Buckle Up: Booster Seats

Buckle Up:

Booster Seats

September 2014

45%

57"

of these children

were riding

without a restraint

that could have saved

their lives.

Motor vehicle crashes are the

second-leading cause of death

for children 4 to 10 years old.

340children this age died in

motor vehicle crashes in 2012.

Although seat belts are safer than

nothing at all, children who should be in

booster seats but wear only seat belts are

at risk of severe abdominal, head and

spinal injuries in the event of a crash.

Safe Kids Worldwide surveyed 1,000 parents of

4 to 10 year olds. The study found seven in ten

parents do not know that a child should be at

least 57 inches (4’9”) to ride in a car using a seat

belt without a booster seat.

The study revealed

9 out of 10

parents move their child

from a

booster seat to seat belt before

their child is big enough.

One in ﬁve parents whose children carpool say

they “bend the rules”

when driving, letting

children ride without seat belts and without the

car seat or booster seat they would normally use.

Buckle up every ride, every time, in the right seat.

REMEMBER: A child needs to be at least 57” tall (4’9”) and weigh between

80 and 100 pounds to ride with just a seat belt.

Booster seats protect children who are too big

for a car seat but too small for a seat belt.

Seat belts don’t fit children properly until they

are at least 57” (4’9”) tall and weigh between

80 and 100 pounds.

Booster seats can

reduce the risk of

serious injury by

45 percent compared

to seat belts alone.

What to Know about Booster Seats

Learn more at www.safekids.org

And 61 percent of parents say they notice other carpool drivers bending the rules.

Buckle Up: Booster Seats 3

Executive Summary

Choosing the right car seat is high on the list for any new parent, and every

parent plans to leave the hospital with a newborn securely buckled up in a car

seat. But as kids grow up, using a car seat or booster seat may feel more like an

option rather than a requirement. By the time kids are older and starting school,

it might seem like moving to a seat belt is a relief.

But many kids still need a boost in order to ride safely in cars. In 2012, 340

children ages 4 to 10 died in motor vehicle crashes, and 35 percent were not

buckled up at the time of the crash.

Motor vehicle crashes are the second-

leading cause of death for children 4 to 10 years old, second only to cancer.

Many children this age should be riding in booster seats which have been shown

to reduce the risk of serious injury by 45 percent compared to seat belts alone

for children ages 4 to 8 years.

Booster seats protect children who are too big for

a car seat but too small for a seat belt. We know that seat belts generally don’t

fit children properly until they are 57 inches or taller and between 80 and 100

pounds.

6,7

With the support of the General Motors Foundation, Safe Kids Worldwide

surveyed 1,000 parents with children ages 4 to 10 to ask about how their child

rides in a car and what leads them to use a booster seat or seat belt.

Seven out of 10 parents don’t know that a child should be 57 inches or taller to

ride using a seat belt without a booster seat. And when asked what was the most

important factor in their decision to move their child from a booster seat to a

seat belt, 56 percent—or almost six in 10—said it was for a reason other than

their child’s height and weight. Eighty-six percent of parents moved their child to

a seat belt before they were the recommended height.

We also asked parents about “bending the rules” when their children are

carpooling—letting children ride without seat belts and not in the car seat or

booster seat they would normally ride in. One in five parents whose children

carpool say they “bend the rules.” However, three times as many parents—61

percent—say they notice other carpool drivers “bending the rules.” Twenty-one

percent of parents say they rarely or never talk to the person driving the carpool

about the type of restraint their own child uses.

What can parents do to make sure their children are safely buckled up for every

ride, every time? Here is the one take-home message for parents and anyone

who regularly drives with kids:

Buckle kids up in car seats or booster seats until

seat belts fit properly, usually when they’re 57 inches

(or 4 feet 9 inches) tall and between 80 and 100 pounds.

Booster seats protect

children who are too big for

a car seat but too small for a

seat belt.

4 Safe Kids Worldwide

Children in Motor Vehicle Crashes:

What the Data Tell Us

Motor vehicle crashes were the second-leading cause of death for children 4 to

10 years old in 2011, surpassed only by cancer.

In 2012, 340 children ages 4 to

10 died in motor vehicle crashes, and 35 percent weren’t buckled up at the time

of the crash (Figure 1).

The good news is that motor vehicle crash fatalities for

children this age has fallen from 598 deaths in 2003, and the proportion that

weren’t buckled up at the time has also decreased from 52 percent.

