Safety Tips
Special Needs
Fall 2007 Second Edition
The authors would like to recognize the generous contribution of the
American Legion Child Welfare Foundation and the Sons of the American
Legion, which made printing this book possible. In addition, we would like
to recognize Safe Kids Dauphin County (Pa.) for allowing us to use some
of the material from their booklet originally published in 1997.
The names of equipment companies, web sites and other resources that are
included in this booklet are for your reference only. This is not an endorsement
of any of these resources by Toledo Children’s Hospital.
Special thanks to Jennifer Gwin, PT, and Cassie Basting, PT, for recruiting
children to be photographed for this booklet. A special thanks as well to the
Tulsa Autism Foundation for their contribution of tips for children with
autism spectrum disorders. A special thanks to the Ohio Developmental
Disabilities Council for supporting the printing and distribution of the
Spanish version of this booklet.
Dear Parent or Caregiver:
Injury is the leading cause of death in children over 1 year in age.
In 2003, unintentional injuries caused the deaths of 4,241 children
under the age of 15 (U.S. Department of Health and Human
Services). In addition, each year more than 92,000 children are
permanently disabled (Safe Kids USA). Children who have chronic
illnesses such as diabetes, asthma and epilepsy are at the same risk
for injury as their healthy peers. Unfortunately, children with
disabilities have higher than average risks for injuries and injuryrelated death (Safe Kids USA).
This book contains general injury prevention information.
Each family’s situation is unique and each child has his or her
own challenges. We encourage you to seek guidance from a medical
specialist or an injury prevention professional if you have questions
that are not addressed in this book.
We hope that you will find the information useful. Please
contact the Community Outreach Department at 419-291-3485
or 1-866-865-4677 if you have any comments or questions.
The Community Outreach Department
Toledo Children's Hospital
Table of Contents
Passenger Safety
Water Safety
Fire and Burn Prevention
Pedestrian Safety
Bicycles and Other Wheel Sports
Poison Prevention
Choking Prevention
Bed Safety
Equipment and Electrical Safety
Playground Safety
Disaster Planning
Transporting children with special
needs can present unique
challenges that will change as a
child grows. Often, a child that is
born prematurely may need a
special seat but then be able to use
a conventional car seat as they
grow. Similarly, a child with
disabilities may outgrow a
conventional car seat and require
a special restraint specifically
designed for larger children.
Adaptive Mall or 1-800-371-2778
Vests and other transportation-related products
Automotive Safety Program at Riley Hospital for Children, Indianapolis, Ind. or 1-800-755-0912
Transportation aids and other equipment
EZ-On Products or 1-800-323-6598
Special needs transportation education and advice
For assistance with car seat installation or education please visit or call 1-866-SEAT-CHECK
University of Michigan Transportation Research Institute or 734-764-2171
Transportation tips for people who use wheelchairs
All children should ride in the back seat of the
vehicle with an appropriate restraint on every trip.
Infants should ride facing the rear of the car until
they are at least 1 year old and weigh at least
20 pounds. Preferably, infants remain rearfacing until they reach the weight or height
maximum for their car seat. Special needs
children may need to ride rear-facing longer
due to poor head or trunk control or low
muscle tone.
■ Never place a rear-facing car seat in front
of an active airbag. The airbag could seriously injure
or kill the child if it deploys.
Once a child can ride forward-facing, they should
stay in a seat with a harness for as long as possible.
Most car seats have a 40-pound weight limit for
harness use. Special restraints are available that have
higher weight limits when appropriate.
Children over 40 pounds but less than
approximately 57 inches in height may
not be able to safely use a seat belt. Belt
positioning booster seats can be used to
improve belt fit and, in some cases, can be
combined with other restraints for special
needs children.
■ A lap and shoulder belt should be used
for older children. Children should be
instructed to leave the shoulder belt in front
of them, never behind their back or under
their arm, and should be watched closely so they
remain safely positioned.
■ Many children with special needs can use
conventional car seats. It is recommended that
you seek the advice of a certified child passenger
safety technician before purchasing a special restraint.
Certified technicians will also be able to help you
learn how to properly install and use
your car seat or other restraints.
