Preventing Heat Stress

Heat stress is something all parents need to be concerned about during the summer months, but children with special needs can be extra susceptible to heat-related illness.

Children who are in poor physical condition or not acclimated to the heat can feel the effects of warmer weather quickly. All children are dependent upon their caregivers to supply liquids and prevent overheating, but impaired communication, decreased body awareness, intellectual challenges or behavioral issues can make some children with special needs particularly vulnerable.

Heat stress can occur with or without exertion on hot or humid days. It can start abruptly or develop over several days. Overheating and dehydration are the primary causes. Medical conditions and medications can interfere with the body’s ability to cool itself or to maintain a fluid/electrolyte balance. Preventing and treating heat stress can sometimes require medical supervision.

At Extra Risk
For Heat Stress

Medical conditions that effect the metabolism such as heart disease, heart defects or cystic fibrosis increase the risk of dehydration. Neurological conditions can interfere with appropriate sweating or the body’s ability to regulate temperature.

If your child was sick recently, it is possible that she might already have some dehydration from reduced appetite, fever or the effects of vomiting and diarrhea.

Children with diabetes can experience elevated blood sugar due to heat stress. Children with medical conditions such as anhidrosis (lack of ability to sweat) or hypohidrosis (reduced ability to sweat) can become severely overheated very quickly.

Compression garments can trap heat and interfere with sweat evaporation. Limit using a compression garment in hot weather and plan onremoving it regularly for cooling breaks. Combination compression/ weighted garments are available. Some parents replace the weights with freezer packs to create a cooling pressure garment.

Ask your pharmacist to review your child’s medications for heat stress risk factors. A medication can contribute to dehydration if it increasesmetabolism or urination, or if it decreases appetite, upsets the stomach, or has diarrhea as a side effect. A medication can contribute to overheating if it decreases sweating or increases metabolism. Chemotherapy and medication with a photosensitivity warning increase the risk of sunburn, which can lead to both overheating and dehydration.

Prevent Dehydration and Overheating

Dehydration is caused by a loss of fluids and essential minerals and salts (electrolytes). Even mild dehydration can interfere with the body’s ability to self-cool. Always have your child drink fluids before a long day outdoors. Replace fluids and electrolytes lost during the day and encourage your child to drink extra liquids once the activity is over.

Gradually introduce your child to the heat by going outside for short periods and increasing time and activity as tolerance grows. You should see your child produce more sweat sooner as he becomes acclimatized.

Once the relative humidity reaches 60 percent, sweat begins to stick to the skin instead of evaporating and a major part of the body’s cooling mechanism is lost. Ask summer program directors about situations that could be a potential threat to your child’s health, such as buses without air conditioning or the length of time spent outdoors.

Hydrate and Replace Electrolytes

Encourage your child to drink fluids before, during and after outdoor play regardless of activity level. Enforce frequent drink breaks, preferably in the shade. Sneak in fluids by offering foods that have a high liquid content like fresh fruit, popsicles, jello, yogurt and fruit sauces. Prepare low sugar frozen snacks to cool and rehydrate. Avoid caffeine and sugary drinks as they can increase urination and cause dehydration.

Urinating less often, dark or strong smelling urine or crying without tears are warning signs of dehydration.

Bananas, oranges, potatoes and green leafy vegetables are natural electrolyte-replacers. Salty foods replace lost sodium and can also encourage drinking. Do not use sports drinks intended for adults — they can cause diarrhea and dehydration.

Cool Off and Block Sun

Pack portable umbrellas and canopies so you have back up shade for long days out. Take longer meal and rest breaks in air conditioning if possible.

Even mildly sunburned skin cannot properly cool the body or maintain fluid balance. Apply sun block 30 minutes prior to going outside then reapply according to the label directions — even if it is an all day, waterproof formula. Limit outdoor activities between 10am and 4pm. If your child’s skin is pink and warm, and it doesn’t return to its normal color and temperature with rest and cooling, then he is sunburned. Outdoor exposure needs to end for the day.

Excerpted from Parenting with Special Needs, Reprinted with permission. ©Parenting Special Needs LLC,

Categories: Family Life, Special Needs Parenting