Buckling up

saves lives: a much smaller proportion of children who were injured but not killed

in motor vehicle crashes were not buckled up, compared to fatal crashes. Of the

72,600 children ages 4 to 10 who were injured in motor vehicle crashes in 2012,

only 6 percent were not buckled up.

Figure 1: Motor vehicle fatalities and the proportion of fatalities that were

unrestrained have declined.

Number of Fatalities,

Ages 4 to 10

Percent of Fatalities

Unrestrained

100

200

300

400

500

600

700

800

10%

20%

30%

40%

50%

60%

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

How Are Children Riding in Cars?

Safe Kids Worldwide, with the support of General Motors Foundation, surveyed

1,000 parents with children ages 4 to 10 to ask about how their child rides in a

car and what factors lead them to use a booster seat or seat belt. If parents had

more than one child between the ages of 4 and 10, they were asked to think

about their child this age who had the most recent birthday.

Parents most often said their child rode in a booster seat (48 percent), followed

by a seat belt without a booster seat (37 percent), a front-facing car seat (11

percent), or no restraint (4 percent). Parents of older children more often say

they use seat belts; 69 percent of 8 to 10-year-olds use seat belts, compared to

23 percent of 6 to 7-year-olds (Figure 2).

Sixty-six percent of parents with children ages 4 to 7 years say they use a

booster seat; this is higher than the estimate of 46 percent of children this

age, based on a national observation survey from the National Highway Traffic

Safety Administration.

According to the American Academy of Pediatrics, all children under the age of

13 should ride buckled up in the back seat.

However, we found that 16 percent

of parents say their child rides in the front seat at least occasionally (Figure 3).

Reasons parents gave for letting children ride in the front seat include short

rides (28 percent), if the child is the only passenger (20 percent) and when the

backseat is full (19 percent). Even more parents say they have noticed other

children similar in age riding in the front seat: 65 percent say they have noticed

other children sitting in the front at least occasionally.

All children whose weight or

height is above the forward-

facing limit for their car safety

seat should use a belt-

positioning booster seat until

the vehicle lap-and-shoulder

seat belt fits properly, typically

when they have reached 4

feet 9 inches in height and are

between 8 and 12 years of age.

Policy Statement —

Child Passenger Safety, American

Academy of Pediatrics

Figure 2: Seat belt use is more common in older children.

20%

40%

60%

80%

100%

4 to 5 years old

Forward-facing car seat

6 to 7 years old 8 to 10 years old

Booster seat Seat belt No restraint

Figure 3: 65 percent of parents have noticed other children riding in the

front seat.

20%

40%

60%

80%

100%

How often does your child

ride in the front seat of

the car?

How often do you notice

other children of a similar

age to your own riding in

the front passenger seat

of the car?

Always/Often Occasionally Rarely/Never

When Do Parents Move Kids from a Booster Seat

to a Seat Belt?

Booster seats save lives: Using booster seats reduces the risk of serious injury

by 45 percent in comparison to seat belts for children ages 4 to 8 years.

know that children should use a car seat or booster seat until they are 4 feet

9 inches (57 inches) tall and weigh between 80 and 100 pounds, when they

can safely ride using a seat belt.

6,7

But this important information is not widely

known.

Figure 4: 71 percent of parents don't know the height for a child to safely

use a seat belt.

10%

15%

20%

25%

30%

35%

Less than 38

inches

Between 38 and

48 inches

Between 49 and

56 inches

57 inches or

taller

I don’t know

How tall should a child be to use a seat belt without a booster?

Buckle Up: Booster Seats 5

Straight Talk from a Child

Passenger Safety Technician

“As a Child Passenger Safety

Instructor and mother of two

children who ride in booster

seats, I know how important

car seats and booster seats are

in keeping my kids safe. Seat

belts are designed for adults,

and kids need something

special to make them fit. None

of my friends knew that seat

belts are for older kids who are

at least 4 feet 9 inches tall and

80 to 100 pounds. Kids who

do not fit properly in seat belts

are uncomfortable, and they

tend to put their shoulder belt

under their arms or behind

their back, increasing the risk

of injuries in a crash. I tell

them to read their car and car

seat manuals and keep their

child in a car seat or booster

seat until they reach the top

height or weight of the seat.

If my long-distance friends

are having trouble or have

questions, I tell them to locate

a nationally certified Child

Passenger Safety Technician

in their community who can

help. SafeKids.org has a list.”

