Tag Archives: NYU Langone Medical Center

X-Ray Vision and Our Medical Superheroes: What to Expect in Pediatric Radiology


You care about your children’s health, and it can be extremely anxiety-provoking to see them in pain or discomfort. When they need medical attention, knowing what to expect can help you manage an already-stressful situation.

At NYU Langone Pediatric Radiology, we typically see patients from the newborn period through adolescence. We understand that kids are not just small adults; they have their own needs, and our approach is tailored to children specifically. It matters to us that your child has a positive experience, so we’ve made every effort to ensure they do.

Here’s what you can expect the next time you bring your child in for an imaging appointment:

Fluoroscopy: This type of imaging uses low dose X-rays to look at the inside of the body in real time, usually using a contrast liquid that will appear on our monitors. Some of our most common types of fluoroscopic procedures in pediatrics include contrast enemas, small bowel series, upper GI series, voiding cystourethogram (VCUG), and video swallow studies. Here are some helpful tips:

•  Patients for these exams should be as comfortable as possible. Any soothing comfort items your child would like—toys, pacifiers, etc.—are welcome.
• Babies and toddlers in particular should not eat before their studies.
• Fluoroscopy uses low dose radiation. We subscribe to the Image Gently campaign’s Pause and Pulse philosophy of using the lowest radiation dose possible as described.

CT and MRI: When your child needs imaging done with CT or MRI, there are a few things to keep in mind.

• CT, which stands for Computed Tomography, uses radiation to generate very detailed 3D images of any part of your child’s body. A CT scan does involve a low dose of radiation, but we use the most state-of-the-art equipment to minimize exposure.
• MRI, which stands for Magnetic Resonance Imaging, produces detailed 3D images of the body without using ionizing radiation. MRI takes longer than a CT scan. The decision to image with CT or MRI depends on several factors, including the anatomical location of the problem.
• In order for us to obtain the highest-quality images, it’s important for kids to stay as still as possible during imaging. When necessary, the department of anesthesia is available to provide sedation to make the experience easier.

X-ray: It’s common for pediatricians to refer kids to us for X-ray imaging, often for the evaluation of possible broken bones or pneumonia. Here are some helpful tips:

• Unless otherwise instructed, you can feed your child before the exam so that he or she is kept as comfortable as possible. Other soothers, such as pacifiers and blankets, are also allowed for the exam.
• X-rays do involve radiation, but a very small amount. These procedures are non-invasive and nothing needs to be put into the body. The radiation is isolated to the specific part of the body that needs imaging and nowhere else, making X-rays extremely safe.

Ultrasound: Ultrasound is a very common pediatric imaging procedure. It can be used to evaluate almost every part of the body. One of the most common reasons we see pediatric patients is to evaluate abdominal pain. This procedure is particularly easy for our patients. Here are some helpful tips:

• The entire process is non-invasive, so there’s no stressing out about radiation or discomfort.
• We like to consider the simple things to make our patients more comfortable during medical procedures, so we use warm jelly that will feel more pleasant for the kids.

Imaging is central to any good patient care. Our pediatric radiologists are part of the healthcare team, working closely with your referring physician to gather relevant information as quickly and accurately as possible. We know imaging studies play a huge role in helping doctors diagnose exactly what is happening to a patient and determine which treatment steps to consider.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Nancy Fefferman, MD is an associate professor in the Department of Radiology at NYU Langone Medical Center, and the chief of Pediatric Radiology.

Organization Frustration: Tips to Help Your Child Stay on Top of Schoolwork

Child with learning difficulties. Tired boy doing homework.
Many parents of school-aged children complain that their kids lack basic organizational skills—they forget to complete assignments, leave important materials for homework at school, have messy backpacks, take too long (or not long enough) to complete homework each evening, and fail to plan ahead for projects and tests. Organization is not an innate skill; some children easily organize their materials and juggle multiple tasks while others struggle to keep up with school-related demands. If your child shows problems with organization, time management, and planning skills, consider these concrete strategies and routines for helping children stay on top of schoolwork.

