Child passenger safety: Direction, selection, location, installation

Phyllis F. Agran, Benjamin Hoffman

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


The most significant risk factor for death and serious injury in a car crash is the failure to use a size-appropriate restraint system. Providing accurate car safety seat anticipatory guidance to families is the standard of care. Guiding families on the best car seat for best protection can be done with the four messages, direction, selection, location, and refer, if needed, to community resources for correct installation. Addressing special issues that impact use of a car seat on each and every ride, including challenging behaviors and obesity, will transfer to many other situations. Data support a new recommendation that children stay rearfacing in size-appropriate car seats until they reach the highest weight and height allowed for rear-facing by the manufacturer of the convertible seat. Premature graduation to the next seat type/size/position increases risk of injury. A driver who is distracted by a cell phone, food, or something else, becomes a risk factor for a car crash. State laws may lag behind best practices. Advocacy for stronger laws, better enforcement, and best practices at the local, state, and national levels is a critical role for the pediatric professional community.

Original languageEnglish (US)
Pages (from-to)613-621
Number of pages9
JournalPediatric annals
Issue number9
StatePublished - Sep 2008
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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