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How old is that child? Validating the accuracy of age assignments in observational surveys of vehicle restraint use

Objectives: Many large scale observational studies of child restraint usage require observers to estimate the ages of the vehicle occupants. The accuracy of age assignments were assessed and possible methods to improve observational accuracy in research and field studies of child restraint use were identified. Methods: The validation study was performed at fast food restaurants in a metropolitan area. Three, two person teams observed 449 occupants of vehicles with at least one child passenger. The drivers were then interviewed to obtain the actual ages of the vehicle occupants. The primary outcome measure was the per cent of age assignments that were correct by age category (infant, toddler, school age, teen, adult). The observers had previously conducted a statewide child restraint observation study and were trained in estimating age categories. Results: A total of 391 (87%) of the 449 occupants were assigned to their correct age categories. Incorrect assignments were more common among infants (22% incorrect), but few infants (nine) were observed. The most frequent error was classifying adults (19 years and older) as teenagers (13–18 years). Conclusion: Trained, experienced observers approached 90% accuracy in their assignment of children to specific age categories. Additional study is required to determine whether these results are applicable to different age categories and observers. It is recommended that the National Highway Traffic Safety Administration, the Centers for Disease Control and Prevention, state and local agencies, and other sponsors of observational surveys consider observer competence as an important variable. The validity of age assignments can be assessed by randomly interviewing a sample of drivers. More accurate age estimates will improve decisions regarding prevention programs, funding, and policies.