After the Education for All Handicapped
Children Act of 1976 became
law, it was common practice
to transport children in wheelchairs
facing sideways in school buses, with the
large wheels captured by mechanical rim-pin
clamps, with bungee cords attached to
the most-available wheelchair components,
such as the armrests and footrests, or by other
inadequate securement methods.
Seat belts, if provided at all, were often
placed around the student’s abdomen instead
of low on the pelvis and over the shoulder.
In other words, students in wheelchairs
were not provided with the same level of
crash protection as students seated on the
forward-facing, closely spaced, high-back,
padded seats required by Federal Motor Vehicle
Safety Standard (FMVSS) 222.
In fact, at the time, FMVSS 222 excluded
children in wheelchairs from the crashworthiness
provisions of the standard, identifying
them as students facing 45 degrees or
more to the longitudinal axis of the vehicle.
Fortunately, the opportunities for safe transportation
for students in wheelchairs have increased
significantly over the past two decades.
In 1992, FMVSS 222 was modified to
include wheelchair-seated students and now
requires all wheelchair stations provided by
school bus manufacturers to be installed for
forward-facing travel and equipped with four-point,
strap-type wheelchair tiedown and
three-point pelvic/shoulder belt restraint systems
that meet static strength requirements.
Most school bus wheelchair stations are
now equipped with wheelchair tiedown and
occupant restraint systems (WTORS) that comply with SAE J2249, a recommended
practice that was completed in 1996
by the Restraint Systems Task Group of
the Society of Automotive Engineers’
Adaptive Devices Subcommittee.
In addition, it is now possible for students
to travel in wheelchairs that comply
with ANSI/RESNA WC19, which
means that they have been designed
and crash tested for use as seats in motor
vehicles. A key feature of WC19-
compliant wheelchairs is four accessible
attachment points on the wheelchair
frame to which tiedown straps can be
easily and effectively attached.
Best practices
While changes to FMVSS 222 and
increased availability of WTORS and
wheelchairs that comply with voluntary
industry safety standards provide
greater opportunities for wheelchair-seated
students to travel more safely
to and from school, it is important
that school bus operations implement
transportation policies and procedures
based on basic principles and best practices
of transportation safety.
Assuming that the buses are equipped
with properly installed WTORS
that comply with FMVSS 222 and, ideally,
SAE J2249, there are several fundamental
DOs and DON’Ts that should be
part of every school transportation program
involved with the transport of students
who use wheelchairs.
DO consider transferring students
in wheelchairs to the school bus seats.
It is generally considered safest for
students who use wheelchairs to transfer
to the vehicle seat when this can be
done safely and without compromising
special medical and seating needs.
However, even when transfer is feasible,
it may not always be the safest option
in the school bus environment.
For example, if a student is using a
WC19-compliant, crash-tested wheelchair
that facilitates proper placement
of vehicle-anchored seat belts, the student
may actually be safer traveling in
their wheelchair than sitting on a bus
seat that’s not equipped with shoulder
and pelvic belt restraints.
For students who transfer to a school
bus seat, safety can be enhanced beyond
the level provided by compartmentalization
through the use of crash-tested
harnesses. In addition, postural
support vests can help keep smaller
children positioned on the bus seat.
DO encourage the purchase and use
of WC19 wheelchairs.
As noted earlier, WC19-compliant
wheelchairs provide four easily accessible
attachment points that greatly facilitate
effective wheelchair securement
using a four-point, strap-type tiedown.
Because these wheelchairs have been
successfully crash tested, transportation
personnel can have confidence that the
wheelchair will support the student and
be effectively secured if the vehicle is involved
in a crash or rollover. Therefore,
school transportation personnel should
encourage parents to choose WC19-
compliant wheelchairs whenever there
is an opportunity to do so.
DON’T deny transportation to
students who do not have a WC19
wheelchair.
Although WC19-compliant wheelchairs
will make wheelchair securement
easier and more reliable, students
should not be denied school bus transportation
if they don’t have a WC19-
compliant wheelchair. Denying transportation
to students in wheelchairs
will generally result in having them
travel to and from school in smaller
vehicles that are more likely to be involved
in a crash, thereby putting the
student at greater risk of injury.
Rather than denying transportation,
school transportation personnel should
work as a team to identify and permanently
mark the best and strongest
wheelchair securement points on structural
members of the base or seating system.
This may require attaching webbing
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loops sold by most WTORS manufacturers
to frame members to create accessible
tiedown attachment points. Modifications
to plastic trim of powerbase wheelchairs
may be necessary to allow access
to the most effective securement points.
DO make sure that students in
wheelchairs are using crashworthy
pelvic and shoulder belt restraints that
are properly positioned.
Although effective wheelchair securement
is important, it will do little to protect
the student in a crash, vehicle rollover
or sudden movement if the student
isn’t restrained by a properly positioned
and relatively snug pelvic belt and diagonal
shoulder belt. Most WTORS manufacturers
provide detailed instructions
and warnings on how to use and position
the seat belts, including:
DON’T route pelvic belts outside
the wheelchair side frames and wheels
or over wheelchair armrests.
