By JoAnn Stevelos, MS, MPH
Play dates, school field trips and sleepovers are exciting milestones for children. However, for those with Type 1 diabetes, they can also be daunting. Many parents of children with Type 1 struggle with giving their kids the freedom to join activities that take them away from home for a long time. With some planning and good communication tools, however, parents can help their child with Type 1 diabetes take steps to ensure a safe and happy time away from home.
Playdates for your child with Type 1 diabetes can pose a challenge. When your child becomes old enough to visit friends’ houses after school, you will need a plan. However, even the best plan can quickly fall apart without the foundation of trusted friendships with families in your community. You will find it easier to manage your child’s social life if you develop relationships with families who have some knowledge of diabetes or are willing to learn. For example, are there other children with diabetes at school who might be friends with your child? Are there children at school who have siblings, parents or close relatives with Type 1 diabetes?
When parents can’t find families who have the necessary experience or are willing to be trained, they will often suggest that their children’s friends come over for a visit. This is the best scenario, of course, but as your child grows, he or she will seek more independence. It will be healthy for both of you for your child to learn to manage diabetes without you.
For playdates, the hosting parents do not need to be as fully trained as the school nurse. They just need to be taught enough so that they can look after your child for a few hours — a period that typically would include just one meal or snack. It is also a good idea to send along appropriate food for your child that can be shared by everyone. Depending on your child’s age, he or she may handle some or most of the tasks, but it is still important to familiarize the parents in basics like checking blood sugar, glucagon use, and when to call you or 911.
JDRF recommends providing the host family with written instructions. These should include a description of your child’s symptoms of low and high blood sugar, how to treat them, and what to do if your child experiences a severe blood sugar drop while in their care. And, of course, be sure to exchange phone numbers and be available during the playdate.
Encouraging overnight or daylong school field trips is one way for a family to ease into allowing a child with Type 1 diabetes to be away from home. A field trip can help both you and your child build confidence because it is like a trial run for a supervised sleepover at a friend’s home. A school-sponsored trip offers you and your child the benefit of having the school nurse or a diabetes-trained staff member on board who will be able to check with your child about his or her medical needs. Although federal law dictates that schools provide medical staff for children during school activities, sometimes parents are asked to chaperone field trips to help care for their child. Although this is not legal, many states have policies that allow them to be in compliance, but there is no standard of care across states. Therefore, parents should ensure that a school nurse or medical professional will be on the trip. They also need to ask the organizers of the trip what plan is in place if your child has a medical emergency during the trip. A child with Type 1 diabetes should have a 504 Plan on file for the teachers and the school nurse to review prior to the trip. This plan falls under Section 504 of the Rehabilitation Act of 1973 and is part of the federal civil rights law that prohibits discrimination against public school students with disabilities. Calling the teacher in charge and the school nurse prior to the trip to review the 504 Plan can prevent any mishaps.
After your child has gone on a few field trips, you should have learned some lessons. Sit down together and make a list of what went well and what did not. It is important to ask your child specific questions about the experience. The more specific questions you ask about the field trips, the more confidence you can build in your child to have a successful sleepover. Examples of specific questions might be, “Did you get a chance to check your blood sugar during the trip? How often? Did the nurse check in on you to see if you were feeling OK?
Be sure to stay calm if your child reveals that his or her care during the trip didn’t go exactly as planned. Use that information to improve your plan for the next time. It would be wonderful to have the perfect experience of your child being away from home, but imperfect experiences in a supervised setting will help a child with Type 1 diabetes learn important self-care lessons without dire consequences. The lessons learned on each trip will help you prepare your child for the many different circumstances that he or she will face when away from home.
If you’re ready to say yes to a sleepover invitation, call the host’s parents to let them know that your child has Type 1 diabetes. Even if they are familiar with diabetes management, it is still important to review your child’s specific needs, which will give you the opportunity to assess their knowledge level. If they are not familiar with diabetes care, ask if they’re willing to learn and are comfortable having your child spend the night. If the host parents agree, make a date to teach them the basics of treatment: what they need to do, when they need to do it, meal guidelines, the warning signs if something’s wrong and what to do in an emergency. It is best to send written instructions, but keep the information simple.
A book recently published by Disney and Lilly Diabetes, Coco’s First Sleepover, tells the story of a young monkey with Type 1. Geared toward younger children, it features a helpful discussion guide for talking with your child about what to expect before his or her first sleepover. Your diabetes health-care provider may be able to provide you with a free copy. The biggest sleepover challenge your child with Type 1 diabetes may face is food. If you can find out beforehand from the host parents what they will be eating, you can help your child plan for how much to eat and how much insulin will be needed. Also, ask the host parents if they are open to you bringing food that your child can eat and share with the other children.
When it comes to overnights, preparation is the key to helping your child enjoy a fun time while managing diabetes. By working together as a family with field trip organizers and host parents, you are giving your child the freedom to just be a kid and make wonderful memories with friends. With a little planning, education, and the right expectations, sleepovers won’t be something you worry about, but something you and your child look forward to with enthusiasm.
Want to learn more about caring for a child with Type 1 diabetes? Read “The Type 1 Diabetes Diagnosis,” “Insulin Pump Therapy for Kids,” and “Writing a Section 504 Plan for Diabetes.”
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