Special Needs Car Seats, Pediatric Special Needs Car Seats

How do I Choose the Right Car Seat for My Special Needs Child?

While all special needs car seats provide exceptional body support and help to promote proper seating positions, there are several different styles, sizes and configurations available to more fully suit the needs of your own special child. Many of the designs highlight accessories that will help you adapt the restraint to your child’s specific requirements, while others will ‘grow’ with your child, featuring adaptations that can be adjusted as your child grows larger, eliminating the need for numerous car seats through the early years.

Infants and children with special needs, including autism, spinal cord problems or cerebral palsy do require adaptive restraints so that they can stay safe while riding in cars, vans or buses. Children who exhibit certain kinds of behavior, such as a tendency to unbuckle a car seat’s safety harness straps and buckles will need a restraint that they cannot undo.

Here is a general overview of various medical and behavioral conditions that may warrant the use of a pediatric special needs car seat restraint system for infants and children: low birth weight/premature infants, spina bifida, respiratory complications, conditions that require an infant to lay flat, orthopedic conditions, developmental delays, low muscle tone, high muscle tone, casts (hip spica), halo traction, scoliosis, osteogenesis imperfecta, developmentally dislocated hip, achondroplasia, Down syndrome, cerebral palsy, neuromuscular delays, hydrocephalus, spinal muscular atrophy, myeloemengocele, apnea, tracheostomy, Pierre Robin sequence, autism spectrum disorder, severe attention deficit hyperactivity disorder, gastroesophageal reflux, obesity and conditions that require feeding tubes.

Types of Pediatric Special Needs Car Seats and Restraint Systems

Rear-Facing Car Seats

Children are best protected in an automobile accident if they are seated facing the rear of the vehicle, so it is best to keep them in that riding position for as long as possible, even though current guidelines only advise this type of restraint until the child is around the age of two. Special needs car restraint seats that are rear-facing can often accommodate children up to 35-40 pounds, enabling parents to keep their children in this safest position. Smaller sized car seats highlight smaller internal dimensions to more appropriately fit premature infants, while some rear-facing seats offer adjustable head support systems to give infants adequate lateral support.

Convertible Car Seats

Convertible pediatric special needs car seats typically make great ‘grow-with-your-child’ adaptive vehicle transport seats. They are converted from an infant only seat to a toddler seat by making specific changes, always according to the manufacturer’s specific instructions to ensure safety and security is consistently maintained. Convertible car seats can help to keep your child riding rear-facing for as long as possible, as well. Newer, more innovative convertible car seat designs often allow children up to 40 pounds and 40 inches in length to continue to ride rear-facing. This is very beneficial for many children with special needs, as youngsters with poor upper body control and low muscle tone will be much better positioned and protected in the rear-facing restraint. When your child has outgrown the rear-facing specifications, the convertible car seat can be converted to a forward-facing design.

Forward-Facing Car Seats

Along with convertible special needs car seats, forward-facing seats are quickly increasing in availability, providing extended benefits of five-point harness protection for older/larger special needs children. With upper harness limits as high as 90 pounds, this style can give extra restraint protection for children with obesity, behavioral challenges and positional issues. The semi-reclined position in the forward-facing design may help many positioning challenges that occur with children that have poor neck and head control, or who have outgrown the limitations of rear-facing seating. Forward-facing seats that have shallow or low sides may be particularly beneficial to children in hip casts or long-leg broomstick casts. Additional padding and positional inserts can help make children with neuromuscular or bone dysplasia issues more comfortable as they attain better positioning.

Belt-Positioning Booster Car Seats

Suitable for children who are overweight, belt-positioning booster seats can also help children who are much smaller than their peers, such as children with achondroplasia. While they assist smaller children to see out the windows, which may lead to better behavioral control, booster seats with high backs additionally provide good lateral support for larger children who experience intermittent fluctuations with trunk, neck and head control. Comfort is also improved for larger children by giving them the ability to bend their knees and let their legs hang down. Booster car seats are generally best used by children with adequate trunk, neck and head control.

Car Beds

Specifically designed for infants who must travel lying down, the use of a car bed should always be made by your pediatrician, as this option is reserved for infants who demonstrate a medical necessity. There should always be a period of observation made once the baby is placed in the car bed, to ensure that this placement is not exacerbating any of the infant’s symptoms. Your pediatrician should also be involved in the decision to convert your infant’s vehicle riding to a semi-upright position, ensuring that he or she is ready to make this transition. Car beds are often used for infants who are in casts, or who have cardio-respiratory disorders, omphaloceles and other abdominal or midline chest defects and neuromuscular disorders.

Hip Cast Car Seats
As a highly specialized car seat, hip cast car seats such as the Hippo highlight a wedge that can be configured in various ways to better position your child. As a convertible car seat, this hip cast seat can be used both rear-facing and forward-facing. It is specifically designed to accommodate the special needs of children in hip casts.

Hulet Smith, OT
Rehabmart Co-Founder & CEO

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