Does your child have a clear, organized method for keeping track of assignments?
Help your child develop the habit of using a planner to record assignments. Even if teachers post some or all of the assignments on a class website, keeping a personal record will help your child stay organized. Look for a planner that is broken down by subject, has enough space to write details, and has an easily accessible monthly calendar for recording long-term assignments. A space to check off items that need to come home and return to school can help kids who often forget needed materials.

Does your child often lose papers, books, and other important items?
Think about where your child runs into trouble. Is he constantly misplacing one folder? Does she stuff papers into her bag because punching holes and finding the right section in a three-ring binder takes too long? Think about how you can step it down, or simplify the routine. We have found that an accordion file works well for many children; there are no holes to punch, and papers for different subjects are easily filed within one manageable tool.

Help your child develop a routine for checking that all important items are in the bag when packing up in school and at home. A visual checklist pinned to the inside of the backpack can be a helpful cue so your child doesn’t forget critical items.

Does your child struggle to complete tasks in an appropriate amount of time?
You can help your child gain control over his or her schedule by teaching critical time estimation and planning skills. Set aside five minutes each day to review what work needs to be done (consider what is due tomorrow as well as longer-term assignments), how long each assignment should take, what other events are on the schedule (e.g., extracurricular activities), and what your child would like to do to relax. You may find it helpful to create a written schedule, where your child can map out the evening’s activities in 15-minute time increments.

Does your child have difficulty planning ahead for more complex tasks?
If your child is unsure of how to start working on multi-step tasks or if he or she struggles to produce neat, complete work in advance of deadlines, you may need to work on task planning skills. Start by helping your child state the goal for the specific task, break the task down into steps, order the steps, think about materials that are needed, consider how long each step will take, and fit the steps into the schedule. You can write down the individual steps on a calendar so your child can clearly keep track of what to do and when.

Organizational Skills Training at the NYU Child Study Center
If your child has significant difficulties with organization, time management, and planning, he or she may require more intensive intervention to get on track with schoolwork. Organizational Skills Training (OST) is a manualized, empirically supported treatment that has been proven to improve the organizational skills and academic performance of children with Attention Deficit Hyperactivity Disorders. For more information on OST, click here.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Elana Spira, PhD, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry at NYU Langone’s Child Study Center. She is co-author of the treatment manual for OST, Organizational Skills Training for Children with ADHD.

Your Child Has Autism: Now What?


Your child has just been diagnosed with autism spectrum disorder (ASD), and it may feel as though the ground has dropped out from under you. The challenges seem overwhelming at first, but you don’t have to face them alone. With so much going on, it can be hard to know where to start. Here are a few ideas.

Find Professional Support
You are beginning your journey as your child’s advocate and will need to identify the resources you need as soon as possible. Your child will have symptoms, abilities, needs, and challenges that are unique to him or her. With that in mind, a little research will help you evaluate who can best help your child. Be sure to ask questions about each therapist’s approach and methodology, including whether the treatment is grounded in evidence-based practice and how parents and caregivers are included in the treatment.

Make Time for Yourselves
Your child’s needs are paramount, but if you are going to be able to meet them, you must also take care of yourself. As parents, you are under a tremendous strain. It’s critical that you take a deep breath, step back a bit, and process your own emotions and needs. It will be hard at first—your impulse will be to throw yourself into protecting and helping your newly diagnosed child—but it is necessary for your own long-term health and that of the rest of the family.

Be Open with Your Other Children
The diagnosis affects the whole family. Your other children will have questions and reactions, and their feelings about having a sibling with autism need to be validated. Don’t withhold information—it will neither protect them nor make them feel better. Encourage them to ask questions, and process what the diagnosis means for them.