DO position the pelvic belt inside
of the wheelchair side frame so that the
webbing and buckle are in contact with,
or very near, the student’s body and
with the pelvic belt placed as low across
the front of the pelvis as possible.
DO angle the pelvic belt up from
anchor points behind the wheelchair
at 30 degrees or more to the horizontal
with the belt placed inside of the
wheelchair armrest and side frame.
DO position the upper part of the
shoulder belt across the middle of the
outboard shoulder and connect the
shoulder belt to the inboard side of
the lap belt (often on the latch plate of the buckle) near the hip of the student
while keeping the buckle away from
wheelchair components.
Following these instructions may not
be easy, even on many WC19-compliant
wheelchairs, because armrests and
side frames can interfere with proper
positioning of the pelvic belt. In some
cases, it may be necessary to thread the
ends of the lap belt through openings in
or between wheelchair components.
One WTORS manufacturer facilitates
seat belt threading by stiffening the anchorage
ends of the pelvic belt so that
they can be more easily inserted around
the occupant and through wheelchair
openings from the front before attaching
them to pin-bushing connectors on
the tiedown anchorages. To improve
seat belt routing and positioning, select
a WC19-compliant wheelchair that has
been rated A (excellent) or B (good) with
regard to accommodating the proper
use and positioning of belt restraints.
DON’T mix components of
WTORS from different manufacturers.
The various components of a WTORS,
and especially anchorage track and anchorage
components on tiedown assemblies,
are carefully designed to function
together to form a complete and effective
wheelchair securement and occupant
restraint system. Although components
from different manufacturers
may look similar, they may not engage
effectively. It is therefore critical that
equipment from different manufacturers
not be mixed. Doing so can result in
improper use and reduced effectiveness
of the equipment when needed in a collision
or emergency vehicle maneuver.
DO allow students to use postural
supports during transportation.
There has been much confusion on
the use of different types of postural
supports in transportation of students
in wheelchairs. A summary of the
concerns and recommended practices
are in a report by the Rehabilitation
Engineering Research Center on
Wheelchair Transportation Safety
(RERCWTS) titled “Guidelines for
Use of Secondary Postural Support
Devices by Wheelchair Users During
Travel in Motor Vehicles” (available at
www.rercwts.org/info). A few basic principles
should be followed:
Use of postural supports during
travel in motor vehicles should generally
be encouraged, particularly if they
improve the occupant’s seated posture,
since this will also improve the fit and
effectiveness of vehicle seat belts.
Postural supports should be positioned
so that they don’t interfere with
the proper fit and function of belt restraints
of WTORS.
Postural supports should not be relied
on for protection during a crash.
Anterior head restraints attached
to the wheelchair seatback to limit forward
head movement should be designed
to break away at the minimum
force that allows the device to perform
its intended function.
When head support using a neck
support/collar is medically necessary, the
softest and lightest material that achieves
the needed results should be used.
DO remove and store wheelchair
add-on equipment.
In the rare event of a school bus collision
or rollover, heavy and/or rigid
objects that are not adequately secured
can become a hazard. Consideration
should therefore be given to removing
wheelchair add-on items, such as oxygen
tanks and trays, and securing them
to the vehicle using tiedown straps or
other crashworthy storage methods.
If these items cannot be removed and
stored, add-on items should be attached
to the wheelchair by tiedown straps,
and dense padding should be placed
between hard trays and the student in
the wheelchair. Consideration should
also be given to replacing hard trays
with support surfaces made from dense
foam during transportation.
DO make sure that bus drivers are
given detailed training on different
types of wheelchairs.
Much of the challenge to providing
effective wheelchair securement and
occupant restraint is due to the wide variety
of wheelchair makes and models,
many of which do not yet comply with
WC19 and for which proper placement
of seat belts is difficult. One of the keys
to successfully meeting this challenge
is an active driver training program.
Most WTORS manufacturers provide
excellent written and video training
materials with their equipment and
on their Websites. In addition, WTORS
manufacturers often host training seminars
at conferences and at their company
facilities.
Using these and other materials, such
as the Ride Safe Brochure (www.travelsafer.org) and the wheelchair transportation
safety education tool box (www.rercwts.org), bus drivers should be trained in the
basic principles of transportation safety,
including the need for both wheelchair
securement and occupant restraint.
Most importantly, drivers need hands-on
instruction on how to achieve effective
securement and occupant restraint
on different types of WC19-compliant
and non-compliant wheelchairs. Permanent
marking of team-selected securement
points on non-compliant wheelchairs
will make it much easier for
drivers to properly and consistently secure
different wheelchairs.
Lawrence Schneider is a research professor with the
University of Michigan Transportation Research Institute
(UMTRI) and director of the RERCWTS. Miriam
Manary is a senior research associate with UMTRI.