BEHAVIORAL SKILLS TRAINING TO IMPROVE INSTALLATION AND USE OF CHILD PASSENGER SAFETY RESTRAINTS MICHAEL B. HIMLE AND KALON A. WRIGHT UNIVERSITY OF UTAH The risk for serious injury and death to children during motor vehicle accidents can be greatly reduced through the correct use of child passenger safety restraints (CPSRs). Unfortunately, most CPSRs are installed or used incorrectly. This study examined the effectiveness of behavioral skills training (BST) to teach 10 participants to install rear-facing CPSRs correctly using a multiple baseline design. Results show that installation errors were common for all participants during baseline. After BST, all 10 participants were able to install the rear-facing CPSR without error. An extension probe to assess whether the skills taught during BST extended to forward-facing installation showed that each participant made at least 1 critical error. Key words: behavioral skills training, child passenger safety, reinforcement, feedback Injuries sustained during motor vehicle crashes are among the leading causes of death and injury for children in the United States. Each year, more than 1,200 children are killed and over 250,000 children are injured as a result of motor vehicle accidents (National Highway Traffic Safety Administration [NHTSA], 2010a; U.S. Centers for Disease Control and Prevention, 2012). Research has shown that correct use of rear- facing (RF) and forward-facing (FF) child passenger safety restraints (CPSRs) can reduce fatal injury by 45% to 90% (American Academy of Pediatrics [AAP], 2011). Because of their protective value, the AAP recommends that all infants and toddlers ride in an RF CPSR until they are 2 years old and that all children 2 years or older ride in an FF CPSR with a harness for as long as possible. Over the past two decades, legislation and public awareness campaigns have been imple- mented in an attempt to increase the use of CPSRs. To date, all states require that appropriate CPSRs be used when transporting infants and children, and most states issue fines and other penalties for failure to comply with CPSR laws (Governors Highway Safety Association, 2012). Although causal relations cannot be discerned from survey data, overall CPSR use has increased. The NHTSA’s National Occupant Protection Use Survey shows that in 1996, 85% of infant and 60% of toddler passengers were secured with appropriate CPSRs (NHTSA, 1997). In 2009, these figures increased to 98% and 96%, respectively (NHTSA, 2010b). Unfortunately, the majority of CPSRs are installed or used incorrectly (Decina & Lococo, 2005), which can decrease their protective value during a crash (Arbogast, Durbin, Cornejo, Kallan, & Winston, 2004; Lesire, Cuny, Alonzo, Tejera, & Cataldi, 2007). Restraints such as CPSRs serve several primary functions during a crash. Most important, they redistribute crash forces to stronger parts of the body (i.e., from soft tissue to bone), prolong the time of deceleration (thereby limiting crash forces delivered to the passenger), and limit contact with interior vehicle structures (AAP, 2011). However, for a CPSR to serve these protective functions, it must be correctly installed in the vehicle, and the passenger must be appropriately secured in the This study was supported by a University of Utah Undergraduate Research Opportunities Program assistant- ship awarded to Kalon A. Wright under the supervision of the first author. We thank McKenzie Adams for her assistance in data collection. Address correspondence to Michael B. Himle, Depart- ment of Psychology, University of Utah, Salt Lake City, Utah 84112 (e-mail: michael.himle@utah.edu). doi: 10.1002/jaba.143 JOURNAL OF APPLIED BEHAVIOR ANALYSIS 2014, 47, 549–559 NUMBER 3(FALL) 549