Build a Support System
Don’t go it alone. It’s impossible to overstate how important it is to have family, close friends, parents of children with ASD, and therapists who support you as you start on this new path. Other parents will be particularly supportive—who else knows truly understands what you’re going through? They can be an invaluable source of information on family dynamics as well as on therapists and other resources.

Approach the Internet with Caution
While the Internet is a great source of information, it also contains a great deal of misinformation; you must be discerning. When reviewing websites, check to see if the author has a background in ASD and is professionally qualified to provide reliable information. Also, note whether the site’s information has been subjected to rigorous testing and research. Put another way, does the site share information on evidence-based practices?

One last, but important, note. Your child is the same child he or she was before the diagnosis and will continue to develop in his or her own way, and build unique strengths, skills, and interests for you to embrace and celebrate.

April is National Autism Awareness Month. Learn more online at the Autism Society.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Sarah Kern, LCSW, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry, at NYU Langone’s Child Study Center.

NYU Langone Staff—and Their Furry Friends—Bring Springtime Cheer

Therapy bunny2Doctors and patients at the Hospital for Joint Diseases at NYU Langone Medical Center welcomed spring this week with some special guests: Therapy rabbits Nutmeg and Clovis. These bunnies live at the hospital and are part of NYU Langone’s Horticultural Therapy Program, which helps patients rehabilitate from brain and spinal cord injuries, musculoskeletal disorders, strokes, and other conditions. Doctors may recommend bunny time for patients in rehabilitation, because caring for animals can be therapeutic. As you might imagine, Clovis and Nutmeg are especially popular with children, who adore seeing and working with the friendly bunnies.

Purim carnivalWhile Nutmeg and Clovis were getting kids in the Easter spirit, Child Life Specialists got festive with a Purim carnival for children at Hassenfeld Children’s Hospital.

At NYU Langone, we understand that illness and medical procedures have the potential to cause anxiety and fear in children. To ease these feelings and help your family prepare for and cope with your child’s surgery or hospital stay, we offer child life services, music therapy, art therapy, and therapeutic recreation in part through the Sala Institute for Child and Family Centered Care.

Purim carnival 2Child life specialists, along with recreation therapists and creative arts therapists, strive to provide ample opportunities for play throughout the healthcare experience. This allows children to be children, even in the hospital. If your child is ever a patient at NYU Langone, be sure to take advantage of these offerings—and request a visit from Clovis and Nutmeg!

For more information about the horticultural program and its resident rabbits, visit http://nyulangone.org/locations/rusk-rehabilitation/horticultural-therapy. To learn more about NYU Langone’s Child Life, Recreation & Creative Arts Therapies services, visit http://nyulangone.org/patient-family-support/child-life-recreation-creative-arts-therapies.

Fun, Friends, and the ADHD Camper: Choosing the Right Summer Camp for Your Child

SPK
For most parents, sending kids to summer camp for the first time may stir up fond memories, anticipation of the fun awaiting their children, and perhaps a little separation anxiety.

It’s more complicated for parents of children with ADHD. Their kids can find making friends, playing team sports, and behaving appropriately—the hallmarks of a successful summer camp experience—challenging. Asking camp directors and veteran parents the right questions can help parents decide which camp is right for their child. Here are a few suggestions.

Will camp counselors and staff understand my child’s needs?
This goes straight to the heart of the matter. You want to be sure the camp’s counselors have the training and experience to work successfully with children with ADHD. What are their academic and professional qualifications, and do they receive special training to work with special needs children in a camp environment? What is the counselor-to-camper ratio?

What kind of programs do you offer?
Camp can be a wonderful opportunity for your child to develop social skills, increase self-awareness, and learn new coping techniques. At a minimum, that requires a structured environment to help kids stay focused, and team sports to encourage flexibility and cooperation. What skills–including friendship skills—does this camp emphasize, and what goals will your child work toward? What is the mix of sports, academic, and social programs that will help him/her succeed?

Who will administer my child’s medications?
The camp you have chosen is likely to have a nurse on site to administer medications, but it’s best to ask. There may also be a psychologist who can work with you and your child’s psychiatrist to fine-tune the medications if his behavior, symptoms, or moods warrant.

