Frontal and oblique crash tests of HIII 6-year-old child ATD using real-world, observed child passenger postures

Fatal Head Injury in a 1-Year-Old Child Secured in a Rear-Facing Child Seat by Offset Car-to-Car Collision

This case study describes a fatal head injury in a 1-year-old child involved in a motor vehicle accident in Japan. The child, secured in a rear-facing child seat, was a passenger in a car driven by their mother when the offset car-to-car collision occurred. The car rotated counterclockwise before coming to a stop. Despite remaining secured in the child seat, the child suffered severe head trauma, leading to cardiac arrest. Autopsy computed tomography revealed a right open depressed fracture, left head contusion, traumatic subarachnoid hemorrhage, intraventricular hemorrhage, and pneumocephalus. The injury mechanism involved the child's head striking the right headrest, followed by a swing to the left, induced by the initial impact and subsequent rotational movement. This case highlights the importance of age-specific data in understanding pediatric injuries in motor vehicle accidents and improving child seat safety measures.

Comparison of child and ATD belt fit and posture on belt-positioning boosters during self-selected, holding device, and nominal conditions

OBJECTIVE

Pediatric anthropomorphic test devices (ATDs) are important tools for the assessment of child occupant protection and should represent realistic child belt fit and posture on belt-positioning boosters. Previous comparisons have been made to children in either self-selected or nominal postural conditions. This study compares belt fit and postural measurements between pediatric ATDs and a single cohort of children assuming different postures on boosters: self-selected, holding a portable electronic device, and nominal.

METHODS

A cohort of children (n = 25) were evaluated in a stationary vehicle on five boosters and in three postural conditions: nominal, self-selected, and a representative holding electronic device position. The Hybrid III 6- and 10-year-old and Q-Series 6- and 10-year-old ATDs were evaluated in the same five boosters and in two postural conditions: nominal and a representative holding electronic device position. A 3D coordinate measurement device was used to quantify belt fit (shoulder belt score, lap belt score, maximum gap size, and gap length) and anatomic landmark positions (head, suprasternale, ASIS, and patella). Landmark positions and belt fit were compared between ATDs and children for each booster and postural condition, and Pearson correlations (r) were assessed across boosters.

RESULTS

ATDs generally represented Nominal child postures across boosters. In the Device condition, ATDs were seldom able to be positioned to represent both the torso and head position of children, due to limited ATD spinal flexibility. When the torso position was matched, the ATD head was more rear by 63 mm. Correlations between Nominal child and ATD belt fit and belt gap metrics were generally weak and not significant, with the exception of lap belt score (all ATDs p < 0.07, r = 0.8549-0.9857).

DISCUSSION

ATDs were generally able to represent realistic child postures and lap belt fit in Nominal and short duration Self-selected postures in a laboratory setting. However, these results display the potential difficulty of utilizing ATDs to represent more naturalistic child postures, especially the more forward head positions and flexed spinal posture associated with utilizing a portable electronic device.

Assessment of pediatric shoulder range of motion and loading response to evaluate the biofidelity of the Large Omni-directional Child (LODC) anthropomorphic test device (ATD) shoulder design

The shoulder girdle complex, through engagement with the seat belt, influences motor vehicle occupant upper body movement during frontal impacts, affecting the movement of the head and spine. The recently developed Large Omni-directional Child (LODC) anthropomorphic test device (ATD) was designed with flexible shoulder girdle structures that capture the unique kinematics in pediatric occupants. However, the LODC shoulder has not been evaluated for biofidelity due to the lack of biomechanical data available on pediatric shoulder responses. This study evaluated quasi-static pediatric shoulder girdle complex responses through non-invasive displacement measurements. These data were obtained to evaluate, and, if necessary, improve the biofidelity of the LODC ATD. Shoulder range of motion and anthropometric measurements were obtained from 25 pediatric volunteers, ages 8-12 years old. Loads were applied bilaterally exclusively to the shoulder complexes in increments of 25 N up to 150 N per shoulder at 90 and 135 degrees of shoulder flexion. Still photos were used to determine shoulder displacement in the sagittal plane from images captured prior to and following the load applications. Data analysis consisted of motion tracking to evaluate the absolute and relative displacement of the right acromion and T1. The displacements for each volunteer were normalized based on the volunteer's shoulder width compared to the shoulder width of the LODC ATD. For the 90° load, the acromion moved relative to T1 an average of 28.1 mm forward and 3.1 mm downward at maximum displacement. For the 135° load, the acromion moved relative to T1 an average of 15.5 mm forward and 42.7 mm upward at maximum displacement. Similar displacements at higher loads indicated that the volunteers achieved their maximum range of motion. The results of this study will be compared to the LODC ATD, assessing the biofidelity of the shoulder complex.

