Safe transport of children with disabilities and medical conditions: Caregiver experiences

Figures & data

Table 1. Key stakeholder Demographics.

	n (%)
Caregiver
Caregiver gender
Male	22 (11.4)
Female	167 (86.5)
Prefer not to answer	4 (2.1)
Caregiver relationship with child
Mother	162 (83.9)
Father	21 (10.9)
Foster parent	4 (2.1)
Other	5 (2.6)
Missing	1 (0.5)
Caregiver Aboriginal or Torres Strait Islander
Yes	17 (8.9)
No	174 (91.1)
Missing	2 (1.0)
Caregiver language other than English
Yes	9 (4.7)
No	183 (95.3)
Missing	1 (0.5)
State/Territory
Victoria	50 (25.9)
Western Australia	44 (22.8)
New South Wales	36 (18.7)
Queensland	35 (18.1)
South Australia	17 (8.8)
Tasmania	6 (3.1)
Australian Capital Territory	3 (1.6)
Northern Territory	2 (1)
IRSAD
Mean (SD)	6.74 (2.76)
Range	1–10
Caregiver education
Primary school	1 (0.5)
Secondary school	18 (9.3)
University/TAFE	169 (87.6)
Other	3 (1.6)
Missing	1 (0.5)
Number of children under 16 years in family
1	60 (31.1)
2	81 (42.0)
3	35 (18.1)
4	8 (4.1)
5	0 (0)
Over 5	1 (0.5)
Missing	8 (4.1)
Gender of child
Male	106 (54.9)
Female	83 (43)
Prefer not to answer	4 (2.1)
Child Age, years: mean (SD)	8.75 (3.9)
NDIS Access
Yes	176 (91.2)
No	10 (5.2)
In process of applying	6 (3.1)
Does not know what NDIS is	1 (0.5)

Note: IRSAD: Index of Relative Socio-economic Advantage and Disadvantage; NDIS: National Disability Insurance Scheme.

Table 2. Frequency of child disability or medical condition.

	(n)	(% of 193)
Intellectual
Global Developmental Delay/Intellectual Disability	83	43.01
Autism Spectrum Disorder	87	45.08
Down Syndrome	15	7.77
Attention Deficit Hyperactivity Disorder	37	19.17
Physical
Orthopaedic condition	44	22.80
Respiratory condition	39	20.21
Cerebral Palsy	37	19.17
Heart condition	20	10.36
Neuromuscular condition	18	9.33
Prematurity	14	7.25
Spina Bifida	2	1.04
Cancer	0	0.00
Other
Acquired Brain Injury	10	5.18
Seizure disorder/epilepsy	37	19.17
Vision and/or hearing impairment	14	7.30
Other disability	73	37.80
Other medical condition	43	22.30

Note. Children could have multiple diagnoses.

Table 3. Individuals travelling with child and restraint use across vehicle type.

	Main Car	Second Car (%)	Friend’s Car (%)	Taxi (%)	Ride Share (%)	Bus (%)
	(%)
Travel members
Support Volunteer	3.6	1.6	2.1	0.52	0	4.1
Support Funded	20.2	9.3	12.4	3.11	0	11.4
Parent	75.6	36.3	5.2	2.59	2.1	5.2
Sibling	57.5	29.5	9.8	0.52	1.6	3.1
Relative	11.4	5.7	16.1	0.52	0	0
Friend	5.2	4.1	4.1	0.52	0	0.5
Restraint Type
Child Restraint	65.8	28.5	21.2	1.6	1.6	6.2
Special	21.2	6.7	3.1	0.5	0.5	2.1
Wheelchair	13	4.1	1.6	3.6	0.5	7.3
Seatbelt	33.7	23.3	11.4	3.1	1	9.3
Other	3.1	2.1	1	0.5	0	2.6
NA	4.1	29.5	37.3	55.4	55.4	47.7

Table 4. Use of restraints across age groups and disability types.

Restraint Type	Special purpose child restraint (%)	Standard child restraint (%)	Standard child restraint with modification or extra accessory (%)	Vehicle seatbelt only (%)	Wheelchair (%)	Other (%)
All	14.5	30.6	16.1	24.9	9.3	4.7
Age
Under 5 years	5	55	33	0	3	5
5 − 7.5 years	18.4	55.3	13	11	3	0
7.5 − 9.8 years	15.8	23.7	18	18	21	3
9.8 - 12 years	25	19.4	14	36	3	3
12 years +	10.5	0	3	58	16	13
Disability Type
Intellectual	16	29	13	31	7	5
Physical	18	29	19	15	15	4
Other	17.8	32.7	13.1	15.9	15	5.6

Table 5. CRS types by disability group for children under five years of age.

