Buckle release: inspiring innovation to improve road safety for children with disability & families

Page 1

An invitation to innovate Designing complete vehicle safety solutions

Buckle release: LTD

inspiring innovation to improve road safety for children with disability & their families



Contents Imagine... Summary Market need - the problem Market size Current products Market opportunities Insights to spark innovation Market enablers The way forward...

References Appendix: AS 8005:2020


Imagine... Imagine

you are a parent of an eleven-year-old child with a disability like Autism Spectrum Disorder (ASD).

Imagine

if your child regularly tries to escape their seatbelt, and the vehicle, while travelling in the car.

Imagine if you were equally worried about the safety of your

other children in the car, whilst also trying to keep your eyes on the road. If you were this parent, you would be desperate to find a solution that keeps your children and family safe in the car. Right now, the rights of children with disability to safe transport are not being met equal to children without disability.

But together, we can change this. These guidelines aim to inspire and stimulate vehicle manufacturers and product innovators, in Australia and abroad, to solve a real-world problem – the issue of buckle release and associated challenges. Research shows that a significant number of children with disability and challenging behaviours try to escape their child car seat, causing a serious risk to the child, driver and other road users.[1] These children either unbuckle their child restraint or seatbelt, or engage in other behaviours such as sliding underneath the seatbelt, or taking their arms out of the child restraint harness. Several products are marketed to respond to buckle release, the most popular being a buckle cover, intended to prevent access to the


seatbelt or child restraint release button. However, a functional assessment of the available buckle covers reveals limitations. They do not meet Australian standards and are not fail proof. Some products even introduce additional risks – such as the difficulty of quickly removing the child from the vehicle in the event of a crash. Mobility and Accessibility for Children in Australia Ltd. (MACA) and La Trobe University Centre for Technology Infusion received funding from the Commonwealth Road Safety Innovation Fund, with the aim of inspiring vehicle manufacturers, product designers and innovators to develop better solutions for buckle release and associated challenges. The complete vehicle safety solution would ideally consist of products designed to work together – providing allied health professionals the flexibility to respond to the wide range of individual child and family needs. This kind of complete vehicle safety solution requires a collaborative and holistic response, and we invite industry, researchers and other interested parties to partner together in product design and development.

Specifically, we call upon: • innovators to develop holistic solutions that respond to buckle release and associated challenges (such as children sliding underneath the seatbelt).

• vehicle manufacturers to explore integrating a buckle release control mechanism into vehicle design. • industry to channel their technological development in line with the learnings from this project. • regulatory authorities to find ways to improve safety by supporting products and solutions that improve safety for children with disability.

• researchers and universities to concentrate their efforts on developing and evaluating new promising technologies and products. These guidelines outline what we know about the problem, current products, market opportunities and enablers. We hope that they inspire you to push the envelope on developing new and innovative solutions to reduce the risk of buckle release challenges. MACA is placing the needs of children with disability firmly on the road safety agenda through this project and its lead role in advancing the rights of children with disability to safe and accessible transport. Let’s work together to make safe transport a reality.

Imagine the peace of mind!


Summary Objective Market need

To inspire vehicle manufacturers and innovators to solve the real-world challenges of buckle release. Some children with disability and challenging behaviours are prone to getting out of their vehicle seat (or child restraint). For example, research (2013) shows that 74% of children with Autism Spectrum Disorder escape their child restraint, and more than 20% of parents report their child demonstrates aggressive or self-injurious behaviour during travel, affecting their safety and others. [1] This can cause visual, manual or cognitive distraction placing the driver at an increased risk of crashing. Further, some of the products used to manage buckle release (e.g., buckle covers and harnesses) may introduce new road safety risks as they block access to the buckle release mechanism, making it challenging to remove a child in an emergency.

Market size

Buckle covers and associated products are used privately by individuals, as well as by professional and public transportation segments. The professional segment includes organisations transporting people with disability, taxi and community service providers. It is challenging to quantify the size of the local and global market; however, the following key statistics provide an indication:

357,500 Australian children under the age of 15 live with disability. [2] an estimated 95

million (5.1%)

children 0-14 years live with disability worldwide. [3]

1 in 54 children has Austism Spectrum Disorder (ASD). [4] 74% of children with ASD escape their child restraint. [1]


While the project focuses on children with disability and challenging behaviours, the issue of buckle release, and its associated challenges, may impact other vulnerable such as people with dementia.

The most common types of products in the market today to manage buckle release include seatbelt and child restraint buckle covers, and anti-escape buckles on harnesses or special purpose child restraints. Our consultation and product review revealed that the current products do not meet the range of user needs, for example: • • • •

Current products

no one product alone responds effectively to buckle release and the associated challenges. some of the products are difficult to use and not effective. the use of some products can introduce road safety risks and unintended consequences. the look and feel of some products are not child friendly.

The report presents seven areas for further exploration, informed by consultation with industry, allied health professionals and parents. We hope that it will spark innovative solutions to buckle release and its associated challenges. This project revealed the need for complete vehicle safety solutions. Instead of products designed independently of each other, we need products and solutions that are designed to work together and are easy and safe to use.