How do you communicate with parents?
You’ve done all the advanced research and preparation you can—but you’re still going to worry about your child. Find out how frequently the camp communicates with parents, and how you can check on your child’s progress.

Talking to other parents whose children attend the camp can also give you additional insight. Ask for a few references and pose the following questions:

Will my child have fun?
Fun is often overshadowed by the problems children with ADHD have in fun-like situations with insufficient structure and supervision. They may go too far, bully or be bullied. They may be shy and not know how to play with others. But fun is an essential component for camp. Ask other parents if the counselors are fun spirited and love the kids. Find out what their child gained from the experience. Did he/she make friends? Did he/she like the counselors?

Does the camp deliver on its promises?
Did your child receive individual attention? Were medications administered properly? Did the staff communicate with you about your child’s progress and/or problems? Did your child learn new skills that can be carried into every day life?

Will you send your child back next summer?
You can take heart from an enthusiastic “yes”.

About the Child Study Center’s Summer Program for Kids
The Summer Program for Kids is the only all-day, therapeutic summer program in the New York area for children with ADHD. Our methods are grounded in the latest research, and our clinical psychologists continually evaluate the program to help each child. We help our campers learn the skills they need to help them focus, make friends, and improve their social, school, and home behavior. For more information, click here.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Karen Fleiss, PsyD is an assistant professor in the Departments of Child and Adolescent Psychiatry and Psychiatry at NYU Langone Medical Center. She is the clinical director of the Child Study Center’s Long Island Campus, and director of the Summer Program for Kids.

10 Tips For Beating the Winter Blahs

Child in snow
Spring is just around the corner, but many of us are still dealing with the doldrums of winter. While there are lots of things to love about winter, it also means shorter days, less sunlight, colder weather, and more time stuck inside. This is a time of year when many people feel less energetic and possibly a little “blah.” Feeling like you might be in a bit of a winter slump? Here are ten ideas to help you conquer your winter woes.

1. Brighten your world! Winter’s lack of sunlight can cause many people to feel gloomy and sluggish. Get as much natural light as you can. Open the curtains, sit by the window, and enjoy a mood-lifting vitamin D boost from the sun. Decorating your home in light, cheery colors may also help to counteract the dreariness of winter.

2. Make quality zzz’s a priority. Keeping a consistent sleep schedule and getting the right amount of sleep can help you stay energized.

3. Get outside when you can. Being cooped up inside for too long can make anyone feel pretty blah. Bundle up and take an energizing walk in the cold!

4. Exercise! Exercising releases endorphins and helps to decrease stress and anxiety. It can also improve sleep and boost energy. Try a new sport or exercise class. If you’re snowed in, practice yoga, try some workout DVDs, or even have your own private dance party at home.

5. Pump up the jams! Speaking of dance parties, music can be an excellent way to lift spirits. There are tons of potential mental and physical benefits of both playing and listening to music.

6. Eat well. During cold winter months, it can sometimes be tempting to eat the same comfort foods over and over. However, eating a healthy, varied diet full of vitamins and nutrients can improve energy, mood, and overall health.

7. Plan a mini “vacation” and give yourself something to look forward to. This could mean going on an actual trip, but it can also be as simple as planning a special weekend activity close by.

8. Volunteer for a cause that’s important to you. Use your personal interests and skills to make the world a better place. In the process, you can connect to others, build self-esteem, and gain a sense of purpose.

9. Socialize, and not just on social media. Surround yourself with positive people. When you and your friends stick together, the winter blahs don’t stand a chance!

10. Treat yourself! Don’t forget to do something extra nice for yourself once in a while. You deserve it!

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Janis Atty, MA, CCLS, ATR-BC, LCAT is a child life specialist and creative arts therapist at NYU Langone’s Fink Children’s Ambulatory Care Center, and is part of the Pediatric Celiac Disease and Gluten Related Disorders Program. She helps pediatric patients and their families understand and cope with medical illnesses and experiences. By providing education, preparation, emotional support, and guidance, she promotes positive development and well-being in patients facing a wide range of challenging life events.

