Toward an independent lifestyle – Karra Barber talks about her new skill-building workbook for teens and young adults on the autism spectrum

Karra M. Barber is a full-time mother and advocate for her teenage son who has Asperger’s Syndrome. She is the founder and facilitator of a well-established support group for parents of children and teens on the autism spectrum, and is a regular contributor to many autism magazines.

Here, she answers a few questions about
The Social and Life Skills MeNu, her new skill-building workbook for teens on the autism spectrum.

Tell us about your advocacy role, and how the book came about?

My experience advocating stems largely from having to personally interact with the school district on behalf of my son, Thomas. He was in Kindergarten when it became clear to me that he would require accommodations and additional services in school. Since then, like many parents with special needs children, it became my mission for Thomas to receive the support and understanding from educators and professions necessary for him to learn and thrive in an educational setting.

The book really started out as “lesson plans” for my son. Each task was developed toward achieving a specific social and/or life skills goal. Thomas works with a life coach who helps him to implement these specific MeNu tasks. There wasn’t a specific situation that inspired me, only the realization that one day I will be gone and I wanted my son to be as self sufficient and independent as possible.

How did you come up with the strategies and menu theme in the book?

My son is seventeen and is approaching the age of maturity. In an effort to prepare him toward an independent lifestyle (his goal as well), I knew we needed to build his life and community skills. I wanted him to feel confident in everyday tasks such as buying food, returning an item at the store, going to the bank, washing clothes, using public transportation or making himself a meal. And although these tasks are practiced regularly, they are definitely a work in progress. With that said, I knew others with similar social and life skill difficulties could benefit from the MeNu skill building strategies as well.

Because engaging socially can be so difficult, even overwhelming, for students on the spectrum, I came up with the MeNu (a play on words Me and You) as a reminder to focus only on the person you are communicating with. Further, the MeNu used as a template will guide students along their conversations, alleviating anxiety about how the conversation should go (e.g. when to start, stop, pause, add, etc.). I developed this concept for my son, Thomas and it has worked well.

What are the most difficult social situations for teenagers on the autism spectrum to deal with?

I think attempting to navigate social situations in general, and how to respond appropriately and effectively is extremely difficult task for our kids to manage. Something as simple as how to approach someone with a question, or how to enter into an existing conversation can be overwhelming. I hope the Social and Life Skills MeNu will provide a road map for ASD students to practice and follow, while building confidence in how they engage with others.

My son uses the MeNu concept in conversations with me now. It’s an interesting development. Because the book was developed for my son initially, he’s learned to use the strategies in the book quite well and finds them to be useful. Because his goal is to live independently one day, he’s motivated to learn and practice strategies that will help him facilitate that goal.

Copyright © Jessica Kingsley Publishers 2011.

Understanding Disorganized Attachment – An Interview with David Shemmings and Yvonne Shemmings

David Shemmings is Professor of Social Work in the School of Social Policy, Sociology and Social Research at the University of Kent, UK. Yvonne Shemmings is a qualified social worker and Continuing Professional Development Specialist, and has trained professionals in over 30 child protection organizations.

Here, they answer some questions about their new book, Understanding Disorganized Attachment: Theory and Practice for Working with Children and Adults.

Tell us about yourselves and how the book came about.

We each bring different experience to this book. Yvonne worked in child protection for many years, initially as a social worker and then as a supervisor and manager. For the past 15 years she has been training child protection professionals from each of the key agencies. David worked for some years with severely traumatised and abused children before becoming a senior manager in social services. He has been an academic now for nearly 25 years and has worked in three universities in the UK – University of East Anglia, Middlesex and, latterly, Kent – concentrating on child protection and welfare.

