Question for a friend....

agurlsride

New member
My friend watches a little boy with Downs Syndrome, he currently is riding in a combination seat. he is 4 years old and 24lbs. Should she buy him a new seat and turn him rear-facing or is he ok the way he is?
 
ADS

ketchupqueen

CPST and ketchup snob
Staff member
Has he had x-rays and other screenings to determine whether he has occipital-cervical spinal junction abonormalities or cervical instability? If he has it, or if he has not been screened, yes, I would turn him rear-facing. Likewise, if he has any difficulty holding his head up or discomfort I would turn him. However, if it has been determined he has no cervical spinal problems, at 4, it depends on what works best for him, her, and his family. At 4 the margin of safety for rear-facing vs. forward-facing is pretty small IF he has no additional risk factors. It's safer for everyone but it's not a "must" at 4 years old, even for a small child, like it is at 1 or 2.
 

Raegansmom4

New member
Has he had x-rays and other screenings to determine whether he has occipital-cervical spinal junction abonormalities or cervical instability? If he has it, or if he has not been screened, yes, I would turn him rear-facing. Likewise, if he has any difficulty holding his head up or discomfort I would turn him. However, if it has been determined he has no cervical spinal problems, at 4, it depends on what works best for him, her, and his family. At 4 the margin of safety for rear-facing vs. forward-facing is pretty small IF he has no additional risk factors. It's safer for everyone but it's not a "must" at 4 years old, even for a small child, like it is at 1 or 2.

Very well said.
 

agurlsride

New member
I'll have to ask her but thank you for the information. I know he goes to physical therapy but I don't really know how much more his parents have put into his care/well being as a Downs child. The parents are both high money making adults (both are staffing supervisors at hospitals), they have 8 kids and the only one that rides in a car seat is the 4yr old. (my friend is going to buy some of the older kids boosters though). Mom doesn't even require them to wear seat belts. SO frustrating!
 

ketchupqueen

CPST and ketchup snob
Staff member
He's not near needing it by weight, and probably not by height yet, but just so you know, cervical spinal instability is very serious, and is one of the few conditions that NHTSA grants waivers for so kids can use higher-weight rear-facing seats from Sweden legally, if he needs it later.
 

safeinthecar

Moderator - CPS Technician
The dilemma with children with Down Syndrome and testing for OC abnormalities is that the test is not accurate until the spinal column is fused and complete at around 6 years old. It is normal for there to be a extra space in the c-spine on all young children. Sometimes the spacing a way more than normal and you can get a positive diagnosis fairly early, but you cannot get a true negative until 5-6 years old.
 

agurlsride

New member
He's not near needing it by weight, and probably not by height yet, but just so you know, cervical spinal instability is very serious, and is one of the few conditions that NHTSA grants waivers for so kids can use higher-weight rear-facing seats from Sweden legally, if he needs it later.

Soooo...if he did end up having spinal issues, how long would he need to be in a seat (compared to your average child)?
 

agurlsride

New member
The dilemma with children with Down Syndrome and testing for OC abnormalities is that the test is not accurate until the spinal column is fused and complete at around 6 years old. It is normal for there to be a extra space in the c-spine on all young children. Sometimes the spacing a way more than normal and you can get a positive diagnosis fairly early, but you cannot get a true negative until 5-6 years old.

So with that being said, would you turn him back rf'ing until he is old at least 5 or 6?
 

ketchupqueen

CPST and ketchup snob
Staff member
I'm not very experienced in this. I only have information from passing mentions of it. I believe that would be "rear-facing until it's fixed, or as long as possible." I know some kids with DS have behavioral issues as well (and up to a third fall on the autism spectrum as well.) As far as that goes, he needs to be harnessed until he sits properly without a harness. As for the other parts, I'll defer to someone with more knowledge/experience with the issues and condition of CSI.
 

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