Passenger Safety
Specific Considerations*
Technique/Tips and Comments
Decreased head control
Position rear-facing as long as possible
Position head and neck in center of seat with rolled towels
Use car seat that allows semi-recline when forward-facing
Use of a soft cervical collar if necessary, with medical supervision
Decreased trunk control
Position rear-facing as long as possible
Support trunk with rolled towels
Use car seat that allows semi-recline when forward-facing
Slides down in seat
Position cloth roll between crotch strap and child
Increased extensor tone of trunk and hips
Used rolled towels under knees to decrease tone
Transfer into seat in flexed (knees up) position
Hips are abducted (apart)
Pad outside of thighs to push together
Use wrap or hook and loop tape around thighs
Hips adducted (knees close together)
Place foam block or abductor pad between knees
Shoulders retract (arms pulled back)
Place rolls along sides of child, with arms forward
Breathing difficulties when semi-upright
Use car bed after testing to confirm inability to safely
use a semi-upright infant car seat
Prematurity or small size
Check weight limits and harness dimensions of car seats and
choose one that fits your child. Use padding to position child.
Consider car bed if child is too small for car seat.
Bones that break easily
Car bed with padding to limit stress on child’s body
Hip spica or other casts that allow the
child to bend at the hips or sit upright
Snug Seat Hippo car seat can accommodate children in some
casts, others may require a vest to lie down in the vehicle if their
legs are too long
Some conventional car seats with low sides and a wide base
may also be used - contact a child passenger safety technician
for recommendations
Casts that do not allow the child to
bend at the waist or sit upright
Vests are available that allow the child to lie down
in the back seat
Most wheelchairs are not crash tested. Labels on the wheelchair
will indicate if it is safe to use in a vehicle. Follow instructions
about seat belts (positioning belts are not seat belts and will not
restrain your child in a crash). Be sure to use four-point tie-down
devices to secure the wheelchair.
Children with autism spectrum disorders;
older children with behavioral challenges
Children over 80 pounds and over 4 feet 9 inches tall who can
properly maintain a seated position may be able to safely ride
in a seat belt when they have outgrown conventional car seats
and boosters. Other children may require a vest that buckles into
the car and cannot be removed by the child.
Children with autism spectrum disorders may be nonverbal or
have limited verbal skills - fill out an ID card and place in the
glove compartment with insurance information
* Table adapted with permission from Transporting Children with
Special Health Care Needs Training and Resource Manual (2004),
Automotive Safety Program, James Whitcomb Riley Hospital
for Children.
School Transportation
Many children are transported to and from school and enrichment programs in buses or vans. To ensure that
your child travels safely, you should include any special transportation needs in your child’s Individualized
Education Program (IEP). Some points to consider:
■ Does your child need a special car seat or harness system?
■ Does the bus driver need special training to know how to use the restraint and how to handle an emergency?
■ Does the child require an aide to ride safely?
Water sports can be a great way for all
children to exercise and are often an
ideal way for special needs children with
limited mobility to enjoy a new
experience. In addition, bathing is a
necessary part of daily life for all
children. Safety is a primary concern
when any child is near water. Drowning
is the leading cause of death among
children aged 1-4 years and most often
occurs in bathtubs, residential swimming
pools and open water sites. Parents and
caregivers should know the risks.
Any child can drown in as little as an inch of water. Children have drowned in tubs,
buckets, washing machines and toilets in the home.
Supervision is the key element in water safety. Never leave a child alone, even for
a moment, when near water.
To prevent scald burns the temperature on your water heater should be set to no more
than 120 degrees Fahrenheit and an anti-scald device should be installed on faucets.
Always check the water temperature with your hand before placing a child in the
water. Remember that a child’s skin burns much more easily than an adult’s.
Place the child at the end of the tub opposite the faucet to prevent accidentally turning
on the water or striking the faucet with their head.
Use a spout cover (as pictured at right) to reduce the risks of bumps and bruises.
Child unable to sit without support
Never leave a child alone even for a moment.
Use bath chairs with constant supervision.
■ Mount grab bars in the tub.
Tub Spout Cover
Water too hot
Children with low sensation or who cannot
communicate verbally are at increased risk for scald
burns because they may not cry out when exposed
to water that is too hot.
■ Check water temperature with your hand or
a thermometer before putting child into tub.
■ Adjust setting on your water heater to 120 degrees
Fahrenheit or less.
■ Install temperature balance control valves
on all faucets.
Seizure disorders
Parent injuries from lifting
Children with autism spectrum disorders
Ask a physical or occupational therapist to show
proper lifting techniques for the tub.