Complete vehicle safety solutions will bring safety and peace of mind to families.

Opportunity


Enablers

Mobility and Accessibility for Children in Australia Ltd. (MACA) is a key industry enabler for the safe transportation of children with disability and medical conditions. MACA is working hard to remove the regulatory and legislative barriers to product development and supply, paving the way for suppliers and manufacturers to both develop and supply products to Australia. MACA is also developing a national website to support allied health professionals who connect families to products and solutions. Further, the National Disability Insurance Scheme (NDIS) has created a sizeable market for assistive technology (such as buckle covers, harnesses/vests, special purpose child restraints) as these products are now fully funded for eligible NDIS participants.



Market need - the problem

The problem

>

Market size

>

Current products

>

Market opportunities

>

Market enablers

There is a real-world need for innovations to manage buckle release, and associated challenges, for children with disability and challenging behaviours. We know from research that 74 per cent of children with ASD escape their child restraint. [1] This was tragically illustrated in the case of a young boy, and his pregnant carer, who were both killed in NSW in 2017. It is believed the boy escaped his child restraint and his carer pulled over to assist, following him onto the road, where they were both hit by a truck. In addition to the road safety risks of a child getting out of the vehicle seat whilst the vehicle is moving, there is also a risk to the driver (and other vehicle occupants) where the child shows aggressive, self-injurious, or disruptive behaviour. [1] This can cause visual, manual, or cognitive distraction, placing the driver at an increased risk of crashing. Research examples include the child kicking the back of the vehicle seat, attacking the driver or other passengers, opening vehicle doors, head banging, hitting self, and holding breath. A research study by the Riley Hospital in Indianapolis noted “the primary concern of parents was that the child negatively affects the driver (54%) and the child moves the safety belt to an unsafe position (53%).”[5]


e as

underne at h

s arm

t bel at se

rel e

& others self

Unbuckle Release

Slide LTD

Buckle release & associated travel challenges

eh icle

Move

do ors

Trapped or sh in cra

em erg ency

d aroun

Interfere

en ger s

or ws windo

Open

driver

s as p or

v


So, what are the challenges? Our research uncovered that it is not just unbuckling that is the issue, but a broader range of associated challenges, affecting not only the child, but also the driver, other vehicle occupants and road users. Table 1: Examples of buckle release behaviours and impacts Child attempting to get out of child restraint or seatbelt Child unbuckling seatbelt Child unbuckling child restraint Child sliding underneath the seatbelt Child taking arms out of child restraint harness Child releasing arm from seatbelt Child releasing other occupants’ buckles Child interfering with driver Child interfering with other passengers Child moving around vehicle (passive)

This road safety challenge is recognised in the Australian/New Zealand Standard 4370:2013 Restraint of children with disabilities, or medical conditions, in motor vehicles. [6] This standard is used by allied health professionals (AHPs), such as occupational therapists and physiotherapists, when assessing and recommending behavioural strategies and restraint solutions for children.

Excerpt from AS/NZS 4370:2013 “Carers of children with an intellectual impairment, autism or behavioural challenges report a range of challenges associated with motor vehicle travel: - attempting to escape from the vehicle.

Child moving around vehicle (aggressive)

- exhibit distracting behaviours.

Child trying to open vehicle windows (passive)

- engage in physical fighting with other vehicle occupants, and

Child trying to open vehicle windows (aggressive, e.g., hitting) Child trying to open doors of moving vehicle Driver distracted by child

2

Note AS/NZS 4370 does not deal with the design, performance and safety of products – refer to AS 8005:2020

- may physically interfere with the driver.”


Objective To stimulate vehicle manufacturers and product innovators, in Australia and abroad, to solve a real-world problem – the issue of buckle release and associated challenges.

Nearly 80% of AHPs make vehicle seating recommendations in response to children’s behavioural challenges & are central to connecting families of To stimulate the development of innovative products and solutions that effectively respond to buckle release challenges – and deliver on children with disability to the supports they need. [8]

the rights of children with disability to safe transport

In Australia, there are 18,304 registered occupational therapists, & 33,792 physiotherapists.

[9]

[10]

There is a clear need for better solutions – both in terms of improving road safety outcomes and meeting customers’ real-world needs. This creates a unique opportunity for innovators, vehicle manufacturers and product designers to develop new vehicle safety solutions.


Market size Buckle covers and associated products are used privately by individuals, as well as by professional and public transportation segments. The professional segment includes organisations transporting people with disability, taxi and community service providers. Although it is challenging to quantify the size of the local and global market, the following key statistics and information (on right) provide an indication:


There are 4,660,800 children in Australia, of which 357,500 have a disability.

[2]

It is estimated that 95 million (5.1%) children (0-14 years) have a disability worldwide. [3]

1 in 54 children has ASD restraint.

