SPECIAL NEEDS HEALTH CARE TIPS

I General Guidelines  Supervision o Children need constant supervision. Either a caregiver should be watching them or they need to be in a secure place like a crib or playpen. o Never leave a baby alone on a raised surface (like a changing table or high chair). Use the safety strap.  Sleep o Sleep is important for self-regulation. If your child has irregular sleep patterns, talk with your pediatrician. o Sleep routines may help older children get to sleep and stay asleep.  Medications o Read medication labels. o If a child vomits medication, contact pediatrician BEFORE you attempt to give another dose. o If child is taking medications, keep a list of the medications and what they are for.  Emergencies o Take a child CPR class. o Put together an earthquake kit and develop an emergency preparedness plan.

II Going to School may request accommodations for the child with special needs with a 504 plan http://www.ncld.org/disability-advocacy/learn-ld-laws/adaaa-section-504/section-504- rehabilitation-act-1973 Children who qualify for a 504 plan may also be eligible for an Individualized Education Program (IEP). Health goals can be placed within an IEP. Parents may have questions about which type of plan to use http://www.ncld.org/disability-advocacy/learn-ld-laws/adaaa-section-504/section-504- idea-comparison-chart Children with food allergies may require additional help to remain safe at school.  School policies for keeping children safe: https://www.foodallergy.org/document.doc?id=135  Resources for parents: http://www.foodallergy.org/managing-food-allergies/at-school

SPECIAL NEEDS TIPS FOR INTERACTING WITH YOUR CHILD

Things parents can do to bond and interact with their baby/child include:  o If the baby can’t breastfeed, they can still hold the baby against their bare chest while feeding.  Skin-to-skin contact  Carrying/holding the baby  Touching/massaging the baby/child  Talk, sing and read to the baby/child  Describe the baby/child’s emotions (“You seem mad”)  Respond to a baby/child’s cries  Follow the baby/child’s lead o Be aware it isn’t a good time to if the child is tired or irritable; o Be aware of how the baby/child likes to be touched.  Use lots of firm physical touch, bear hugs, or baby massage in a way that won't cause sensory issues*  Physically hold the child face to face.*  Get down to the child's level to make eye contact when talking.*  Work at meeting the ''match'' of the child. Encourage the child to do those things for which the child is ready and capable. Try not to expect too much too soon, frustrating both child and you.*  Speak in a loving and caring manner to child, helping the message of bonding to get through.  Play with the child at the child's level of understanding and ability.*  Visit universal playgrounds (Shane’s Inspiration http://www.shanesinspiration.org/playgrounds/ )  Talk to other parents who have children with similar special needs  Visit a family resource center (Family Resource Center Network of Los Angeles County – FRCNLAC http://familyresourcenetworklac.org)

*Bonding with Your Child, Autism-Help.org

SPECIAL NEEDS BREASTFEEDING TIPS

The first week o produces colostrum. Colostrum is a thick, yellow sticky liquid that provides baby with protection against infection. It also contains properties that help babies gut to mature. o Mother’s milk will increase in volume. This is sometimes described as mother’s milk “coming in.” ’ milk can be delayed by use of medications during the birthing process. o Poor during breastfeeding can cause nipple pain and damage. This is one of the primary reasons given by mothers who stop breastfeeding in the first week. o Mothers who are pumping their are encouraged to pump a minimum of eight times per day to get their milk supply well established. o Mothers who are pumping are also encouraged to pump in the early morning hours to capitalize on hormones like prolactin that increase during those hours.

The first month o Babies are still nursing frequently, between 8 and 12 times per day. It’s expected that babies are still waking up at night 1-2 times per night to feed. o Mother’s milk supply is relatively stable. o Mother may start pumping “extra” breast milk if she needs to return back to work.

The first 6 months o Babies are nursing less frequently and more efficiently, 8 to 10 times per day. o Babies are more aware of their surroundings and may become distracted during feedings. o Mother may be pumping during the day while at work and directly nursing at home. o Baby may start introduction to solids. Breastfed babies tend to be more accepting of new foods due to their exposure to different flavors via breast milk.

Approximately one in 1,000 women experience . The reasons vary from anatomical differences to perinatal PTSD. There are also instances when the baby does not get to the breast due to feeding challenges. The loss of breastfeeding as a “typical activity” may be tragic for many mothers. They may worry about “bonding” with their babies. It’s important to validate all the roles of the : nurturer, teacher and protector. http://www.babycenter.com/0_when-you-just-cant-breastfeed_1172801.bc http://www.whattoexpect.com/first-year/breastfeeding/breastfeeding-guide/why-you-might-not-be- able-to-breastfeed.aspx http://www.babycenter.com/404_how-do-i-know-if-my-baby-and-i-are-properly-bonded_13621.bc http://www.whattoexpect.com/first-year/week-19/bond-with-bottle.aspx

