*Marc Starnes is a Mathematical Statistician in the Mathematical Analysis Division, National Center for Statistics 

and Analysis, NHTSA.

National Center for Statistics and Analysis 400 Seventh St., S.W., Washington, D.C. 20590

U.S. Department

Of Transportation

National Highway

Traffic Safety

Administration

DOT HS 809 559 Research Note March 2003

The Relationship Between Driver and Child Passenger Restraint Use

 Among Infants and Toddlers

Marc Starnes*

Summary

NHTSA’s National Center for Statistics and

Analysis (NCSA) analyzed data from the

Fatality Analysis Reporting System (FARS) to 

investigate the association between the restraint 

use of child passengers involved in a crash and 

their drivers. In addition, National Occupant 

Protection Use Survey (NOPUS) data were

examined regarding general restraint use

patterns of children and their drivers. Results 

show that children are more likely to be

restrained when their driver is restrained, and the 

restraint use of children has improved greatly 

since the mid-1990s.

Methodology

Data from FARS for the period 1991 – 2001 

were used. The FARS database collects

information on crashes where at least one person 

involved in the crash was fatally injured. This 

study includes both children who were fatally 

injured and those that survived the crash. Each 

vehicle included in the study involved a) one or 

more child passengers age less than five years 

old, and b) one driver, age 16 or older. Drivers 

were paired repeatedly with each child

passenger in their vehicle. For example, a driver 

with two child passengers in the vehicle is

included in two separate driver-passenger pairs, 

once for each child. 

A driver is categorized as being restrained if a 

lap and/or shoulder belt was in use at the time of 

the crash. Drivers of unknown restraint use, as 

well as their passengers, were not included in 

this study. 

A child passenger is categorized as being

restrained if a child restraint or lap and/or

shoulder belt was in use at the time of the crash. 

All remaining child passengers were categorized 

as either unrestrained or unknown restraint use. 

Passenger vehicles selected for this study

include passenger cars, light trucks, vans and

sport utility vehicles.

Regarding restraint use patterns, the National 

Occupant Protection Use Survey (NOPUS)

Controlled Intersection Study collects

information on child restraint use among

children with an estimated age of less than five 

years old. This study was conducted in 1996, 

1998, and 2000. At the time of this report, data 

from the 2002 study were not available. Data 

collection for the controlled intersection study 

was conducted for 40 minutes at approximately 

1200 randomly selected intersections with stop 

signs or traffic signals. Two observers recorded 

child restraint usage information in the front and 

second seats of the vehicles. The NOPUS

Controlled Intersection Study covered every day 

of the week, during the hours 8 a.m. to 6 p.m.

Results

The two charts in Figure 1 below represent

FARS crashes, involving nearly 30,000 children 

0 to 4 years old. These data illustrate a strong 

positive correlation between the restraint use of 

young children and the driver of their vehicle.
National Center for Statistics and Analysis 400 Seventh St., S.W., Washington, D.C. 20590

When traveling in a passenger vehicle where the 

driver was unrestrained, 59 percent of children 

age 0 to 4 were also unrestrained, while only 38 

percent were restrained (the restraint use of 3 

percent was unknown). When the driver was 

restrained, 80 percent of children age 0 to 4 were 

also restrained, 16 percent were unrestrained,

and restraint use was unknown for 4 percent. 

Thus, for children 0 to 4 years old involved in a 

fatal crash from 1991 through 2001, the

probability of being unrestrained was 3.7 times 

greater when the child was with an unrestrained 

driver versus being with a restrained driver. 

 Restraint Use of Child Passengers Age 0-4, By Driver Restraint Use

Among Vehicles Involved in Fatal Crashes

1991-2001

Source: National Center for Statistics and Analysis, NHTSA, FARS 1991-2001

Another result is that a large improvement in 

restraint use among child passengers, regardless 

of the restraint use of the driver, was seen

among FARS crashes between 1991 and 2001. 

Table 1, as seen below, shows that when the 

driver of the vehicle was restrained, the

percentage of children 0 to 4 years old who were 

restrained increased from 73 percent in 1991 to 

86 percent in 2001. When the driver of the

vehicle was unrestrained, the percentage of

children 0 to 4 years old that were restrained 

rose from 26 percent in 1991 to 50 percent in 

2001.

Findings from the NOPUS Controlled

Intersection Study displayed below in Table 2

also show an improvement in restraint use. 

When traveling with an unrestrained driver, the 

NOPUS study found the percentage of children 

under five years old who were restrained

climbed from 31 percent in 1996, to 54 percent 

in 1998, and up to 86 percent in 2000. By

comparison, 87 percent of children traveling

with a restrained driver were restrained in 1996, 

with this percentage rising to 97 percent in 1998 

and 2000. This improvement may be

attributable to NHTSA’s Buckle Up America 

campaign instituted in 1996.

