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Car Seats

Always consider commercially available products as the first option. Most infants, children and youth with special needs do not require specialized equipment.

 

Try to find a commercial child safety seat that does not require modification in order to support the child. However, if there are no standard commercial car seats that are appropriate for your child’s needs, there are other options.

  

Always follow the manufacturer’s instructions for installation and use (check the safety seat and vehicle manuals). Safety seats are designed and crash-tested to work the way they are manufactured.


 
  • Ensure that the car seat meets the Canadian Motor Vehicle Safety Standards
  • Ensure that the car seat shows the National Safety Mark:


  • Safety seats that do not display this safety mark may be available for purchase locally or online. These have not been crash-tested to the Canadian Motor Vehicle Safety Standards and are therefore not supported by national or provincial governing bodies, meaning they are not recognized under the law. 
Size and fit: 
  • Read and follow all specifications on the car seat to match the height and weight of your child. These may be slightly different for each model. 
  • For multi-use seats (rear, forward, and booster conversions), make sure you are aware of the restrictions for each level of use. 
Installation: 
  • Always refer to the manufacturer's instructions.
  • Read and follow all specifications for installation and ensure the seat is compatible with the vehicle(s) in which it will be used. 
  • For your child car seat or booster seat to be effective, it must be installed correctly (see car seat installation guides from Parachute Canada). 
Safety check: 

Information in additional languages

Visit Choosing a child car seat or booster sea - Transport Canada for instructions with diagrams, and key information regarding all of the above in Arabic, Chinese, Punjabi, Somali and Spanish.

Call 1-877-247-5551 to speak with an expert at the Child Passenger Safety Program.


 

Premature Infant: Safe Travel With Your Baby - HealthLink BC


Size and Fit: 
  • Select a seat that is appropriate for the height and weight of your child
  • Look for the lowest minimum weight limit and shortest distance between the seat and the first shoulder strap harness slot. 
Car Seat Challenge:
  • May be required for some infants before leaving the hospital.
  • The health care team and parents assess the infant’s tolerance for sitting for a length of time. This assessment includes observations of breathing and any physical/medical issues. 


Specific car seats may be available from your hospital for loan under special circumstances. 

 
Casts that may interfere with transportation are: 
  • body casts
  • hip spica casts 
  • long leg casts 
This document on hip spica casts covers a number of issues, including transportation; Hip Spica Body Cast (PDF) - BC Children's Hospital. 

Before surgery

If surgery is planned in advance, determine a transportation plan with input from the whole team, including:

  • Parents/caregivers 
  • Orthopedic clinic team members (doctor, therapist, nurse). 
  • Community rehabilitation team (occupational and/or physical therapist). 

After surgery

  • Calculate the child’s weight with the cast on. 
  • Determine if the child can use their pre-surgery equipment, i.e. child safety seat, the vehicle seat or wheelchair. If not, consider other options:
    • Special Needs Transport or ambulance. 
    • A different commercial car seat
      • take measurements of the child’s width at the hips and knees
      • look for a car seat with a wide/open front 
    • Hospitals may loan equipment, e.g. abduction adapted car seat for younger children or a modified E-Z-on vest for older children. 
    • Change position on a regular seat, e.g. Sit in the middle back bench seat, rest one leg on the front centre console and the other on the folded-down front passenger seat. 
  • Note: Meeting short-term transportation needs may mean some costs for the family

 
We recommend that parents consult with an occupational therapist or physiotherapist and the medical team in assessing and selecting the most appropriate transportation options. 

In the event that the child/youth cannot be safely transported with a commercially available car seat or custom restraint, considerations for selecting a special needs car seat may include:

  • Postural issues: Low or high muscle tone
  • Orthopedic issues: post-operative casting, spinal curves, hip displacement
  • Height and weight: When the child has grown out of commercial restrictions; low weight/size
  • Medical conditions: Seizure disorder, tracheostomy, cardiac and respiratory issues
  • Behavioural concerns
Note: Some of the special needs equipment products available on the market may not have the National Safety Mark. These products are still available for purchase in Canada through a dealer or online.
 
It is always best practice to use a car safety seat/harness with the National Safety Mark before considering a product that has not been approved by Transport Canada. 


 

Modifications

Do's

Modifications can be considered as long as they do not interfere with or alter the original product. 


Trunk control

  • Lateral support along the trunk and side of the head using tightly rolled blankets, towels, or foam rolls. 
  • Rolls can be added between the child’s legs and crotch strap
  • A foam roll or rolled blanket can be placed under the child’s knees (NOT under thighs or buttocks) to increase hip flexion to reduce sliding forward

Neck control

  • Lateral support along the trunk and side of the head using tightly rolled blankets, towels, or foam rolls.
  • Soft foam collar can be used to prevent the head from falling forward. Only soft foam collars are recommended. DO NOT use stiff neck collars, moulded stays, or head straps as they may increase the risk of neck injury.  

Behavioural issues

  • Use a safety seat with a five-point harness as long as possible. Upper weight limits for harness wear vary among manufactures. Always follow the manufacturer’s instructions for harness use. 
  • Consider a special-needs car seat with a five-point harness or the E-Z-On vest for children who have outgrown commercial seats.
  • Consider a buckle guard if opening the seat belt is a safety issue. These can be difficult to open in an emergency, so have a seat belt cutter available in the car.
  • Use a social or personalized story/story boards to augment communication of expected behaviour when travelling. 

Don'ts

  • Do not use blankets, extra padding, bunting bags or bulky clothes behind/under the child or between the child and the harness. In a crash, these materials compress allowing the harness to become too loose to properly secure the child. 
  • Do not modify the seat belt. Items that alter the fit or effectiveness of the harness or seat belt could cause injury to the child. 


Transporting Infants and Children with Special Needs in Personal Vehicles: A Best Practices Guide for Healthcare Practitioners (PDF) - Transport Canada: highlights what you need to know about custom restraints.   

“For infants and children with special needs who are unable to use conventional car seats, there are two options: the use of production restraints or custom restraints. These two types of restraints are manufactured for children with special needs. It is vital that parents are informed about production and custom restraint options in order to avoid the use of substandard products, makeshift restraint systems, or unsafe methods of securing children in motor vehicles.”

"Certificate of exemption for use of a seatbelt" (PDF) - Government of British Columbia 

"Note to Applicant: This application is a request for exemption from provincial laws that require passengers up to and including age 8 in motor vehicles in British Columbia to use seat belts and child restraints." 

 
SOURCE: Car Seats ( )
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