Modified car seats

The Australian Standard (AS/NZS 1754) requires all car seats to include a general warning in the instruction booklet "do not alter or modify this restraint". MACA is aware that many health professionals undertake modifications, and there is little evidence to support this practice. To address this gap MACA has established the Australian Safety Assessment Program (AuSAP) and is working with health professionals to improve knowledge and practice. In addition the Australian Standard (AS/NZS 1754) is currently being reviewed and is considering safety and performance requirements for variations to Australian standard car seats for children with disabilities and medical conditions.

Modifying an Australian standard car seat means it no longer complies with the Australian Standard (AS/NZS 1754) and the restraint may not perform as designed in the event of a crash. This can potentially increase the risk of injury to the child and other vehicle occupants.

If you are considering modifying a child restraint it is important that your organisation or practice has current policies and procedures in place to support this. MACA's online training course is designed to give allied health professionals access to up-to-date information about the latest research, standards and best practice prescribing approaches.

MACA requested Standards Australia for a review of AS/NZS 4370 to ensure its guidance for modifying child restraints is based on evidence, and that it remains relevant and reflects best practice. This review was approved however has been delayed due to the review of AS/NZS 1754 taking longer than anticipated.

MACA will be developing more policies, like our Buckle Cover Model Policy to support allied health professionals when prescribing modified Australian standard car seats.

The Australian standard (AS/NZS 4370) provides guidelines for using padding and highlights not using padding beneath or behind the child’s back, as it will collapse/compress in a crash causing the harness to become loose, impacting on the child’s safety. It also outlines that if padding is required for short term use or specific positioning to:

• use firm foam (e.g., EPS foam)
• not exceed 2 kg in total weight
• use padding that is flame retardant and slow burning, and
• ensure the padding is covered and secured, as appropriate, with flame retardant material to prevent the child from accessing the foam.

However, MACA's Australian Safety Assessment Program and national survey have identified concerns relating to the lack of evidence informing current modification practices in Australia. Modifying a car seat means it no longer complies with the Australian standard and the restraint may not perform as designed in the event of a crash. If you are undertaking any modifications ensure your organisation or practice has up-to-date policies and procedures that reflect current research and best practice.

MACA's online training provides guidance for allied health professionals when assessing and prescribing for children's motor vehicle transport needs. Training participants receive a free copy of the MACA Guide, a best practice resource to support assessing and prescribing for children's motor vehicle transport needs.

Common accessories that parents self-prescribe and use with Australian standard car seats are chest-cross straps and buckle covers. This is because these types of devices are readily available on-line and through shop-fronts. Some manufacturers also claim that their product complies with Australian standards, however there are no chest-cross straps or buckle covers certified to the Australian accessory standard (AS 8005).

Therefore you should review the child’s transport needs, using tools such as The MACA Guide, and if required prescribe the chest-cross strap and/or buckle cover. It is also advisable to ensure you have policies and procedures in place to support prescribing accessory products that do not comply with standards. MACA has developed a Buckle Cover Model Policy which can be adapted for your organisation or practice.