Every summer, when news hits about yet another child found dead after being left behind in a hot vehicle, parents and others are horrified.
In 2014, 31 children across the U.S. died from heatstroke after being left in vehicles. In the past two decades, about 750 U.S. children have died in hot vehicles, according to KidsAndCars.org, a nonprofit child safety organization.
Experts are quick to explain why it can happen: Schedules are busier, work pressure more intense and sleep deprivation is common among parents of small children.
More difficult, however, is consensus on how to prevent heatstroke deaths of children in vehicles. Is the answer more or better technology? Should automakers step up in-vehicle technology? Do we need more government advice and product evaluation? The debate is ongoing, but the answers are not yet clear.
Heatstroke deaths of kids are most talked about in summer months, but the danger isn't just seasonal.
"The issue always comes to the fore at the extremes of temperature," said Ben Hoffman, M.D., professor of pediatrics and director of the Tom Sargent Safety Center at the Doernbecher Children's Hospital and Oregon Health and Science University. Hoffman also is a member of the American Academy of Pediatrics' Council on Injury, Violence and Poison Prevention.
"But it should be a year-round concern," he said. Always, he said, "it needs to be front of brain."
Statistics in Perspective
Most heatstroke deaths are terrible mistakes, the byproduct of stressed parents, changed schedules or temporary lapses in memory.
"About half of the time, a parent just forgets the child was in the car," said Kyran Quinlan, M.D., chair of the Council on Injury, Violence and Poison Prevention for the American Academy of Pediatrics. He is also a professor of medicine at Rush University Medical Center in Chicago.
In other cases, a parent may decide to run into a store to do an errand, figuring he will be gone five minutes, but then gets delayed and returns to the vehicle to find his child is dead. In other instances, children crawl into unlocked cars and the family may not notice them missing in time to prevent their deaths.
The highest-profile hot-car death of 2014, involving a then 33-year-old Georgia father who left his 22-month-old son in the car as he went to work, is not typical. The father was charged with murder, and controversy swirls about whether the death was truly accidental.
Currently, 19 states have legislation that specifically makes it against the law to leave a child unattended in a vehicle, according to KidsAndCars.org.
Technology to the Rescue?
Anyone with a smartphone and Internet access can find a host of applications to help them remember their child.
For instance, a free app, Baby Reminder, has the user set the day and time intervals during which children are usually driven. The app monitors the user's driving and, shortly after the typical drop-off time, sends a reminder alert.
Remember the Kids is a $1.99 iPhone app. Once a driver reaches speeds of 20 mph, the app switches to driving mode. Once the driver stops moving for more than three minutes or disconnects from Bluetooth, the app alert asks if the driver remembered the kids. (When drivers are in very congested traffic and stop moving for more than three minutes, no alert would sound if the Bluetooth were still connected, said Cody King, the company's founder and CEO.)
The bottom line for these phone apps is that they are wonderful to use as extra safety measures, said Amber Rollins, director and volunteer manager for KidsAndCars.org. "We definitely do not recommend relying on them 100 percent."
Other devices are also available. Perhaps the lowest-tech is the DIY E-Z Baby Saver. Developed by a youngster, Andrew Pelham, when he was a fifth grader, it's a strap made of rubber bands and neon duct tape. Once finished, a parent attaches it to the driver side door handle and the back of the driver seat or headrest bars. As Pelham notes, the gadget forces a parent to stop before leaving the car and ask: "Is anyone still strapped in the backseat?" Directions for making the saver are on the E-Z Baby Saver Web site.
Another product, called the ChildMinder SoftClip System, sells for around $70 and consists of a child safety seat chest clip outfitted with an electronic unit. The clip replaces the child safety seat's existing shoulder-harness strap retainer device, which holds the car seat straps in the best position in the event of a crash. The other half of the system is a key ring device, according to a spokesperson for the developer, Baby Alert International.
The user pairs the clip on the child's seat with the key ring device. Once the driver gets more than about 18 feet from the vehicle for about 12 seconds, the key ring beeps as a reminder.
Are Devices Effective?
Research to test the effectiveness of the devices and apps is scarce. In July 2012, the National Highway Traffic Safety Administration (NHTSA) published a report after evaluating three devices: the Suddenly Safe Pressure Pad, the ChildMinder Smart Clip System (a predecessor to the SoftClip) and the Child Minder Smart Pad.