We wrote the book because we were concerned about the gaps in our ability to predict confidently when a child is being abused or neglected. Although child protection professionals help keep many children safe – and it’s important to remember that the UK has one of the lowest rates of child homicide at the hands of their carers – nevertheless, they sometimes bring the wrong families into the system while missing others – not because they lack skill but as a result of gaps in our knowledge about what leads to maltreatment. In its simplest terms, we over-concentrate on the lifestyle of the caregivers but overlook key factors explaining why some parents who take drugs, who have mental health problems, who were abused as children, who are single parents, etc., abuse their child/ren … while, clearly, others do not. Our review of the research showed us convincingly that the most accurate and reliable way of assessing whether a child is being maltreated is the presence of disorganised attachment in their behaviour.

The book helps child protection professionals understand precisely what is going on when a child experiences disorganized attachment (DA). Without that understanding, practitioners are likely to misinterpret behaviours and contexts. Attachment theory and research have come a long way since the early pioneers began their quest to understand why good – but particularly ‘not so good’ – parenting can have such a profound effect on how we develop as children and later as adults. But it is the recent research on neurology, biochemistry and their implications for attachment that help child protection practitioners because the insights shift their focus back to relationships, rather than ‘form-filling’.

What is disorganized attachment and why is it considered to be the ‘most extreme form of insecure attachment’?

Mary Main evocatively called DA ‘fear without solution’: it occurs when a child is simultaneously frightened in a situation into which a caregiver enters. For example, if a toddler is in a room on their own or with a stranger they will usually protest by crying. For most children, the appearance of their caregiver usually provides comfort and a safe haven to go to. But what if the caregiver is the source of danger, apprehension or dread? Then the child is faced with an unsolvable dilemma: ‘I’m scared in the room … but I’m more frightened of my caregiver’. What happens is that the child freezes. They fall on the floor, or walk towards the caregiver but with their head turned the other way. In older children DA behaviour becomes apparent if they are asked to complete an attachment-related story or reflect upon their relationships with their caregivers.

We argue that too much attention is often paid in social work to ‘insecure attachment’. But so many studies now indicate that, if a large enough sample is taken, about 40% of children (and adults) are insecurely attached. This relative proportion applies across cultures (although members of different cultures will ‘show’ their insecurity differently). The point is that insecurely attached people have an organised strategy to deal with anxiety; they just have different ways of dealing with their emotion. Children who are maltreated do not have an organised way of reducing the stress; that is why DA is the most extreme form of insecurity.

What kinds of interventions work best with children and adolescents who suffer disorganized attachment?

It depends on whether the plan is for the child to remain with their carers or to be found an alternative placement. If the child is going to stay with its carers then the intervention needs to focus on the carers, not the child. The preparation for placement with a child should seek to raise the foster carer’s and adopter’s awareness of about how DA operates, and under what circumstances, otherwise they will quickly be caught off-guard. Additionally, there are a number of initiatives being set up in schools – such as Nurture Groups and the Roots of Empathy – which have been shown to increase significantly children’s opportunities for secure base experiences. But if the child continues to live with maltreating adult/s the work must address the abusive parenting.

What work can and should be done with their neglectful, often abusive parents?

There is a growing amount of research indicating strongly that chronically maltreating caregivers do not respond well in the medium- or long-term to approaches which are exclusively cognitive in their approach. Such interventions are effective with many families but have only limited impact with highly resistant and chronically abusive caregivers. It is thought that such parents almost need a kind of ‘re-parenting’ themselves, before they can offer sensitive care to their child/ren.

But we are now a lot clearer about the form such re-parenting needs to take: it has to include large elements of what is called ‘mentalised experience’ when they are watching videos of themselves parenting their own child. The worker ‘speaks for the child’ while providing the parent with lots of empathy, compassion and understanding (the intervention is designed in such a way as to increase the likelihood that positive interactions are observed). The best example of this approach, which we give an example of in the book, is the Video-based Intervention for Positive Parenting (VIPP), first developed at Leiden University in the Netherlands. Quite dramatic results can be observed after 4-6 sessions of 1.5 hours.

How might your book inform child protection practice and services?