Unrestrained Drivers

Unknown

3%

Restrained

38%

Unrestrained

59%

Restrained Drivers

Unknown

4%

Unrestrained

16%

Restrained

80%

Figure 1
National Center for Statistics and Analysis 400 Seventh St., S.W., Washington, D.C. 20590

The NOPUS Controlled Intersection Study

provides data representing a population estimate 

of child restraint use among children under five 

years old, based on observations at controlled 

intersections. The NOPUS data listed in Table 2 

are based exclusively on observations made

during the day. By comparison, the FARS data 

shown in Figure 1 and Table 1 refer to restraint 

use of children involved in fatal crashes

occurring during the day or night. This

difference in data collection methodology is

likely to contribute to the higher restraint use 

observed in the NOPUS studies as compared 

with data collected from the FARS fatal crashes. 

Observing child restraint use at randomly

selected sites poses certain collection and

estimation problems. Since only 8 percent of the 

resident population of the country are children 

under the age of five, observing enough children 

in passenger vehicles to produce reliable

estimates is difficult. Consequently, the NOPUS 

estimates of child restraint use shown below in 

Table 2 are subject to large sampling errors and 

should be interpreted with caution.

Table 2

Percent Restraint Use of Child Passengers Under Five Years Old

By Driver Restraint Use and Year

Year

Category 1996 1998 2000

Children Under Five with Unrestrained Driver 31 54 86

Children Under Five with Restrained Driver 87 97 97

Source: NCSA, NHTSA, NOPUS 1996, 1998, 2000

Finally, as restraint use among children under 

age five has increased since the mid-1990s, the 

number of passenger vehicle fatalities within

this age group has dropped. Table 3 shows how 

the number of passenger vehicle fatalities among 

children less than five years old has declined 

from 1996 through 2001. The number of

fatalities fell each year, from 647 in 1996 to 497 

in 2001, representing a total reduction of 23.2 

percent. The largest drop of 8.2 percent

occurred from 1996 to 1997, following the

introduction of NHTSA’s 1996 Buckle Up

America safety campaign. The reduction of 

fatalities since 1996 coincides with the increase 

in child restraint use as measured by NOPUS

during this time period.

Table 1

Percent Restraint Use of Child Passengers 

Under Five Years Old

Among Vehicles Involved in Fatal Crashes

By Year and Driver Restraint Use

Percent of Child Passengers 

Restrained

Year When Driver 

Restrained

When Driver 

Unrestrained

1991 73 26

1992 76 32

1993 74 29

1994 76 34

1995 80 37

1996 77 42

1997 82 39

1998 82 44

1999 83 48

2000 84 49

2001 86 50

Source: NCSA, NHTSA, FARS 1991-2001
National Center for Statistics and Analysis 400 Seventh St., S.W., Washington, D.C. 20590

Table 3

Passenger Vehicle Fatalities Among Children Under Five Years Old

By Year

Year

1996 1997 1998 1999 2000 2001

Number of 

Fatalities

647 594 567 551 532 497

Percent Reduction N/A 8.2 % 4.5 % 2.8 % 3.4 % 6.6 %

Source: NCSA, NHTSA, FARS 1996-2001

Conclusions

Based on data collected during fatal crashes

from 1991 through 2001, the following

conclusions can be made regarding the

relationship between the restraint use of child 

passengers under age five and the restraint use 

of their drivers.

• The restraint use of child passengers and

their drivers are strongly correlated. Child 

passengers are far more likely to be

unrestrained if their driver is unrestrained, 

and similarly, child passengers are far more 

likely to be restrained if their driver is

restrained. 

• The probability of a child being unrestrained 

is 3.7 times greater when the child is with an 

unrestrained driver versus being with a

restrained driver.

• The probability of a child being restrained is 

2.1 times greater when the child is with a 

restrained driver versus being with an

unrestrained driver.

• As child restraint use has improved since 

1996, the annual number of fatalities among 

children under age five has dropped 23

percent, from 647 in 1996 to 497 in 2001.

For additional copies of this research note, please call 1-800-934-8517 or fax your request to (202) 366-3189. For 

questions regarding the data reported in this research, contact Marc Starnes [202-366-0183]. This research note and 

other general information on highway traffic safety may be accessed by internet users at: http://wwwnrd.nhtsa.dot.gov/departments/nrd-30/ncsa/AvailInf.html

U.S. Department

of Transportation

National Highway

Traffic Safety

Administration

400 Seventh Street, S.W., NPO-120

Washington, D.C. 20590