■ Install lifting equipment in the bathroom as your
child grows.
Never leave a child alone in the tub for even a moment.
School aged children should shower when old enough
to bathe alone.
Need active parental supervision at all times.
May have no fear or understanding of dangers of
water; at the same time may be drawn to water and
may enter water without knowing how to swim or
behave safely.
Water Safety
Specific Considerations
All parents and caregivers should
recognize the importance of prep l a n n i n g f o r f i re - re l a t e d
emergencies. Early warning and
quick action can save lives.
AbleNet, Inc. or 1-800-322-0956 ■ Switches and other simple-to-use assistive
technology for children with special needs
Harris Communications or 1-800-825-6758 (voice), 1-800-825-9178 (TTY)
for deaf and hard of hearing people
All special needs children
Contact your local fire department and explain
any special circumstances you may have. Ask them
to visit your home and check for potential fire
hazards. Introduce them to your child and discuss
his or her disabilities and health concerns.
Have a bag of any medicine or special equipment
your child may need available in an emergency.
Obtain a medical alert device that is attached
to your child’s clothing.
Child cannot speak or communicate in an
Keep a whistle or bell by the bed for your child
to alert others to danger.
Place an alarm with a switch that is easy to operate
within reach of your child’s bed.
Child cannot escape a room without assistance
Keep a blanket, mechanic’s creeper or scooter
board near your child’s bed to facilitate evacuation.
Place your child on the blanket or board, secure
and drag him or her to safety.
Child is visually or hearing impaired
Sight impaired children should practice escape
techniques using feel. Consider using a buddy
system with a sibling.
Use smoke detectors with a strobe light for hearing
impaired children. Practice fire safety messages in
sign language.
Children with autism spectrum disorders
Teach your child the basic concepts of
hot and cold.
Create visual signs as needed to depict an
escape route (a GO sign) and dangerous areas
(STOP sign).
Develop social stories about smoke detectors,
fire alarms and the dangers of touching fire.
Electrical safety
Never overload circuits or outlets with multiple
medical devices such as monitors, suction machines,
ventilators or humidifiers.
Teach children not to hide from firefighters.
Visit a fire station so your children are
comfortable with firefighters.
Teach your children how to dial 911 from a
neighbor’s home after escaping your house.
Practice proper escape techniques: check for
fire, stay low and crawl along walls to avoid
becoming disoriented, meet at the designated
spot once outside and never go back inside
the house.
Practice the Stop, Drop and Roll technique
to extinguish flames on clothing.
Place at least one smoke detector on each level
of your home and in all sleeping areas.
Check the batteries in each detector once a
month and replace the batteries twice a year.
Create a fire escape plan for your home that
includes at least two escape routes from each
room and a meeting place outdoors. Practice
the plan regularly.
Keep all lighters, matches, barbeque lighters
and other sources of fire out of the reach of
children and in safe containers.
Keep an ABC-type fire extinguisher in the
kitchen area at all times. Learn when and
how to use it.
Fire and Burn Prevention
Specific Considerations
As children grow, they gain
independence and stretch their
limits. Your child may be ready
to cross the street, walk to school
or ride a school bus. Here are
some tips to avoid common
pedestrian injuries.
Children under 10 should not cross the street alone. Parents should observe their child until they
are satisfied that he or she uses safe behaviors.
Teach children to cross streets only at corners, using traffic signals and crosswalks when available.
They should always walk, not run.
Train kids to look left, right, then left again when crossing a street and to take special care when
there are parked cars in the area.
Never allow your children to play in the street, driveway or unfenced yards near the street.
Young children should not play outside or ride a bike after dark. Older children should wear
white clothing or reflectors at night.
When entering or exiting a school bus, children should walk at least 10 feet in front of the bus
and make eye contact with the driver before stepping off the curb.
Work with your community to
install sloped curbs, signs or audible
devices at intersections to make them
safer for children.
Ensure that there are safe places for
your child to wait for the bus.
If your child has problems with
attention, impulse control or other
behavioral problems, pedestrian
injuries may pose a particular risk.
Work with your child’s therapy team
to ensure that he or she learns safe,
positive behaviors in traffic. Set clear
limits and enforce rules consistently.
Mark wheelchairs with reflective
tape and add a bike flag for greater
visibility in crowded areas.
Children with autism spectrum
disorders may wander or run away
from an adult and dart into traffic
or a busy parking lot. A handicap
permit may be necessary to ensure
safety. They may also have delayed
processing of external dangers such
as an oncoming vehicle.
