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There is a paucity of data regarding the potential for pediatric cervical spine injury as a result of acceleration of the head with no direct impact during automotive crashes. Sled tests were conducted using a 3-year-old anthropomorphic test device (ATD) to investigate the effect of restraint type and crash severity on the risk of pediatric inertial neck injury. At higher crash severities, the ATD restrained by only the vehicle three-point restraints sustained higher peak neck tension, peak neck extension and flexion moments, neck injury criterion (Nij) values, peak head accelerations, and HIC values compared to using a forward-facing child restraint system (CRS). The injury assessment reference values (IARVs) for peak tension and Nij were exceeded in all 48 and 64 kph delta-V tests using any restraint type. The test at a delta-V of 64 kph using only the vehicle belts as restraints resulted in peak upper neck tension, peak upper neck extension moment, and Nij values two times greater than the corresponding IARV. Only small differences were found in the injury metrics between a CRS installed with and without webbing tension except that head excursion was greater in the installation without webbing tension. These data show that the potential for neck injury exists for children involved in severe frontal crashes and restrained in either a forwardfacing CRS or by vehicle belts-only, even in the absence of head contact.

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Sled tests were conducted using a 6-year-old anthropomorphic test device (ATD) to investigate the effect of restraint type and crash severity on the risk of pediatric inertial neck injury. Tests were conducted at three severities, using three restraint configurations: properly restrained, misused restraint, and an age-inappropriate restraint. ATD injury measurements increased with increased crash severity. Head accelerations, head injury criteria, and neck loads, with the exception of neck flexion, were relatively independent of restraint configuration at a given crash severity. The data show that children are at risk of inertial neck injuries at high frontal crash severities.