Answers to commonly asked questions from allied health professionals about safe vehicle transport for children with disabilities and medical conditions
Reliable and accurate information
At MACA we know, through our national survey, how difficult it’s been for many health professionals to find trustworthy information to support clients in the area of safe vehicle transport.
Find answers to general common questions here, or find more specific questions and answers as you move around this site.
We are a not for profit dedicated to advancing the rights of children with disabilities and medical conditions to safe and accessible transport by leading research and providing independent, evidence informed resources and training.
Find out more about MACA’s role and work program.
We are a registered charity dedicated to advancing the rights of children with disabilities and medical conditions to safe and accessible transport.
We do this by focusing on four key priorities, developed with input from stakeholders across the disability, transport, education, and health sectors.
- Build capacity and capability across organisations and among allied health professionals.
- Strengthen policies and systems to be more inclusive and responsive to the transport needs of children with disabilities and their families.
- Advance knowledge to address a historic and global lack of information in this area.
- Drive innovation to encourage new solutions for children and their families.
We have initiated the first and largest program of research and activities to advance the rights of children with disabilities and medical conditions to safe and accessible transport. For example:
- national survey with Curtin University to understand the knowledge, perceptions and experiences of parents, health professionals and organisations
- ethnographic research with Monash University Emerging Technologies Lab to understand the lived experience of Australian families and how transport impacts on their day-to-day lives
- a review of buckle release challenges with Latrobe University
- developed the Australian Safety Assessment Program (AuSAP), funded by the Transport Accident Commission and supported by NeuRA, Britax and Vehicle Design and Research
Learn more about us, our research and other projects that are building the evidence base in this important area.
No. We provide independent and evidence-based information. We value our independence which is why we do not sell child restraint products or align our organisation with particular suppliers.
Information and FAQs about the different vehicle restraint options used by children with disabilities and medical conditions.
Yes, there are vehicle restraint options available in Australia that are designed specifically for children with disabilities and medical conditions. This includes special purpose car seats and harnesses/vests.
However, it is important to know that many Australian standard car seats (that you can buy from mainstream stores) are also suitable for children with disabilities and medical conditions. For example, there are forward facing car seats with built-in harnesses. This type of car seat (Type G) is suitable for 50 per cent of children up to at least 10 years of age (labelled as suitable from 6 months to 8 years of age). However once a child outgrows this type of car seat they may need to transition to a special purpose car seat.
Yes. The Australian/New Zealand Standard 4370 Restraint of children with disabilities, or medical conditions, in motor vehicles.
AS/NZS 4370 was last reviewed before the introduction of the NDIS, and the establishment of MACA. To ensure this standard remains relevant and reflects recent research MACA requested a review of AS/NZS 4370, which was approved by Standards Australia. However due to delays with the review of AS/NZS 1754 this review will take place at a later date.
In the interim MACA's website brings this standard to life and also provides timely access to information based on our latest research and learnings.
Special purpose car seats are available through disability equipment suppliers who work closely with allied health professionals. Unlike Australian standard car seats they comply with overseas standards or regulations, and come with an extensive range of optional accessories. The selection, issuing and fitment of special purpose car seats therefore requires the allied health professional to work closely with the supplier and other local supports where available.
Our Australian Safety Assessment Program (AuSAP) is developing information resources to ensure allied health professionals and parents have access to the information they need to support safe use.
MACA maintains a national product register.
We have undertaken a scan of Australia to identify all the special purpose car seats available today. In addition, we have scanned the globe to find out what special purpose car seats are available.
We want to ensure that Australian children have access to the most suitable and safest options available in the world today. And of course we want to take this one step further, which is why we have initiated and established the world leading Australian Safety Assessment Program (AuSAP).
Special purpose car seats comply with one or more overseas standards/regulations, however until the establishment of the Australian Safety Assessment Program (AuSAP) we had no independent information about their safety and performance. Refer to MACA's national product register of special purpose car seats.
Until recently, there was no Australian standard for specialty harnesses and vests.
‘AS 5384: Accessories for seat belts used in motor vehicles’ was published in September 2023 and caters for the design, safety and performance of the specialty harnesses/vests commonly used by occupants in motor vehicles.
It includes requirements for postural support devices (i.e., specialty harnesses/vests) and outlines crash testing, labelling and packaging requirements.
This provides suppliers in the Australian market with an opportunity to develop and supply products that comply with the relevant section of this new standard.
Despite specialty harnesses and vests being the most commonly prescribed device by Australian allied health professionals, there is a lack of information and research relating to their design, construction, safety performance and use.
To address these gaps MACA sought funding support and is now leading an Austroads project, in collaboration with The George Institute for Global Health, to research and investigate specialty harnesses/vests for both Australia and New Zealand.
Most of the specialty harness and vest manufacturer’s instructions advise that the products must always be used with the vehicle seatbelt.