[4]

and 74% of children with ASD escape their child

[1]

Whilst this project focuses on children with disability and challenging behaviours, the issue of buckle release may impact other vulnerable road users, such as people with dementia. About 459,000 Australians live with dementia, expected to increase to 590,000 by 2028 & 1,076,000 by 2058. [11]

Globally, 50 million people have dementia and this is expected to increase to 82 million in 2030, and 152 million in 2050. [12]


Current products The most common types of products in the market today to manage buckle release challenges include seatbelt and child restraint buckle covers; and anti-escape buckles on harnesses or special purpose child restraints. Most products are available to purchase directly from manufacturers, distributors, or online from various local and overseas suppliers. A seatbelt buckle cover is an accessory product that is placed over the top of the adult seatbelt buckle to prevent the occupant from accessing the seatbelt’s release button. Figure 2: Houdini 31 Harness11

A child restraint buckle cover is an accessory product that is placed over the top of the buckle release on the inbuilt harness of a child restraint. There are other devices available, such as the Stayput Safety Belt Security System [14] that uses electronic features. Stayput report they are working on a prototype for the challenge of children sliding out from under the seatbelt.

Figure 3: Special purpose child restraint antiescape buckle

The variable quality and performance reliability of buckle covers often results in the purchase of a number of buckle covers (trial and error approach). Where the situation escalates, a harness or special purpose child restraint with anti-escape features is sometimes used. In more extreme cases children continue to travel unsafely or bespoke solutions are sought. The table below summarises the advantages and disadvantages of the product types identified as part of this project.


Type of solution Buckle cover (for both seatbelt and child restraints)

Price range $20 - $78

How it works Plastic cover that prevents access to the buckle release and – in most cases – requires a tool (e.g., a key or a buckle tongue) to open it.

Benefits Low cost Easy to transfer from vehicle to vehicle

Challenges • • • • •

• • •

Mainstream shops Online Specialist distributors

• •

Most buckle covers require a tool to open Limited reliability Restrictive practice implications Increased difficulty to remove child in an emergecy Seatbelt buckle covers still enable a child to slide out from under the lap part of the seatbelt Child can release arms from child restraint harness or seatbelt Challenging to manage more than one occupant using a buckle cover in the same vehicle Some children quickly work out how to access the child restraint or seatbelt buckle. Often used as a low-cost option where supervision of the child is not available No product complies with Australia Standards [7] Not well studied and no real world injury data [15]

• • • •

No product meets Australian Standards [7] Not well studied and no real world injury data [15] Increased difficulty to remove child in the event of an emergency Potential for a child to learn how to undo, negating any benefit

Mainstream shops

Online

Higher cost Restrictive practice implications Time delay in accessing (bespoke and/or awaiting NDIS funding) Safety risks in the event of a vehicle crash Depends on occupant acceptance/suitability (e.g., sensory challenges) May be difficult to transfer across multiple vehicles (depends on the harness/vest) May not be compatible with all vehicle types (e.g., bus) Some products use PVC which may be uncomfortable for the occupant Often difficult to use, requiring multiple steps to fit to the occupant Vehicle compatibility – may need different products for different vehicle types (e.g., bus)

Specialist distributors

Online

• • • •

Chest cross strap

Harnesses/vests

$25 plus

$250 - $2000 plus

Aftermarket devices designed to keep the shoulder straps of a child restraints in-built harness together to minimise the chance of these coming off the shoulder.

Low cost

Some harnesses/vests come with anti-escape features. This includes using custom made buckles that are difficult to open; locating buckles away behind the vehicle seat so the occupant cannot access the buckles. Some also use magnetic features and zips to “lock” the occupant in.

Reliable

East to access

Availability

[15]

• • • • • • • • • •

Electronic seatbelt buckle lock

$500 - $1000

Electronic and mechanical buckle lock that can be operated from the vehicle’s dashboard. (Stayput Safety Belt Security System)

Less restrictive: Looks like a regular seatbelt. The locking mechanism is only activated by the driver, when needed during transport.

• • • • • •

Higher cost Restrictive practice implications Occupant can slide out from under the seatbelt Child can release arms from seatbelt Not transferrable from vehicle to vehicle Not evaluated

Specialist distributors

Electronic warning system in the event of a buckle release

$250 - $1000

After-market buckle status warning device for vehicles that do not have an inbuilt buckle release warning system. (Bucklemeup)

Forewarning system

• • • •

Not an active solution; only passively monitors (warning) Not transferrable Occupant has access to buckle release feature Not evaluated

Online for advance purchase

Lower cost electronic product


Market opportunities Our consultation with industry and other stakeholders revealed that the current range of products available in the market do not meet the range of user needs, for example: • • • • •

• •

no one product alone responds effectively to buckle release and the associated challenges. some of the products are difficult to use and not effective for all users. the use of some products can introduce road safety risk and unintended consequences. For example, a child placed in a seatbelt with a buckle cover is still able to get out of the vehicle seatbelt – this usually involves the child sliding out from under the lap part of the seatbelt, whilst the vehicle is moving. the look and feel of some products is not child friendly.

The opportunities Opportunities exist to deliver on the rights of children with disability to safe transport by developing products and solutions that respond effectively to buckle release and associated challenges. We encourage you to develop products and solutions that consider the safe system approach; universal design principles; and reducing or eliminating restrictive practice.