SPECIAL NEEDS SAFETY TIPS

 Car safety o Use a car seat that is the correct size for your baby and/or meets your child’s special needs. - Kohl's Safety & Injury Prevention Program – Children’s Hospital Los Angeles http://www.chla.org/site/c.ipINKTOAJsG/b.6216247/k.B067/Kohls_Safety__Injury_Prevention_ Program__Car_Seat__Inspections__Classes__Loaner_Program__Seats_for_Special_Needs.htm# specialneeds  Caregivers o Parents should make sure that everyone who cares for their child is trained to meet his/her special needs; o Parents should make sure that caregiver’s homes are safe for their child.  Choking hazards o Children with developmental disabilities may continue to put things in their mouths past babyhood. Make sure they have safe things to chew.  Community safety o Parks and playgrounds should have fences around them to prevent a child from running off; o Use age appropriate playground equipment; o Parents should hold their children’s hands, carry them or have them in a stroller if they are near a street.  Emergencies o Fill out the emergency information form (and keep it current). Take it with your to doctor’s appointments and to the emergency room; o Put together an earthquake kit and develop an emergency preparedness plan (make sure you have a three-day supply of all medications); o Parents should make sure at least three people know how to take care of their child (and know how to use any equipment). This will allow someone else to provide good care for the child, if a parent is injured during the emergency; o Parents should sign up for the Specific Needs Disaster Voluntary Registry. https://snap.lacounty.gov/index.cfm?fuseaction=app.registryLogin&CFID=23399&CFTOKEN=7e7 8c72fb57779c2-C9922A62-EDA1-B047-2876E4F10C3DFFE6  Exposure to illness o Children who are medically fragile may get sick more easily – keep them away from children and adults who have contagious diseases.  Medical equipment o Parents should learn how to use the equipment; o Parents should know where to get the equipment fixed if it breaks.

 Medications o Parents should keep a list of all the medications their child takes and share this list with all doctors and pharmacists.  Supervision o If a child needs to be supervised at night, take sleeping shifts with your partner; o Talk with your regional center service coordinator about respite and/or nighttime supervision.  Toy safety o Give your child age and developmentally appropriate toys.  Water safety o Parents should always supervise their children when they are in or near water (bath, pool, etc.); o Always check the temperature of bath water. your group members are concerned about. In your group, you can ask parents:  What are some of your safety concerns?  What are things that you need to think specific to your child’s special needs?  Where do you go for safety information? Parents may also want to discuss how to prepare for emergencies like earthquakes. One thing that you can discuss in your groups is filling out an emergency information form and also having an emergency plan that takes their children’s special needs into account.

o

Special Needs – Safety – 2015 Funded by First 5 Los Angeles

SPECIAL NEEDS SCHOOL TIPS I Differences between Early Start and School-Age Special Education

Early Start (Part C) School-Age (Part B) Who is the Client? The family The child Where are services Usually in the home Usually at school provided? Who is eligible? Children under age 3 with a Children who fall under one of the developmental delay or eligibility categories and need special condition with an established education services to benefit from their risk of a developmental delay education When does it end? Age 3 Age 18 (or 22, if a child doesn’t graduate with a diploma at age 18) What is the plan Individualized Family Service Individualized Education Program (IEP) called? Plan (IFSP) Who provides the Regional Center (in most cases) School is the main service provider (if a services? child is also eligible for regional center then regional center provides services for home and community involvement). What is the focus? The child’s developmental needs Educational benefit (the whole child)

II Preparing for school – Parents  Look at different choices of school and types of classrooms.  Talk with regional center service coordinator about transition from Early Start.  Learn about special education.  Ask questions.  Learn about child’s disability and his/her educational needs.  Help the child prepare for school.  Make sure the teacher has a copy of the IEP.  Parents should make sure they understand what is in their child’s IEP.

III Preparing for school – Children  Take the child to visit the school before he/she starts.  Meet the teacher (if possible).  Talk about what children do at school.  Take the child to play with other children (at the park, a play group, etc.).  Read to the child.  Make sure vaccinations and dental care are up-to-date.

SPECIAL NEEDS TIPS TO IMPROVE SLEEP PATTERNS

1. Make sleep a priority. Teach children and reinforce behaviors that value sleep and rest. Without a good night’s sleep, children may have difficulty participating fully in activities, such as developmental activities and therapies.

2. Develop a bedtime routine. Everyone needs this, even adults. A short set of calming activities helps children “wind down” to be ready for sleep.

3. Keep schedules consistent between weekdays and weekends. Kids who stay up later and sleep in on weekends may find it hard to return to their regular schedules during the school week. Children under the age of 5 don’t really understand the need to “sleep in” on weekends, so think of routines for them that allow you to sleep and them to play quietly or rest in your room.

4. In fact, keep schedules consistent every day. Going to bed and waking up around the same time daily trains your brain to account for the hours you need for other regular activities.

5. Make the bedroom a restful place. TV and video games are not only distracting in the bedroom, but they also produce bright light that signals the brain to wake up.

6. Sleep in the same place every night. Children who sleep on the couch, on the floor or in different beds have more trouble developing good sleep habits.

7. Avoid caffeine. Caffeine in sodas, teas and coffees can keep children and adults awake.

8. Put your children to bed when they are sleepy, but not yet fully asleep. Self-soothing is a fundamental skill for children. Putting children in bed before they are completely asleep gives them an opportunity to develop this skill.

9. Address anxiety. Anxiety commonly affects children with disabilities, and makes sleep difficulties worse.

10. Take note of sleep problem signs. Tracking patterns and signs can help your pediatrician or a sleep expert to more quickly identify the problem and offer solutions.

This tip sheet is based on an article published by the Kennedy-Krieger Institute, “Another Restless Night or Something More: Five Signs of Sleep Disorders in School-Age Children with Special Needs,” March 7, 2013