In-depth analysis of 26 child fatalities in 2017–2022 CISS vehicle crashes

Most vehicles (65.4%) were ≥10 years old. They were driven by a mix of Hispanics, Blacks or Whites involving 4 or more occupants in multi-impact collisions. There was a transition in crash characteristics with the child's age: 0-35 mo typically had a female driver without alcohol-drugs not causing the crash on a freeway, 3-5 yo typically had a male driver many with alcohol-drugs causing the crash on a freeway and 6-12 yo typically had a female driver some with alcohol-drugs causing the crash on a two-lane road or intersection. There is a need for education tailored to gender, race and SES of drivers of older vehicles to avoid aggressive, risk-taking speeding and to properly restrain children, particularly with many occupants in the vehicle. Vehicle and child-seat manufacturers need to focus on head protection in rear seats.