Car Seats + Special Needs Situations
I've written about how to choose a car seat as a foster or adoptive parent, but what if you run into a unique or special situation where it's not easy to find what you need? What happens when your child can't use a conventional car seat? What do you do if they've outgrown a seat by height or weight but aren't old enough or developmentally mature enough to move on to the next type of seat? What if they have a medical issue that makes them unable to sit properly in a car seat?
In 2023, I was fortunate enough to attend the Safe Travels for All Children course. This class equips Child Passenger Safety Technicians (CPSTs) to work with children who have special healthcare needs. I was eager to take this additional training because in my work with the foster care population, we run into these kinds of needs more frequently. We also often don't have the luxury of having lots of time to research solutions - when kids are placed, they need something that works for them NOW.
Recently, we began completing a car seat screening for each child we place. Our intake team is trained on how to quickly assess a child's fit in their car seat, making sure they are in the correct seat and that it is fitted and installed properly. After the initial screening, myself our our other CPST, Nicole, connects with the foster parents to review any potential issues they might encounter, and offer support in case any questions or problems arise throughout the placement.
Our first goal is always to find a conventional car seat that works for the child. While special needs car seats do exist, they can be challenging for anyone to obtain, especially a child in foster care. Because they are extremely expensive, they are typically ordered and paid for through the child's medical insurance. However, this is a long process that can take months, and we often don't have days let alone months to wait to be able to safely transport a child. If we are working with a child who we anticipate will need a medical seat within the next year or so, I would always recommend starting that process as soon as possible to make sure that they have the seat they need by the time they need it.
As a CPST, I am happy to help families find a conventional car seat that works for their unique situation. For example, I worked with a family who was caring for a little boy who was extremely tall for his age. Due to his developmental delays and low muscle tone, he was not yet ready to ride in a booster seat, but he had exceeded the height limit for the harnessed car seat that the family had. Thankfully, I was able to point them to the one seat on the market with a height limit tall enough to accommodate him, and it was quickly provided for him by a generous donor through The Kindness Project.
Another time, one of our families was caring for a child who frequently unbuckled her chest clip to escape from her car seat. I was able to direct them to a car seat manufacturer (Evenflo) who allows use of a special anti-escape chest clip with some of their seats. In fact, we now have one of the approved seats as well as the anti-escape clip in our office, so that we can lend them to families to use immediately while waiting for them to ship if they run into this problem. This has essentially reduced months of waiting for a medical seat into a same-day solution!
Some other examples of special needs we may encounter include:
- Casts/injuries
- Very low birthweight babies
- Very tall or heavy children who have exceeded the height or weight limits of their seats
- Older children with autism or developmental disabilities who are unable to sit safely in a booster seat
- Older child with physical disabilities who need more positional support than a booster seat provides
For some of these conditions, children will be helped by their medical team before being discharged from the hospital. For example, if a baby is too small to fit in a conventional car seat, their doctor will either choose to keep them admitted until they weigh enough to fit in the seat, or determine that a special car bed needs to be ordered for them.
In other cases, the need doesn't always become apparent until the child is placed in their foster home. For example, a foster parent may put a 6 year old child in a booster seat, and later discover that when they become dysregulated or have a meltdown in the car, they unbuckle their seatbelt and move around the vehicle or try to hurt other children. At this point, the need becomes and emergency situation because they are not able to drive again with that child until they are able to find a way to keep them safely restrained. This is where we can help!
Providing the services of our on-staff CPSTSs is just one of the many unique and special ways that The Salvation Army Children's Services supports and cares for our foster and adoptive families. And we're always looking for ways to improve our services, so if you have an idea of a special way we could support our families, please don't hesitate to reach out!
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