Pedestrian Safety
The single most important safety
tip for safe bicycling, in-line
skating, skateboards and roller
skating is simple—make sure your
child wears a properly adjusted
helmet every time he or she rides.
Helmets reduce the risk of brain
injury and death. There is no better
way to ensure your child a safe, fun
wheel sport experience. Here are
some other safety tips to consider:
Freedom Concepts, Inc. or 1-800-661-9915
Adaptive bicycles for children and adults
Adaptive Adventures, Inc. or 877-679-2770 or 866-679-2770
sports, camps and activities for people with disabilities
Information about adaptive
Check your child’s helmet fit regularly, adjusting
for growth as needed. A helmet that fits is snug
and does not slide over your child’s scalp. If the
helmet is too loose, use thicker pads. If the helmet
is too loose with the thickest pads, choose the
next smaller sized helmet.
The straps need to come to a “V” under the ears
and be snug enough that you can slide only a
finger or two under the chinstrap. Adjust frequently
and teach your child to snap and unsnap without
pinching their neck.
Perform regular safety checks on bikes looking
for proper tire inflation, tight screws and
working brakes.
Bikes must follow the rules of the road.
Teach your child to obey traffic signals including
hand signals for turns and stopping at all
stop signs.
Ensure that your child wears safe clothing.
Avoid loose pant legs, loose shirts and shoes
that come untied easily. Clothing should be bright
colored or reflective to increase visibility
to motorists.
If recommended by the manufacturer, knee,
elbow and wrist pads should be worn with skates,
skateboards or scooters. Some sports require eye
protection and mouth guards.
Never allow a child to participate in an activity
for which he or she is not developmentally ready.
Children need good balance and coordination
for some sports.
Many types of adapted bikes are available for
children with disabilities and may be a safe way
for children to enjoy bicycling.
Ask your child’s therapist for advice on fitting
helmets or adapting equipment.
Bicycles and Other Wheel Sports
Specific Considerations
Poisoning often involves young
children as they begin to explore their
environment. Some of the most
common household items involved
in poisonings include:
■ cosmetics
■ cleaning substances
■ plants
■ foreign bodies and toys
■ pesticides
■ art supplies
■ alcohol
■ pharmaceuticals (over the counter
and prescription)
Remember that many poisons
look like safe items (e.g. oil
soap resembles apple juice,
window cleaner resembles blue
fruit drink, etc.) Children
cannot tell the difference
between safe and poisonous
items. Blocking access to
poisonous items and
medication is the best way
to prevent poisoning.
Store potentially poisonous
items out of the reach of
children, in locked cabinets
or closets.
Keep poisons in original
containers and avoid storing
anything except food in
food containers.
Place the 1-800-222-1222
Poison Control phone number
on all telephones and in critical
places in your home. If
someone has collapsed or
stopped breathing, call 911.
Every home should have a
carbon monoxide detector.
Follow the instructions
for proper placement
and maintenance.
Syrup of ipecac is no longer
considered an essential
poison safety item and should
be discarded due to the
potential for inappropriate use.
If you need to contact Poison
Control, try to have the
following information available:
Child’s age, weight and
Product container
Time the poisoning occurred
Your name and the telephone
number you are calling from
Stay calm and have a pencil
and paper handy. Stay on the
phone until instructed to
hang up.
Poison Center assistance
is available for hearing
impaired and non-English
speaking callers.
Keep a sheet with the names
of the conditions your child
has, medications he or she
takes and any special concerns
available for babysitters or
siblings to use when calling
911 or Poison Control.
Older children may be able
to open locked closets or
cabinets. Take this into
consideration when securing
poisons and medication.
For children with autism
spectrum disorders, you may
need to use visual cues such
as a “NO” sticker to identify
poisonous items. Older
children may be able to operate
simple locks so more advanced
mechanisms may be required.
Children with pica need to be
actively supervised at all times
to prevent ingestion of natural
poisons in the environment.
Poison Prevention
Choking is a possibility for any child,
but for many children with special needs
it is a particularly dangerous risk area.
A child with special health care needs
may be at risk of choking when reclined
in a vehicle or when sleeping. If your
child’s medical condition causes him
or her to have trouble eating,
swallowing or breathing you may want
to discuss potential choking issues with
their medical team. Physicians or
therapists may have specific advice to
offer about how to prevent choking.