A safe system approach

Universal design principles

The five pillars of the safe system, as shown in the image, operate in harmony to reduce fatalities and serious injuries. It is intended to be an inclusive approach that caters for all groups using the road system. The principles of a safe system approach include: • Human fallibility: we all make mistakes on the road. • Human vulnerability: people are physically frail with limited ability to tolerate the forces in a crash. • Forgiving system: a road transport system must be ‘forgiving’ of mistakes within these limitations. • Shared responsibility: the responsibility for road safety is shared by system designers, maintenance, decision-makers and road operators and users. [16]

Universal Design is performance-based and addresses usability issues for people of all ability levels. • Body fit: accommodating a wide a range of body sizes and abilities. • Comfort: keeping demands within desirable limits of body function and perception. • Awareness: ensuring that critical information for use is easily perceived. • Understanding: making methods of operation and use intuitive, clear, and unambiguous. • Wellness: contributing to health promotion, avoidance of disease, and protection from hazards. • Social integration: treating all groups with dignity and respect. • Personalisation: incorporating opportunities for choice and the expression of individual preference. • Cultural appropriateness: respecting and reinforcing cultural values and the social and environmental contexts of any design project. [17]

Restrictive practices involve the use of interventions and practices that have the effect of restricting the rights or freedom of movement of a person with disability with the primary purpose of protecting the person or others from harm. These primarily include restraint (chemical, mechanical, social or physical) and seclusion.

Reducing or eliminating restrictive practice

While restrictive practices may be used in some circumstances with people with disability and challenging behaviours there are concerns that such practices can be imposed as a ‘means of coercion, discipline, convenience, or retaliation by staff, family members or others providing support’. Such practices may infringe a person’s human rights. As a result, there are significant concerns about the use of restrictive practices in Australia. [18] It has been recognised internationally and domestically that restrictive practices can be significantly reduced and, in many cases, eliminated. Buckle covers, for example, may be considered a mechanical restraint if the use of the buckle cover is to prevent, restrict, or subdue a person’s movement for the primary purpose of influencing a person’s behaviour. [19] The key point being the purpose or intention of using the device.


Insights to spark innovation The following areas for innovation emerged from engagement with industry, parents, allied health professionals and disability organisations. The ideas are broad concepts or thought starters, intended to generate further thinking and discussion about what is possible. Our hope is that they will lead to partners collaborating to develop complete vehicle safety solutions that effectively respond to buckle release and associated challenges.

Complete vehicle safety solutions have the greatest potential to improve road safety and bring peace of mind to families.

Innovating seatbelts

Preventing buckle access What if we could develop

How might we innovate

products that enable easy

seatbelts to prevent

physical access to the buckle

unbuckling whilst the

by all people, except the

vehicle is moving?

person in the vehicle seat?

Passenger & driver monitoring What if we had aftermarket or vehicle integrated systems that detect both driver distraction and that a child is about to unbuckle?

Driver safety What if we could develop an emergency or on-demand capability that, when activated, enables the driver to pull over safely in response to a child getting out of their vehicle seat?


Child friendly harness designs

Preventing children getting out from under the seatbelt

What if harnesses were

What if we could develop

buckle covers that are 100 per

child-friendly and easy to

solutions to prevent children

cent effective and comply with

put on and take-off?

from getting out from

the Australian Standard (AS

under the seatbelt?

8005:2020)?

Compliant buckle covers What if we could develop


Insights to spark innovation 1. Innovating seatbelts How might we innovate seatbelts to prevent unbuckling whilst the vehicle is moving? Since mandatory seatbelt legislation was first introduced in Australia in 1970, we have seen improvements to seatbelt design and use, including advancements in technology such as audible seatbelt reminders. However, seatbelt design does not meet the needs of some children with disability or challenging behaviour who habitually unbuckle and get out of the vehicle seat. However, there are some great examples of innovators looking at solving seatbelt related challenges for children. Further, we know that vehicle manufacturers have the capability to integrate electronic solutions, such as seen in electronic child car door locks.

Current products/prototypes Stayput Safety Belt Security System The Stayput Safety Belt Security System [14] is an Australian aftermarket seatbelt that replaces an existing vehicle seatbelt. It comes with an electronic control unit that gets mounted on the vehicle dashboard, enabling the driver to lock the seatbelt release button. When locked the occupant is unable to push down and unlock the seatbelt. When not locked it performs as a regular seatbelt. Stayput reports that in the event of a crash the seatbelt automatically “unlocks”.

Stayput advise that they have recently developed a prototype to respond to the challenge of children sliding out from under the seatbelt. Seatbelt retractor prototypes A recent prototype, aimed at increasing safety for children, was developed by a U.S company Tool Inc. The project, funded by the U.S. DOT Small Business Innovation Research program and the National Highway Traffic Safety Administration, designed a seatbelt retractor countermeasure aimed at reducing the risk of seatbelt entrapment. Most seatbelts have locking mechanisms built into the retracting mechanism. Called an Automatic Locking Retractor (ALR), this seatbelt design is a safety feature. In misuse conditions, such as when a child pulls a seatbelt all the way out, the ALR activates, locking the seatbelt in place and tightening it until it is reset by feeding the belt back into the retractor. If the seatbelt is wrapped around a child’s head, neck, or waist when the ALR activates, the seatbelt can strangle or seriously injure the child. The prototype designs changed how the locking mechanism engages and disengages, either through moving control of the locking mechanism to a button elsewhere in the car cabin, or through only activating the locking mechanism when the seatbelt is buckled. The design features were aimed at giving parents more control over the ALR, allowing them to quickly free an entrapped child.