It does this in at least three ways. Firstly, readers are introduced to the latest research on the ‘neuropsychology of attachment and maltreatment’; we do this in an accessible, non-technical way because we understand that child protection professionals are busy people who are much more likely to engage with evidence-based research when it is easy to read and digest.

Secondly, we include practice-related and relevant examples to illustrate the theoretical material outlined; we have found over the years that child protection practitioners and their supervisors like re-visiting theory if it is presented in the right way.

Thirdly, we include three chapters each of which is co-authored by practitioners involved in our innovative Assessment of Disorganised Attachment and Maltreatment (ADAM) Project, currently being implemented in London and other parts of Europe. We have now trained over 200 professionals to use our Maltreatment Pathway model and their feedback has been extremely positive and enthusiastic. Their overall reaction is an unequivocal ‘thumbs-up’ for the increased confidence they experience in the quality of their assessments, both in court as well as within child protection procedures more generally.

Copyright © Jessica Kingsley Publishers 2011.

Breaking Bad Habits in Communication for the Helping Professions

By Maggie Kindred and Michael Kindred, authors of the new book 500 Tips for Communicating with the Public, which addresses the communication challenges that people in the helping professions face in the workplace, covering topics such as managing conflict, assertiveness, feelings, listening and boundaries. It also includes guidance on reflection, supervision, confidentiality and anti-discrimination.

We hope that the advice we provide in our new book, 500 Tips for Communicating with the Public, will help you to do your job more effectively – but it comes with a warning: some bad habits may have to be ditched!

How do people get into these bad habits? Life consists largely of ‘learned behaviour’. We learn everyday skills, like cooking, mainly by example. It is quite possible to get by doing all kinds of things which could be done better. Interestingly, many people decide to have lessons to supplement their cooking, recognizing that their level of competence is perhaps limited – but when when it comes to communication, it does not necessarily occur to us that we could do it better!

At the extreme end of the scale it is obvious that shouting at people, causes distress and does not get the desired result. But how many people do not realize that they are causing offence by:

  • standing too close to people?
  • writing letters and emails which SHOUT, because of the lettering and style they have used?
  • using nicknames and over-familiar modes of address?

Do we perhaps take for granted our ability to communicate effectively? How can we recognize our bad habits in communication and un-learn them?

Hopefully this is where our book comes in. Over the years experts in the helping professions gradually learned what helps and what does not in communication from their detailed observations and analysis of clients’ and patients’ reactions. This collective knowledge is generally thought to make up the tools of counselling and psychotherapy, but we believe that volunteers, carers, public servants and everyone in the helping professions can benefit enormously from learning adapted forms of counselling and communication skills.

This book contains advice for all who work with people on ‘the front line’. With its  jargon-free, practical advice, our book brings communication skill development within the reach of all, helping us to break the bad habits of a lifetime acquire some new, good ones!

Here’s a sneak peak at some of the many helpful tips in the book:

One-to-one communication is best in short bursts.
Take breaks when you or your client needs them. No session should be longer than an hour – even this is three times the 20-minute attention span commonly recommended by educationalists. (page 36)

Check whether your client prefers information in writing.
It’s preferable to provide information in writing to avoid it being forgotten or misinterpreted. (page 53)

Beware of communication running too smoothly.
Things rarely progress without conflict or negotiation…If there’s anger or disagreement under the surface, it needs to be brought up as it can sabotage your work. (page 117)

For 497 more great tips, read 500 Tips for Communicating with the Public!

Copyright © Jessica Kingsley Publishers 2011.

Rising Above Bullying: Powerful new book from Red Balloon shines light on 15 years of success in recovering bullied children

By Dr Carrie Herbert, founder and Chief Executive of the Red Balloon Learner Centre Group (pictured, left) and children’s author Rosemary Hayes – authors of Rising Above Bullying: From Despair to Recovery, published this month by JKP.

