Safe travel for Tiana and her family
Tiana's transport needs were changing. Her existing Australian standard car seat was no longer adequately supporting her positioning, comfort and safety, and travelling was becoming increasingly difficult for the whole family.
Client profile
Tiana is three years old and has cerebral palsy (GMFCS V) following hypoxic ischaemic encephalopathy. She lives with her parents and two siblings, aged six and four.
Step 1: Assess
Tiana travels mainly in her mother's 2017 Subaru Forester. She generally spends around 30–60 minutes in the vehicle each day, including trips for her siblings' school drop-off and pick-up and travel to medical and therapy appointments.
Tiana currently travels in a forward-facing Australian standard car seat. Her parents report that it is becoming increasingly difficult to position her comfortably. Despite using the restraint's available recline, Tiana's muscle tone and posture mean her head frequently falls forward during travel.
Tiana often becomes distressed and her mother regularly needs to stop the vehicle to reposition and comfort her. This makes travel stressful for Tiana and her family and affects her mother's ability to concentrate on driving. It is also limiting the family's ability to get out and participate in everyday activities.
Tiana's parents are finding it increasingly difficult to lift and position her into her car seat.
Jo assesses Tiana's postural support, comfort and transfer needs, together with her current restraint, the family vehicle and the needs of the other occupants.
Jo's assessment identifies that:
- Tiana's current car seat is no longer adequately meeting her postural support and comfort needs
- she requires improved support for her head and trunk during travel
- transfers into and out of the vehicle are becoming increasingly difficult for Tiana and her parents
- the family needs a solution that can accommodate Tiana and both siblings in the rear seating positions
- Tiana's current transport arrangement is affecting her and her family's travel experience and participation.
Together with Tiana's parents, Jo agrees that the goals are to:
- improve Tiana's positioning, comfort and safety during travel
- reduce the need to stop and reposition or comfort her
- make transfers into and out of the vehicle easier and safer
- maintain a practical transport arrangement for the whole family.
Step 2: Plan
Using the findings and agreed goals from her assessment, Jo develops criteria to guide the selection of an appropriate vehicle restraint.
Jo identifies that any new restraint needs to provide:
- additional head and lateral trunk support
- sufficient recline or other positioning options to support Tiana's posture and comfort
- a swivel base to assist with transfers
- sufficient space to allow Tiana's siblings to continue travelling safely in the rear seat
- compatibility with the family's vehicle.
Jo first considers whether Tiana's assessed needs and the agreed criteria can be met by an Australian standard car seat.
Jo determines that an Australian standard car seat suitable for Tiana does not provide the combination of postural support, positioning and transfer features she requires. She therefore scans the available special purpose car seats and identifies two options that meet the selection criteria for trial.
During the trials, Jo and Tiana's parents consider:
- Tiana's comfort and body position
- the postural support provided
- compatibility with the family's vehicle
- whether Tiana can be transferred safely
- her parents' confidence in using the restraint
- whether the restraint can be accommodated with the restraints used by Tiana's siblings.
Both restraints provide appropriate postural support and improve transfers through the swivel function. Because the family needs to accommodate all three children in the rear seat, the narrower of the two suitable restraints is agreed as the preferred option.
Step 3: Implement
Jo prescribes the selected special purpose car seat and documents the agreed transport arrangements in Tiana's Motor Vehicle Transport Plan.
She also completes a Transport Safety Advice Form, including information about the prescribed restraint, its correct installation and use, and the review period.
For this car seat, Jo documents that the vehicle seatbelt must be used at all times to restrain Tiana during travel, as the harness provides postural support only.
Jo completes the documentation required by Tiana's funding body.
Once funding is approved, Jo coordinates implementation with the supplier and Tiana's parents. The supplier installs the car seat in the family vehicle, with Jo involved to ensure Tiana is appropriately positioned in the restraint.
The supplier provides education about the correct installation and use of the car seat. Jo works with Tiana's parents to ensure they are confident using the restraint and provides education and strategies to support safe transfers into and out of the vehicle.
Jo completes the referral letter for Tiana's mother to obtain a medical certificate from Tiana's doctor. This is required to legally use the special purpose car seat in the state where Tiana lives.
A review is scheduled for three months.
Step 4: Review
At review, Jo reassesses Tiana’s positioning, comfort and transfers, and discusses with the family how the restraint and agreed transport strategies are working in everyday use.
She considers whether the restraint and other strategies continue to meet Tiana’s needs and the family’s transport goals, whether the restraint is being used correctly, and whether there have been any changes to Tiana’s needs or transport arrangements.
Jo updates Tiana’s Motor Vehicle Transport Plan and Transport Safety Advice Form where required.
A further review date is agreed, recognising that Tiana’s needs and her family’s transport circumstances will continue to change as she grows.
Outcome
Tiana is more comfortable and better supported during travel. Her parents find transfers easier, and the need to stop and reposition Tiana has reduced. The new transport arrangement has improved the travel experience for Tiana and her whole family.
Tiana’s comfort increased significantly in the special purpose car seat, improving Tiana and her family’s safety and travel experience.
