Survey design: Using a multi-stage random sampling technique, a total of 2,700 children were observed in 1,975 passenger cars and pickup trucks in Illinois during August 2001. There were a total of 120 randomly selected survey locations (41 day care centers, 11 health centers, 32 McDonald's restaurants, and 36 shopping malls) within 12 counties. These 12 counties were grouped into three different regions which included Cook County, the Collar Counties (DuPage, Kane, Lake, McHenry, and Will), and Downstate Counties (Champaign, Macon, Montgomery, Peoria, Rock Island, and St. Clair) The survey design had four characteristics: The survey was conducted between 7:00 a.m. and 6:30 p.m. when the light was adequate for observation, the survey was restricted to a total of 30 observations or an hour of observation per site, the survey was conducted at the exit/entrance of selected locations, the survey included four basic incorrect uses of child seats: seat faces wrong way; harness not used; seat not secured; and belt across face.