The approach and criteria for choosing the “best special needs restraint ” is same as with any child and determination of the need for and type of CRD should be made by health care professionals. Special needs restraints generally are more expensive and may be more difficult to access and use.

Breathing difficulties that some low birth weight and/or premature infants have while in semi reclined child restraints is the most common special transportation needs condition. Premature infants should be observed in a child restraint before discharge from the hospital to see if the semi-reclined position adds to or causes possible breathing problems. If recommended by a pediatrician, a crash-tested car bed may be used for a short period so that the baby can lie flat. Whenever possible, a premature infant should ride where an adult can watch his or her breathing.

Special transportation needs restraints may also be needed for:
1. Children with orthopedic conditions requiring casts,
2. Children with poor trunk or head control due to conditions like cerebral palsy, or
3. Children with behavior problems.

Persons in North Carolina interested in learning more about the transportation of children with special health care needs training should contact Vickie Whitlatch, Western NC Safe Kids at Mission Hospitals in Asheville by phone: 828-213-5554 or email: victoria.whitlatch@msj.org.

For additional information about the transportation of children with special physical and/or developmental needs, refer to the Automotive Safety Program, Riley Hospital for Children.