Rising Above Bullying is a book for all those who encounter bullying. For those who are being bullied and their families, for the perpetrators and their families and for teachers and other adults who are in a position of influence. And for the bystanders – those who ‘turn a blind eye’ thinking it is not their business. We all have a shared responsibility to ensure the safety of our children; adults must be proactive in putting a stop to bullying behaviour. This involves doing something if you believe a child is being subjected to unkind and unpleasant treatment.

The sections which deal with coping strategies and the advice to parents and teachers on how they can be proactive in preventing or dealing with bullying have been compiled after years of first hand experience in recovering severely bullied children at Red Balloon Learner Centres. It is our hope that this invaluable advice will be absorbed by adults and passed on to children who are experiencing bullying, helping them to begin to find a way through their misery, to deal with their tormentors and to regain their self-esteem.

The sheer scale of bullying is often not recognised; gang-bullying and cyber bullying, for example, are both relatively new – and they are escalating.

Rising Above Bullying also serves to make readers aware of the long term effects of bullying – and this is brought sharply into focus by the stories in the book recounted by young people (Red Balloon students and ex-students) who have suffered such traumatic bullying that they could no longer cope in mainstream education. Most of us think of bullying as a bit of unpleasant behaviour: a poke or pinch here or there, being called a few names, being ignored. What you will read about here is the traumatic, tortuous, systematic destruction of a young person’s self worth and self-belief.

In order to recount their experiences, these children have had to return to this trauma and relive their pain and fear. For some, the bullying happened a decade ago, for some it was only a few months ago. We are enormously grateful to them all and hope that their courage in contributing to Rising Above Bullying will show readers how destructive bullying can be. Their stories make uncomfortable reading but they are all based on personal experiences – though, for obvious reasons, all names have been changed – and illustrate just how widespread and diverse bullying is. The damage inflicted can be devastating so it is crucial that bullied children don’t suffer in silence. Overcoming their reluctance to admit to being bullied is the first hurdle. They need to be able to trust not only the person or organisation in whom they confide but also their school and their family to deal with the bullying and to keep on top of it. ‘Letting on’, ‘snitching’, ‘grassing’ can often make things worse if ongoing support from school and home is not forthcoming.

Not only have Red Balloon students contributed to this book but we have also had the help of staff at the centres in Cambridge, Norwich, Merseyside and North London who have given freely of their time, answered questions and set up interviews. They are in a unique position to provide comfort, counselling and one-to-one targeted education that begins where the child left off learning. They rebuild confidence and teach useful strategies to help students deal with bullying behaviour.

Dr Carrie Herbert is founder and Chief Executive of the Red Balloon Learner Centre Group, a qualified teacher and Educational Consultant.

Rosemary Hayes is a children’s writer, a reader for an authors’ advisory service and runs creative writing workshops for both children and adults.

The book’s Foreword was written by Esther Rantzen, CBE, journalist and broadcaster and patron of Red Balloon, amongst other various hospices and charities for children and disabled people.

For more about Red Balloon, visit www.redballoonlearner.co.uk.

Copyright © Jessica Kingsley Publishers 2011.

Music for Special Kids – An Interview with Music Therapist and JKP author Pamela Ott

Pamela Ott has over 20 years experience using Music Therapy in the treatment of individuals with developmental disabilities, and has released nine albums of music for use with children with special needs.

Here, Pamela answers some questions about her new book, Music for Special Kids: Musical Activities, Songs, Instruments and Resources.

Tell us about your background – why did you decide to become a music therapist? How did the book come about?

I’ve had an interest in music since taking piano lessons at age 10 which continued into high school. I was interested in pursuing music in college, but also wanted to go into a field such as psychology or speech therapy in which I could help others. My choir teacher in high school encouraged me to look into the field of Music Therapy – one which he felt could combine both interests. Upon learning more about Music Therapy and visiting the program at Colorado State University I was hooked! I graduated from there and fulfilled my internship at Travis State School in Austin, Texas. Over the next 25 years I worked mainly with individuals with developmental disabilities (DD); autism, Down syndrome, cerebral palsy, SPD, etc., in private practice, clinics and finally as the Director of Music Therapy for United Cerebral Palsy of Southern Arizona (UCPSA).