All caregivers should be trained in first aid and CPR
and be prepared to step in if a child chokes. Keep
copies of instructions for CPR in areas where your
child plays and eats.
Children should be taught to sit at a table when eating,
not walking or playing.
The following foods should not be given to toddlers
or children younger than age 5:
hard candies, jelly beans, chewing gum
popcorn, raisins, marshmallows, seeds and nuts
The following foods may be given to children between
the ages of 2 and 5 ONLY if they are prepared
■ Hot dogs (slicing lengthwise before cutting crosswise
reduces the risk of choking)
Grapes or cherries (peeling, removing seeds or pits,
and cutting in half reduces the risk)
Carrots, apples, celery, green beans (cooking, then
dicing or cutting into small strips reduces the risk)
Peanut butter (spread thinly)
Meat, potatoes, or raw vegetables and fruits
(dice or cut into small strips)
Processed frozen potato products shaped like
a hot dog (mash or cut length-wise)
Other common household choking hazards include:
■ latex balloons
small toy parts
pen or marker caps
button-type batteries
toys that could be squeezed into a child’s mouth
Toys are a common choking hazard
■ Always follow the age recommendations on toys
and other products.
Keep toys belonging to older children away from
younger children or those that may be developmentally
If you are unsure about the safety of an item, try
placing it in an empty toilet paper tube. If it’s small
enough to slide through, it’s a potential choking hazard.
Choking Prevention
Safe sleeping arrangements are often
a challenge for parents as children
grow. Parents must balance safety,
privacy and independence issues.
Anticipating that a child will climb
out of a crib, fall from a bed or open
a window is often the best way to
prevent injuries. A regular review of
your child’s physical and behavioral
abilities can be a good way to keep
him or her safe as they grow
and develop.
Home Security Store or 1-888-501-7870
sensors and other safety products
Window and door alarms, motion
Head banging
Child should wear helmet in bed.
Safely pad the bed to prevent injury.
Bunk beds are not appropriate for children under
the age of 7, and may not be appropriate for any
child with a seizure disorder.
Falling from the bed
Use mesh side rails. If the child climbs over rails,
consider using a mesh cover that extends over the
bed to prevent falling.
No sense of danger or sleepwalking
Place the crib or bed
away from windows.
Crib slats should be no
more than 2 3/8 inches
apart to prevent head entrapment. If a 12 ounce
soda can will fit through the slats on the crib,
they are too far apart to be safe.
Use a baby monitor so you can hear if
the child awakens.
Place babies to sleep on their backs, unless
a medical professional advises otherwise.
Limit blankets, sheets and
padding and use only tight
fitting linens on the crib
or bed.
Use mesh side rails on both
sides of a bed; pushing the
bed against the wall can
create an entrapment hazard.
Use door and window alarms along with
a baby monitor.
Choking or trouble breathing
when lying down
■ Ask a therapist about using
foam wedges to position child.
Bed Safety
Specific Considerations
Some special needs children require
medical equipment to maintain their
health. Careful use of this equipment
is essential to the safety of your child.
Consider the following electrical and
equipment concerns when checking
your home for potential hazards:
Never overload a circuit or a wall socket.
Never place a cord under a rug or carpeting.
Use outlets with a Ground Fault Circuit
Interrupter (GFCI) or multi-outlet plug strips
to help prevent electrocution.
Maintain all electrical equipment according
to manufacturer recommendations and carefully
follow all cleaning and maintenance
Notify your local fire department and your electrical
supplier if you have a child who uses a ventilator
or other essential equipment. Ask about any special
programs or information they may need to serve
the needs of your family in the event of an electrical
failure or a utility shut-off.
Ensure that all back-up batteries are charged
and maintained according to manufacturer
Keep equipment manuals handy along with the
phone number for the manufacturers’ customer
service lines, in case of emergency.
GFCI plug
Equipment and Electrical Safety
Specific Considerations
More of today’s playgrounds are
designed to permit children of all
abilities to enjoy the fun along with
their friends and siblings. Parents of
other special needs children can be a
great resource for ideas about suitable
and safe play areas. Many safety issues
related to playgrounds apply to all
children and some may be a unique
challenge for your child.
