“When should a child self carry epinephrine?” I’m asked this question a lot. First of all, it’s a decision between you and your spouse, your child and your allergist or pediatrician. It’s important to remember that we need to meet our child where he/she is developmentally and from a maturity standpoint. School staff often say to me, “We have a kindergartener that is able to self carry epinephrine, why not this child?” Ok, that’s fine if that is what the parents, physician and child have decided. However, just as 504 accommodations are not cookie cutter, meaning what works for one child may not work for another child, either is self carrying epinephrine.
When your child is ready to take on a more active role in his/her food allergy management, consider reading these posts. From the American Academy of Allergy Asthma and Immunology: age appropriateness for self-administering epinephrine and when a child assumes responsibility for self-treatment of anaphylaxis.
I haven’t come across anything written on when to transition your child to self carry epinephrine and so I decided to share with you how I have started to navigate this path. Hopefully it will give you some ideas on how to handle your child’s growing independence.
When is my child ready to self carry epinephrine?
As with many food allergic children our son is an old soul who is mature beyond his years. We were able to explain complex information, at a very young age, and knew it was understood. As a result, he became well-organized in his daily routines and knows how to take care of himself and manage his food allergies.
Through the years, we noticed how outgoing our son is and his healthy interest in a variety of activities: student government, working at the school store, swimming, basketball, tennis, and recently he mentioned that he would like to join the after school chess club. When you consider some of these activities, and the fact that we have a second child, we knew eventually that we wouldn’t be able to attend, wouldn’t be permitted to attend or our son wouldn’t want us there, e.g. a four-hour tennis camp, a student council meeting, etc.
He also shared with us that there were times during the school day when he wanted to exchange his books at the library, but couldn’t because he wasn’t permitted to self carry his epinephrine. He is not only growing in size, but maturity and him starting to periodically self-carry is a natural progression; a logical next step in his growing independence.
When our son was in third grade he asked us to sign a permission slip so that he could run for student council. Once he was elected, it meant that new accommodations had to be written into his 504 Plan since this was the first time he was involved in an extracurricular activity. In addition, two council members work at the school store, without teacher supervision. Seeing our son’s world widening, and rightly so, encouraged us to have a discussion with him: “If you want to do these types of activities, then you need to take on more responsibility regarding your food allergies and self carry epinephrine.” He reassured us that he understood and was ready.
The next step was for us to speak with our allergist about the possibility of our son occasionally self carrying epinephrine, because it’s not just about what our son wants, or what we want as his parents or about what our allergist believes he’s ready for…it’s about what all of us think collectively.
It’s time to try it out!
Be sure to provide your child with a compact medication pack. There are many to choose from, our pack is insulated and from Allergy Apparel™. If you’re looking for other carrier options, check out this great entry from The Grateful Foodie.
Currently, we allow our son to self-carry when he has student council meetings, pre and post school council activities and when he works at the school store. Once he’s at a student council meeting or an activity, he is with two teachers that are familiar with his 504 Plan and know how to administer epinephrine. The mornings when he works at the school store, without immediate adult supervision but with adults close by, he understands that should he not feel well or if he is uncomfortable with a situation…he needs to leave and go to the school office for assistance.
When it comes to our son’s sporting activities, my husband or I are always with him. Even in this circumstance, we have him carry his medication pack in his sport bag. Once again, encouraging the habit that the pack is always with him.
Caregivers can help train your child to self carry epinephrine.
It’s also important to mention that our son’s teacher supports him in his growing independence. During the school day, when he leaves his home classroom to attend specialists (computer, art, music, physical education, Spanish) or go to lunch, etc., his teacher has our son grab his medication pack and bring it to him. Our teacher’s great idea allows our son to develop the habit of remembering his medication pack. This is an essential training element for him as he will begin to self carry epinephrine full time his 5th grade year (2016-2017 school year) and in preparation for entering middle school (2017-2018 school year).
Prepare your child for when forgetfulness happens.
Since our son is in fourth grade, we are on our second year of him periodically self carrying and we are pleased. We had one snafu in third grade when he forgot his medication pack on a student council meeting day, but he quickly and easily navigated how to fix the situation. He went to the school office and asked the administrative assistant if the health office was open for him to grab his medication pack; however, the health office wasn’t open at that hour. He then moved to his Plan B: Sought out his classroom teacher and took the classroom medication pack with him to student council. Plan B worked perfectly.
It’s all about little steps and a network of support when the time comes to self carry epinephrine.
My husband and I are very proud of how our son has adapted to his growing responsibilities. Keeping safe can be mentally all consuming as there is a lot to remember with his medication pack, in caring for himself and managing his food allergies at such a young age. With practice, diligence and a strong network of support, I am confident that he is set up for success and will undoubtedly flourish.