Development of an alternative five-point restraint harness to accommodate children with special healthcare needs in child safety seats.

Commercial automotive child restraint systems (CRSs) do not accommodate all children with special healthcare needs. This study developed an alternative harness for a commercial CRS to meet the needs of children for whom a five-point harness cannot be positioned over medically involved areas and/or children whose conditions require the harness belts to be threaded through medical devices. After initial design work and a series of frontal sled-impact tests, one of two prototype designs was chosen for fit testing on children with and without healthcare conditions. After a minor modification, additional sled-impact testing was conducted to determine compliance of the system to federal standards. The CRS with alternate harness provides good fit to children with a variety of healthcare needs and complies with all performance criteria of FMVSS 213, with the exception of peak forward head excursion using the Hybrid III 6-year-old crash-test dummy. It is expected that all performance criteria will be met using the newly-issued federal allowance to conduct CRS frontal-impact tests using an earlier version of the dummy. The new harness shows promise as a low-cost solution for achieving a safer level of transportation for children who may otherwise travel unrestrained or with a severely misused CRS harness.