Consider the Continuum of Occupant Safety

From Car Seat to Driver’s Seat

This article originated in the September/October 2011 issue of Safe Ride News.

Dr. Winston is a board-certified practicing pediatrician, biomechanical engineer, and clinical researcher.  She is the founder and co-scientific director of The Center for Injury Research and Prevention at The Children’s Hospital of Philadelphia (CHOP).

Since 1997, CPSTs have helped families safely navigate occupant protection for children with measurable results.  Motor vehicle crashes are no longer the leading cause of death for children under age 4.* We have tracked steady increases in appropriate restraint use and a corresponding drop in fatalities—from about 2,000 per year in the 1990s to fewer than 1,100 in 2009 for children less than 16 years old.

But this is no time to rest. The same families we guided safely through childhood into adolescence still need us.  While CPSTs should continue to focus on helping new parents choose and install the right CRs for young children, there are at least two important reasons why CPSTs should also care about teen driver safety.

First is the risk that teen drivers pose to child occupants. Teens drive not only other teens, but also younger children. When they do, these children are at increased risk for inappropriate restraint use, injury, and death. In one study, 40 percent of child passengers driven by teens were less than 13 years old. These children were about three times more likely to be injured than children driven by adults. Teen drivers were more likely to be involved in severe crashes. In addition, lack of or inappropriate restraint use was higher among children driven by teens. Specifically, about one quarter of children under age 4 years and nearly all children aged 4 to 8 years were inappropriately restrained when driven by teens.  A greater proportion of children under the age of 13 sat in the front seat when driven by teens.

Federal crash data tell us that older children (8–17 years) driven by teen drivers (16–19 years) have double the passenger fatality rate as those driven by adult drivers (25 years and older).  For drivers ages 16 and 17 years, passenger fatalities double between passenger ages of 11 to 12 years and peak at a passenger age of 16. Nonuse of restraints is common in these fatal crashes.

Second, parents play an important role in assuring that their teens safely navigate the first years of driving.  In research from CHOP and State Farm, 87 percent of teens report having a parent involved in teaching them to drive.  Four in 10 teens report having only their parents teach them to drive.  But emerging research shows parents may not be adequately equipped to teach teens the specific things they need to become skilled drivers and avoid crashes.  Additionally, teens who describe their parents as setting rules and being supportive are half as likely to crash and twice as likely to use seat belts. They are also less likely to speed, use cell phones while driving, or drive intoxicated.  Parents continue to matter long after you teach them to install their child’s safety seat.

With both the expertise and the platform, CPSTs have the unique opportunity to educate parents about keeping their older child passengers safe and begin the process of developing safe teen drivers as well.

Parents and their older children need continued counseling about:

  • Making safe passenger choices. Remind teens to use seat belts and  to avoid riding in cars driven by novice teen drivers.
  • Providing quantity and quality of practice drives in varied and diverse environments.
    Using graduated driver licensing (GDL).  These rules keep teens out of high-risk driving situations (such as at night, with peer passengers) while they have a chance to develop driving skills in lower-risk situations. It is one of the few proven interventions known to reduce teen crashes.  Parents should make sure their teens follow state GDL laws.  If these are lacking or lax in a given state, family rules can be implemented to mirror model laws.

Flaura Winston—Flaura K. Winston, MD, PhD


Teen Driver Source, a program of CHOP.
This site is organized into user-group sections, including one titled “I Educate and Support Parents.”  By selecting this section, CPSTs and others can access a train-the-trainer webinar and related curricula materials by clicking on “Enhance Their Education.”