The results were not encouraging: "None of the three heatstroke devices tested was found to be completely reliable and consistent in their ability to detect children," the report said. It was possible, the report added, that improvements had been made since the NHTSA testing in 2011.
Any device that modifies a child car safety seat should not be used without approval from the car seat maker, said Hoffman of the American Academy of Pediatrics.
Carmakers to the Rescue?
Carmakers have solved all kinds of safety issues, said Janette Fennell, president and founder of KidsAndCars.org. They have the wherewithal to solve this one, too.
"No seatbelt and you get a buzz," she said. "Leave your keys in the ignition, and you get a warning. With all of these types of reminder systems, it's absolutely a given fact that car companies know we're human."
As she is fond of saying, "The question that begs to be asked is, 'Who has decided it's more important to not have a dead battery than a dead baby?'"
No such technology seems to be in the offing soon, according to an informal poll of major carmakers and university-based centers for automotive research.
Some experts suggested that the experimental Mobile Interior Imaging project from Ford and Intel, also called Project Mobii, could be tweaked to help detect a forgotten child. The system, under study and unveiled in June 2014, uses in-vehicle cameras and facial recognition software to authenticate the driver. As shown in this video, a mobile phone app allows a driver to access the vehicle camera remotely to check for belongings left inside or to permit other drivers to use the vehicle.
By adding some sort of additional reminder, drivers conceivably could be alerted to check the vehicle interior after departing.
Such an application does not appear to be coming soon, however. When asked about any forthcoming technology related to preventing the deaths of children in hot cars, Kelli Felker, Ford's safety communications manager, said: "We do not have any technology related to this."
The Toyota Prius offers as optional equipment a solar-powered ventilation system that can be activated to cool the car's interior before the driver returns. However, it is solely "a convenience feature," said Craig Taguchi, a spokesperson for Toyota. "It is not a safety feature, and occupants should not be left in the vehicle," he says.
Help on the Horizon?
More information (and perhaps some guidance) is on the way, according to a statement from NHTSA. In a 2014 statement, NHTSA said it "continues to study technologies to help prevent heatstroke deaths. The agency expects to issue an additional product evaluation in the coming months."
As of mid-April 2015, NHTSA was continuing to evaluate the products, according to NHTSA spokesperson Karen Aldana, although no definite date has been set for issuing more information.
A petition that KidsAndCars.org launched in 2014 asked the federal government for funding to research technology to prevent heatstroke deaths of children in vehicles and to test that technology.
However, the petition failed to get the required 100,000 signatures needed by the deadline to send it to the White House, said Rollins of KidsAndCars.org. The organization may try it again, she said.
Low-Tech Strategies for Parents
Parents and other caretakers should never rely on a single strategy to remember kids in cars, experts concur. They compare it to depending only on a fence around the backyard pool to prevent drowning.
Visual cues and better communication between parents and child-care providers can help.
"Put a stuffed animal in the front passenger seat," Fennell said. Parents should be sure it is medium sized so it won't fall between the seats or off to the side and be overlooked, she said. To drive home its purpose, the stuffed animal can sit in the child seat when it is empty, then be moved to the front seat when the child is placed in the seat.
Or parents can place something they need in the backseat: purse, cell phone, ID badge, lunch or briefcase, she said. "Whatever it is you can't get very far without saying 'I have to go back to my car to get that,"' Fennell said.
Parents should tell the child-care provider they will always call if the child is not going to be dropped off that day, Fennell said. In turn, the child-care provider agrees to call a list of emergency numbers to find the child if they get no call and no child is dropped off.
"In so many cases, just that one phone call could have saved the lives of those children," Fennell said.
Educational campaigns promoted by KidsAndCars.org and others urge parents and caregivers to "Look Before You Lock."
NHTSA's "Where's Baby? Look Before You Lock" campaign arms parents with facts: Leaving a child in the car to run an errand is risky. Cracking a window doesn't help. Heatstroke can happen on cloudy days and in outside temperatures even below 70 degrees.
Heatstroke can happen quickly. Kids overheat up to five times more quickly than adults do, according to NHTSA. And the temperature inside a vehicle can rise more than 20 degrees in just 10 minutes, so if it's 80 degrees initially, the temperature inside could get to 110 in 15 minutes. And children die when their body temperatures reach 107.
Whatever strategies parents decide to use, Fennell said, awareness and action are key to minimizing the risk. "The worst thing you can do is think, 'This can never happen to me.'"