Guest Post: Traveling Abroad with Special Needs Children

Today we have a guest post from Marcela De Vivo. Marcela's son has cerebral palsy, and she offers some insights and tips for traveling abroad with a special needs child. Have you traveled with a child with special needs? We'd love to hear about your experiences!

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My oldest son, Nathan, is six years old, and has severe cerebral palsy. What many people are surprised to learn is that Nathan has traveled to about 10 countries, including England, Thailand, Argentina, Brazil and even the Dominican Republic.

Nathan has always enjoyed every trip, and it has been incredibly beneficial to him from a developmental standpoint. As a parent, I would encourage any family with special needs children to travel as much as possible.

Of course, the first question in your mind is probably a big HOW? How do we manage the logistics of traveling with a non-verbal, non-ambulatory special needs child?

The answer isn't always simple, and what you need to do will be based on the special needs of your child, but let me tell you right now, travel is certainly possible.

Traveling abroad with a special needs child is possible. We’re proof.

Image Courtesy of En.Wikipedia.org

Plan Ahead, Arrive Early

Whenever we travel, we call the airline and let them know we need wheelchair access. We also have our own wheelchair, which makes the process easier and more efficient; if your child needs one, bringing your own wheelchair can be very helpful.

One key note when it comes to traveling with a wheelchair: keep it with you as long as possible. Airlines treat it like luggage if you check it, and it could ultimately end up broken. It happened to us, and it’s not something that you will want to deal with.

We also take the time to let airport security know that we have fluids with us and that we’re traveling with our child’s medication, which, of course, he needs. It’s always taken us a bit more time to go through security, but most people are quite supportive and friendly while helping us through the process. On the rare occasion that we've encountered security or airline staff members that were rude, we've generally said something to management so that they’ll be more prepared in future situations when dealing with children with special needs.

Leave yourself ample time for getting through airport security when traveling with a 

special needs child.

Image Courtesy of Flickr

Ask for Help

Once on the plane, we generally explain to people around us about our son’s needs. Of course, we don’t go into a long drawn out story, but it often helps to give people some information about what’s going on around them.

In many cases, people will offer their assistance and help with basic things – like making room for our child. Typically, we bring a special seat, called a Special Tomato Chair, which makes our son more comfortable during flights, but requires just a little bit of extra room in some cases.

Once the airplane lands, we’re often the first ones off. In some cases, we’re the last ones off. It works either way – we just want to make sure we’re not involved in the general mayhem of a large group of people exiting an airplane.

Consider Your Destination

When you arrive in your destination, it’s important to consider where you are and what you’re going to be doing. For example, when we've visited places like Canada, which really aren't all that much different than home in the United States, we've rented a car. This is helpful since we can take our time and make sure we have everything we need for a day trip.

In other places, we've had to rely on taxis, and we may need to take some special equipment. In general, we simply try to make sure that we have everything our son will need with us. From there, we really just have to go with the flow of travel since everything can’t be completely under our control.

For most people, the most difficult part of traveling with a special needs child is the actual travel, not the day-to-day stuff that occurs when you arrive in your destination. Once you have that figured out, you’re well on your way to a successful trip.

Of course, the information here was personal, and it may not all apply to your child. Nathan has cerebral palsy, so his needs are very different from those of a child with autism, for example. Before you plan a trip, always take your child’s needs into account and talk to your child’s doctor if you’re unsure about health and safety concerns of traveling abroad.

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Marcela De Vivo is a freelance health & wellness writer from the Los Angeles area whose specializes in alternative medicine, sustainability, and special needs advocacy. She works with the California Special Needs Law Group to spread the world about inclusion and offer advice to other parents with special needs children. Marcela keeps a personal blog about her son and their story at www.prayfornathan.org.

Ask-Me Monday 5/20/13: Infant Car Seats

This week's Ask-Me Monday video is for fan Megan, who asked, "How long should I use my infant car seat?" I've written several blog posts about car seats and extended rear-facing, and I'm excited to offer this video full of useful information about when it's time to stop using your infant car seat.

