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Automobile transportation; car seats, wheelchair carriers and van lifts.


Automobile travel is a part of everyday life that begins in early infancy. Most infants, including many infants with disabilities, can travel safely in commercially available infant car seats that are secured to the automobile via standard seat belts. Padding the sides with diapers or blankets may help hold an infant comfortably.

Infants under 18-20 pounds musl always ride in a rear-facing position. Although it is usually safer for a infant or a child to be seated in a back seat, a child with a medical condition with possible respiratory problems should always be observeable. Accordingly, when the driver is the only adult in the vehicle, these children should be seated in the front passenger seat, facing rearward. If a baby is in the rear seat facing the b!ck of the car, the driver will be to see the baby's face.

for infants who are considered "medically fragile" and must lie flat for travel, the Swinger car bed can be used for a child up to 20 pounds and 26 inches in height). This car bed has a padded cary cot that can be used to carry the child. Inside the cot, the baby is secured in a bunting bag. Recently, a premie bunting bag, which includes slots for monitor lead and/ or a gastrostomy tube, was designed for infants under five pounds. for information about the Swinger, contact: Shinn and Associates Inc., 2853 West jolly, Suite 2, Okemos, MI 48864; (517)332-0211.

Infants and toddlers wi4h hip spica casts (for congenital hip dislocation) can use the Spelcast car seat; rear facing position for infants, foward facing for toddlers. For information, contact Jerome Koziatek and Associates, 190 W. Boston Road Hinckley, Ohio 44233; (216)659-4961.



When any young child gets too big or too long for an infant seat, if the child is able to sit upright without special assistance, she/he moves onto a booster weat or the regular seat and is secured via the seat belts that come with the vehicle.

For young children with disabilities who need special seating system or other kinds of special equipment in order to sit upright, harness restraints and/or special car seats are usually required for safe transportation. Special harness restraints and (called vest) can be used for children in large casts or braces who need to lie down to travel or as restraint systems for children who are unable to control their own behavior in a vehicle. SELECTING CAR SEATS

Special car seats offer different features. Some are designed to be used on mobility systems like strollers or wheelchairs as well as in an automobile; other are only for transportation. some positioning systems which usually used on mobility systems can also be used as special car seats. For safe travel, trays which are part of positioning systems should always be removed.

special car seats come with a harness or safety strap to secure the child in the seat; some require special harnesses especially for larger children. Some are safe when used with regular available seat belts; some require additional tether (restraint) straps bolted to the vehicle floor or the reat window shelf.

Belts, harnesses, and straps are describe by the number of points of the body secured. Standard vehicle seatbelts are three point (two hips, one shoulder) or two point (two hips). special seats or positioning systems may use four point (two hips, two shoulders, and between the legs) restraints.

In order to determine which special car seats are appropriate, parents need to review the child's specific seating needs as well as be certain that the child's weight (including special appliances like braces) is within the tested limits stated by the manyfacturer. With the help of experienced therapists, commercially available positioning systems, special car seats, and ordinary car seats can often be adapted (customized) to meet specific needs. Parents also need to review the installation instructions of any car seat to be certain that the particular seat can be installed in the model of automobile to be used.

Parent should discuss travel safety with their child's team; however, parents cannot always expect expertise in this specialized area because of it is a relatively new area for many professionals.

Special car seats are expensive compared to the cost of ordinary child safety seats. They are available from medical equipment retailers. Prices begin over $400 and can be a great deal more expensive depending on the individual special pieces of equipment that may need to be added to the basic seat.

Reimbursement from third parties such as health insurance plans or agency programs varies widely in relation to car seats, even when the car seat is prescribed by a physician. Parents will need to review this with health insurers or other reimbursement programs as well as with the medical equipment dealers who sell special car seats.


An older, heavier child who needs a special seating system or is unable to transfer from a wheelchair to an automobile seat will need to travel in his wheelchair or scooter, which then needs to be placed into a vehicle via a ramp or lift. Whenever possi-ble, once in the van (or bus), the individual will be safer if he or she can be transferred to a seat with a proper seating restraint system. When the individual remains in his wheelchair, it must be secured to the van properly.

One product (Auto-Mate) makes it possible for an individual in a wheelchair to be transferred into the car withoutleaving the wheelchair. With this system, a special wheelchair can be put directly into some intermediate and larger two-door cars that have a split bench or bucket fron seat. An arm extends from the automobile that locks onto the chair and lifts it. Then the wheels are removed; one is stored under the seat, and one is stored on the back of the seat. The wheelchair is then automatically positioned into the car. for more information about the Auto-Mate, contact KG Engineering, 115 Front St., Woonsocket, R.I. 02895, (401)765-0103


Van equipped with automatic lifts provide easy access to vans; semi-automatic lifts are also available. There are different types of van lifts; not all van lifts fit all models of vans. Some types of lifts may not work under extreme weather conditions. Platform lifts fold out from a van like a draw-bridge and require perpendicular access to load the wheelchair. Rotary lifts rotate outward from the side door of a van so that access is parallel to the van.