National Program for Playground Safety or 1-800-554-PLAY ■ Comprehensive resource
for ADA requirements and suggestions for playground safety for all children
Boundless Playgrounds or 1-860-243-8315
playground information and assistance
Source for accessible
Supervision of all children is key to having safe
fun. Parents and caregivers need to actively supervise
their children and be on the lookout for unsafe
play situations.
Children should play on developmentally
appropriate equipment based on their age and their
physical abilities. Look for playgrounds with separate
equipment for young children (ages 2-5) and schoolaged children (6-12).
The playground should be in good condition, with
no exposed bolts, hooks or other features that might
snag a child’s clothing or skin.
Falls should be cushioned with materials like wood
chips, mulch, sand, pea gravel or rubber mats. Grass,
concrete and asphalt are not safe surfaces for play.
Specific Considerations
Try to find ways that your child can safely challenge
himself or herself with your supervision.
If your child cannot play safely on the equipment,
bring toys for him or her to play with and allow
interaction with other children in this way.
The Americans with Disabilities Act requires that
new or revamped playgrounds be accessible. This
means there are ramps, guardrails and space for
adults to assist children. If the playground is not
safe or accessible, go to another area.
Children with autism spectrum disorders require
constant supervision. Look for fenced playgrounds
for children who may run away. Many children on
the autism spectrum may appear insensitive to pain
– be sure to thoroughly check your child’s condition
after a fall.
Playground Safety
All parents strive to provide a safe and healthy
environment for their children. It is natural to
want to avoid thinking about the unthinkable:
according to the American Academy of Pediatrics,
95% of people think a disaster will never affect
them. In fact, 60% of the population of the United
States has experienced some kind of disaster.
Knowing what types of natural and human made
disasters may affect you and being prepared to
handle them is the best way to ensure that your
family will be protected and will recover quickly
after a major event. While all of us can and should
prepare, families of children with special health
care needs have some specific challenges and
requirements that can best be met with some
prior thought and preparation.
Florida Institute for Family Involvement
American Academy of Pediatrics
Sample emergency medical history forms and other resources
AAP’s Family Readiness Kit
Ohio Legal Rights Service
and sheltering-in-place
Includes separate checklists for evacuation
National Fire Protection Association
for people with disabilities
General information about disaster preparation
National Organization on Disability
if you use a service animal and other resources
Guide for planning evacuations
United States Department of Homeland Security
Tips for preparing for a disaster
Center for Disability Issues and the Health Professions ■ Resources for planning for evacuation
Sources of information include the American Academy of Pediatrics Family Readiness Kit and the Florida Institute
for Family Involvement’s publication “Disaster Preparedness for Families of Children with Special Needs.”
Supplies for children with special needs
Step 1. Get a kit.
Consider the safest place in your home in a crisis and
store these supplies in an accessible location, preferably
in portable waterproof containers that you can
transport yourself if needed.
Two-week supply of all disposable supplies needed
(dressing materials, nasal canulas, suction catheters)
Two-week supply of medicine (prescription and
Generator or battery backup for electrical
medical equipment
Copies of prescriptions for medications
and all equipment and supplies
Special dietary foods and supplies
Manual wheelchair if unable to lift or carry
Diapers and toileting supplies, personal hygiene
and wound care needs
Essential Emergency Supplies
List for Sheltering In Place
Signal, flare and whistle
Map of the area and list of important
phone numbers
Three gallons of water per person
Seven day supply of ready-to-eat
canned or packaged food
Manual can opener
Paper cups, plates and plastic utensils
Blankets or sleeping bags
Essential Items for Evacuation – Keep these in
a portable, waterproof container such as a plastic tote
or zip top bags
Battery powered radio, flashlight
and extra batteries
Credit card and cash
Copies of important documents (see list)
and emergency medical history forms
(see resources section for examples)
Toiletries and hand sanitizer
Extra set of car and house keys
Cell phone charger, extra batteries
Extra pair of eyeglasses
Change of clothing, sturdy shoes and rain gear
Matches in a waterproof container
Plain chlorine bleach and coffee filters
for sanitizing water
First aid kit and needed medications
(recommend one month’s supply)
Plastic garbage bags
Copies of prescriptions
Plastic bucket with a tight lid
Sunscreen and insect repellant
Items needed for pets (food, water, litter and
cage). Note that pets are not permitted in shelters.
Small toys, books and games to keep kids busy.
Comfort items such as stuffed animals or
special toys.
Important Documents – Originals should
be stored in a safety deposit box. Keep one copy
on hand and send one to an out-of-town contact.