— Fatou Benoit

Child Passenger Safety

Coordinator,

Safe Kids Palm Beach County

6 Safe Kids Worldwide

Among all parents, 71 percent didn’t know that a child should be 57 inches or

taller to ride using a seat belt without a booster seat (Figure 4). Twice as many

parents with a child in a booster seat (38 percent) or forward-facing car seat

(37 percent) knew the height that children can ride safely with a seat belt,

compared to parents whose child rides in a seat belt (15 percent) or without a

restraint (16 percent) (Figure 5).

Figure 5: Parents with children in booster seats or front-facing car seats are

more likely to know the height that children can safely use a seat belt.

0% 5% 10% 15% 20% 25% 30% 35% 40%

Booster seat

Forward-facing car seat

Seat belt

No restraint

Percent of parents who correctly identiﬁed 57 inches or taller as the

height to safely use a seat belt

Eighty-three percent of parents in the survey who say their child currently uses

a seat belt say their child used a booster seat in the past. While 44 percent

of parents correctly say that their child’s height and weight was the most

important factor in their decision to move their child from a booster seat to

a seat belt, 56 percent—or almost six in 10—cited other reasons such as

state laws (16 percent)—which might not reflect best practices—their child’s

comfort (7 percent), and their spouse’s opinion (5 percent) (Figure 6).

Figure 6: Height and weight were the most important factor in parents'

decision to move their child from a booster seat to a seat belt.

0% 10% 20% 30% 40% 50%

My child’s height and weight

The laws in my state

My child’s age

My child’s comfort

My pediatrician’s recommendation

My spouse’s opinion

How my child looked in the car seat

The car seat manufacturer’s recommendation

My child’s opinion

Other

My family member or friend’s opinion

Percent of parents whose children previously

used a booster seat

71 percent of parents didn't

know that a child should be

57 inches or taller to ride

using a seat belt without a

booster seat.

Buckle Up: Booster Seats 7

Only three percent say their child was 57 inches or taller when they moved

them from a booster seat to a seat belt—the recommended height to use

a seat belt (Figure 7). Only six percent of parents say their child was over 80

pounds when they moved to a seat belt.

Figure 7: Only 3 percent of parents say their child was 57 inches or taller

(the recommended height) when they moved to a seat belt.

57 inches or taller

Less than 38 inches

I don’t know

Between 38 and 48 inches

Between 49 and 56 inches

We also see in data from car seat checkups that parents aren’t sure when to

move children from booster seats to seat belts only. From January 1, 2013 to

January 1, 2014, 24,037 children ages 4 to 10 were seen at Safe Kids Buckle

Up car seat checkup events, where trained technicians inspect and properly fit

car seats and booster seats and educate parents about buckling up. For every

age group within this range, a greater proportion of children left the car seat

checkup event in a booster seat, compared to when children arrived (Figure

8). For example, 25 percent of children ages 6 and 7 arrived at the checkup

event in booster seat, and 43 percent left the event in a booster seat. A greater

proportion of older children ages 8 to 10 left in booster seats than arrived—13

percent compared to 7 percent. Previous research has found that adult drivers

report issues with seat belt fit for children ages 4 to 9, especially the position

of the lap belt.

These findings point to a need for more education about the

importance of keeping all kids in car seats and booster seats until seat belts fit

properly.

Figure 8: The percentage of children leaving from car seat checkup events

in booster seats increased for every age group.

10%

20%

30%

40%

50%

4 and 5 years old

Percent using booster seats on arrival

6 and 7 years old 8 to 10 years old

Percent using booster seats on departure

8 Safe Kids Worldwide

Carpooling: Bending the Rules

We asked parents if their child ever carpools (when more than one child is

traveling in a car with a driver other than the parent.) Thirty-eight percent of

parents say their child carpools at least one day a week. Of these parents, 21

percent say they rarely or never talk to the person driving the carpool about

the type of restraint their own child uses. One in five parents whose children

carpool say they “bend the rules”—letting children ride without seat belts and

not in the car or booster seat they would normally ride in (Figure 9). However,

three times as many parents—61 percent—say they notice other carpool

drivers "bending the rules."

Figure 9: Sixty-one percent of parents say they notice other carpool drivers

"bending the rules."

Always/often/occasionally

How often do you notice others “bending the rules”?

Rarely/never I never drive the carpool

How often do you “bend the rules”?

Talk with your child’s carpool

driver about using the right

restraint for him or her.

Buckle Up: Booster Seats 9

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10 Safe Kids Worldwide

Booster Seat Laws Make a Difference in Saving

Children’s Lives

The age requirements of booster seat laws have an impact on the motor vehicle

crash fatality rates among kids of booster seat age across states. Currently,

among 50 states and Washington, D.C., 35 states have more stringent laws on

booster seat use, requiring that young kids ride in booster seats until they are

7 years old, or even older in some states.

