Driver report of improper seat belt position among 4- to 9-year-old children

Michelle L. Macy*, Matthew P. Reed, Gary L. Freed

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objective: To determine the frequency with which drivers report improper seat belt positions among children 4-9 years of age and the frequency with which reported problems were attributable to the lap belt, shoulder belt, or both. Subjects and Methods: Analysis of driver responses to 5 questions related to seat belt positioning from the cross-sectional, phone-based 2007 Motor Vehicle Occupant Safety Survey. Belt position problems categorized as related to (1) shoulder belt and (2) lap belt. Improper belt position was compared across age groups (4-6 years, 7-8 years, and 9 years) and use of a child safety seat with χ 2 statistics or Fisher exact tests as appropriate. Results: Seat belt use was reported for 334 of 891 (37%) 4- to 9-year-old child passengers, and 261 (78%) drivers reported improper belt fit among these child passengers. Improper shoulder belt position (44%) was less common than improper lap belt position (62%). At least one improper belt position was reported by 78% of drivers of 4- to 6-year-old children, 77% of 7- to 8-year-old children, and 79% of 9-year-old children (P =.87). There were no significant differences in report of improper belt position among children who never and those who occasionally use a child safety seat were compared. Conclusions: Drivers frequently report improper lap and shoulder belt positions for their 4- to 9-year-old child passengers yet persist in restraining children by the use of seat belts alone. Clinicians can promote the use of size-appropriate child passenger restraint systems, including car seats and booster seats, to overcome the improper belt positions identified in this study.

Original languageEnglish (US)
Pages (from-to)487-492
Number of pages6
JournalAcademic Pediatrics
Issue number6
StatePublished - Nov 1 2011


  • child
  • passenger safety
  • seat belt

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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