Child restraint headrest and belt routing design features and their association with child passenger behavior and restraint misuse

OBJECTIVES

Ergonomic design of child restraint systems (CRS) may facilitate optimal travel behavior and crash protection of child passengers during motor vehicle trips. However there have been few studies examining the relationship between CRS design and child passenger travel behavior. The aim of this study was to examine whether associations between CRS design features and child passenger behavior exist during real-world, everyday vehicle trips.

METHODS

Video from a naturalistic driving study (NDS) was analyzed in this study. Families drove an instrumented study vehicle for approximately two weeks with at least one child aged between one and eight years traveling in their own forward-facing (FF) CRS or belt positioning booster (BPB). Video for one child passenger was randomly selected from each trip for analysis. Video was coded for five-second epochs at nine time points (5%, 17%, 25%, 30%, 50%, 53%, 75%, 89% and 95% of trip length). Two types of child passenger travel behaviors were identified by manual review of the video and audio recordings: (i) optimal/suboptimal head position and (ii) correct/incorrect use of the internal harness/shoulder belt. Video screenshots were used to characterize CRS design features. Random effects logistic regression models were used to examine the associations between specific CRS design features and the travel behaviors of interest, whilst accounting for clustering of data by child and trip.

RESULTS

Suboptimal head position was associated with the absence of a height adjustable headrest and a narrow headrest wing width in FFCRS. Incorrect harness use in a FFCRS was associated with the absence of an adjustable headrest, in addition to headrest features such as wing width and depth. In BPBs, a reduction in suboptimal head position was associated with the absence of a sash belt guide, however no restraint design features were associated with incorrect shoulder belt use.

CONCLUSIONS

Some CRS design features may influence undesirable child passenger travel behavior. These early findings support enhanced and user-centric CRS design as a likely important mechanism to improve child passenger safety.

Self-reported Non-nominal Sitting in Passengers is Influenced by Age and Height

Automotive safety devices, such as airbags and seatbelts, are generally designed for optimal performance when occupants adopt a "nominal" upright anatomical sitting position. While a driver's sitting behavior is largely influenced by the requirements of driving, a passenger may adopt any number of non-nominal positions and behaviors. Very few studies have investigated the behaviors that teen and adult passengers actually adopt. The present study investigates self-reported nonnominal sitting in passengers and quantifies the influence of age and anthropometrics on these behaviors. A better understanding of passenger behavior is a timely research topic because advanced sensors may eventually allow better detection of non-nominal sitting and the advent of autonomous vehicles increases the number of passengers and seating options. Ten online survey questions were created to assess how frequently non-nominal sitting was adopted. Results were obtained from 561 anonymous participants, ranging in age from 14 to 83 years old. Analyses included 1) averages for each question, 2) a statistical linear mixed model to test for the influence of age and height on responses, and 3) correlations between all questions. Statistical significance was set at p<0.05. In summary, there was a sizable percentage of participants who self-reported behaviors or sitting positions that potentially increase risk of injury. Younger subjects were significantly more likely to adopt non-nominal sitting. Shorter subjects adopted non-nominal foot position more often, while taller subjects' knees were significantly closer to the dash. Participants opted not to wear their seat belt in the rear seat more than the front seat.

Evaluation of static belt fit and belt torso contact for children on belt-positioning booster seats

Objective: Previous studies have indicated that gap between the seatbelt and torso (reduced belt torso contact) for children on belt-positioning booster seats (BPBs) may lead to less torso engagement and increased likelihood of shoulder belt slip-off during evasive vehicle maneuvers, potentially increasing injury risk during crashes. However, current BPB belt fit measures do not quantify belt gap and may not be able to fully discriminate between designs which provide good vs. poor dynamic outcomes. The goal of this study was to evaluate both novel (belt gap characteristics) and conventional measures of seatbelt fit for BPB-seated children.Methods: Ten BPBs and three seatbelt anchor locations were investigated. Fifty volunteers (4-14 years) were recruited and each evaluated on six unique combinations of BPB and seatbelt anchor location on a vehicle rear seat in a laboratory setting. A 3 D coordinate measurement system quantified positions of anatomic, seatbelt, BPB, and vehicle reference points. Novel belt gap (gap size, length, location, and percent torso contact) and conventional belt fit (position of belt on shoulder and pelvis) metrics were calculated using anatomic and seatbelt landmarks. Variation in belt fit and belt gap outcomes due to BPB, seatbelt anchor location, and anthropometry were investigated.Results: BPBs produced significantly different outcomes, while seatbelt anchor location did not. BPBs with features that directly routed the lower portion of the shoulder belt more forward on the buckle side produced the largest (29.3 ± 12.6 mm) and longest (106.9 ± 68.2 mm) belt gap on average, while BPBs that pulled the belt less forward or did not directly route the belt produced the smallest (13.9 ± 6.7 mm) and shortest (16.9 ± 33.9 mm) gap on average. Belt gap outcomes were not strongly correlated with conventional belt fit metrics, indicating that evaluation of belt gap may provide additional insight when attempting to discriminate between BPBs which provide good vs. poor seatbelt engagement during vehicle maneuvers and crashes.Conclusions: This is the first study to evaluate belt gap characteristics for BPB-seated children. Results suggest that belt fit and belt gap are influenced by BPB design, particularly lower shoulder belt routings, and may have implications for belt engagement during dynamic events.