 

To submit a question for Ask-Me Monday, like Jessica on Babies on Facebook and comment to one of my Ask-Me Monday posts throughout the week. I'll select one question each week to answer in an Ask-Me Monday video. And subscribe to the channel so you don't miss any new videos!

Is a Helmet a Helmet If It's Not Buckled, or Is It Just a Hat?

Walking with my first-grader to and from school each day, I see lots of other kids of all ages riding scooters, skateboards, and bicycles. My son occasionally rides the scooter he got for his birthday, and, of course, always wears his helmet when he does so. The other skateboarders, scooter-riders, and bicyclists also wear helmets, per state law. (In California, all children under 18 must wear a helmet when riding a bicycle, scooter, or skateboard, as of 2003.) However, I've noticed a disturbing trend: The older (fourth and fifth grade?) skateboarders, especially, will put their helmets on their heads but not buckle the chin strap.

Now, it should seem obvious to the average adult, and hopefully to the average 10-year-old, that wearing a helmet that isn't fastened to your head isn't going to do a whole lot of good in protecting your brains should you take a spill on your skateboard. I wonder, if these kids' parents knew that they were skateboarding, scootering, or bicycling with their helmets' chin straps dangling uselessly, would they be concerned? I would be. In fact, it occurred to me to double-check the proper way to fit a helmet so that I can teach my kids to use one correctly. I'm not much of a bicyclist (I haven't ridden in, oh, 5 years?), so I haven't worn a helmet much recently, and I wasn't sure exactly what the guidelines were. Here are some excellent instructions from NHTSA.

Now, let's be honest, my kid is mostly only riding his scooter along flat sidewalks at a fairly leisurely pace just to and from school, with me following as close behind as I can. I don't imagine the copious brains contained under his adult-sized helmet are in much danger from a fall from his scooter. But that isn't the point, is it? The point is to establish good scootering and bicycling habits, so that if he should take an interest in more "extreme" riding, he will know how to properly wear his helmet, and will know the importance of doing so. And random falls do happen, even at the scootering-to-school-with-Mommy-following-behind pace.

N proudly showing off his new scooter. And now that I look at it, I don't think his helmet is fitted properly after all.

When my son is older and getting himself to and from school without me, should he decide to ride his scooter, he will, of course, be required to wear his helmet. And if he disdains to wear it correctly, then he will not have the privilege of riding, because I personally find his skull and brains far more valuable than his desire to ride a two-wheeled scooter when his own two feet will serve him nicely. I do hope the parents of these other kids I see, wearing decorative helmets, chin straps a-dangling, would care enough about their kids' brains to insist upon proper strap-fastening should they become aware of the misuse. Maybe they wouldn't. I know that plenty of people do not like helmet laws and may feel that allowing their kids to flout these laws is their prerogative. It's not my business, and it's not my kid. I'm just making an observation.

If your son was spotted by a neighbor improperly wearing his helmet, and your neighbor, out of concern, came to you one day and said, "Hey, I saw Nate on his skateboard yesterday coming home from school. His helmet was on his head, but the strap wasn't fastened. I just thought you might want to know about it," how would you react? Perhaps some people might say, "Yes, I know. He wears the helmet because it's the law, but I told him if he doesn't like the chin strap, he can just not fasten it. I'm not that worried about it." Others might say, "Oh, he's in trouble now! If he's not going to wear his helmet properly, then he doesn't get to ride!" Still others might say, in all honesty, that they didn't realize that not fastening the chin strap rendered the helmet useless, for all intents and purposes, and would be glad to have filled in that information.

I'm sure that by now you can see where I'm going with this.

I see properly buckling your kid in his car seat as in the same vein as making sure your kid is wearing his helmet correctly. The goal is to keep our kids as safe as possible from preventable injury while still allowing them to be out and about and exploring the world. Kids can and should be out there on their bikes and skateboards and scooters. They should be seeing how fast they can go and riding with no hands and jumping off curbs (when there aren't cars coming) and taking turns on the ramps at the local skate park. But they should be wearing helmets when they do so. They'll need those brains for years after they need those skateboarding skills.

