1. The Child Passenger Safety Technician Technical Webinar will begin at 10:00 am SafetyBeltSafe U.S.A. www.carseat.org Please remember to mute your phone – BUT DO NOT PUT US ON HOLD!!! Thank you!

2. California Department of Public Health Vehicle Occupant Safety Program with the support of California Office of Traffic Safety Child Passenger Safety Technician Technical Webinar November 20, 2014 SafetyBeltSafe U.S.A. www.carseat.org Stephanie M. Tombrello, LCSW, CPSTI Kate Quirk, PhD, CPSTI

3. Topics Upcoming Events Recall Announced Warning Announced Vehicle Recall: Air Bag recall Research Focus: booster seat recommendations New Safety Seats Review: Unsafe at Any Age CEU Process + SafetyBeltSafe U.S.A. www.carseat.org

4. Certification Class in Long Beach, CA, January 21 – 24, 2015 For application: i0680@hotmail.com or 310/222-6860i0680@hotmail.com Safety Seat Checkup, 1/24/15, Long Beach, 10 am -2 pm To register: Families: 310/222-6860 Checkers: i0680@hotmail.com or 310/222-6860i0680@hotmail.com Upcoming Events: Long Beach + SafetyBeltSafe U.S.A. www.carseat.org

5. Quick link to www.carseat.org : icon on the Home Page allows one-tap shortcut on your phone.www.carseat.org Thanks to Heidi Heflin and Wendy Thomas for setting this up. + Please mute your phone – but don’t put the line on hold – thank you. SmartPhone Users

6. Evenflo Embrace 35: 12/2011-5/2013 AmSafe Qt1 harness buckle can stick and could cause risk in an emergency, making it hard to extricate the child. See the recall list on www.carseat.org for a complete list of model numbers.www.carseat.org Specific model numbers are involved. Client needs to have the model number to get the replacement buckle. Once again, as NHTSA is asking, remind owners to send in their registration cards by mail, telephone, or e-mail. October Recall + SafetyBeltSafe U.S.A. www.carseat.org

7. + Please mute your phone – but don’t put the line on hold – thank you. Media Watch: NHTSA Thanks to Lily Caravello, Mendocino County Car Seat Safety Program who submitted a Media Watch form after noticing this image on the NHTSA web site. The offending picture has been reported via Sandy Sinclair (NHTSA) to “appropriate persons” but it still there today on the Where’s Baby? Page. The SBS USA Media Watch form is available at www.carseat.org under Media.www.carseat.org

8. Britax Click Tight Convertibles: Advocate, Boulevard, Marathon Issue is related to clever method for changing the harness fit for child. The hip straps either are wrapped around a metal part of the seat and fitted into a hook-like piece similar to a splitter plate OR for forward- facing child, released and simply attached in the hook. Problem: the strap may not be secured into the hooked area and can detach without the parent’s awareness IF there is no reason for them to check on the security of the strap end. First announced on CPS Listserv by Alisa Baer, MD, The Car Seat Lady, as a repetitive finding; subsequently confirmed by Consumers Union: www.consumerreports.org/cro/britax1114. www.consumerreports.org/cro/britax1114 + Please mute your phone – but don’t put the line on hold – thank you. November Alert

9. + SafetyBeltSafe U.S.A. www.carseat.org

10. + SafetyBeltSafe U.S.A. www.carseat.org http://www.britaxusa.com/learning-center/harness-hip-adjustment-standard-position

11. + SafetyBeltSafe U.S.A. www.carseat.org http://www.britaxusa.com/learning-center/harness-hip-adjustment-extra-room

12. Automobile Recall SafetyBeltSafe U.S.A. www.carseat.org Problem: Air bag inflator can produce excessive internal pressure, leading to disintegration of metal parts, rupture of air bag and metal shrapnel. + SafetyBeltSafe U.S.A. www.carseat.org

13. Automobile Recall SafetyBeltSafe U.S.A. www.carseat.org Air bag inflators made by Takata – Japanese parts manufacturer that made air bags for all of the companies involved. Involves up to 100,000,000 Takata inflators in a wide variety of vehicles, dating back to 2000 but as recent as this year. Original recall related to issue: Honda 8 years ago. First was in 2004 in 2001 vehicle. Suspected 3 deaths, 100+ injuries in US. + Please mute your phone – but don’t put the line on hold – thank you.

14. Automobile Recall Manufacturers: Acura, BMW, Chrysler, Dodge, Ford, General Motors, Honda, Infiniti, Lexus, Mazda, Mitsubishi, Nissan, Pontiac, Saab, Subaru & Toyota Date Range: 2001-2011; Chevrolet Cruze: 2013-2014 another air bag issue. NHTSA placed urgent warning, including not riding in the front seat or even not driving vehicles until checked by dealer. + SafetyBeltSafe U.S.A. www.carseat.org

15. Automobile Recall SafetyBeltSafe U.S.A. www.carseat.org Size of the Problem: Initially, it was thought to be related to Honda vehicles only. Now, it seems that Takata does not have a good system for identifying the problem inflators. Vehicles exposed to high humidity appear to have higher risk. U.S. Senators asking for dealers to provide rental vehicles for owners. U.S. House of Representatives planning hearing. + Please mute your phone – but don’t put the line on hold – thank you.