Wills, insurance policies, contracts,
deeds and investments
Passports, social security cards, immunization
records and emergency information forms
Bank account and credit card numbers
Inventory of valuable household goods
(photos or videos)
Family records and photos
Identification (copies of driver’s licenses,
birth certificates, adoption records)
Disaster Planning
Specific Considerations
Disaster Planning
One of the most difficult things a family with special
needs may face is the decision to stay at home (also
called sheltering in place) or to evacuate to another
community or a shelter in the event of a disaster.
You should ask yourself:
Step 2. Make a Plan
All families should teach children their phone number
and address, their parent’s name, and how and when
to call 911. Talk with your children about what to
do if you are separated – choose a meeting place
outside of your neighborhood and an out-of-town
contact to call. Teach them to recognize emergency
officials and tell them that they can seek help from
these people.
Can we handle all of the day-to-day needs
of our entire family for three days with little
or no outside assistance?
What if there is a medical crisis? Can we
make the needed decisions without outside
support for three days?
Do we have enough supplies and equipment
to meet our regular and special needs for
at least three days?
If your answer to any of these questions is “no,” your
best option may be evacuation. Try to plan for both
a shelter-in and an evacuation situation. Consider
this as you complete your steps in disaster preparation.
Specific Considerations
If someone in your household has hearing or vision
loss, consider how they will be alerted to a disaster.
Create a support network of friends, family
and caregivers that know your family’s situation
and are aware of your needs. If your child has
communication, mobility, cognitive or behavioral
issues, talk about how those will be handled.
Check with local authorities to see what your
options are for evacuation.
Call your local fire department and speak to them
about being listed as a special needs household.
This is especially important if someone in your
home is dependent on electrical equipment for
their health or safety.
If your child has special needs, make sure they
have a medical alert bracelet, necklace or other
identification describing their needs – tuck an
information sheet into their pocket or use a
shoelace tag. This is especially important if their
condition or disability is not obvious (such as
allergies, diabetes or asthma).
Contact your local American Red Cross or
emergency management office and speak to them
about what your community needs to be prepared
to face. Natural disasters can occur anywhere, but
you may also face danger from local manufacturing
or energy facilities, wildfires or other hazards specific
to your community.
Make sure you know your community’s warning
signals and what to do if you hear or see them.
Learn how to turn off your utilities if needed.
Keep a wrench and flashlight near the shut-offs.
You will need a professional to turn a natural gas
supply back on, so only do this if instructed
or in an obvious emergency.
Make sure you have enough insurance.
Take a CPR and first aid class.
Disaster Planning
Step 3. Be informed
Specific Considerations
Many communities are in the process of creating and
evaluating disaster plans for people with special needs.
Get involved by calling your local emergency, fire or
police officials and asking whether or not plans are
in place. Your local American Red Cross is also a
good resource for this information, especially related
to policies and procedures at shelters.
Step 4. Practice and
maintain your plan
Go over your family disaster plan
and hold a drill every six months.
Replace stored food and water.
Make any needed updates to
your kits and your paperwork.
Supporting your child’s
emotional health and safety
Children that experience a disaster will need
reassurance and understanding from adults that they
will be alright. Talk on a level that your child can
understand. Explaining that you have a plan and
providing an appropriate level of detail to the child
will help. Limit what your child sees on television,
hears on the radio, and overhears in discussion.
Try to keep routines and a regular schedule or start
new routines and rituals that the child can predict.
The Center for Children with Special Needs,
Children’s Hospital and Regional Medical Center,
Seattle, Washington
The Injury Free Coalition for Kids
Emergency Medical Services for Children
United States Fire Administration
The American Academy of Pediatrics
Safe Kids Worldwide
See tips for preventing all unintentional injuries
Harborview Injury Prevention and Research Center
Includes many injury topics, especially pedestrian
and bicycle information
The American Association of Poison Control Centers
See poison prevention information
National Highway Traffic Safety Administration
Includes information on child passenger safety,
bus safety and a technician locator
Safety 1st and The National Association of
Children’s Hospitals and Related Institutions
Developed and printed
by the Community
Outreach Department
Toledo Children’s Hospital
Funded in part by
generous grants
from the
American Legion
Child Welfare Fund, the
Sons of the American
Legion and the Ohio
Disabilities Council.
©2007 ProMedica Health System
Fall 2007 Second Edition