The other 16 states allow children to

use a seat belt alone at a younger age, even as young as age 5.

In 2012, the crash fatality rate for children ages 4 to 8 in states with less strict

laws was 13.7 per 100,000 children. In contrast, states with stricter laws had a

fatality rate of 8.6 per 100,000 children.

10,11

Eight of the top 10 states with the highest crash fatality rates are states with

less strict booster seat laws (Table 1). These findings are in line with other

studies that have looked at the impact of booster seat legislation. Researchers

found that states that passed laws requiring the use of a child restraint with

internal harness or a booster seat until age 7 or 8 saw reductions in the per

capita rate of both fatal and nonfatal motor vehicle crash injuries, and a three-

fold increase in the per capita rate of child seat use among children in crashes.

Only two states—Wyoming and Tennessee—have laws requiring booster seats

through age 8.

Table 1: Top ten states with the highest motor vehicle crash fatality rate per

100,000 among children ages 4 to 8 years, 2012

State Fatality rate

per 100,000

Number of

fatalities

Child passenger

safety law requires

booster seats until

at least age 7

Child safety

seat required

by law up to

age

Wyoming 37.5 15 Yes 8

Montana 27.1 17 No 6

Mississippi 20.8 44 No 6

Arkansas 19.0 38 No 5

Kentucky 18.2 52 No 6

New Mexico 17.8 26 No 6

South Carolina 16.1 49 No 5

Oklahoma 15.0 40 No 5

Alabama 14.6 45 No 5

Kansas 14.6 30 Yes 7

Buckle Up: Booster Seats 11

Table 2: Top ten states with the lowest motor vehicle crash fatality rate per

100,000 among children ages 4 to 8 years, 2012

State Fatality rate

per 100,000

Number of

fatalities

Child passenger

safety law requires

booster seats until

at least age 7

Child safety

seat required

by law up to

age

District of

Columbia

0 0 Yes 7

Rhode Island 1.7 1 Yes 7

Massachusetts 2.6 10 Yes 7

Utah 3.1 8 Yes 7

New York 4.1 47 Yes 7

Minnesota 4.7 17 Yes 7

Washington 4.7 21 Yes 8

Virginia 4.8 25 Yes 7

Maryland 4.8 18 Yes 8

Connecticut 5.1 11 No 6

Require booster seat use

for children through age 8

Do not have such

requirement

Motor Vehicle Crash Fatality Rate per 100,000 for Children Ages 4 to 8

Only two states require booster seats for children through age 8.

0.0 - 5.1

5.2 - 8.8

8.9 - 13.7

13.8 - 20.8

20.9 - 37.5

12 Safe Kids Worldwide

Public Policy for Child Passenger Safety

Smart public policy has been used effectively to encourage parents and

caregivers to protect their children from car crashes with car seats. Since 1997,

when Safe Kids teamed up with the General Motors Foundation to create

the Buckle Up program, the fatality rate involving kids 9 years and under has

declined by 54 percent. There are laws in every state requiring the use of car

seats for small children, and with the passage of a law in Florida this year, 49

states have laws requiring the use of booster seats when kids get older and

larger. South Dakota is the only state without a booster seat law.

Law enforcement faces a challenge in enforcing these laws because visibility

in the back seat is difficult. However, these laws also send a powerful message

about the importance of car seats to parents. In our survey, 70 percent of

respondents said they knew about booster seat laws. There are several ways

that government can continue to play an effective role in increasing the usage

of child restraint systems, using the right seat for the right size and encouraging

the correct use of the seat.

Car Seat Checkup Events: We found in the results of this survey that parents

who have had trained technicians check the installation of car seats are more

likely to have a good history of adhering to child safety in cars. For example,

parents who have had their seat checked are more likely to say they always

or often talk to a carpool driver about the type of car seat their child uses

(70 percent) compared to parents who haven’t had their child’s seat checked (50

percent). In the federal law providing funding for highway safety, resources are

available to support car seat check events in states, among other safety efforts.

There are ways to better incentivize states to effectively use the funds for car

seat checks. As it stands today, the funding formula in the law is skewed in favor

of seat belt usage awareness and enforcement. Both car seats and seat belts

are vitally important and there should be parity—matched by law enforcement

pragmatism—in the way the programs are supported in states.