16. Automobile Recall SafetyBeltSafe U.S.A. www.carseat.org CPS response: SBS USA usually doesn’t publicize vehicle recalls due to the large volume and relative ease of locating owners. However, this recall is very high risk. Consider including recall information in contacts with clients if vehicle falls into the manufacturer and date range. Warn owners to check the NHTSA Web site and/or call the vehicle dealer with information about the vehicle immediately.

17. New Crash Test Dummy b Please mute your phone – but don’t put the line on hold – thank you. New crash-test dummy in development by Humanetics to reflect crash risk of obese adults more accurately. Dummy is 273 lbs (BMI = 35) Obese persons 78% more likely to die in a car crash. Fat around mid-section can lead to out-of-position fit in vehicle seats/belts, etc. Age also impacts injury severity. Risk jumps 20% for 50 year old driver and 40% for an 80 year old. Dummy use is critical; however, to save funds, car companies are using computer modeling and investing in more biofidelity in their data pool.

18. Research Focus. SAFE KIDS Worldwide Report – Buckle Up: Booster Seats Published September 2014 Survey of 1000 parents of 4 – 10 year olds. Key findings: children transition out of booster seats too early; laws across the U.S. are outdated. Emphasis on height & weight requirements as determining criteria for booster use/belt fit – defined as 4’ 9” and 80 – 100 lbs. + SafetyBeltSafe U.S.A. www.carseat.org

19. Research Focus SAFE KIDS Worldwide Report – Buckle Up: Booster Seats Findings Restraint choices: 48% booster seat 37% safety belt 11% safety seat 4% unrestrained Older children more likely to use belt alone (69% of 8 – 10 year olds; 23% of 6 – 7 year olds; 5% of 4 – 5 year olds). 66% of parents of children 4 – 7 years say they use a booster seat – significantly higher than 46% estimated booster use in NHTSA national observation survey. 7 out of 10 parents “don’t know that a child should be 57” or taller” to ride without a booster seat. Please mute your phone – but don’t put the line on hold – thank you.

20. Research Focus SAFE KIDS Worldwide Report – Buckle Up: Booster Seats Findings Factors in parents’ decisions to transition child from booster seat to safety belt: + SafetyBeltSafe U.S.A. www.carseat.org

21. Research Focus SAFE KIDS Worldwide Report – Buckle Up: Booster Seats Further findings Death rate of booster-age children (4 – 10 years) falling: 2003 – 598, 52% unrestrained 2012 – 340, 35% unrestrained. 6% of 72,600 children injured in 2012 not restrained 1 in 5 parents ‘bend the rules’ when carpooling 61% notice other parents bending the rules. Please mute your phone – but don’t put the line on hold – thank you.

22. Research Focus SAFE KIDS Worldwide Report – Buckle Up: Booster Seats Further findings 16% allow children to ride in front seat at least occasionally. Reasons: 28% short journey 20% child the only passenger 19% back seat fully occupied + SafetyBeltSafe U.S.A. www.carseat.org

23. g Please mute your phone – but don’t put the line on hold – thank you. Commentary from SBS USA on the SKW Report: Height & weight recommended as markers for judging the time to transition from booster by SKW. However 4’9” and 80 lbs. adopted by NHTSA, based on an empirical study of measurements in vehicles of the 1990’s. Never intended by researchers to be a standard. 80 lbs. was dropped quickly. Height found to be poor predictor of belt fit in SBS USA data: Height criteria recently removed from NHTSA recommendations and those of the committee tasked with recommending the focus for teaching how older children should ride. Research Focus SAFE KIDS Worldwide Report – Buckle Up: Booster Seats

24. SafetyBeltSafe U.S.A. www.carseat.org Challenges in framing standard test for belt fit Must take account of: Varying proportions of children of same height and weight. Varying vehicle environment – dimensions of vehicle seats, belt geometry etc. Children’s behavior. Ease of explanation. Pre-existing knowledge of parents (rarely know child’s height & weight by booster years). Ability to engage child in the protective behavior. Research Focus SAFE KIDS Worldwide Report – Buckle Up: Booster Seats

25. Please mute your phone – but don’t put the line on hold – thank you. The SBS USA 5-Step Test: Developed in 2001; adopted by many organizations in materials shortly thereafter. Why the 5-Step Test is a user-friendly and more accurate test: Offers an individual assessment focused solely on belt fit – not a one-size-fits-all approach. Takes account of differences in the vehicle environment. Easy and quick to learn for both children and adults. Allows children to take responsibility for their physical welfare (a key step for booster-age children who are away from parental supervision much of the day). Requires no additional knowledge (e.g. weight/height of child). Takes account of child’s behavior. Research Focus SAFE KIDS Worldwide Report – Buckle Up: Booster Seats