 

Breastfeeding Tips for New Moms


Breastfeeding has proven to have wide-ranging health benefits for infants: breast milk provides essential vitamins, protein, and fat to help babies grow. It is also easier for babies to digest than formula and contains antibodies to help fight off viruses and bacteria that cause illness or infection. Both the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists strongly recommend the practice. Still, breastfeeding is a personal choice that can be influenced by family support, the personal health of the mother, breastfeeding education, and the necessity for mom to return to work.

These factors can influence different cultural groups in a variety of ways, and the staff at NYU Lutheran Family Health Centers’ Women, Infant, and Children’s (WIC) Program found that in particular, most Chinese moms they saw were bottle-feeding rather than breastfeeding. The WIC program collaborated with the NYU Lutheran Labor and Delivery Unit to provide Mandarin- and Cantonese-speaking peer counselors five mornings a week, to facilitate prenatal discussion with Chinese moms on the importance of breastfeeding. This education resulted in a significant increase in breastfeeding among that population.

We asked two front-line community physicians, Girish Gowda, M.D., a neonatologist and partnering physician with NYU Lutheran’s WIC breastfeeding support program; and Sharon P. Joseph-Giss, M.D., medical director and pediatrician at NYU Lutheran Family Health Centers Sunset Park for Women and Children for their top tips for new moms struggling to make breastfeeding work for them:

  • The first milk produced is called colostrum. It may seem like it’s not enough but it is sufficient for your baby. In fact, it is necessary to give your baby important nutrients and ingredients such as antibodies to fight infection. The full milk supply will take a day or two to begin, so put your baby to your breast—they are getting plenty of nourishment, and more milk will be produced in a couple of days.
  • Breastfeeding improves health for both mom and baby. For mom, it helps decrease uterine bleeding after giving birth. Exclusively breastfed babies have a smaller chance of ear infections and illness, as well as fewer hospitalizations in the first six months.
  • Put the baby to your breast often! Supply and demand is in effect here, and the more the baby suckles, the more milk the body will produce.
  • When your baby is hungry, make sure his mouth opens WIDE, and put as much of the dark part of your breast and nipple in his mouth as possible. This will ensure a good latch. If the baby just suckles the nipple, this will make you sore.
  • You will need to nurse about every 1.5–2 hours. Better yet, nurse on demand! This will ensure good growth for your baby, and ramp up your milk supply.
  • If your baby has six to eight wet diapers per day that means he or she is getting an adequate intake of milk.
  • Be careful of your diet. Foods that give you gas (broccoli, onions, garlic, beans) can give your baby gas as well.
  • You will know that your baby is drinking if you hear gulping sounds and the baby seems satisfied—sleepy and content—at the end of the session. Since there is no way to measure the milk your baby drinks directly from your breast, this is the best indication that she is getting enough.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Girish Gowda, M.D., is a neonatologist and partnering physician with NYU Lutheran’s WIC breastfeeding support program.

Sharon P. Joseph-Giss, M.D., is medical director and pediatrician at NYU Lutheran Family Health Centers Sunset Park for Women and Children.

The ABCs of AT: A Primer on Assistive Technology


A
ssistive technology (AT) can be loosely defined as the use of equipment to facilitate independence in a person with a disability.

Both children and adults can benefit from the many types of assistive technology.

Children’s needs can differ greatly from adults due to the nature of their disability and their educational needs.

Here’s what you need to know about high and low tech assistive technology:

• Low Tech AT is usually less invasive and easy to incorporate. Examples include adaptive pencil grips, large print text, line guides for reading, or a picture scheduling system for a child that has a hard time understanding text or numbers. While these changes are simple, they can make a big difference in independence for everyday tasks such as handwriting and reading.