	Special purpose child restraint (%)	Standard child restraint (%)	Standard child restraint with modification or extra accessory (%)	Wheelchair (%)	Other (%)
Intellectual	7	56	26	4	7
Physical	1	38	43	5	5
Other	11	61	17	6	6

Table 6. Challenges reported by caregivers.

Challenge	All Conditions (%)	Intellectual (%)	Physical (%)	Other (%)
Needed to pull the vehicle over to reposition or comfort child	65.3	68.7	70.9	71
Difficulty physically getting child in and out of the car	64.2	63.3	69.9	69.2
Distracted by child’s behaviour/needs whilst driving	64.2	69.4	58.3	69.2
Child has become angry and upset whilst driving, causing stress for driver or passengers	61.1	64.6	57.3	61.7
Difficulty checking/watching child whilst driving	55.4	56.5	64.1	59.8
Child has got out of his/her child restraint (part or all of their body) whilst driving	45.1	53.1	39.8	43.9
Child has needed 1:1 support in the car, but this was not available	36.3	37.4	43.7	43
Child has got out of his/her seatbelt whilst driving	35.8	42.9	27.2	33.6
Difficulty fitting child plus others in the car due to the space taken up by their child restraint	30.6	31.3	38.8	33.6
Child’s head and/or body are inadequately supported in their restraint/car seat	26.4	24.5	35.9	32.7
Child has got out of the restraint (any type) and escaped the car in the road environment	9.8	10.9	6.8	7.5
Vehicle is not suitable/appropriate for the restraint/seating required (e.g., ISOFIX)	9.3	10.9	13.6	11.2
Other challenges	8.8	10.2	9.7	10.3

Table 7. Restraints used by children who escaped their CRS.

	Total	Special purpose child restraint (%)	Standard child restraint (%)	Standard child restraint with modification or extra accessory (%)	Vehicle seatbelt (%)	Wheelchair (%)	Other (%)
All	105	14	33	14	32	2	4
Age ranges
Under 5	17	6	53	29	0	0	12
5-7.5 years	25	8	64	8	2	0	0
7.5 − 9.8 years	24	25	29	17	25	0	4
9.8 - 12 years	23	22	13	17	39	4	4
12 years +	16	6	0	0	88	6	0

Table 8. A comparison of caregiver concern and confidence for children who have escaped their CSRS compared to children who had not escaped their CSRS.

	median (IQR)
	Children who have escaped	Children who have not escaped
Concerned about safety	8 (5)	6.5 (7)
Confidence in knowledge - main car	8 (3)	8.5 (1)
Confidence in knowledge - school bus	1 (5)	3 (6)
Confidence in knowledge - public bus	1 (3)	1 (6)
Confidence in knowledge – taxi	2 (6)	1.5 (6)
Confidence in knowledge - other vehicles	1 (5)	1.5 (6)

Table 9. Challenges faced by caregivers when seeking transport solutions.

Challenge	%
Limited opportunity to trial different solutions	57.0
Health professionals who look after my child do not seem to have enough knowledge about possible solutions	33.7
Long amount of time taken for recommendations to be implemented	32.6
Inadequate funding for recommended equipment	30.1
I do not know where to find information	25.9
Other	21.2
No one had the information to help me	19.2
NA	19.2

Table 10. Source of information on safe transport.

Source of Information	%
Health Professional	22.8
Doctor	8.8
Child Safety Organization	8.3
Disability Equipment Provider	6.7
Website	5.2
Social Media	5.2
Mainstream shop visited in person (e.g., Baby Bunting)	3.1
Maternal and Child Health Care Provider	2.6
Government	2.6
Relative or Friend	2.1
Other	1.6

Table 11. Preferred sources of information for caregivers.

Source of Information	Most preferred (%)	Second most preferred (%)
Health professional	36.8	18.1
Website	28.5	12.4
Hospital	6.7	1.6
Government website	4.7	4.7
Child Safety Organization	4.1	8.3
Social media	3.1	6.7
Maternal and Child Health Service	2.6	4.1
Seminar	2.1	4.1
Doctor	2.1	7.3
Telephone	1.6	3.1
Early Childhood Service	1.6	4.1
Disability Equipment Provider	1.6	13.5
Mainstream Shop	1	4.1
Webinar	0.5	1
School	0	3.6