Five Rules for Proper Car Seat Use:

1.  The harness should be snug. When you try to pinch the harness strap at the child's collarbone, you should not be able to maintain a fold in the strap between your thumb and forefinger.
2.  The chest clip should be fastened and aligned with the child's armpits, and the crotch strap should be fastened.
3.  The car seat should be installed tightly with either LATCH or the vehicle seat belt (but not both), so that it cannot wiggle more than 1" (one inch) side to side or front to back. Make sure the seat belt is locked if installing with the vehicle seat belt.
4.  Your child should be in the proper car seat for his age, weight, and height.
5.  Your child should remain in a five-point harness until he is at least four years old and 40 pounds (the older, the better) and tall enough that when he sits in a booster seat, the seat belt falls comfortably across his upper thighs (not abdomen) and shoulder (not neck).

Watching What We Say To Our Kids

When my oldest, N, was young, probably toddler-aged, I read in a book or on a blog or in some article a very, very important bit of parenting advice that has stuck with me more than anything else I've read or tried, and applies regardless of what other parenting or discipline methods you subscribe to. It has to do with how we talk to our kids, both in praise and in displeasure.

It's a simple concept, really, but in practice it takes concentration and self-control. What it boils down to is, when we talk to our children about their behavior, positive or negative, good or bad, it's vital to talk about the action, not the character of the child. We need to reinforce actions we want them to take again, and we want to point out and correct actions we want them to change. What we don't want to do is praise or criticize things they can't change or traits they can't "do."

Let's look at a positive example first.

Let's say your kid is very smart (of course!), and they bring home their first report card, and it's straight A's (of course), and the teacher's comment is that your child is a pleasure to have in class and is above grade level in every subject. That's fantastic. You're ecstatic! You've always demanded academic excellence of your children, and you knew he had it in him, and you're thrilled that he's living up to all your expectations for him. You want to convey to your child that you are very happy with his performance in school and want him to continue to excel, put out effort, work hard, and enjoy learning.

What not to say: "You're so smart!"

Why not? He is smart! He should be proud of himself!

Yes, but "smart" isn't something he does or doesn't do. "Smart" isn't something he can change about himself. "Smart" isn't a lesson he can learn or an action he can repeat. And what happens when he fails his first test or forgets to do his homework or gets yelled at by a teacher? Is he suddenly not "smart"? How is he supposed to remedy any setbacks with "smart"?

What to say instead: "You worked hard and it shows! I'm so proud of the effort you made!"

Here, you're praising what he did, not the trait of "smartness." This way he knows that hard work and persistence is what's going to get him ahead in life and in school. "Smart" is all well and good, but it's what you do with "smart" that will make the difference. Plenty of smart people do poorly in school, fail out, or give up, either because they're bored or because they don't know how to deal with not understanding something or failing once. With praising the effort rather than the trait, he now knows that it's up to him to continue to put out that effort to do well, and that if there is a setback or failure, he can step it up and keep trying in order to succeed.

Now, let's look at the flip side - a negative example.

By negative, I mean a behavior you want to correct.

Let's say your kid has trouble getting ready for school on time. She dawdles when she's getting dressed, wastes time while eating breakfast, and takes twice as long as she should to pack up her backpack, and even then manages to forget stuff, and you find yourself constantly having to bring her lunch or homework to school for her later. This, understandably, causes frustration every morning, and in a moment of pique, you yell at her.

What not to say: "You're so lazy! What's wrong with you? It's the same every morning! Why are you so slow?!"

Why not? She is being lazy and slow! And it's annoying! And you're sick of it!

Yes, of course you're sick of it, and frustrated, and you can't understand why she hasn't learned yet. But telling her she's lazy and slow is reinforcing an image she's already created of herself. And if she's a lazy, slow kid, then that's just who she is - see, even Mom thinks so - and it's not going to change now. You even said so: it's the same every morning.

