“Best-Fit” Questions

What to ask before your IEP meeting

By David Wegbreit

When choosing child safety restraints, there are many options and few hard rules to help transportation directors know which system goes best with which child. In most cases, school transportation personnel will need to individually assess each student to determine the right restraint. But by asking the right questions at IEP meetings, transportation directors can make sure they get off on the right foot.

“Can this child fit in a conventional car seat?”
Kathy Strotmeyer of the Pennsylvania chapter of the American Academy of Pediatrics advises districts start with the premise that a child may be able to fit in a conventional car seat. With capacities from five pounds in rear-facing seats to 65 pounds in some of the newest forward-facing seats, these restraints will serve many younger students and can offer the support some special needs students require. Strotmeyer said conventional seats are more affordable than other special needs systems and are more readily accessible because they may not require a healthcare professional to write a letter of medical necessity to purchase and pay for the seat.

“Will this child’s bus have traditional seats or reinforced seats with seat belts?”
Depending on your state’s laws, you need to pay attention to which buses you intend to use for your special needs students. While some companies have approved their restraints for traditional, non-reinforced seats, some states, including Indiana, require students in child safety restraints be in seats that are FMVSS 210 compliant, that is, meet standards for seat belt anchorages. Know which vehicles you have and talk to the restraint manufacturers to make sure your vehicles aren’t out of sync with the best restraint technologies or the law, warns Cheryl Wolf, Safety and Training Supervisor for Lafayette School Corporation and Riley Hospital for Children in Indiana. If you are going to use a conventional car seat, you will need a seat that is equipped with seat belts.

According to Strotmeyer, you’ll also need to make sure the webbing on the seat belt is of the proper length. Ideally, the buckle end (non-adjustable end) of the seat belt would be one to two inches from the bight or crack of the seat. Some CSRS, positioning belts and car seats can never be used on non-FMVSS 210 seats. With the exception of integrated seats and car seats, other restraint systems require the seat behind to be empty or the child be restrained.

“What is this child’s measurements?”
In recent years, the carrying capacity of child safety restraint systems has increased considerably. SafeGuard’s Star Plus fits children up to 90 pounds, and other specialized seats can accommodate children up to 105 pounds. But you’ll want to know more than just the student’s weight and height to make sure you’re choosing the right restraint. Charlie Vits, bus market development and compliance manager at SafeGuard, advises looking at student’s torso height (the distance from seated position to top of shoulder blades) in addition to their total height. Knowing a child’s torso height ensures the belts on the restraint never come from below the top of his or her shoulder.

Vests, by contrast, have no size and weight limitations and can often be custom built. If you have a student that requires restraint but is too large to use an add-on seat, a vest may be the right solution.

“Will this child need to be moved from a wheelchair into adaptive seating?”
Even if the child safety restraint system fits, it might not always be the right solution. In making the decision to move larger students, Shu Shutrump of the Trumbull County, Ohio, Educational Service Center suggests districts consider the risk of moving the student from their wheelchair to a restraint system. More movement can mean more opportunity for injury so, given the proper wheelchair securement, it may be best to keep the student in his or her chair.

“Does this child require close supervision?”
If the answer is yes, a child safety vest may be the right solution. Some vests zip up in the back, preventing students with emotional and behavioral issues from releasing themselves from the restraint. If you have a Houdini on board who can escape from any restraint, you may want to consider this option. At the same time, if a student has severe behavioral problems or is violent, it may be too difficult to get him or her into a vest. Some have solved the issue by requiring parents and special needs teachers to place students in the vest before they get on the bus. Whatever the child’s level of supervision outside the school bus, you’ll want to come as close as you can to duplicating it inside the bus. The more you know about a child’s behavioral needs, the safer you can make their ride, Shutump said.

“Does this child require special support?”
Children with cerebral palsy and certain musculoskeletal issues may need more support than traditional seats can provide. Child safety vest and specialized seats often offer more support at more points than traditional seats. According to Jean Zimmerman, supervisor of occupational and physical therapy, Palm Beach County, Fla., even some students in vests may require the additional support, including soft cervical collars.

Students with severe head trunk control seats may require medical car seats. Because these seats are more expensive than traditional seats, Cheryl Wolf suggests trying more traditional seats before investing in specialized medical restraints.

“Does this child require any additional equipment?”
Be sure to ask if you will be expected to transport oxygen tanks, feeding tubes or other equipment in addition to the child. Charlie Kennington, director of Region IV Transportation Services in Houston, noted that if you don’t have the means to secure this additional equipment or the means to secure it, you’ll need to order it well ahead of time to ensure you can transport that student from Day One.

What equipment students require may also dictate what kind of seat they should be in. Sue Shutrump notes students with the birth defect hydrocephalus may require a plastic tube (or shunt) to drain excess fluid from a child’s brain. Other students will require ostomy pouches. In these cases, you may want to ensure that no restraint equipment interferes with the necessary medical equipment.

When the IEP is written, Wolf suggests transportation directors use “words of limitation” rather than technology-specific words. Instead of writing “Johnny will be in a car seat,” she suggests something along the lines of “Johnny will be in some type of CSRS that is appropriate for his size, weight and age.” Using this kind of broader language assures greater flexibility as Johnny grows and means you won’t be in violation of Johnny’s IEP.