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Please complete and mail back the evaluation form and the participant information form! Available at http://miemss.org/EMSCwww/CPSConference.htmlhttp://miemss.org/EMSCwww/CPSConference.html Happy Children in Safe Seats: Not As Easy As It Sounds July 17, 2013 Moderator: Susanne Ogaitis-Jones Presenter: Caroline Langrall, CCLS, CPST Sponsored by The Maryland Institute for Emergency Medical Services Systems
Happy Children in Safe Seats… Not as Easy as it Sounds Considerations every safety advocate needs to know to solve car seat challenges Caroline Langrall, CCLS, CPST
Objectives Identify key phases of a child's psychosocial and cognitive development that may create challenges regarding safe travel in the car. Identify developmentally appropriate strategies to encourage and enable caregivers to use car seats properly. Explore ways to address the transport of children with special needs and developmental delays.
What are the challenges? Crying Tantrums Refusal Unbuckling
Challenging behaviors… leading to dangerous “solutions” Excessive crying/screaming? ◦ Loosen straps ◦ Front seat ◦ No seat use Escaping ◦ Altering seat ◦ Compromising Vomiting/Motion sickness ◦ Early forward facing
First Step: Check the use… ◦ Age/size appropriate? ◦ Straps snug and routed right? ◦ Buckles functional? ◦ Installation correct?
Infant development & interventions Bonding, attachment, trust. Sensorimotor & object permanence. ◦ Blanket with familiar smell ◦ Adult in back seat ◦ Rock/sway the seat ◦ Pacifier ◦ Soothing music ◦ Convertible for older infant?
Infant development & interventions, continued… Physiological Immaturity ◦ Allow an hour for digestion ◦ Different seat with a different angle ◦ Overheated ◦ Swaddle/boundaries
Toddler development (1-3) Autonomy Egocentric Lack of reasoning Separation Anxiety Improving dexterity
Improper harness use injury patterns http://www.youtube.com/watch?NR=1&feature=endscreen&v=akGpsPyhDdk
Interventions for toddlers Consistent, simple messages from all cgs Reinforce good behavior frequently. Ignore ‘bad’ behavior Calm voice, empathy, don’t get angry. Pull over and wait…or time-out Offer choices Keep hands busy: Cheerios, cling stickers. Special rotating bag of soft ‘car toys’ Divert attention Music Coat tricks
Preschooler development (3-6) Initiative Want to please others Literal interpretations Lack abstract thought Dramatic play and magical thinking
Interventions for Preschoolers “Write” a story together Be clear and consistent with expectations Dramatic play Give a “job” or “role” Sticker chart for behavior Choose car seat or decorate. Seek & find books Game for long car rides
School age development (6-12) Spelling and language Development of scientific method Moral development: good vs. bad Use feedback to judge their competency Acceptance by peer group
Interventions for School Age Be clear with rules Run an ‘experiment’ Praise for good behavior Empathize Low back booster…choices
Adolescent development Abstract/higher-level thinking Critical thinking emergence Independence Influence of peers Risk taking behaviors
Adolescent challenges MVC’s = 40% of deaths ◦ Age 16-24 = lowest seatbelt use (CDC, 2006) Driving under the influence Reckless or careless driving Texting while driving ◦ >50% of teens >16 yrs admitted to TWD ◦ Less likely to wear seatbelt, ◦ More likely to drive while intoxicated or with someone who is intoxicated (Balin et al., 2013) Bailin, A., Adesman, A., & Sunday, S. R. (2013). 134. Texting While Driving Among High School Students in the United States: Analysis of 2011 Data From the National Youth Risk Behavior Survey (YRBS). Journal Of Adolescent Health, 52(s1), S85-6 National Center for Injury Prevention and Control (CDC). Web-based injury statistics query and reporting system (WISQARS). http://www.cdc.gov/ncipc/wisqars/: 2006
Adolescent interventions Makes rules and consequences clear Follow-through on consequences Provide choices when possible Demonstrate expected behavior Reward
Dealing with motion sickness No reading, video games Middle seat I Spy games to look outside Open window Ice pack to back of neck Cool washcloth Saltine crackers or ginger snaps Peppermint/ginger aromatherapy (Lua,& Zakaria, 2012) “Sea bands”/acupressure (Hunt, 2011) Breathing Frequent stops Travel at night/naps Hunt, K., & Ernst, E. (2011). The evidence-base for complementary medicine in children: a critical overview of systematic reviews. Archives Of Disease In Childhood, 96(8), 769-776. Lua, P., & Zakaria, N. (2012). A Brief Review of Current Scientific Evidence Involving Aromatherapy Use for Nausea and Vomiting. Journal Of Alternative & Complementary Medicine, 18(6).
Special Needs PDD/Autism spectrum/Cognitive delay ◦ Seat options decrease with age/size ◦ Difficulty with reasoning ◦ Need for routine & difficulty with change ◦ Sensory processing challenges Be kind; for everyone you meet is fighting a hard battle. –John Watson
Interventions for Children with Special Needs ◦ Anticipatory guidance to prepare for seat change ◦ Consider other seats. ◦ Refer to http://www.preventinjury.org or search Safe Kids website for a CPST trained in Special needs.http://www.preventinjury.org
Special needs EZ-On floor mounted vest and tether ◦ Vehicle modification ◦ Seat bight http://www.ezonpro.com/
Special needs http://eztether.com/index.php/product-info/roosevelt Roosevelt by Merritt Manufacturing ◦ 35-115 lbs & 33.5-62” ◦ Harness cover & EZ Buckle guard NOT for use with other seats ◦ Not compatible in all vehicles
Thank you for participating! Final Instructions: Evaluation form is available on our website: http://www.miemss.org/EMSCwww/CPSHome.htm; alternatively, we can email it to you. Return your completed evaluation along with the contact info page.