What to say instead: (And, yes, you can yell this if you need to!) "It takes so long for you to get ready in the morning! Why don't you get your stuff together the night before! That would save so much time, and I wouldn't have to constantly be bringing your things to you at school! You need to get dressed before you eat breakfast, and you need to eat more quickly."

Here, we're talking about specific actions she can take to improve the mornings. Suggesting, even yelling, that she get her backpack together in the evening gives her a goal, something clear she can do to help her along and save her time. Maybe she honestly hasn't thought of doing that, and having you plant the idea is all she needed. Knowing that she doesn't get breakfast until she's dressed might mean she'll get dressed more quickly, because she has a goal. And, if you're willing to go that far, you can even add in that if she doesn't get dressed fast enough, she won't have time for breakfast and will either have to skip it (not recommended) or take a banana or something along in the car or on the walk to school so she isn't starving.

It's very important in a scenario like this that when she does make a positive change, such as getting her backpack ready the night before, that you acknowledge it. And, referring to above, don't say, "Good job!" Say, "Wow, getting your things ready last night made it so much easier this morning. Look at that, you're ready to go 10 minutes early!" You don't actually have to praise her, but you definitely need to show that you noticed and point out what a difference it made. If she's anything like my kid, you'll see her swell with pride at having done something "right," and hopefully that's a feeling she'll want to recapture and will continue to improve.

Let's look at one more example of each.

First, the positive.

Let's say your teenage daughter is very pretty (of course!). People are always telling her, "You're so pretty!" Even you take pride in the fact that she's so beautiful and perfect. One day, she wears an outfit that suits her especially well. Her makeup is done just-so, her hair is shiny and perfect. You're so lucky to have such a pretty daughter.

What not to say: "You're so pretty!"

Why not? She is pretty!

Well, we all know that beauty can fade, and while girls can get by on their looks for a while, eventually they also need some substance to their character to be anything in life. I hope that beyond beauty, you have dreams for your daughter to succeed in areas that require persistence, intelligence, or kindness as well.

What to say instead: I think there's a twofold reaction needed here. First, if you want to express that she's looking especially good that day, start with, "Wow, I love that outfit on you. You pick out such nice clothing." This is praising the act of choosing an attractive outfit, rather than the trait of "being pretty." She can continue to choose flattering, appropriate clothing for herself even if something happens to alter her current looks. But it's also important that you don't emphasize beauty over everything else. Be sure you're praising her for other achievements or activities, such as acts of kindness, persistence, or academic excellence. She needs to know there's more to life than looks, and she also needs to know that you value her for more than her appearance.

And now something you want to change.

Your four-year-old son is having trouble with his behavior at preschool. He's been biting and pinching other kids, and finally the director calls you in and says that if there's one more incident, he'll be asked to leave. The violence, defiance, and other difficult behaviors have to stop, because it's causing too much of a disruption and other parents are angry that their children are being hurt. You know it's time for some serious action on your part.

What not to say: "You're such a bad kid! Look at you, four years old and getting kicked out of school! Why can't you behave?!"

Why not?

I hope this time it's obvious. At four years old, you've already told him he's "bad" and that he can't behave. He's going to internalize statements like these and just assume that it's true: He's a bad kid who can't behave. And guess what bad kids who can't behave do? They misbehave!

Calling names or assigning negative traits to your child will only make things worse. Instead, they need to know both the "don't"s and "do"s of what happened so that they can hopefully make corrections in the future.

What to say instead: "Biting and pinching hurts other kids and makes them sad. If you hurt other kids, you won't be allowed to go to school anymore, and I think that will make you sad. You always tell me how much you like going to school." That's the "don't" part. But he may need more help. Continue with, "If you don't like something another child does, you need to use your words to tell them. Say, 'Don't do that!' instead of pinching, or go tell the teacher if you're upset about something." Now he has an action he can take. You've given him an alternative to violence. You're telling him to use words, and not just a vague, "use words," but exactly what words to use.