Portable ramps or folding tracks can be used with all vans. Since these are not permanently fastened, they must be re-positioned for each use. Folding ramps can be bolted to the floor inside the side or rear door of the. Then the ramp can be folded and stored in an upright position just inside the door.

When an individual can transfer from a wheelchair or scooter into an automobile; wheelchair loaders and carriers provide ways to bring the wheelchair along. Loaders can be mounted in a vain, the trunk of a car, or in the back of a pick-up truck. Wheelchair carriers can be mounted to the bumper, a trailer hitch, or on the top of the car.


Although the Federal government (via Federal Motor Vehicle Safety Standards 213) has developed standards for children's car seats designed for children up to 50 pounds using ordinary automobile seat bealts, there are no regulations or safety standards regarding the transportation of children with disabilities. The manufacturers of most of the special car seats described in this article certify that their seats meet the U.S. Government standards and have been crash tested at the weights listed.


Eight sizes; from small children to adults; tested up to 164 pounds; for use in an upwright seated position. Also used for children in large casts or braces who need to lie down. The vest is mounted via a tether over the back of the car seat. E-Z-On Products Inc., 500 Commerce Way West, Jupiter, Fla. 33458; 1-800-323-6598


Three sizes; attaches to a strap on the car seat. Has not been crash tested; manufacturer does not certify that it is approved under federal guidelines. Therapeutic Creations, 1365 North Boradway, Suite #261, Walnut Creek, Calif. 94596; (415)930-3460.



Four sizes: pre-school, to 40 pounds; elementary, to 60 pound; junior, to 100 pounds; small adult, to 130 pounds. Positioning features are molded into seats. Additional tether necessary for safety. J.A. Preston, 60 Page Road, Clifton N.J. 07012; 1-800-631-727.




One size; crash tested at 65 pound secured with the vehicle seat belt; crash testing qt 102 pounds in process. Padding and support can be inserted. Columbia Medical Manufacturing Corp., PO Box 633, Pacific Palisades, Calif. 90272; (213)454-6612.


Wheelchair with removable bucket seat on the frame (three seat sizes); used as car seat to 50 pounds by adding a "car seat packet' (harness, tether stap). Gunnell, 221 North Water Street, Vassar, Mich. 48768; 1-800-551-0055


Positioning system can be used as a car seat up to 35 pounds. Use with safety harness and tether sold by the manufacturer as one unit. Mulholland Positioning Systems, Mobility Plus, 215 N. 12th St., PO Box 391, Santa Paula, Calif. 93060; (805)525-7165.



Positioning system seating unit; two model M6302 tested to 50 pounds; large model not yet tested. Placed on front passenger seat; an additional seatbelt must be installed because system requires two seat-belts. Does not fit easily in all cars. Ortho-Kinetics, Inc., PO Box 1647, Waukesha, WI 53187; 1-800 558-7786.


Two series of positioning systems. Primary 500 Series, two sizes: 501, to 40 pounds; 502, to 60 pounds. 900 Transporter Series, two sizes: 901 and 902, both to 125 pounds. Requires special child positioning restraint and tether strap. 900 series does it fit easily in all cars. Safety Rehab Systems, Inc., 147 Eady Court, Elyria, Ohio 44035; 1-800-421-3349


Seating system; two models. SS1 for children to 40 pounds uses the car seat belt; SS2 model for children up to 70 pounds requires tether sold with unit. Snug Seat Inc., PO Box 1141, 648-B Matthews Mint Hill Road, Matthews, N.C. 28106; (704)847-0772.


Formerly called the Britax Handicapped Child Safety Seat; can be used for children from 20-50 pounds with vehicle seat belt; for heavier children, up to 105 pounds, requires special tether strap. Shinn & Associates, Inc., 2853 West Jolly, Suite 2, Okemos, MI (517)332-0211.


Positioning system; four models, from "Tiny Tot" up to adult. Has not been crash tested or certified under federal guidelines. Palmco Engineering Company, 12007 Rivera Road, Santa Fe Springs, Calif. 90670; (213)696-5325.


Safely Home. Videotape, 1/2 inch 16 minues. Demonstrate the Swinger Bed, Spelcast Car Seat, abd E-Z-On Vest. Send $25 donation payable to Indiana University Foundation, c/o Automative Safety for Children Program, Riley Hospital for Children, 702 Barnhill Drive, Room S-139, Indianapolis, Ind. 46223.

Problems in Transporting the Handicapped. Film, 16mm, 27 minutes. Problem solving techniques for transporting children with disabilities. Available for sale, $400; preview charge, $25. Contact Visucom, PO Box 5472, Redwood City, Calif. 94063; (415)364-5566.

PHOTO : Automated by KG Engineering transports a person in a wheelchair directly into the car.
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Publication:The Exceptional Parent
Date:May 1, 1989
Previous Article:ABLE: the future of mechanical aids.
Next Article:Respite services; a national survey of parents' experience.

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