In 2009, due to an extreme budget shortfall, the state of Arizona made major cuts to the funding of Music Therapy for children with DD and UCP had to end the Music Therapy program which at that point was providing services to 125+ individuals a week. Many of the parents of our clients felt stranded and asked for any suggestions I could give to at least continue providing music through activities at home.

In response, I began a blog – www.musicforspecialkids.com – giving simple musical ideas and suggestions for parents and teachers to use with their children in a learning setting. The response to the blog has been so overwhelming that I began to write a book with many of the musical activities I had used over the years which will now be published by JKP as Music for Special Kids: Music Activities, Songs, Instruments and Resources.

Music Therapists are trained during a four year program at accredited universities to manipulate the elements of music (such as rhythm, melody, harmony, dynamics and timbre) to bring about a change in identified goal areas, so using these activities, songs and resources does not equip an individual to provide music therapy, just as providing language activities does not equip a person to provide speech therapy.

That being said though, music has been widely used in educational settings, preschools and at home to augment a learning process (especially by increasing the retention of material presented), provide outlets for self-expression and encourage socialization – an example being the ABC song, through which many of us first learned the alphabet! My hope in writing this book is to encourage more parents, teachers and caregivers to use more music with their children as a way to connect and encourage learning.

What is it about music that makes it particularly effective with children with special needs?

Music is a medium that can be non-threatening, encourage participation, encourage attending skills, and encourage stimulation or relaxation. Because of these outcomes and more, music can be used to reach a child that may be hesitant to respond to other forms of communication.

One of my favorite moments occurred while working with a little four year old with autism who was essentially non-verbal. Even though she didn’t show it, I could tell by her attending level that she enjoyed coming to music. After working with her for several weeks, I used one of the song omission activities I’ve listed in the book. At the end of a song that was very familiar to her, I purposely left out a word. She fidgeted and quickly touched my mouth as if to get me to finish the sentence. I sang the sentence again, leaving out the same word and after a moment of silence – she blurted out “O”. Her mom and I were absolutely amazed! The language was in there, she just needed a little encouragement to get it out!

Where did the songs, activities and games in the book come from? Are there certain kinds that work better for different needs?

The songs in the book were either written by me or are traditional children’s songs. The activities and games in the book are activities and games that I have created or augmented through my 25+ years of work with special needs children.

As with all children, all special needs children are different. Not all songs and activities will work equally as well with each child and some may be changed to fit each child’s needs. I have given ideas to modify some of the activities at the end of the activity.

What are some common challenges that parents and professionals face in implementing music? How can your book help?

The biggest challenge I hear in implementing music activities and songs with special needs children is when the adult or leader is not a musician and doesn’t feel confident singing or presenting musical activities. My hope is that the book will present these songs and activities in a manner that will encourage even non-musicians to give it a try. Children are not generally critical of a person’s voice or musical ability – they instead respond to a leader who is confident and having fun through the music!

Check out Pamela’s book to learn how you can use music to connect with a child with special needs! 

Copyright © Jessica Kingsley Publishers 2011.

JKP author Jan Greenman attends the Ambitious About Autism charity launch at the House of Lords, UK

By Jan Greenman, author of Life at the Edge and Beyond: Living with ADHD and Asperger Syndrome.

Last year my son Luke spoke to author Nick Hornby’s Treehouse Charity staff, and they were so impressed with him that they asked him to become a Youth Patron for their new Ambitious About Autism charity – watch their video below to see Luke and I being interviewed.

They also asked Luke to speak at their launch at the House of Lords on 10th February. Lord Tim Clement-Jones introduced Luke, and the next speaker after Luke was the Speaker of the House of Commons John Bercow.

