors or their health clinics for immunization, they also get informed about what safety seat are you sitting in your vehicle and lets look at you height and weight to be sure you are in the safest possible seat. So if we could build a more routine approach to helping families make sure their children are safely seated in vehicles, just like we do on immunization, allergies, and all those other important health behaviours, I think it would go a long way for achieving much greater outcomes and safety outcomes for children in Canada.
What are the future directions of your research?
The future directions of this research is to inform my colleagues in the health professions. Nurses and physicians in emergency departments, paediatricians, family health teams, primary care physicians, nurse practitioners, all of us need to be very well educated and very clear on the importance of safe use of child seats and booster seats for our school-aged children so that we can give that much more support to these families as children grow and develop over time. As children change in their heights and weights, they need different strategies and health professionals are very well positioned to help them do that, to make sure there are making those good decisions about how to keep your child safe on Canada's roadways.