How might these innovations and learnings contribute to developing complete vehicle safety solutions?

What would enable vehicle design to incorporate an inbuilt electronic buckle release control?


Insights to spark innovation How can we

2. Preventing buckle access What if we could develop products that enable easy physical access to the buckle by all people, except the person in the vehicle seat?

design products that cater for children with sensory challenges or challenging behaviour?

Seatbelt and child restraint buckle access is important to enable easy and quick removal of an occupant in an emergency. However, this design feature means that some children with disability and challenging behaviour regularly engage in unbuckling themselves. So how can we ensure ease of access to the buckle release function, whilst preventing the child from accessing it? Our consultation generated ideas such as a table style feature that prevents the child’s hand being able to access the child restraint or seatbelt buckle, without the child noticing or realising it (think out-ofsight, out-of-mind). Another interesting child restraint feature available overseas is the child restraint impact shield (Figure 4). A young child using this type of system would not be able to physically access the seatbelt buckle. And in this instance, there is no buckle on the child restraint.

Figure 4: Example of an impact shield [21]

Research notes that “the impact shield may be perceived uncomfortable by children and may result in resistive behaviour of the child against using the impact shield.” [20]

Figures 5: Concept for a “foldable” table


Insights to spark innovation 3. Passenger and driver monitoring What if we had aftermarket or vehicle integrated systems that detect both driver distraction and that a child is about to unbuckle? Globally, there is significant activity and investment in Driver Monitoring Systems (DMS) and Occupant Monitoring Systems (OMS). Many vehicles today already come with seatbelt warning systems, and there are several after-market products that also assist in monitoring seatbelt status. However, in all cases they only provide an alert once the occupant has unbuckled! The good news is that with the emergence of connected and automated vehicles, innovation is accelerating and opening new opportunities that will advance vehicle technology for healthcare needs.

OMS capabilities range from enabling more reliable and cost- effective passive safety systems to fully AI enabled interiors able to anticipate and care for the needs of both the driver and passenger(s). [22]

DMS can already measure facial and voice cues to calculate emotional status, in particular high emotional load (in addition to fatigue, drowsiness, gaze, head orientation, etc.) and combine this input to generate highly reliable signals relating to engagement and attention. There is an opportunity to investigate the application of DMS and OMS together, which may provide new opportunities for predictive capability relating to unbuckling and related driver distraction.

Product examples There are many examples in the market and exciting new products under development. In-vehicle examples include: Bitsensing mini V The bitsensing mini V reports that it reliably detects in-car passenger presence and monitors passengers’ vital signs such as heartbeat and respiration rate - in real time. In addition, this technology can provide DMS as the radar sensor also recognizes gestures of the driver to detect drowsiness, send out distraction warnings or offer post-crash monitoring. Seeing Machines Seeing Machines has been in the business of driver monitoring technology since 2010 and is recognised internationally for its innovations in this arena. They report that their algorithms can robustly, accurately and in real-time, measure a driver’s visual attention to their environment, assess their degree of drowsiness, and ultimately detect if the driver has passed a threshold of risk.  Child presence detection For children, an important innovation has been the advancement in technology responding to children being left in vehicles on hot days. A highly emotive issue, the development of this technology has been driven by community demand and media coverage. Car manufacturers and consumer vehicle safety programs have also jumped on board. Euro NCAP in their 2025 Roadmap state that from 2022 a reward is given to Child Presence Detection, which can detect a child left alone in the car and alert the owner and/or emergency services, to avoid heatstroke fatalities. [23]


Insights to spark innovation After-market product examples Some vehicles already come with a seatbelt warning system, and there are also several after-market products. However, in all cases they only provide an alert once the child has unbuckled! Bucklemeup (Australia) Bucklemeup is a wireless Bluetooth seatbelt alarm that alerts the driver via a smartphone (for car) or a dash mounted screen monitor (for buses) if a passenger unbuckles.

How can we apply OMS and DMS to buckle release challenges? How can we design products that prevent a child undoing the buckle in the first place? How can emerging technology detect a child may be about to unbuckle and intervene (e.g., child car locks are automatically activated if the child unbuckles)?

Maxsafe (Australia) Maxsafe is similar to the Bucklemeup solution, however it is only available as a retro-fitted option for bus fleets. It uses a visual display to inform the driver about how many seatbelts aren’t buckled in. It can be tailored to notify both the driver and passenger via audible alarms and warning lights. SensorSafe Children who habitually take their arms out of the child restraint inbuilt harness are often prescribed a chest cross clip. In Australia, the most popular product is the Houdini chest cross clip. A new “smart” chest cross clip is being considered for entry to the Australian market, called SensorSafe. This product connects to a smartphone and provides alerts if the child unbuckles the chest cross clip; if the child is at risk of being too hot or too cold; or if the child has been seated for too long (and needs a break!).