We know that each child and family has unique needs. Find information and case studies about specific transport challenges commonly experienced by children with disabilities and medical conditions. Each transport challenge page also includes answers to common questions about the topic.
It is important that you have policies in place that are based on the latest evidence and best practice. This not only helps you meet your professional responsibilities but ensures children and families are offered trustworthy and reliable support.
Our policies are updated regularly in response to emerging evidence and best practice.
The Australian standard for child restraints (AS/NZS 1754) does not provide requirements for special purpose car seats. In comparison, overseas standards/regulations have some requirements, which means special purpose car seats available in Australia comply with an overseas standard or regulation.
The Australian standard for child restraints is currently being reviewed and is proposing a new section to allow for variations to Australian standard car seats for children with disabilities and medical conditions.
Hip spica transport
Information to help prepare families for hospital discharge, following their child's hip dysplasia surgery.
MACA is committed to helping build a system that enables access to an appropriate car seat in a timely way for hospital discharge.
To support families, improve current practice and develop an ongoing evidence base, we are working with researchers, AuSAP participants, hospitals, and allied health professionals to address gaps and advance the evidence base. This includes:
- Advancing research into the modification of Australian standard car seats through the generous support of a NeuRA PhD scholarship.
- Investigating and crash testing special purpose car seats designed for hip spica transport through our world leading Australian Safety Assessment Program.
- Working closely with allied health professionals to inform the development of model policies, resources and training to better support health professionals working with hip spica clients.
Unlike standards/regulations in other countries the Australian standard for child restraints does not cater for special purpose car seats.
Until MACA was established there was no national body advocating for the safe transport needs of children with disabilities and medical conditions. The Australian Safety Assessment Program has undertaken some assessment of overseas products, with the Expert Committee identifying the need for further research, testing and review.
After surgery, many children are unable to fit comfortably and safely in their current child restraint due to the shape and size of the hip spica cast or brace. Unfortunately, some families discover only on the day of their child’s surgery that their child restraint is not suitable.
Currently, there’s a lack of evidence base to guide best practice hip spica transport. Until the research base is developed, MACA can only provide general advice.
If the family has an Australian standard Britax car seat, it may be suitable to keep using this restraint after surgery with a Britax “hip spica adjustable crotch buckle” (crotch buckle with extended strap) that can be added to the car seat for the time the child is in the cast/brace.
Britax advises that the crotch buckle with extended strap is only suitable for use with Australian standard Britax child restraints branded:
- Britax Safe-n-Sound
A crotch buckle with extended strap provides a longer adjustable crotch buckle strap, that can temporarily replace the car seat’s crotch strap, enabling a longer length to accommodate the child’s hip spica cast.
Britax supplies the crotch buckle with extended strap to approved prescribing organisations (e.g., some Australian hospitals) and safety advocates.
The use of a crotch buckle with extended strap with an Australian standard car seat means the child restraint no longer complies with this standard and is recognised as a modified car seat.
The legal requirements in each state and territory for the use of a modified car seat vary. MACA is working to bring about national consistency, but this may take some time.
In the meantime, to help parents comply with the road laws, MACA has developed specific state and territory information and prescriber templates.
We've reviewed the road laws in each Australian state and territory that impact on the transport of children with disabilities and medical conditions. We found that in many cases they are inconsistent, unclear, and not supported by community education. We're working closely with the transport sector to close these gaps.
Meanwhile, we've developed easy to use templates specific to each state and territory to help you in your professional role supporting families in complying with road laws in your state or territory.
Model Australian Road Rules (ARR) were first introduced in 1999 and form the basis of the road rules in each state and territory.
The National Transport Commission is responsible for maintaining the Australian Road Rules, which are reviewed every two years. Many jurisdictions copy the model law, however MACA’s review of each state and territory’s road rules impacting on the transport of children with disabilities and medical conditions revealed examples where jurisdictions have not followed the model law.
Our research provides the evidence-base and lived experience understanding to ensure that future changes to the Australian Road Rules, and jurisdictions road rules meet the needs of children with disabilities and medical conditions.
MACA's training, resources and templates are kept up to date to reflect any changes to state and territory road laws.
This is because there has been limited research and understanding of the transport needs of children with disabilities and medical conditions.
This means that their needs have not been considered equal to the needs of children without disabilities and medical conditions when unable to travel in an Australian standard car seat.
MACA is changing this - our research and activities are paving the way for national evidence-informed policies, programs and training.
We have extensively reviewed the current legislative environment which means we have a deep understanding of each state and territory's road laws. We work closely with road agencies, to remove unnecessary barriers and to identify opportunities for improvement.
This approach is increasing awareness of the transport needs of children with disabilities and medical conditions and has resulted in some new laws for the use of seatbelt buckle covers.
Our website, information resources and training are regularly updated to reflect any changes.
I have always found the the legal requirements for using special purpose car seats confusing. MACA's resources and templates make it easy for me to understand and to help families comply with road laws.