• High Tech AT refers to complex devices that have a power source. For children, high tech devices are often used for communication impairments and include adaptive hardware or software to access a computer, equipment to participate in leisure tasks, and home automation devices.

• Computer Technology: AT for the computer includes adaptations to hardware or software. Keyboards can be made larger or smaller and keyboard letter keys can be given alternate layouts. A mouse can be adapted to a joystick or trackball, or made to be controlled by the head or eyes. On-screen keyboards, voice to text or text to voice software, and word prediction software can all help to make communication easier.

• Alternative and Augmentative Communication: These are devices that enhance or replace speech when a child is unable to make his or her needs known. Devices like iPads can be used as children’s communication tools with appropriate applications. There are also “dedicated” devices; these are meant for communication only but have accessibility built in for use with head movement or eye gaze.

• Home Automation: With the advancement of technology, it’s much easier for a child with a disability to control his or her environment, including lights, TV remote, fan, door locks, etc. With the use of a simple remote, smart phone, or tablet, a child can access all of the electronics at home independently.

The use of assistive technology can greatly improve the life of a child or adult with a disability or mixed abilities, and the inclusion of accessibility options in mainstream technology makes access of the necessary easier for a person with an AT need.

Want to learn more? Join the experts from Rusk Rehabilitation at NYU Langone Medical Center for a discussion on the use of assistive technology to enhance independence of children outside the classroom:

Date/Time: Thursday, February 25 at 5pm
Location: Ambulatory Care Center, 240 East 38th St., 11th Floor Conference Room

To RSVP for this free lecture, click here.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Holly Cohen, OTR/L, ATP, SCEM, CDRS is the Program Manager of Assistive Technology and Driving Rehabilitation at NYU Langone Medical Center’s Rusk Rehabilitation.

NYC Parenting Classes for You, Too!

While our major focus at Kidz Central Station is classes for kids, we also make sure to offer options the NYC parents out there who, like us, need a hand with this whole parenting thing every once in a while. At programs uptown, downtown and in between, there are great NYC parenting classes available, whether you want to get in shape after having a baby, brush up on important safety tips, or learn about the painstaking process of enrolling in preschool. So without further adieu, here are some great programs available right now!

NYU Langone Medical CenterBaby Sitting Happily In Car Seat. One of the best hospitals in NYC, NYU Langone Medical Center offers an array of informative classes to get you through every stage of being a parent—from prenatal to postnatal. Expectant parents can experience a free hospital tour and information session with the Ready . . . Set . . . Baby class, and if you want to brush up on CPR and first aid, there are courses for that too. You can even attend sessions for buckling your little one safely in a car seat—a must for any parent on the go. Bottom line, NYU Langone’s parenting classes cover everything you’d ever want to know about becoming a parent—and if you haven’t read NYU’s weekly expert blog posts, make sure to check them out for parenting topics and tips!

 

92nd Street Ystandard_fit_yoga_pregnantside_lg. The 92nd Street Y has classes for everything—you have probably seen a wide variety of their kiddie programs on Kidz Central Station. What you might not realize is that they also offer some amazing classes and workshops for new and experienced parents as well—from semester classes you can join for a season to drop-in workshops on various parenting topics. Expectant parents can check out classes like Lamaze Complete Childbirth Preparation and Caring for a Newborn, and newbies to the job can get back into shape with Yoga For Mommy and Baby or learn the basics of breastfeeding with a weekly Breastfeeding Workshop. Even experienced parents have their pick: you can learn how to best navigate the stresses of parenthood with workshops like Planning Your Child’s Early School Years and Motherhood and Your Professional Identity!

