Installing a Safety Seat? It's Not Child's Play

Complicated instructions leave many adults in the dark

MONDAY, March 3, 2003 (HealthDayNews) -- You have to be an engineer to understand child safety seat instructions, or at least be able to read at a 10th-grade level -- a skill nearly half of adults in the United States don't have.

That's the conclusion of a new study that found child safety seat instructions are written using needlessly complicated language. That could be one reason why so many parents improperly install the seats, says Dr. Mark Wegner, lead author of the study and an epidemiologist at the Wisconsin Division of Public Health.

Previous studies have found as many as 94 percent of child safety seats are improperly installed, a potentially serious safety hazard.

"Child safety seats are a very important safety tool if they're used correctly," Wegner says. "But in order for them to be fully effective, they have to be installed correctly. That's why the instructions are so important."

The study appears in the March issue of Pediatrics.

Researchers looked at 107 instruction pamphlets from 11 U.S. manufacturers. The instructions were obtained from the National Highway Traffic Safety Administration, which compiled them on a CD-ROM.

The researchers analyzed the readability of the instructions using the SMOG test, which was developed in 1969 and is used extensively to analyze health-related writing, Wegner says.

The SMOG test uses 10 sentences from three sections of the sample (beginning, middle and end), counts the number of words with three of more syllables, then applies a simple mathematical equation to come up with a grade level.

Researchers found the child safety seat instructions averaged a 10th-grade reading level.

The price of the seat had no bearing on whether the instructions were clear or complicated, Wegner says.

The problem is that 21 percent of the adult population -- more than 40 million people -- have only rudimentary reading abilities, meaning that they read at or below the fifth-grade level, according to a 1992 study by the U.S. Department of Education's National Center for Education Statistics.

Another 25 percent read at or below the eighth-grade level.

Wegner acknowledges he did not look at instruction pamphlet diagrams, which could have made the instructions either more or less confusing.

Wegner suggests manufacturers use simpler language whenever possible: Use shorter sentences and words, such as "crash" instead of "collision," "fixed" instead of "remedied," and "car" instead of "automobile."

Lives could depend on it, he says. Child safety seats reduce the risk of a child dying in a car crash by about 71 percent and being hospitalized by 67 percent, previous research shows.

"We suggest manufacturers write the instructions at a fifth-grade level to make sure the general public understands," he says.

Stephanie Tombrello, executive director of the non-profit SafetyBeltSafe U.S.A., says instruction manuals have improved over the years. "But I have no doubt that his [Wegner's] assessment is correct," she says.

Tombrello's Los Angeles-based organization offers free clinics to teach parents, social workers and educators how to properly install safety seats.

During the nearly 25 years she has been helping people install seats, Tombrello has noticed one disturbing phenomenon that clear, simple writing isn't going to help --- most people never bother to look at the directions at all.

"I cannot tell you how many people bypass the instructions completely," she says. "It would certainly help to have the instructions simpler and more graphic, but some people are never even going to read them."

More information

Wondering if your child's safety seat is properly installed? Still confused about when it's safe for your child to move from a child safety seat to a booster seat and then to an adult seat belt? Check out the American Academy of Pediatrics' safety seat guide or SafetyBeltSafe U.S.A.

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