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 Start Brainstorming:
Ideas to Improve Tether Use
in Your Community
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   Every community could do more to promote the use of tethers.  The following observations are offered as suggestions to help CPSTs get the brainstorming started.
Light Bulb   Consistently include tethering when describing the transition from rear to forward facing.  I appreciated the National Transportation Safety Board’s CPS Week blog post,* which said “When children outgrow a rear-facing car seat, they should use a forward-facing car seat with an internal harness and tether.”  This promotes the tether as part of the transition process and keeps it from being linked only to the LATCH system.  On the word “tether,” the NTSB even provided a hot link to the SKBU tether report.
Light Bulb   Don’t save tether talk only for caregivers of children currently using forward-facing CRs.  While it’s important not to overload parents with too much information, I’d argue that tethering is important enough to mention in every interaction.  So, even when I’m talking to expectant parents or those with babies, I point out the tether anchor hardware for future reference (and the tether strap, if present). We always discuss next steps with these folks, so why not mention tethering as something to expect down the road? 
Light Bulb   Include failure to use, or properly use, the tether on educational materials that list common forms of misuse.  The SKBU study certainly supports that this is a prevalent mistake, but often I see this form of misuse left off of these types of listings of mistakes for caregivers to avoid.
   Light BulbMention tethering first when describing how to install a forward-facing CR.  Because tethering is a final step in the FF installation process, we tend to talk about it last.  However, besides making tethering seem like an afterthought, there is another problem with this approach:  Not every seating position has a tether anchor.  Why tell the caregiver how to install a CR, and then end with a step that might not be possible in the seating position chosen? Instead, training materials should instruct CPSTs to begin describing the installation of a forward-facing CR by saying, “select a vehicle seat that has a tether anchor that can be used with the CR, per the instructions.”

* Find the full NTSB blog post on CR selection here:
https://safetycompass.wordpress.com/2017/09/18/are-you-making-the-right-choice

 Safe Kids Finds Tether Usage Still Low
A recent study found only 36% of FF CRs
are tethered—the same low rate as in 2012.
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SKCR Tether Essential but Overlooked   A new study from Safe Kids Buckle Up (SKBU), Car Seat Tethers:  Essential for Safety But Consistently Overlooked, revisits the topic of tether use and misuse, comparing information from recent checkup forms to similar studies from past years.  The results show that not only does tether use continue to be very low but also shows no improvement over the past several years.  Also, among tethers that are used, misuse rates continue to be high.
   Looking at checkup forms from inspection events over a 15-month period (October 2015 through December 2016), SKBU found that only 36 percent of forward-facing CRs were tethered upon arrival.   By comparison, a similar review of forms from an 18-month period from 2011 to 2012 found the exact same usage rate. So, despite modest improvement compared to an earlier 12-month period studied (2009 to 2010), when usage was found to be 28 percent, no progress has been made in recent years.
   Also of concern is the frequency of tether misuse.  SKBU reports that CPSTs have seen many types of misuse among the few tethers that are attached, including attachment to hardware that’s not a tether anchor.  To assess current levels of misuse, SKBU looked at inspection forms from April to October 2016 and found that tethers that were used had some form of misuse 44 percent of the time.  Ten years ago, SKBU conducted a tether misuse baseline study, which found 46 percent tether misuse.   So, nearly half of tethers are misused, and this percentage is roughly the same today as it was a decade ago, when tethering was a relatively new practice in the U.S., and many fewer vehicles had tether anchors built-in.
   The SKBU report reminds readers of the importance of caregiver education provided by the more than 40,000 CPSTs across the nation.  Those who attend checkup events might not arrive using a tether, but all are certainly educated about its use during the inspection.  And the misuse part of the study included a follow-up component to learn how many of the tethers used correctly upon leaving an event are still being used properly six weeks later.  In the 2006 study, that figure was 83 percent, while in 2016, 93 percent were using the tether correctly in the follow-up inspection. SKBU notes that this shows that CR checks with caregivers are successful at explaining the importance of tethers and changing safety behavior.

Reference: MacKay, M.; Walker, L. Car Seat Tethers: Essential for Safety but Consistently Overlooked. Washington, D.C.: Safe Kids Worldwide. September 2017.

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