Tougher Enforcement: Knowing the challenges in enforcing child restraint

system laws, high-visibility "click it or ticket" law enforcement efforts should be

expanded to include buckling kids into car seats.

NHTSA calls the program

“the most successful seat belt enforcement campaign ever.”

High-visibility law

enforcement works best when coupled with aggressive public awareness.

The

report “Towards Zero Deaths” has embraced high-visibility techniques for child

restraint system use.

Tax-Free Car Seats: A car seat may be one of the most important purchases a

parent will ever make, but can be expensive. In addition to passing a booster

seat law in 2014, Florida passed a companion bill that allows parents to

purchase car seats and booster seats free from state sales tax.

Connecticut

also exempts car seats from sales tax.

This helps encourage parents to invest

in potentially life-saving car seats. Safe Kids favors tax-free purchases of car

seats and encourages other states to work towards similar legislation.

Buckle Up: Booster Seats 13

Tougher Laws: In 2011, the American Academy of Pediatrics adopted a policy

position that kids should be in booster seats until they reach 4 feet 9 inches tall

and between 8 and 12 years old.

Some states have passed laws to approach

that standard, including California, Georgia, Illinois, Maryland, New Jersey,

Washington State and others.

However, too many states do not reach far

enough; even the recently passed Florida law is inadequate in requiring kids to

ride in booster seats until only age 6. Safe Kids encourages states to press for

stronger laws that require booster seat use until seat belts fit children properly.

Booster Seats and Seat Belts:

How Tall Do Kids Need to Be?

Older kids are weighed and measured less often than babies, so check your

child’s growth a few times a year. Generally, kids need to use a booster until

they are about 4 feet 9 inches (57 inches) tall and weigh between 80 and

100 pounds.

When your child is seated in the booster seat, make sure the lap and shoulder

belts fit. The lap belt should fit low across the hips (not belly) and the shoulder

belt across the shoulder (not neck.)

Use a booster seat with the vehicle lap and shoulder safety belts until your child

passes the Safety Belt Fit Test.

Safety Belt Fit Test

Children are usually between 8 and 12 years old when the seat belt fits them

properly.

Where to Go for

Hands-On Help

In our survey, 39% of parents

say that they have had a

safety expert check that

their child's car seat or

booster seat was installed

properly. Each year Safe Kids

coalitions hold more than

8,000 car seat inspection

events in the U.S. You can

find a list of your local events

at safekids.org.

The vehicle lap belt fits across

the upper thighs; and

The child’s knees should bend at

the edge of the seat when his or

her back and bottom are against

the vehicle seat back; and

The shoulder belt fits across the

shoulder and chest.

14 Safe Kids Worldwide

Methodology

The online survey was completed by adults with children ages 4 to 10

(n=1,000). A minimum of n=140 was set for each age of the child being

discussed. The survey lasted 10 minutes and was fielded from July 31 to

August 3, 2014, using the Survey Sampling International adult panel.

Most online samples are not projectable according to strict sampling theory

which states that in order for a sample to be projectable to a population

it must be a random sample of that population; that is, one in which all

members of the population have a known and non-zero probability of

selection. Therefore, in a strict sense, no estimate of theoretical sampling error

can be calculated for most online samples. Having said that, online samples,

if recruited, managed and selected correctly, can effectively reflect a known

universe.

For practical purposes, the margin of error for the total sample size of this

study (n=1,000) is 3.1% at a 95% confidence level. This means that if this

study was repeated using the same parameters, 19 times out of 20 (or 95% of

the time) we would expect to get a result within +/- 3.1% of the results we have

here.

For the exploratory analysis of booster seat legislation’s impact on motor

vehicle fatality rates, a t-test was used to compare motor vehicle fatality rate

among children ages 4 to 8 in states where the age requirement is less than

7 years old with those where the age requirement is 7 years old or older.

References

1. National Highway Traffic Safety Administration. Motor vehicle occupant fatalities, 2003-2012, ages 4 to 10.

Available at http://www.nhtsa.gov/FARS. Accessed August 22, 2014.

2. Centers for Disease Control and Prevention. WISQARS, 10 Leading Causes of Death, United States, 2011.

Available at http://www.cdc.gov/injury/wisqars/leading_causes_death.html. Accessed August 22, 2014.

3. Arbogast KB, Jermakian JS, Kallan MJ, Durbin DR. Effectiveness of belt positioning booster seats: an

updated assessment. Pediatrics. 2009; 124(5):1281-6.