It's important to model that behavior for him, too. If he tries to bite or pinch a sibling when he's angry, or he takes a swipe at you when you do something he doesn't like, that's your opportunity to show him, in the heat of the moment, how he should act. Stop the negative behavior first, physically if you have to (grab his wrist to stop a pinch, or pull him away from the sibling - not something violent, just stop it before he gets there, if possible), and then supply the words instead. "We don't pinch, remember?! Say, 'David, I was playing with that toy and you took it. Please give it back!'" Or, "We don't hit Mommy! If you're angry with me, you can say, 'Mommy, I'm mad that you won't let me watch TV!'" Then encourage him to try it. That doesn't mean you have to let him do whatever it was he wanted to do, but you're giving him words for his feelings and a healthy way to express those feelings, instead of hitting you.

I'm not saying you're going to see a change overnight in any of these scenarios. Indeed, if there are deeper issues affecting your child's behavior, it may take far more than simple words to make that change. But words are a great place to start, because kids take far more meaning from what we say than we think they will. They also imitate what they hear and internalize values based on what you say to them. If we show them the proper behavior, demonstrate it in context, and live according to the values we want them to absorb, most kids will live up to, or even exceed, the goals we have for them.

Ask-Me Monday: Induction Advice

Today's Ask-Me Monday gives some general advice for an induction of labor. I hope you find it helpful.



To submit a question for Ask-Me Monday, like the Facebook page and comment to one of the Ask-Me Monday threads!

Four Kinds of Breastfeeding Support: Emotional, Practical, Improper, and Unhelpful

I can't emphasize enough that when you have a new baby, you need support. Going it alone is unnatural and stressful. They say it takes a village, and while you may not have an entire village to help you, I hope you at least have your partner and a few trusted friends and relatives who are there for you.

When it comes to breastfeeding support, you need to make sure that (a) you have some, and (b) you have the right kind.

I've identified four types of support for new mothers. Each description below contains suggestions for the new mom herself and for the support people around her.

1.  Emotional Support

For Mom: Emotional support is crucial. You might also call this moral support. This kind of support could come from your partner, your mother, your sister, aunt, cousin, best friend, a random person you meet in the park, or even someone on the internet. When someone is offering emotional support, it's those encouraging words when you're at the end of your rope; it's the, "You're doing great!" when you feel like you're doing everything wrong. Emotional support helps you keep going, push through the rough spots, and lets you know that others have been where you are, and it does get better.

To Support Mom: Even if you don't have personal breastfeeding experience, you can be there for her. Let her vent, listen to her concerns, and offer an encouraging word, whatever comes naturally to you. Some of us are more comfortable with being cheerleaders, while others are better at simply listening and being a sympathetic ear. Avoid trying to give advice she isn't asking for, but offer to help in any way you can. For example, "Can I do something around the house for you so you can rest? I'm a great laundry folder! Do you need anything from the store? Diapers? Snacks? Juice? Can I get you a glass of water?" Make specific offers, not a general, "Is there anything I can do to help?" because she may not be able to think of something in particular, or she may feel uncomfortable making a request.

2.  Practical Support

For Mom: Practical support is also crucial. As much as you think you might know going in (and I say this as someone who's nursed a few babies!), it never hurts to have someone you can call upon when you have a practical question about your baby's latch, strange nursing behaviors, or other concerns. Every baby is different, and every nursing relationship is unique, and you'll want to know someone you can contact who has seen lots of  mom-baby pairs and helped solve many types of problems. It's important that whoever you lean on for practical support actually knows what to say or do to help. This may be a La Leche League leader, a breastfeeding peer counselor or other trained breastfeeding support person, an International Board Certified Lactation Consultant, or even just your mom who's nursed four kids. You need to know that the advice you're going to receive is correct advice. If you get advice you're not sure of, feel free to double check it on a reputable site like Kellymom.com, or contact a lactation consultant.