Analysis of Kinematic Response of Pediatric Occupants Seated in Naturalistic Positions in Simulated Frontal Small Offset Impacts: With and Without Automatic Emergency Braking

Naturalistic driving studies have shown that pediatric occupants do not assume ideal seating positions in real-world scenarios. Current vehicle assessment programs and child restraint system (CRS) sled tests, such as FMVSS No. 213, do not account for a wide range of seating postures that are typically observed during real-world trips. Therefore, this study aims to analyze the kinematic and kinetic response of a pediatric human body model in various naturalistic seating positions in booster seats when subjected to a frontal offset impact in a full-vehicle environment, with and without the application of pre-crash automatic emergency braking (AEB). A 6YO (seated on a lowback and highback booster) and a 10YO (seated in no-CRS and on a lowback booster) PIPER pediatric human body model's response was explored in a reference, and two most commonly observed seating postures: forward-leaning and forward-inboard-leaning. The vehicle environment with a side-curtain airbag (SCAB) was subjected to a small offset barrier impact (25% overlap at 40MPH), with and without the application of a pre-crash automatic emergency braking (AEB). 24 conditions were simulated using finite element analysis. Cases with a pre-crash AEB resulted in relatively lower kinematic and kinetic values due to the occupant being in a more flexed position before impact compared to without-AEB cases, coupled with the increased ride-down effect due to AEB. Moreover, different seating postures resulted in substantially different kinematics and kinetics, the injury metrics crossing the injury assessment reference values in some cases. Therefore, to design a passive safety standard test for pediatric occupants, it is important to consider the possible postural changes that may occur.

Pediatric occupant human body model kinematic and kinetic response variation to changes in seating posture in simulated frontal impacts - with and without automatic emergency braking

OBJECTIVE

The study quantifies the kinematics of children in booster child restraint systems (CRSs) in various naturalistic seating postures exposed to frontal impacts in a full-vehicle environment, with and without the application of pre-crash automatic emergency braking.

METHODS

The PIPER 6YO and 10YO pediatric human body models were positioned in CRSs. The 6YO was restrained on a lowback (LBB) and highback (HBB) booster, while the 10YO was positioned on an LBB and in a NoCRS condition. All simulations used the 3-point seatbelt. The child models were pre-positioned (gravity settled, seatbelt tensioned) in four naturalistic seating postures: leaning-forward, leaning-forward-inward, leaning-forward-outward, and a pre-submarining position, along with a baseline reference seating position. A 2012 Toyota Camry finite element (FE) model was used as the vehicle environment. A standard 3-point lap-shoulder belt system was modeled to restrain the child and CRS in the left-rear vehicle seat. Two vehicle impact cases were considered: with and without a pre-crash AEB. For with-AEB cases, a pre-crash phase was run to incorporate postural changes due to the application of AEB. All seating positions were ultimately subjected to a full-frontal rigid-barrier impact at 35 MPH. A total of 40 conditions were simulated in LS-DYNA.

RESULTS

Injury metrics varied widely for both occupants. Shoulder belt slippage was observed for the 6YO leaning-forward-inward on HBB. No head contact was observed for any simulated cases. Forward-leaning and forward-inward-leaning postures generally had greater head excursion across all seating postures. The lap belt rode over the pelvis for pre-submarining postures. Injury metrics for cases with pre-crash AEB were lower compared to their corresponding without-AEB cases. HIC15, head acceleration, upper neck tension force, and upper neck flexion moment were similar or lower for with-AEB scenarios.

CONCLUSIONS

Pre-crash AEB reduces the effect of the impact despite the same collision speed as cases without-AEB. This is primarily due to the limited travel distance of the occupant, thus, starting an earlier ride-down during the crash. Moreover, different initial seating postures lead to a wide range of injury exposures. Vehicle and child restraint design should incorporate these seating postures to ensure robust protection of the occupant in a crash.