JCC ManhattanHappy Young Father is Playing with his newborn baby girl at home, and kissing noses together.  Vintage style color filter.. For Upper West Siders (or anyone nearby!), the JCC Manhattan offers a variety of great classes for kids (swimming, dance, sports, and more) as well as classes parents will definitely appreciate. If you’re new to the whole parenting game and want to meet others in your shoes (and eat!), there’s a Dad’s Meet Up Brunch and a New Moms Breakfast you won’t want to miss out on, as well as weekly parenting sessions ( called Parents Talk: Everything from A to ZZZs) that cover important topics such as baby sleep schedules and safety and first aid. And that’s not all—check out the full selection of parenting classes here!

standard_Postnatal_fitness_group14th Street Y. Whether you want to get in shape or bond with other parents, this downtown program has a class or workshop to meet your needs. Want to tone with baby in tow? There are some awesome fitness classes in yoga, pilates, barre, and more (prenatal yoga too!). Find out the answers to your burning questions about raising a toddler? The Parenting Your Preschool class is a series of informative sessions focusing on preschool age kids. Topics such as helping your child adjust to the demands of preschool, limit setting, language development, and even topics YOU bring to the table will all be covered throughout the semester. Conveniently located in Stuyvesant Town not too far from Union Square, this program draws parents from all areas and neighborhoods throughout the year.

Safety First: Teaching Safety Skills to Children with Autism Spectrum Disorder

Child holding father's hand
If you have a child with autism, you know that safety skills are a primary concern. Your child can encounter situations every day—like crossing the street—that might pose a risk, or they might engage in dangerous behaviors such as wandering. It can be hard to know where to start when it comes to teaching your children best practices to avoid or how to respond to unsafe situations, but the strategies below can be applied to many common safety concerns that arise. Think about applying these steps to the scenario of your child getting lost in a store.

1. Assess: What is the safety issue? What does your child know about the situation?
Your child tends to wander or get separated when you’re shopping in a large store and you want to create a plan for what to do in that situation. Right now he doesn’t know who to seek help from or what information to give him if he gets separated from you.

2. Plan: Create a strategy for dealing with the safety issue at hand if and when it occurs.
In case of separation, make sure your child knows his full name, parents’ names, home address, and telephone number. If your child has very limited language abilities, he should have an ID card or bracelet with him at all times. If he gets lost in a store, he should go to the person or people you have indicated are safe to go to for help—e.g. police or security.

3. Teach a plan: Talk to your child about how she should behave in the situation.
Speak to your child about what might happen if she gets separated from you at the store. Explain how to respond when people call her name and to listen for an announcement on the loudspeaker. Also make sure she knows who to ask for help and to stay in one place if she can’t find help. Many children with autism respond well to having concrete rules and steps to follow.

4. Model appropriate skills: Demonstrate skills or activities in action using social stories, pictures, videos, and other helpful teaching tools.
Show him pictures online of the types of people he should ask for help (e.g. police, firemen, security). You can demonstrate the steps for him at home: pretend you are a lost child and go through the steps. You can also find videos online that demonstrate what to do when lost in a store.

5. Practice: Practice putting your child in the situation—in a safe, controlled environment—and allow her to practice the new skills in many different natural settings.
When you’re at a store, have your child point out people who could be helpers. Have her repeat what she would say to someone if lost, such as “I can’t find my mom, can you help me?” Then set up a realistic drill. Give the security guard at a store you’re familiar with a heads up that you’ll be practicing. Stay within earshot of your child—but not with her—and have her go through the steps you’ve explained. Generalization doesn’t occur easily, so repeat in a variety of settings with different kinds of helpers to ensure she can demonstrate her skills in unfamiliar situations.

Reward/give feedback: Praise and reward your child when he gets the skill right. You can gradually phase out the reward system as the skill becomes well-learned.
Tell your child how well he followed the steps of your plan, provide additional teaching where necessary, and reward attempts at learning new safety skills.

The most important step is to practice, practice, practice! Not only will it help your child stay safe, but it will help your peace of mind to know he has the skills to manage the situation.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Rebecca Doggett, Ph.D. is a clinical assistant professor of Child and Adolescent Psychiatry at the Child Study Center at NYU Langone Medical Center.