The original child restraint law passed in Virginia in 1982 required that children under 4 years of age use a child safety seat, except for those who weighed at least 40 pounds or were at least 40 inches tall, who could use a standard safety belt. In 1997, Sections 46.2-1094 and 46.2-1095 of the Code of Virginia were changed to require that all children under age 16 use safety restraints. In 2002, the legislature amended Section 46.2-1095 so that "Any person who drives on the highways of Virginia any motor vehicle manufactured after January 1, 1968, shall ensure that any child, through age five, whom he transports therein is provided with and properly secured in a child restraint device of a type which meets the standards adopted by the United States Department of Transportation" [emphasis added]. In addition, Section 46.2-1100 stipulated that "The use of a seat belt . . . shall not violate this article if (i) the affected child is at least four years old but less than six years old and (ii) the weight and size of the child is such as to make the use of such seat belt practical and the use of an approved child restraint impractical." Safety restraint use among children has been monitored in Virginia using roadside surveys since the early 1980s. Changes were made in the 2002 survey methodology to allow the survey to reflect the changes in the child restraint law. The age categories previously used in the survey were changed to (1) infants and toddlers 0 through 3 years, (2) preschoolers 4 and 5 years old, and (3) children 6 through 15 years old. These categories will allow the investigators to continue to analyze the longitudinal restraint use data using the previous age categories (0 through 3 years and 4 through 15 years) as well as to evaluate the impact of the legislative changes made in 2002 using the new age categories (0 through 5 years and 6 through 15 years) when sufficient data are available. A total of 2,452 children were observed during the 2003 survey: 353 children under age 4 and 2,099 children 4 through 15 years of age. In 2003, total child restraint use for metropolitan areas and mid-size cities combined was 91.1% and correct use was 89.3%. Total seat belt use among 4 through 15 year olds in metropolitan areas and mid-size cities combined was 65.1%, and correct use was 53.5%.

In 2004, Virginia's child restraint use survey was conducted in four metropolitan areas of the state (northern, eastern, central, and western) and in four mid-size cities (Charlottesville, Danville, Lynchburg, and Harrisonburg) at the same sites, on the same day of the week, and at the same hour of the day as in previous surveys. The principal goal of the survey is to monitor (1) safety and booster seat use by infants under 4 and preschoolers 4 and 5 years of age, and (2) safety belt use by older children 6 to 16. Each survey estimates compliance with the child restraint law in place at the time. The surveys have been conducted every year since 1983. Changes were made in the 2002 child restraint survey methodology to reflect the changes in the child restraint law. The age categories previously used were changed to (1) infants under 4, (2) preschoolers 4 and 5, and (3) older children 6 to 16. These categories will allow investigators to continue to analyze the longitudinal restraint use data using the previous age categories (infants under 4 and children 4 to 16) and to evaluate the impact of the legislative changes made in 2002. In this survey, safety belt and child safety seat use were divided into three categories: correct use, incorrect use, and nonuse. The definitions of correct use and incorrect use for child safety seats were changed in 2003 to measures that could be consistently determined from outside the vehicle. Incorrect use for children under 6 was defined to include safety seat or lap belt use by a child either too large or too small for that form of restraint. For children 6 to 16, the definition of incorrect use was not changed and included wearing the shoulder belt either behind the back or under the arm. Total use rates defined as correct plus incorrect use are also presented in the report to represent a rate not biased by any remaining variability in the incorrect use category. A total of 2,596 children were observed during the 2004 survey: 375 infants under 4 and 2,221 children 4 to 16. In 2004, total child restraint use for infants in metropolitan areas and in mid-size cities combined was 98.1% and correct use was 92.8%. Total seat belt use among 4 to 16 year olds in metropolitan areas and in mid-size cities combined was 76.0%, and correct use was 65.4%.

During nine days in June 1983, 1984, and 1985, four major metropolitan areas of Virginia were surveyed to determine the extent to which safety restraints were being used by urban travelers. Observers stationed at selected signalized intersections displayed to stopped motorists a clipboard bearing the question, Are you wearing safety belts? The observers then approached the vehicles to visually verify any response given, and recorded whether safety belts or child safety seats were being used. They also recorded the license numbers of the vehicles and the sex and approximate age of each occupant. Results published in previous reports have shown that passage of the state's Child Safety Seat Law resulted in a significant positive change in the usage rates by passengers less than four years of age. The rates of usage for infants in 1983, 1984, and 1985 were nearly identical. Nearly three-fourths of the infants traveling as right front passengers (RFP's) and two-thirds of the infants classed as remaining passengers (RP's) were observed to be in safety restraints (Table 6). The 1985 data replicate earlier findings that when there was an infant in the car, and the infant was in a child safety seat, belt use by drivers and passengers was significantly higher than use rates by drivers and passengers when the infant was not in a child seat (Table 3). In 1984 and 1985, over 30% of the drivers, 40% of the RFP's, and 75% of the RP's used belt systems when a child was in a child seat, but fewer than 10% of these occupants were using safety restraints when the child was not in a child seat. The study also identified an association between the driver's use of safety belts and the use by other passengers. When drivers do not use belts, few passengers use belts. When drivers use lap belts, an increasing proportion of passengers use safety belts. Belt use rates by passengers are highest when drivers use the lap/shoulder belt combination (Table 2). This longitudinal study of observed belt use patterns shows an increase in the use of safety restraint systems by drivers and passengers. In June 1985, 28.4% of the drivers and 25.7% of all passengers were using belt systems (Table I). The rates in 1984 were 20.4% and 19.4% and those in 1983 were 16.4% and 19.0% An analysis of the data also produced additional findings that could relate to various educational or public information campaigns. These findings include the following: I. the percentage of belt use by female drivers and RFP's is higher than that for their male counterparts (Table 4); 2. belt use by drivers was highest in the afternoon, but use by passengers was highest in the morning (Table 5); 3. other than that for infants, belt use was highest for middle adult drivers and pre-adult passengers (Table 6); 4. belt use by drivers and passengers was greater in newer cars (Table 7); and 5. belt use was highest in the northern area and lowest in the western area of the state (Table 9). These findings lead to the conclusion that the Child Safety Seat Law has been responsible for a significant increase in restraint usage by infants. There also appears to have been a spillover effect that has increased safety restraint usage by other categories of vehicle occupants.

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