Riding to school in a wheelchair

Exceptional Parent, The, July, 2007 by Mary Ellen Buning, Sue Shutrump, Miriam A. Manary

Riding on a school bus is one of the safest forms of transportation in the U.S. Every year 450,000 public school buses travel more than 4.3 billion miles to transport 23.5 million children to and from school and school related activities. Students are reportedly eight times safer on the school bus than they are in cars. However, the percentage of these 23.5 million students across the country who use wheelchairs as seats in school buses is not actually known. Not all states collect this data, and no federal agency mandates it. Many school transportation districts are proactive and invest expertise and resources in meeting the unique transportation requirements of students who ride in wheelchairs. Some districts need prodding and education from informed and proactive parents to engage in best practices. For this reason, parents need to be educated on wheelchair transportation safety issues.

The strategy of "compartmentalization" that provides crash protection for children sitting in high back seats yields to very specific requirements for students riding in wheelchairs. In 1994, the Federal Motor Vehicle Safety Standard (FMVSS) 222 was amended with requirements for wheelchair securement and wheelchair occupant restraint systems:

* The wheelchair securement positions must be forward-facing. There are several reasons why this makes sense. The securement system is designed to be used with the wheelchair facing forward and is tested that way. All school buses manufactured with wheelchair securement systems since January 1994 only have forward-facing systems. Both wheelchairs and the human body are better able to withstand the forces of a frontal impact when facing forward.

* The anchorages for the wheelchair and occupant restraint and the securement and restraint devices must be of minimum strengths. Strength standards for wheelchair securement and occupant restraints have been developed by the Society of Automotive Engineers and exist as SAEJ2249. A school district should be using tiedown straps and occupant restraints that meet this standard.

According to FMVSS-222, securement systems must include the following for each wheelchair station:

* A 4-point wheelchair securement system that anchors the wheelchair to the vehicle floor. Straps must attach to a strong part of the wheelchair frame or the securement points of a crash-tested WC19-compliant wheelchair and meet the bus floor at angles between 30 to 45 degrees. These straps must be tensioned to prevent wheelchair movement and no wheelchair part should interfere with the strap's path of travel.

* A 3-point occupant restraint system that keeps the occupant in the wheelchair. The shoulder belt portion must attach to the vehicle wall just behind the student at a height that allows it to lie against both the collar and breast bones. The pelvic portion of the occupant restraint should be low and snug across the pelvis or top of the thighs. Torso and pelvic belts meet at the right or left hip and attach either to the wheelchair's 4-point anchor system or to the vehicle floor. Proper belt fit is the key to injury prevention. No wheelchair part should interfere with the path of travel for these straps. Positioning belts are not crash-tested and should NOT be relied on as safety belts. Lateral pads or any postural supports that enable a child to sit optimally should be used in combination with the occupant restraint system as they enable the seatbelt to stay properly positioned.

The beauty of a WC19-compliant wheelchair is that it facilitates proper securement and restraint. It is a wheelchair designed to eliminate many common transportation issues. However, even when a student does not have a WC19-wheelchair, knowledgeable professionals can mark the optimal locations for placing securement straps. Keeping a clear space around wheelchairs, removing hard trays, stowing any equipment that could become a projectile, and keeping straps and belts clean and functioning are part of bus safety, too.

School transporters also look to families to keep wheelchairs maintained and operating well. Drivers worry when wheelchairs fit poorly or are worn and wobbly. Parents who are planning on getting new wheelchairs for their children should request models that are WC19-compliant as these wheelchairs are crash tested, easier to secure, and are more durable under the wear and tear of transportation. School OTs and PTs can often answer questions about students with unique needs. When a student's securement or occupant restraint needs are unique or complex, a digital photo can be used to show correct placement.

A bus driver and bus aide typically work together to create a travel plan for their routes. They choose securement stations for students based on criteria such as the order in which they are loaded and unloaded. Students with respiratory problems may need to sit away from the lift area and away from rear windows near the exhaust. Students who are medically fragile or vulnerable may need to sit further front where there is less bounce and where they can more easily be seen. Bus personnel also make note of who needs extra supervision because of behavior or a medical condition. Their plan is typically put in writing and filed with a transportation supervisor. In addition, these plans should be kept on the bus to assure proper follow-through in the event of staff absence. Documentation of student needs paired with a photo are also important in the event of an emergency to assist emergency medical personnel. Having an emergency evacuation plan and strap cutters available could make a life-saving difference in some situations. All of this specialized knowledge means that regular and systematic training and skill demonstration should be expected for both long-term and new bus drivers.