4. National Highway Traffic Safety Administration. Estimate of passenger vehicle occupants (ages 10 &

younger) injured in motor vehicle traffic crashes, by age and restraint use. General Estimates System (GES)

2012. Generated July 23, 2014.

5. National Highway Traffic Safety Administration. The 2013 National Survey of the Use of Booster Seats.

June 2014. DOT HS 812 037.

6. Committee on Injury, Violence, and Poison Prevention, Durbin DR. Child passenger safety. Pediatrics. 2011.

127(4):788-93.

7. Safe Kids Worldwide. Booster Seats. Available at http://www.safekids.org/safetytips/field_age/big-kids-

5%25E2%2580%25939-years/field_risks/booster-seat. Accessed August 26, 2014.

8. Macy ML, Reed MP, Freed GL. Driver report of improper seat belt position among 4- to 9-year-old children.

Acad Pediatr. 2011;11(6):487-92.

9. Governors Highway Safety Association. Child Passenger Safety Laws. August 2014. Available at http://www.

ghsa.org/html/stateinfo/laws/childsafety_laws.html. Accessed August 13, 2014.

Buckle Up: Booster Seats 15

10. National Highway Traffic Safety Administration. Motor vehicle crash fatalities, 2012, ages 0 to 12. Available

at http://www.nhtsa.gov/FARS. Accessed August 22, 2014.

11. U.S. Census Bureau, Population Division. Annual Estimates of the Resident Population by Single Year of

Age and Sex for the United States, States, and Puerto Rico Commonwealth: April 1, 2010 to July 1, 2013.

Released: 2014. Available at http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml. Accessed August

21, 2014.

12. Eichelberger AH, Chouinard AO, Jermakian JS. Effects of booster seat laws on injury risk among children in

crashes. Traffic Inj Prev. 2012;13(6):631-9.

13. For example, the Texas “Click it or Ticket” program emphasizes both front and back seats, both seat belts

and child car seats. “Click It or Ticket now includes backseat passengers.” Press release. http://www.txdps.

state.tx.us/director_staff/public_information/pr052410.pdf. Accessed August 27, 2014.

14. National Highway Traffic Safety Administration. National Seat Belt Enforcement Mobilization. May 19

through June 1, 2014. Available at http://www.nhtsa.gov/PEAK. Accessed August 26, 2014. A 2008 study

analyzing how states attain high seat belt usage said the most important difference between high and low

achieving states is enforcement, and “High-visibility seat belt law enforcement is critical.” Hedlund, J, Gilbert

SH, Ledingham K, Preusser D. How States Achieve High Seat Belt Use Rates. August 2008. DOT HS 810 962.

Available at http://www-nrd.nhtsa.dot.gov/Pubs/810962.pdf. Accessed August 26, 2014.

15. National Highway Traffic Safety Association. “High Visibility Enforcement Implementation.” Available at

http://www.nhtsa.gov/Driving+Safety/Enforcement+&+Justice+Services/HVE-implement. Accessed August

27, 2014.

16. “Toward Zero Deaths: A National Strategy on Highway Safety.” April 2014. Available at http://www.

towardzerodeaths.org/dld/TZD_Strategy_4_30_2014.pdf. Accessed August 28, 2014.

17. HB 5601, http://legiscan.com/FL/text/H5601/id/1020904/Florida-2014-H5601-Enrolled.pdf.

18. “Exemptions from Sales and Use Taxes.” State of Connecticut, Department of Revenue Services. Available

at http://www.ct.gov/drs/cwp/view.asp?a=1477&Q=269920&drsPNavCtr. Accessed August 28, 2014.

19. A bill was introduced in New York State to provide a sales tax exemption for child restraint systems, New

York AB 1574, January 19, 2013. Available at http://legiscan.com/NY/text/A01574/id/682504. Accessed

August 26, 2014. Hawaii provides a $25 tax credit for the purchase of child restraint systems.

20. American Academy of Pediatrics. “AAP Updates Recommendation on Car Seats.” March 3, 2011. Available

at http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Updates-Recommendation-on-Car-

Seats.aspx. Accessed August 26, 2014.

21. Safe Kids Worldwide. Child Safety State Law Tracker. Available at http://www.safekids.org/statelaws.

Accessed August 26, 2014.

Suggested citation: Ferguson RW, Yang M, Green A, Walker L. Buckle Up:

Booster Seats. Washington, D.C.: Safe Kids Worldwide, September 2014.

Safe Kids Worldwide

1301 Pennsylvania Avenue, NW

Suite 1000

Washington, D.C. 20004

202.662.0600