Children & Auto Injury


It was recently relayed to me the comments of an individual regarding a child who had been involved in a motor vehicle collision. They had informed the mother that she did not need to take the child to a chiropractor.  Unfortunately, it is common for people to feel that children are not hurt in collisions or if they are, chiropractic is not the course of treatment for them. Both of these ideas are far from the truth!

Children, while having more flexibility in their spines and ligaments, can still suffer similar injuries consistent with Whiplash Associated Disorders or WAD’s.

A Swedish study published put the risk factors for children’s injury at two-thirds that of adults. (1) Another study, an 8-month emergency room survey of children ages 4-16, involved in auto collisions, demonstrate that 47% experienced symptoms of Whiplash Associated Disorder (WAD). Of these, 22% developed symptoms within 24 hours and the rest within 48 hours. (2)

A presentation to the Association for the Advancement of Automotive Medicine (AAAM) in October of 2000 provided some insight into the cervical acceleration deceleration injury of children. They concluded there was an overall injury rate of 47%, with 60% being symptomatic the day of the collision and the remainder the next day.(3) The weakness of this study is that they performed follow up survey only on the parents of children who were presented to the emergency department after the collision. It does not take into consideration those children seen by pediatricians or family practitioners. Taking into account these non-emergency department visits and this percentage, arguably would be higher.

When evaluating children for WAD’s, there are many variables that are unique to children that should be considered:

  • front or rear seat passenger
  • shoulder restraints,
  • car seats or booster seats.
  • height and weight

If the child is seated in the rear seat, many times this limits the force of the impact. Typically, there is less elasticity in a rear seat and the child, if sitting upright, usually has their whole spine and head against the seat. Thus when struck from behind, the child’s spine moves forward with the seat.

Depending upon the child’s size they may be in a car seat or booster seat.  Typically, a car seat offers a significant amount of protected from the acceleration forces.

However, one danger is if a child is not in a car seat or a booster seat. If a child is small framed and has a lap belt on, many times the belt is across the abdomen and not the pelvis. The child can be thrown against the lap belt causing injury to the low back and even abdominal organs.

Further, if the child is not in a booster seat, the shoulder harness can rid up across the child’s lower neck. This creates a fulcrum for the head and neck to pivot around on impact causing injury to the neck.

Along with these unique factors, the typical influencing factors can be applicable. The position of the child’s head: looking straight ahead or turned. Did they attempt to brace? Did they strike any body part on something in the car?

Obviously, the older the child the better able they are to communicate where they hurt. With infants or toddlers there are some common signs they may have an injury and not be able to explain it.

Parents should look out for these signs:

  • Vomiting
  • Irritability
  • Changes in sleep schedule
  • Restlessness/Inability to fall asleep
  • Excessive crying

The good news, in many instances children respond quicker to care than adults do. Chiropractic has been proven safe and effective in caring for children and spinal issues and parents should not hesitate to seek the care of a chiropractor qualified to handle spinal trauma.

Since graduating in 1984, Dr. Schmaltz has many years of experience treating auto injury victims, many of which were children. His calm and gentle approach makes him a “hit” with children. If you are in need of a Hazelwood chiropractor for you or your children, call us now at (314) 731-4383 or CLICK HERE TO CALL

  1. Lövsund P, Nygren A, Salen B, Tingvall C: Neck injuries in rear end collisions among front and rear seat occupants. International Council on the Biomechanics of Impacts (IRCOBI) Conference, Bergisch­Gladbach, Germany, 319­325, 1988.
  2. Whiplash associated disorder in children attending the emergency department, R Boyd, R Massey, L Duane, D W Yates Emerg Med J 2002;19:311–313
  3. Boyd RJ, Massey R, Duane L, Yates DW: Whiplash­associated disorders in children attending the emergency 
department. 44th Annual Proceedings of the Association for the Advancement of Automotive Medicine, Chicago, IL, Oct 2­4, 2000, 485­489