Figure 6: Bucklemeup seatbelt reminder and alert system

Figure 7: Sensorsafe


Insights to spark innovation 4. Driver safety What if we could develop an emergency or ondemand capability that, when activated, enables the driver to pull over safely in response to a child getting out of the vehicle seat?

Figure 8: Eject helmet removal system

Many parents have had the terrifying experience of their child getting out of their child restraint or seatbelt whilst the vehicle is moving. This may also include the child being aggressive and injuring themselves or others. Some parents in this situation install driver dividing screens (commonly used in taxis and buses), to provide a barrier so that if a child gets out of their seat the driver is able to safely pull the vehicle over. However, our consultation found that allied health professionals do not feel comfortable recommending dividing screens for private use as they isolate the child from his/her parent/family. An alternative to isolating the driver, would be to consider temporarily immobilising the occupant using air-activated products (e.g., harness; seatbelt) in response to the child releasing the vehicle seatbelt.

Current product examples Driver Protection Screens Mobility Station (in the UK) produces an example of a Perspex dividing screen for cars, that can be transferred from vehicle to vehicle. New and innovative designs are quickly emerging in response to COVID-19, particularly in the airline industry to physically separate airline passengers. [24]  Air activated devices Air has been used for many safety protections devices, such as the Eject helmet removal system and Mammut Pro Protection Airbag 3.0

Figure 9: An example of Adaptation Station’s protection screen

Figure 10: Klymit’s inflatable Jacket (top left), Hovding inflatable jacket (bottom) & Ford’s inflatable seatbelt (top right)

Figure 11: Mammut Pro Protection Airbag


How might we develop driver safety barriers that are family friendly, and only activated when needed in an emergency? How might air activated products be used to respond to buckle release and associated challenges? How might OMS and DMS be used in combination with emergency response products (to enable the driver to pull over safely)?


Insights to spark innovation 5. Child-friendly harness designs What if harnesses were child-friendly and easy to put on and take-off? Some harnesses are made from PVC or other plastic-like materials; many are black and intimidating in their design. In the current range, there appears to have been minimal consideration to sensory and visual factors – colour, texture, material, temperature conductivity, pattern, breathability, and auditory responses.

In the event of a crash, harnesses with anti-escape features make it very difficult for a bystander to release the occupant quickly if required. There is an opportunity for harnesses to incorporate singlepull emergency release of the occupant – for example, as seen in the parachuting industry.

Current product examples The Crelling Harness is an example of a product using PVC. This harness was originally designed for use in the UK, a much cooler climate than Australia. The following advice is provided in the Crelling Use of Vehicle Harnesses Policy – highlighting some of the limitations with the harness. [25]

For passengers who perspire excessively (especially during summer months) it is recommended that frequent checks are made to ensure the passenger is not becoming overheated when wearing the harness. Regular checks should be made to ensure that perspiration is not causing unnecessary chaffing from the harness against the passengers skin. If overheating / chaffing occurs, actions must be put in to place to prevent this. Some clients have used cotton fabric and secured this around the PVC back pad and chest pad of the harness with self-adhesive Velcro. Care is advised during hot summer months as the metal part of the buckles may become hot if left in direct sunlight, whilst in the vehicle. Please check that buckles are not too hot prior to putting them against the passenger.

Figure 12: This Crelling Harness utilises PVC and metal buckles (available through an Australian supplier)

Figure 13: Snaphook from Aerosafety


How might a comfortable harness be developed that responds to the needs of children, including those with sensory challenges?


Insights to spark innovation 6. Compliant buckle covers What if we could develop buckle covers that are 100 per cent effective and comply with the Australian Standard (AS 8005:2020)? Buckle covers are commonly prescribed by allied health professionals in response to buckle release challenges. However, this project’s functional assessment of buckle covers available on the market today revealed that they do not meet Australian Standards and are variable in terms of quality and performance reliability. An accessory standard was introduced in 2013, AS/NZS 8005:2013 which included buckle covers; however, to date, no one has produced a buckle cover that complies with this standard. The current version of this standard is AS 8005: 2020. [7] To comply with the standard the buckle cover must include features, such as: • • • • •

needed to determine whether this standard will be sufficient to ensure good safety performance of accessories. [15] If this is achieved, there may be an opportunity to incorporate a buckle cover in a complete vehicle safety solution.

Is it possible to make buckle covers that comply with the standard (and are 100 per cent ‘fail proof’)?

toolless release. releasable only by a single press operation; no sliding or rotary actuation for release. hinges (flaps) or removable parts to cover the release button cannot be used.

The standard also includes requirement for material selection, performance, packaging, marking and instructions. Therefore, there is an opportunity to develop a buckle cover that is effective and complies with AS/NZS 8005, noting that research will be

How might we develop products and solutions where the buckle cover is part of a suite of vehicle safety solutions designed to address buckle release and associated challenges?