Child Posture and Belt Fit in a Range of Booster Configurations

Belt positioning boosters reduce injury risk for child occupants compared with seat belts alone. While boosters shorten the effective seat length (and thus reduce slouching), “boosting” the child relative to the vehicle interior components also achieves additional safety benefits. First, the increase of the lap belt angle usually improves belt fit across the pelvis and reduces the risk of the occupant slipping (“submarining”) under the belt. Second, the torso belt is re-centered over the bony landmarks of the shoulder for more effective/secure restraint. Third, the child’s head is relocated in a range better protected by side airbags. The objective of this research was to quantify differences in posture and belt fit across a range of booster designs that provide different levels of boosting. Posture and belt fit were measured in 25 child volunteers aged four to 12. Children were measured in three laboratory seating conditions selected to provide a range of cushion lengths and belt geometries. Six different boosters, as well as a no-booster condition, were evaluated. The low height boosters produced postures that were more slouched, with the hips further forward than in other more typical boosters. Lap belt fit in the low height boosters was not meaningfully different from the other boosters. Shoulder belt fit produced by the lowest height booster was similar to the no-booster condition. Belt positioning boosters that boost the child less than 70 mm produced postures similar to the no-booster condition. While lap belt guides on these products can produce a similar static lap belt fit, they may not provide adequate dynamic performance and do not achieve the other benefits that come with raising the child to a more advantageous location relative to interior components and belts.

The common characteristics and behaviors of child occupants in motor vehicle travel

Objective: Child occupant behavior and head position when travelling in child restraint systems (CRS) may have an effect on injury risk in the event of a motor vehicle crash. The current study aimed to describe the common characteristics and behaviors of child occupants during everyday, real-world motor vehicle travel in a sample of Australian families to identify potential safety implications of observed behaviors and head position within the CRS. Methods: Two instrumented study vehicles were used by 42 families for approximately two weeks. Continuous video and audio data were collected across 1,651 trips (over 600 hours). An online survey provided additional parent, familial and child occupant data. The characteristics and behaviors of 72 child occupants (aged 14 months to 9 years) who travelled in a forward-facing CRS (FFCRS) or a belt-positioning booster seat (BS) were observed and recorded by manual review of a sample of the video/audio recordings. One quarter of all trips (n = 414) was randomly selected for coding/analysis and, within each trip, one child occupant was selected who was travelling in a FFCRS or BS. Child occupant behaviors, head position within the FFCRS or BS, and other relevant information was coded for each trip during nine discrete five second intervals or 'epochs' (5%, 17%, 25%, 30%, 50%, 53%, 75%, 89% and 95% of trip duration). Results: In the majority of epochs (74%), child occupants' heads were observed to be 'optimally' positioned within the FFCRS or BS. For more than half of the epochs, child occupants were observed to be: correctly restrained (58%) and involved in an interaction with another vehicle occupant (59%). Bivariate analyses revealed that children travelling in a FFCRS were significantly more likely to be observed to have optimal head positions than those travelling in a BS (78% vs. 62%), χ² (1) = 86.00, p < 0.001. Child occupants who were observed to be 'correctly' restrained were significantly more likely to be observed to have optimal head positions than those who were observed to be 'incorrectly' restrained (80% vs. 20%), χ² (1) = 10.33, p < 0.01. Conclusions: This is the first naturalistic driving study (NDS) to specifically explore the factors associated with child occupants' head position when travelling in a CRS. Findings from the current study can be used to inform the positioning of anthropometric test dummies (ATD) in CRS testing, guide improvements to CRS/vehicle design, and develop targeted educational strategies to improve child occupant safety.

Cross-chest clips in child restraints: A crash testing study

Objective: Cross-chest clips are widely used in North American child restraints but are less common in other countries, partially due to concerns over anterior neck contacts in frontal crashes. They have recently been reported to be associated with lower odds of injury in real-world crashes, but there is a paucity of crash test performance information. This study aimed to compare the dynamic performance of a small child occupant in frontal crash tests with and without cross-chest clips in place. Methods: Frontal sled tests at 49 km/h were conducted to compare 2 cross-chest clip designs to nonuse of a chest clip. Tests using a P3/4 anthropomorphic test device (ATD) to represent the smallest occupant in a forward-facing child restraint were conducted with the chest clips in the recommended position and also in an incorrect lower position and with and without additional harness slack present. Results: Though contacts were observed between the chest clips and the base of the ATD's neck, there was little difference observed in head excursion or ATD sensor loads in the presence of the chest clips. No detectable change in the neck forces or moments was detected at the time of the neck contacts. The position of the clips did not affect the results. Harness slack increased head excursion, as expected, but this effect did not differ between the tests with and without the clips. Conclusions: Cross-chest clips do not appear to greatly influence the dynamic performance of a forward-facing child restraint in a simulated frontal crash. Taken together with recent research suggesting a potential benefit in injury reduction from the clips in the real world, possibly due to maintaining the harness straps in place on a child's shoulders, it may be appropriate to re-evaluate safety standards that prevent their use.