Motor vehicle crashes remain a leading cause of death among children and teens in Texas, with restraint use declining sharply as children age out of booster seats. Observational and crash data reveal that school-age children and adolescents consistently have lower seat belt use rates than other age groups, particularly when riding in the back seat. These patterns point to persistent behavioral and situational factors that place youth at elevated risk. Understanding when, where, and among whom nonuse occurs is essential to designing effective education and enforcement strategies.
Benefits to Texas Transportation Safety
This research supports the CTS goal of conducting research to reduce deaths and injuries in traffic crashes through measurement and reporting seat belt use and other risk-taking behaviors among a historically low occupant restraint use population. Survey results showing low situational use among school-age children in nine urban areas highlight the need for programmatic emphasis on improving occupant protection for this population segment.
Project Need and Approach
In 2023, 197 children and teens in the 5-18 age group perished in motor vehicle crashes in which restraint use was determined. As a group, only 35.5 percent were restrained. Examining restraint use for the youngest of Texans reveals that nonuse increases with age, once children transition from forward-facing car seats. This is borne out in crash data, which shows restraint use among child fatalities ages 5-9 was 57 percent; among 10-12 year-old (tweens) was 31 percent; and among teens 13-18 years old was 33 percent in 2023.
Observational surveys have shown that school-age children and teens have lower restraint use rates than older ages in Texas. A youth occupant protection survey was initiated in 2024 to obtain a sample of children riding in vehicles in nine Texas cities. The survey found the percentage of restrained child passengers, based on a minimum sample of 500 in each city, ranged from 63 percent to 80 percent at the city level. As a group, using surveyor estimates of age, 5-8 year-olds were restrained 66 percent of the time, 9-12 year-olds were also restrained 66 percent of the time, 78 percent of 13-15 year-olds were seat belted, and 76.5 percent of 16-18 year-olds were seat belted. Children riding in the front seat were more likely than children riding in the back seat to be buckled up – 78 percent in front compared to 59 percent in back.
The youth occupant protection survey was repeated in the 2024-2025 school year in nine new Texas cities. The observational survey was designed to collect data regarding seat belt use, teen driver cell phone use, and bicycle helmet use at a variety of urban area street sites, selected to maximize potential for observation of youth passengers and teen drivers in a variety of settings.
Project Activities
2025
Observational surveys were conducted in Abilene, Amarillo, Bryan/College Station, El Paso, Fort Worth, Lubbock, Midland, Tyler, and Wichita Falls. Sites were selected that were expected to yield either a high volume of traffic or a high proportion of children. Sample size goals were set according to site type. In each city, target samples by site were:
- 300 observations from elementary, middle, and high school sites, with a goal of roughly equivalent sample sizes from each school level.
- 200 observations from non-school locations.
- At least 100 weekend observations in each city. Weekend was defined as Friday beginning at noon (for non-school sites) through Sunday.
Overall, the survey design was opportunity-based, combining time frame opportunities and quota goals. School sites were conducted throughout arrival and departure periods. Non-school sites were conducted for a minimum of 30 minutes or a maximum of 25 child observations. Across the nine cities combined, 158 unique sites were surveyed, and restraint use was recorded for 4,446 child passenger occupants ages 5-18 in 4,359 vehicles.
Observations were made from stopped vehicles, with exceptions for turning traffic under 10mph, and visibility from the observation point such that front and back seat were clearly observable. The data collected pertained to any vehicle observed at the intersection that had at least one child occupant 5 through 18 years old. For each vehicle, the observer recorded:
- Driver gender and driver belt use, non-use or incorrect use.
- Front passenger – gender, estimated age, and the correct use, incorrect use, or non-use of safety belts or child safety seat for each passenger in the target age range. Data for other occupants was not collected.
- Second row rear passenger outboard positions – gender, estimated age, and the correct use, incorrect use, or non-use of safety belts or child safety seat for each passenger in the target age range. Data for other second row occupants was not collected.
- Cell phone use by teen drivers in vehicles for which seat belt use was collected.
- Bicycle helmet use was collected as ancillary data while observing occupant restraint use.
Results are summarized in the bullets below:
- Seat belt use for all ages of passengers combined was 77.3 percent.
- Children in the youngest age group (5-8 years) were restrained least often (68.5 percent).
- Drivers were seat belted at a higher rate than were child passengers, with a 9.8 percentage point difference in restraint use.
- Overall, males buckled up at lower rates than females.
- Children in the back seat were restrained less often than children in the front seat (64.8 percent compared to 84.6 percent).
- With all child ages combined, total restraint use for child passengers reached 80 percent in four of the nine cities (Abilene, Amarillo, El Paso, and Tyler). Four cities reached 70 percent and above (Bryan/College Station, Lubbock, Midland, and Wichita Falls). Fort Worth had the lowest citywide use at 65.2 percent.
- Eleven percent of children who were counted as restrained were restrained incorrectly.
- Child passenger seat belt and booster seat use did not differ substantially by vehicle type – overall 77.3 percent in cars and 77.4 percent in pickups.
- Seat belt use was lower for school trips (73.7 percent) than non-school trips (84.0 percent).
- Lowest restraint use was observed for 5 to 8 year-olds on school trips (61.1 percent)
- Weekend restraint use (80.2 percent) was higher than weekday use (76.4 percent).
- Seat belt use for the 591 teen drivers observed in the survey was 86.1 percent. The survey also revealed that 9.7 percent of the 591 teen drivers observed were using a cell phone while driving for texting.
- Thirty-six youth on bicycles were observed during the course of the nine-city survey. Eight of them were wearing helmets.
2024
For this project, the project team planned and executed youth occupant protection and traffic safety observational surveys. Observational surveys were conducted across 135 sites in nine cities, recording data on restraint use for 4,487 occupants aged 5–18 in 4,263 vehicles. Using a multifaceted approach, the project team developed a protocol for observation ensuring that results were consistent. Observations included front and back seat passengers, teen drivers, and cyclists. Teams of trained observers focused on capturing accurate data by observing vehicles at stop signs and traffic signals, ensuring clear views of occupants’ behaviors.
Behavioral variables recorded included seat belt and booster seat use, teen driver cell phone use, and bicycle helmet use. Detailed protocols ensured data reliability, with unclear observations coded separately. Results showed that seat belt use for all ages combined was 70.0 percent, with younger children (aged 5–8) restrained least often at 61.9 percent. Notably, children in the back seat were restrained less often (58.6 percent) than those in the front seat (78.2 percent), and teen males were less likely to buckle up compared to teen females. Successful conduct of this survey should lead to full-scale survey implementation as a follow-up. Detailed patterns of seat belt use for school-aged children are of great interest throughout the country. Once termed the forgotten children for occupant protection, aging out of car seats and progressing into seat belts was shown in past TTI surveys to warrant the expression.
Project Title: Youth Occupant Protection Observation Survey
Project Start and End Dates: Ongoing
Author List: Katie Womack
Sponsor/Funding Source: Texas Department of Transportation (TxDOT)