Insights to spark innovation 7. Preventing children getting out from under the seatbelt What if we could develop solutions to prevent children from getting out from under the seatbelt? Our consultation found that when a buckle cover is used with the adult seatbelt (i.e., the child is seated directly on the vehicle seat), some children then attempt to slide out from under the lap part of the seatbelt. This can cause the seatbelt to end up around the child’s neck area, resulting in a potentially unsafe and traumatic experience for the child, driver, and others in the vehicle. Children who get out from under the seatbelt are often recommended a harness. However, there may be other innovations that we can learn from. For example, the Tummy Shield, designed for pregnant women, redirects the lap part of the seatbelt away from the stomach area by placing the lap part of the seatbelt under a hook. The aim of the Tummy Shield is to protect both mother and baby from potential injury in a crash.

How might existing products, such as the Tummy Shield, be adapted to restrict children from getting out from under the lap part of the seatbelt?


How might we design products that work together with a buckle cover to prevent the child from sliding out from the seatbelt?

Figure 14: Tummy Shield


Market enablers National Disability Insurance Scheme The introduction of the National Disability Insurance Scheme (NDIS) to Australia in 2013 has seen a significant shift in market opportunities and funding arrangements. The NDIS entitles people with a “permanent and significant” disability (under the age of 65), to full funding for any “reasonable and necessary” support needs related to their disability (subject to certain restrictions). Funding is allocated to the individual, and the individual, or their guardian, chooses which providers supply the funded goods and services (subject to certain restrictions). The NDIS funds a range of supports and services which may include education, employment, social participation, independence, living arrangements and health and wellbeing. The National Disability Insurance Agency (NDIA) is the agency responsible for implementing the NDIS. The NDIA is seeking a marketplace with a diverse array of providers that maximises choice and control for participants.

What assistive technology does the NDIS fund? Assistive technology includes items that help people with disability do things they can’t do because of their disability, or things that help people with disability do something more easily or safely. Assistive technology (such as buckle covers, harnesses/vests, special purpose child restraints) are now fully funded for eligible NDIS participants. All NDIS supports (including assistive technology) must meet the reasonable and necessary criteria.


To be considered reasonable and necessary, the assistive technology must: • • • • •

• •

be related to a participant’s disability.

MACA will increase allied health professionals’ knowledge of best practice restraint options for children with disability through professional development, and support. This enables MACA to promote safe, high quality, reliable products and solutions that support the safe transport of children with disability.

represent value for money. be right for the participant (i.e., is the right item for the participant’s needs, is safe to use and meets Australian safety standards, where this is possible, will work well for the participant). not be funded or provided by someone else. [26]

How do people access assistive technology? Allied health professionals are the key people who support the families of children with disability to the access supports and services they need - including assessing and recommending the safest and most suitable restraint options in line with Australian Standards.

MACA’s national information resource Established in 2019, Mobility and Accessibility for Children in Australia Ltd. (MACA) is the leading Australian not-for-profit organisation dedicated to advancing the rights of children (under 16 years of age), with disability and medical conditions, to safe and accessible transport.   MACA has received an NDIS grant to develop a National Information Resource supporting the rights of all children to safe and accessible transport and participation in community life (2019-22), providing a national one-stop-shop website and information resources.

In addition to developing MACA’s national website (scheduled for launch in 2021), resources and training, MACA is working hard to remove the regulatory and legislative barriers to product development and supply. MACA’s activity in this area is paving the way for suppliers and manufacturers to both develop and supply products to Australia.

MACA’s supporters MACA has received funding from the NDIA, the Office of Road Safety (who has funded this project), the Transport Accident Commission (who have funded the establishment of a safety assessment program for special purpose child restraint systems) and the Department of Transport.


The way forward... MACA’s vision is that every Australian child should have access to safe and equitable transport, regardless of circumstance. We look forward to working with you to make this vision a reality. Please get in touch with MACA CE Helen Lindner to discuss your ideas, or for more information helen@macahub.org



References 1. Yonkman, J., Lawler, B., Talty, J., O’Neil, J., & Bull, M. (2013). Safely transporting children with autism spectrum disorder: Evaluation and intervention. American journal of occupational therapy, 67(6), 711-716. 2. Disability, Ageing and Carers, Australia: Summary of Findings, 2018 | Australian Bureau of Statistics (abs.gov.au), accessed 11 February 2011. 3. The global burden of disease: 2004 update. Geneva, World Health Organization, 2008. Cited in the World Report on Disability Summary Report, World Health Organization and World Bank, 2011. 4. Maenner MJ, Shaw KA, Baio J, et al. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016. MMWR Surveill Summ 2020;69(No. SS-4):1–12. DOI: http://dx.doi.org/10.15585/mmwr.ss6904a1 5. Janell Yonkman, Bryanna Lawler, Judith Talty, Joseph O’Neil, Marilyn Bull (2013): Safely Transporting Children with Autism Spectrum Disorder: Evaluation and Intervention. American Journal of Occupational Therapy, 67, 711-716. http://dx.doi. org/10.5014/ajot.2013.008250 6. Standards Australia, Australian/New Zealand Standard 4370:2013 Restraint of children with disabilities, or medical conditions, in motor vehicles. 7. Standards Australia, Australian Standard AS 8005:2020 Accessories for child restraints used in motor vehicles. 8. Baker A, Galvin J, Vale L, and Lindner H, Restraint of children with additional needs in motor vehicles: Knowledge and challenges of paediatric occupational therapists in Victoria, Australia. Australian Occupational Therapy Journal, 2012, 59(1), 17-22.