26. SafetyBeltSafe U.S.A. booster education – what we have learned: 5-Step Test and ‘Boosters Are For Big Kids’ curricula originally focused on K-3 rd grade. However, testing of children taught us that kids need boosters until ages 10 to 12. Data on several thousand children show that: At age 10, only 47% fit. 27% of those 4’9” fail the 5-Step Test. 5% under 4’9” passed. Most state laws are woefully outdated, giving the wrong message to families. (In Europe, boosters are mandated to age 12 in some countries.) 8 of the top 10 states for childhood deaths have laws covering only up to age 5/6. Laws which have a correct use component can be applied beyond age 8. However, getting that message to professionals and parents is a challenge. We need to consider re-opening the issue and educating legislators that boosters are for BIG kids. Research Focus SAFE KIDS Worldwide Report – Buckle Up: Booster Seats + SafetyBeltSafe U.S.A. www.carseat.org

27. New Seats SafetyBeltSafe U.S.A. www.carseat.org Diono Cambria 40 – 120 lbs., 38 – 63” High-back & backless modes. 6-position headrest 2 recline positions Folds flat for storage LATCH attachments + SafetyBeltSafe U.S.A. www.carseat.org Please mute your phone – but don’t put the line on hold – thank you.

28. New Seats SafetyBeltSafe U.S.A. www.carseat.org Ingenuity InTrust 35 4 – 35 lbs. Infant insert must be used 4 – 11 lbs. Vehicle belt positioner on base – looks like a lock-off but is not. 3 recline positions Automatic adjustment of headrest and shoulder straps to correct position as harness is tightened. Cannot be used with inflatable safety belt. + SafetyBeltSafe U.S.A. www.carseat.org Please mute your phone – but don’t put the line on hold – thank you.

29. New Seats SafetyBeltSafe U.S.A. www.carseat.org Maxi Cosi Pria 85 14 – 40 lbs. rear-facing, 22 – 85 lbs. forward-facing No re-thread, 9-position adjustable harness 3 recline positions 2 sets of harness covers – larger one used if over 65 lbs and tether not used Lower anchor use to 40 lbs.

30. New Seats SafetyBeltSafe U.S.A. www.carseat.org Jane Montecarlo R1 30 – 100 lbs, to 57”. 5-position headrest 2 recline positions Adjustable width headrest & armrests Highback use only – no backless mode. Rigid LATCH connectors Please mute your phone – but don’t put the line on hold – thank you.

31. Research Review SafetyBeltSafe U.S.A. www.carseat.org “Unsafe from the Start: Critical Misuse of Car Safety Seats for Newborns at Initial Hospital Discharge”, Benjamin Hoffman, M D., F.A.A.P. Presented at American Academy of Pediatrics national conference, 10/14. Submitted for publication. Observational study conducted at Oregon Health and Science University Hospital, 11/13 – 5/14. Observation of both infant placement & safety seat installation. Observation followed by checkup to ensure infants traveled home safely. 267 mother-infant pairs, randomly selected (excluding preemies & NICU grads).

32. Research Review: Please mute your phone – but don’t put the line on hold – thank you. Findings: Most common errors: 1.Loose harness: 69% 2.Loose installation: 43% 3.Wrong angle for seat: 36% 4.Retainer clip too low: 34% 5.Safety belt unlocked: 23% 6.Use of unregulated products: 20% 7.Harness located above infant’s shoulders: 18% 8.Safety seat too close to back of front seat: 17% 9.Unaware of how to adjust the harness: 15%

33. Research Review: SafetyBeltSafe U.S.A. www.carseat.org Demographics: Problems were more pronounced for those in the following categories: 1.Low income 2.Lower education level 3.Non-white 4.Non-English speaking 5.Unmarried without a partner

34. Research Review: Please mute your phone – but don’t put the line on hold – thank you. Response: Question: Do these findings reflect what you see? SBS data on newborn installations (in orange):

35. Research Review: SafetyBeltSafe U.S.A. www.carseat.org Response: Those with contact with a CPS Technician were 13 times more likely to have the baby properly buckled up. What does this mean for hospital policy in California? How many hospitals have CPSTs on staff or on call? What is the risk for liability when, knowing this, hospitals do not have a policy of offering checkup services? Where should our focus be in terms of demographics?

36. CEUs 1 CEU awarded by Safe Kids To claim:  www.carseat.org  Click on Calendars, Professional and Technician Training, California Technical Teleconference, Request for CEU  Download form, complete & email to i0680@hotmail.com  Verification Code: Click Tight + SafetyBeltSafe U.S.A. www.carseat.org

38. Research Corner SafetyBeltSafe U.S.A. www.carseat.org ‘A Study of General Aviation Accidents Involving Children in 2011’, K. M. Poland & N. M. Marshall, Space Environmental Medicine, 2014, 85, 818-822 Examination of aviation accidents involving children in 2011 19 accidents & incidents identified 39 children under 15 involved. 26 killed, 2 serious injuries, 5 minor injuries, 6 unhurt. All children under 2 were restrained in safety seats & were unhurt. NTSB routinely to collect information on child casualties in future.