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 Transporting
Children with Special Needs
My
child has special health care needs. What is the safest way for him to ride
in a vehicle?
All children
must ride in cars and other vehicles as safely as possible. Some children
with certain medical conditions can ride in the standard types of car safety
seats that are commonly found in stores. Children with breathing or muscle
control conditions, casts, or other health care needs may need to use special
medical car safety seats or restraints. If your child has special needs,a
variety of child restraint options are available.
General
guidelines for transporting a child with special needs
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Talk
to your pediatrician or surgeon about your child's positioning and transportation
needs.
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Remember
that some children with special needs are able to use standard child restraints
such as infant-only seats, convertible seats, forward-facing seats/restraints,
or belt-positioning booster seats.
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Check
the label on the car safety seat and make sure it states that the seat meets
or exceeds Federal Motor Vehicle Safety Standards.
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Never
try to alter a car safety seat to fit a child with special needs. Never
use a car safety seat that has been altered to fit a child with special
needs unless it has been crash tested with the change.
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Stay
up-to-date on what might be available for your child. New child restraints
offer more options every year.
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Keep
your child in the type of car safety seat that gives the most protection
until your child reaches the top weight or height recommended by the manufacturer.
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Read
the instructions for the car safety seat/restraint and your vehicle. Both
sets of instructions will be necessary to make sure that your child is secure
in the safety seat/restraint and the safety seat/restraint is correctly
installed in your vehicle.
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Make
sure that all harness adjustments are made according to instructions.
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Be sure
that all harness straps are snug and flat against your child's body.
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Position
plastic chest or harness retainer clips at armpit level to keep the harness
straps over the shoulders.
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Never
place anything under or behind your child in a car safety seat/restraint.
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You may
place rolled blankets, foam, or towels along each side of your child to
keep him centered in the car safety seat.
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To help
keep your child from sliding down in the seat, you may place a rolled cloth
such as a washcloth or diaper between the crotch strap and your child's
diaper area.
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The back
seat is the safest place for all children to ride.
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Never
put a rear-facing baby in front of a passenger air bag. In a crash, the
air bag inflates very quickly and with great force. The child safety seat
could be hit by the air bag and cause serious injuries or even death to
the baby.
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If you
have no other option than to transport a child who is medically fragile
in the front seat and your car has a passenger air bag, you will need to
have your air bag switched off. Contact the NHTSA for a permission form
and details (888/DASH-2-DOT [888/327-4236] or http://www.nhtsa.dot.gov).
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Depending
on your child's condition, it may be wise to limit the amount of car travel.
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Stop
often if your trip is long.
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When
possible, an adult should ride in the back seat next to your child to watch
her closely.
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Develop
a medical care plan in case your child has a medical emergency during travel.
Some parents attach a copy of the plan to the child's car safety seat/restraint.
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Carry
with you an emergency kit that includes any special medications or supplies
that your child may need. A checklist will help you ensure that the right
medications and supplies are always with you. Do not leave this kit in the
vehicle.
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Keep
a cellular phone with you to contact help, if needed. Some cellular phones
can dial 911 even if you do not purchase a service contract.
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Never
use a reclined vehicle seat to transport a child. In a crash, the child
can slip out of position and not be protected by the seat belt.
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In some
instances, such as very tall children in casts, professional transport may
be needed.
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Apply
for a handicap parking permit on behalf of your child if it is hard to get
her in and out of the car safety restraint. Handicap parking often allows
more space to maneuver.
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Never
leave your child alone in a vehicle, even to do an errand that should only
take a minute. Your child's safety is worth the effort to remove her from
the car safety seat/restraint, take her with you, and then secure her again
when you return.
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 800/290-2344
or http://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. To get a free copy, call 888/DASH-2-DOT
(888/327-4236) or view it on the Internet at http://www.nhtsa.dot.gov.
Medical equipment
Some children must travel
with devices such as apnea monitors, oxygen tanks, ventilators, walkers, and
crutches. Secure these in the vehicle so that they do not become flying objects
in the event of a crash or sudden stop. At this time, there is no single product
available to secure medical devices. Try wedging the equipment on the vehicle
floor with pillows or securing it with seat belts not being used by a passenger.
Make sure that any devices that use batteries have enough power for at least
double the length of your trip.
Published online:
4/08
Source: Safe Transportation of Children With Special Needs: A Guide for Families
(Copyright © 2002 American Academy of Pediatrics)
Parents can find
more information on this topic in Caring for Your Baby and Young
Child: Birth to Age 5. To order a copy of this book visit the AAP
Bookstore.
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The information contained
in this publication should not be used as a substitute for the medical care
and advice of your pediatrician. There may be variations in treatment that your
pediatrician may recommend based on individual facts and circumstances.
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