To Support Mom: Unless you're sure you know what you're talking about - i.e., you're a lactation consultant, peer counselor, CLC, La Leche League leader, or you've at least done your breastfeeding research, it's best to leave the advice to someone who is one of those people. If you do know how to help, make the offer. "Hey, I'm a lactation educator. If you want, I can come sit with you and check out your baby's latch." If I'm not absolutely certain what to say or do to help a new mother with her question, I will always recommend that she meet with a local lactation consultant. If you don't know of one, you could help her find one. If you do, give her the number!

3.  Improper Support

For Mom: Many friends and relatives will mean well, and they probably really do want to help you. However, sometimes you get tips and advice from people that is not what would be recommended by a lactation expert. For example, just because your best friend introduced a bottle of formula every night but continued to nurse for a year doesn't mean it's a good idea or that it will work for you. People improvise, get lucky, or make decisions based on unique situations that may or may not apply to you. Make sure you've done your own research and have consulted with someone trained in lactation before you supplement unnecessarily or make a decision that could harm your breastfeeding relationship.

To Support Mom: It's important not to give advice willy-nilly. Every mom will have different circumstances, and unless you are a trained lactation support person or have an educational background to go with your personal experience, you can end up doing more harm than good, even if you're trying to help. Simple suggestions like, "Maybe you want to get his latch checked," or, "My son had a tongue tie and I had the exact problems you're having" can be very helpful and give her a starting point for finding assistance. Thoughts based on your own experience that may make her life easier such as, "My daughter was really fussy, too, and babywearing really helped us on the bad evenings." It's best not to begin supplementation or take drastic measures without being seen by a lactation expert, however.

4.  Unhelpful Support

For Mom: The least helpful kind of support is from people who think they're being supportive but are actually making you feel worse. A great example of this would be, "I'm can see that you're trying really hard to nurse your baby, but if it's this stressful, I would totally understand if you wanted to switch to bottles. A happy mom makes for a happy baby!" This kind of advice, while usually well-meaning, does not help the mother who sincerely wants to exclusively breastfeed but is in the throes of the two-week growth spurt or is battling thrush or mastitis. It's hard, but as a new parent it's important to not allow unhelpful comments like these to affect your mindset.

To Support Mom: Rather than trying to deter her from a path you think may be causing her stress, it is more helpful and more supportive to try to understand what her own goals are. A better comment in the above situation might be, "I can tell you really want to make nursing work, and you're doing an amazing job. I heard of a great lactation consultant in the area. Do you want her number?" If the mom really wants to breastfeed, suggesting that she stop will not make her feel supported. Helping her attain her goals will improve her mood and situation.

Preparation and Education

As new parents, we need to be prepared to avoid the improper and unhelpful advice and to call upon our emotional and practical support people whenever we need to. Gather your support system around you before you give birth, and be ready to discard information and advice that isn't what you want to hear.

As supportive friends and family members of new parents, it's our job to say the right words and be prepared with the right information. It doesn't hurt for others besides the new mom to learn a little about breastfeeding so that we can help in a way that the new parents will appreciate. It's important to know what the parents want and how to help them achieve that. Parents are bombarded by advice, some of which is contradictory, and knowing they have people to lean on who will simply be there to say, "I know it's hard now, but you're doing great, and it gets easier" will be invaluable.

How have you supported friends or relatives as they begin their parenting journeys? How have you been best supported when you've had a new baby? When we came home from the hospital with my third son, it was an incredibly hot and humid day, he screamed whenever he wasn't on the breast, and I was completely emotionally drained. A friend texted me just to say I was doing great, and it felt so good to hear that, even though it was my third baby. What is your favorite thing to tell a new parent, and how do they usually respond?

Ask-Me Monday: Introduction

The new Ask-Me Monday video is an introduction to me, my blog, and my videos. If you're new around these parts, this is a good place to get a quick overview of what exactly is going on!