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  1. #1
    Carseat Crazy agurlsride's Avatar
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    Question for a friend....

    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?

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  3. #2
    CPST and ketchup snob ketchupqueen's Avatar
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    Re: Question for a friend....

    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.
    CPST and Mom to Emma, 15, Bridget, 13, Maggie, 11, Katie Sue, 6, Jimmy, born May 2019,
    and Becky, waiting for us as part of our eternal family.
    Our '02 Odyssey, car seats, and seatbelts saved our lives. Now riding in a '13 Odyssey!

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  5. #3
    Senior Community Member Raegansmom4's Avatar
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    Re: Question for a friend....

    Quote Originally Posted by ketchupqueen View Post
    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.
    Amy - former CPST
    Raegan (11/4/05) - Seat belt
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  6. #4
    Carseat Crazy agurlsride's Avatar
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    Re: Question for a friend....

    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!

  7. #5
    CPST and ketchup snob ketchupqueen's Avatar
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    Re: Question for a friend....

    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.
    CPST and Mom to Emma, 15, Bridget, 13, Maggie, 11, Katie Sue, 6, Jimmy, born May 2019,
    and Becky, waiting for us as part of our eternal family.
    Our '02 Odyssey, car seats, and seatbelts saved our lives. Now riding in a '13 Odyssey!

  8. #6
    Moderator - CPS Technician safeinthecar's Avatar
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    Re: Question for a friend....

    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.
    Kimberly
    Proud mommy of Becky 18! Danny 15 Hope 12~Auntie to William-14, David-10, and Logan 2~

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  10. #7
    Carseat Crazy agurlsride's Avatar
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    Re: Question for a friend....

    Quote Originally Posted by ketchupqueen View Post
    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)?

  11. #8
    Carseat Crazy agurlsride's Avatar
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    Re: Question for a friend....

    Quote Originally Posted by safeinthecar View Post
    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?

  12. #9
    CPST and ketchup snob ketchupqueen's Avatar
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    Re: Question for a friend....

    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.
    CPST and Mom to Emma, 15, Bridget, 13, Maggie, 11, Katie Sue, 6, Jimmy, born May 2019,
    and Becky, waiting for us as part of our eternal family.
    Our '02 Odyssey, car seats, and seatbelts saved our lives. Now riding in a '13 Odyssey!

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