9. Ahpra.gov.au accessed 21 December 2020. 18. Australian Law Reform Commission (2014), Restrictive practices in Australia | ALRC, accessed 11 February 2021. 10. Ahpra Physiotherapy Board, accessed from www. physiotherapyboard.gov.au on 21 December 2020. 19. NDIS Quality and Safeguards Commission website, https://www. ndiscommission.gov.au/regulated-restrictive-practices, accessed 11 11. Dementia Australia (2018), Dementia Prevalence Data 2018-2058, February 2021. commissioned research undertaken by NATSEM Canberra. 20. Johannsen, Heiko1; Beillas, Philippe2; Lesire, Philippe, Analysis of 12. World Health Organization website, Dementia (who.int), accessed the performance of different architectures of forward-facing CRS 11 February 2021. with integral restraint system. 13. Medifab website, https://www.medifab.com.au/products/car21. Accessed from Pushchairexpert website, https://www. seats-harnesses/houdini-31-7-point-harness, accessed 11 pushchairexpert.com/en/car-seat-reviews/cybex-pallas-b-fixFebruary 2021 review/ , 29 December 2020. 14. Stayput Restraints website, Stayput seat belt (stayputrestraints. 22. PR Newswire website, https://www.prnewswire.com/newscom.au), accessed 11 February 202. releases/seeing-machines-extends-its-industry-leading-dms to-occupant-monitoring-301149940.html, accessed 29 December 15. Neuroscience Research Australia and Kidsafe Australia: Best 2020. Practice Guidelines for the Safe Restraint of Children Travelling in Motor Vehicles, 2nd Edition. Sydney: 2019 23. Euro NCAP 2025 Roadmap, euroncap-roadmap-2025-v4.pdf, accessed 11 February 2021. 16. Australian Government, The Department of Infrastructure, Transport, Reginal Development and Communications, National Road Safety 24. https://www.aircraftinteriorsinternational.com/features/ideas-toStrategy 2011-2020, available at National Road Safety Strategy boost-airline-passenger-confidence-during-covid.html accessed 2021-30 | National Road Safety Strategy. 29 December 2020. 17. Universal Design Principles, University at Buffalo, Center for Inclusive 25. Crelling Harnesses website information, Use of Vehicle Harnesses Design and Environmental Access, School or Architecture and Policy, accessed 30 December 2020. Planning website, Universal Design - IDEA Center (buffalo.edu) accessed 11 February 2021. 26. NDIS website, What assistive technology do we fund? | NDIS, accessed 11 February 2021.


Appendix: AS 8005:2020 10.2.1 Seatbelt buckle covers Seatbelt buckle covers shall conform to the following requirements: (a) When the seatbelt buckle cover is fitted to the seatbelt buckle, the seatbelt buckle shall be able to be released without the use of tools. (b) When the seatbelt buckle cover is fitted to the seatbelt buckle, the seatbelt buckle shall be able to be released with a single press operation. (c) A rotary or sliding actuation shall not be used to operate the seatbelt buckle. (d) Hinging flaps or removable components that cover the actuator button shall not be used. (e) Any seatbelt buckle cover that has an aperture through which the seatbelt buckle is to be released shall allow a 25 mm diameter spherical probe to pass through the aperture, to operate the seatbelt buckle release button with a distance of no more than 20 mm, fully depressed from the surface to top of cover. The probe shall be fitted with a rod of 8 mm to 12 mm in diameter of a suitable length to hold and apply by hand. NOTE 1 - This requirement is intended to be applied if the buckle is fitted with a cover which may include a hood to make access more difficult for a child. NOTE 2 - The gap is intended to allow an adult thumb or finger to be inserted to operate the buckle’s actuator. (f) Any seatbelt buckle cover that fully encloses the seatbelt buckle shall — (i) have an indicator of the actuation surface permanently fixed to the cover or cover assembly with an area between 125 mm2 and 300 mm2 showing where to press the cover to actuate the release button; and


(ii) not require a force of more than 60 N to operate the seatbelt cover’s release mechanism. (g) The colour of the indicator of the actuation surface of the cover shall be red or orange. The colour of the external surfaces of the cover, other than the actuation surface, shall not be red or orange. NOTE 3 - For the purpose of this requirement, colours acceptable as red or orange include the following, as defined in AS 2700: (i) R11 — International Orange. (ii) R12 — Scarlet. (iii) R13 — Signal Red. (iv) R14 — Waratah. (v) R15 — Crimson. NOTE 4 - Bright shades with good contrast to surrounding surfaces should be used. (h) When tested in accordance with AS/NZS 3629.5, the average initial force required to operate the release actuator and the average force required to operate the release actuator after 5000 operations shall be not more than 80 N. (i) The seatbelt buckle cover shall not use a hook and loop tape connection where the hook may contact and abrade the seatbelt webbing.