The photo below is of Sally Bercow, wife of the Speaker of the House of Commons, myself, John Bercow, Luke, Luke’s sister Abbi, Luke’s dad and our MP James Gray, who wrote the foreword to my book, Life at the Edge and Beyond.

In other exciting news, Luke is off to the Artic on 24th March as a mentor to four pupils from the school that turned his own life around, and just today he received an invitation to represent Ambitious About Autism as a guest of Her Majesty’s Garden Party at Buckingham Palace.

Our life is crazy and the challenges of autism are still with us, but we share our story to help inspire and encourage others never to give up. Our children are exceptional!

Jan Greenman
March 2011

Copyright © Jessica Kingsley Publishers 2011.

JKP attends the NAS Professional Conference 2011

This week, JKP attended the National Autistic Society (NAS) Professional Conference for the first time, and we are pleased to say that it was a resounding success!

The theme, “Delivering excellence in times of austerity”, was poignant as the announcement of the new public sector budgets approaches, but the mood of the conference was definitely one of optimism.

On the first day, JKP author Dr Wendy Lawson spoke on the theories outlined in her new book The Passionate Mind: How People with Autism Learn, shedding light on her personal experience of autism, and giving an insight into her unique worldview. With her engaging speaking style, Wendy was definitely a success with the audience and a queue quickly formed at the JKP stand to buy copies of her book!

Later that day, Professor Digby Tantam spoke on ‘Autism and the Interbrain’, a subject he explores in his recent book Can the World Afford Autistic Spectrum Disorder? Nonverbal Communication, Asperger Syndrome and the Interbrain. Professor Tantam was pleased to see his new book Autism Spectrum Disorders Through the Lifespan available for pre-order on our stand, and even agreed to pose for a photo.

On day two, Linda Woodcock spoke about her book Managing Family Meltdown, offering a range of practical strategies for managing behaviours that challenge, and outlining the low-arousal approach advocated in the book.

We were also pleased to see some of our authors attending the conference as delegates, with Penny Kershaw arriving just in time to pose for a photo with her new book, The ASD Workbook, before we sold out!

Linda Miller, author of Practical Behaviour Management Solutions for Children and Teens with Autism also obliged us with a photo.

It was great to see so many people at the conference (around 400 delegates attended), and thanks so much to all of you who stopped by the JKP stand for a chat and to browse our titles – it’s always such a pleasure to meet our readers!

Check out our NEW Complete Autism Catalogue for our full range of titles…

Street-Based or Detached Youth Work: What it looks like, and why it matters

By Vanessa Rogers, youth worker and author of 101 Things to Do on the Street: Games and Resources for Detached, Outreach and Street-Based Youth Work.

A uniform definition for ‘detached youth work’ is a topic that has been the subject of hot debate over the years. The term ‘detached work’, reported to have first been heard in the UK from the USA in 1955, has come to mean a whole range of interventions outside of a building. When people talk about street-based work they can be describing very different things ranging from ‘quick fix’, one-off sports sessions to targeted crime prevention to longer-term community projects. As well as more traditional street projects, lots of agencies including health and police, community support services, street pastors and social care agencies claim to be using detached youth work to target ‘hard to reach groups’ with great success.

For me, at its simplest, detached youth work is all about engaging young people where they choose to meet – be it a village green, retail-park or urban housing estate – and working with them to an agreed outcome. It is about empowering, politicising and supporting young people within their community, and definitely should not be used as a tool for social control or trying to get ‘kids off the streets’. Detached youth workers literally enter the ‘space’ occupied by young people, and the dynamics are different to other youth work interventions. The key to success is in the positive relationships built and this requires time, commitment and really good negotiation skills.

All detached work should be planned in consultation with young people to ensure that it really meets their needs. As such it needs to be paced to match the young people’s engagement and interest in the project, and focussed on the issues that they wish to explore, rather than set up to meet another agenda. If the young people are not interested they will vote with their feet, literally.

