Shoulder Height Labeling of Child Restraints to Minimize Premature Graduation

Abstract

We hypothesized that parents and caregivers would make better judgments about child restraint fit if shoulder height labeling was used to communicate appropriate child restraint transition times. Participants were recruited at a shopping center in New South Wales, Australia, and were observed choosing restraints, with and without shoulder height labels indicating appropriate restraint fit, for each of 2 test mannequins (representing a 3-year-old child and a 5-year-old child). Demographic and child restraint use experience data also were collected. Generalized estimating equations were used to examine associations between labeling condition and participant's judgment of restraint appropriateness. Participants (N=86) made significantly fewer errors in judging restraint appropriateness for the test mannequins when the restraints included shoulder height labels (P<.001). Depending on label format, the odds that a participant would always make the correct decision were 5.2 (95% confidence interval: 2.7-9.8) to 3.7 (95% confidence interval: 2.0-6.9) times greater when shoulder height labels were included than when they were not. The use of shoulder height labels on child safety seats and booster seats is an effective means of communicating child restraint fit to parents and caregivers.