Often presented as a modern solution to anti-social behaviour, today’s detached youth workers are actually following in the footsteps of a rich history of creative and effective street-based work. It is certainly worth looking at the work of some of the early pioneers such as T.H. Tarlton (1844) and Maude Stanley (1890), and reflecting on how much the concerns about young people (e.g. teenage pregnancy, alcohol consumption, youth unemployment and fighting) have changed over the last 175 years – or not!

So what is the difference between ‘detached’ and ‘outreach’ work? Well, although there are similarities I think that detached is very different to outreach work. Detached means working where the young people are, and outreach aims to engage with young people and then support them into centre or building-based provision. A description I often use is to imagine a new bar opening in town. If I am employed to hand out flyers to potential customers and encourage them to come to the bar for a drink then I am doing ‘outreach’ work. If I am employed to engage with a group of potential customers and support them in setting up a satellite bar on the street, then it is detached. Easy!

One of the things I like best about being a detached youth worker is the element of excitement; no two days are likely to be the same. Street workers need to be quick thinking and have a wealth of ideas to keep young people focussed and interested. The games, activities and ideas contained in 101 Things to Do on the Street have been put together to enable both new and experienced detached youth workers do just that. From team-building games and energisers to lift a dull evening, through to ideas for longer projects and issue-based sessions, all have been tried out with young people in a detached or outreach session so can be used with confidence.

I hope you enjoy using them as much as I have.

Copyright © Jessica Kingsley Publishers 2011.

Keeping your Grandchild with Special Needs Safe

By Charlotte E. Thompson, M.D., author of Grandparenting a Child with Special Needs

It is a great responsibility to care for a grandchild, particularly one with special needs. Keeping any grandchild safe, no matter what age or special problem can be a great challenge. One of the things I did when my children and my grandchildren were small was to do a daily or nightly check to see if there was anything that could cause harm.

As a practicing pediatrician, I have had patients swallow a razor blade, safety pin, dishwasher powder, bleach, cigarettes, and alcohol. Some caused considerable damage and required extensive surgery. Now, button or disk batteries and magnetic balls are being swallowed.

Open windows without screens, open doors leading onto second story balconies, garages, swimming pools, and even fish ponds can be dangerous.

Medicines in a bedside table, a purse, or cabinet may look like candy and be ingested by a child.

Car seats need to be appropriate for a child’s age and size and properly installed. In the UK, requirements can be found for car seats at www.childcarseats.org.uk/law.

Peanuts, hard candies, carrots, cubes of cheese, hotdogs, and popcorn can all cause choking in a small child or one with swallowing problems. Knowing how to give a child CPR can be life-saving. In the UK, on-line courses are offered at www.safekids.co.uk/CPRChildren.html. CPR is particularly important to know if a child has a seizure disorder. Posting the telephone number of your grandchild’s doctor by the phone, plus the numbers of an ambulance, the nearest hospital, and the poison center could be life-saving. Remember, too, that if you have to seek medical care for your grandchild, a letter from the child’s parents may be needed to give you permission to act for them.

Smoke detectors and fire extinguishers are important for every home as are fireplace guards and strong enclosures around wall heaters. Playpens, gates on playrooms and at the top of stairs can be life-saving. Remember to check toys for removable parts that can be swallowed. Some pacifiers can be pulled apart and having one on a string around the neck could cause strangulation.

Hot water heaters should be turned down below 120 degrees Fahrenheit (approximately 49 degrees Celsius), particularly if a grandchild has spina bifida or lacks sensation in the lower extremities. Electrical outlets can be covered with special covers and frayed cords should be replaced.

Always be aware of where the child is and what he or she is doing. Once you get into the habit of making sure your house, garage, and yard are safe, then you can sit back and enjoy your grandchild!

 Copyright © Jessica Kingsley Publishers 2011.