How Can OTs Assist Families of Children with Special Needs Before and After Disasters?

By: Anna Cole McTish OTD, OTR/L

Pediatric SIS Chair

When asking about subject matter for upcoming articles during the UOTA conference, an interesting yet very important topic was brought to light. As OTs, how can we help families of special needs children in preparation for and with concerns after a disaster? In our current world and day in age, this topic is more important than ever before. Over the past few years, our country has experienced multiple natural and man-made disasters that have affected millions of people including children with special needs. This prompted me to complete some research on techniques/tools as well as resources that we can provide for our families prior to, during, and after a disaster.

Preparation is Key:

  • Encourage families of special needs children to make a plan in the event of a disaster. Depending on the skills, communication, and awareness of the child, plan a meeting spot for disasters. If not, discuss between the family members who will be responsible for making sure the child gets to the meeting spot. Two meeting spots are often appropriate (one right outside the home and one in your community, if by chance, the disaster occurs when no one is at home).
  • Discuss potential disasters with children prior to the occurrence of one. This is not intended to scare the child but provide information and knowledge. Discuss different terms such as “earthquake” and “aftershock”. Children might hear these terms on the news and from peers during and after a disaster.
  • Teach children, if able, how to call 911 in case of an emergency.
  • Create an emergency supply kit that includes the child’s favorite non-perishable food or a replacement for a blanket/binkie that might become lost. Also include a story or letter to read to the child as a reminder of the plan.

Things to keep in mind:

  • Children are in-tune with the reactions, emotions, and state of their caregivers. Even if parents have not verbally expressed their concerns, children pick up on these signals and might start to worry themselves.
  • Media is stressful for all of us, especially for children. This can be the case for children that are experiencing the disaster first hand or kids that are thousands of miles away from the disaster.
  • Children with special needs often have a difficult time with transitions and changes in routine. Changes in routine and transitions can occur frequently and quickly during and after a disaster. This might make it even more overwhelming for kiddos who have difficulty changing plans at the drop of a hat.
  • Children are resilient and are stronger than you think. Trust them with information but also remember that they are still kids!!
  • Separation anxiety can increase tenfold after a disaster.
  • Sometimes we focus so much on the child that we do not address the needs of the parent. Make sure that the parent is taking care of their own needs. It is difficult to take care of a child, if a parent is not taking care of themselves.

What can we do?

  • Prompt parents to have difficult conversations with their children about what they are seeing or what is happening during/after a disaster. Use simple terms that children can understand. Parents do not have to leave emotion out of their conversations. It is ok for children to know that others are saddened or hurt by the recent events.
  • Make sure a parent always makes their child feel safe. Proprioceptive input/deep pressure is a great way to provide this sensation. This can either come from the parent or an object (blanket, etc.). Continuous discussion/conversation is another way to provide security. A parent does not need to have all the answers; they just need to provide the security.
  • Physical activity is an important aspect of children’s play. Allow children to play actively and regularly to maintain sensory regulation.
  • Propose that parents share detailed information regarding next steps/moves with their children as soon as these details are relatively concrete. Updates are just as important for children as they are for adults. Keeping children in the loop of changes coming their way will help them prepare.
  • Relay the importance of keeping as much normalcy as possible. Sometimes allowing a child to go play, even in the midst of a disaster aftermath, is the best thing a parent can do for their child. Allow the child to be a child for a little while and then bring them back to reality (when the time is right) with the difficult discussions.
  • Encourage parents to ask their children what they are worried about, but keep in mind that parents do not need to overwhelm their children with questions (parents use their judgement to make sure their child is not overwhelmed).
  • It is OK for kids to miss things that are no longer there, let parents know that it is OK for their kids to grieve what they have lost and to talk about this loss. Parents can discuss their wishes as a way to help their child grieve: “I wish ___ was OK too.” OR “I wish I had my own bed to sleep in.” OR “I wish I could have ice cream for dessert.” This allows children to express their wants or fears in a safe way. It also allows parents a way to listen to their child without having to “fix” the problem.
  • Sometimes children recover best when they are helping. Propose that parents allow their children to help with everyday tasks in order to get back into a routine. If the child is older, the parents and children can come up with a volunteering plan or helping plan together.
  • Visual schedules can be used to assist with changes in routine and creating a new routine. Just as you would use a visual schedule in therapy for the day’s activities, let the parents use a visual schedule for their day at home.
  • Remind parents that they should let the child know when they are leaving and when they will return in order to decrease anxiety regarding separation from a parent. Have parents consider leaving a ‘special’ item for the child to hold onto for the parent (necklace, scarf, pillow, etc.).
  • Explain to the child that the disaster does not make sense to anyone involved. It is OK to feel confused and scared. Sometimes acting out or playing out the disaster is helpful. Recognizing rescue workers and heroes can help the situation and help a child process what occurred.
  • Talk about what a child has done in the past that helped them get through difficult situations. Can the child use these same strategies now?
  • Any personal items that can make the transition to a new home or place will be important for the child.

Helpful Preparation Documents:


Evans, C. (n.d.). Disaster Preparedness Tips for Special Needs. Retrieved January 25, 2018, from

Faustino, P., Dr., & Livanis, A., Dr. (n.d.). Helping a Child LIving with Autism to Deal with Disaster.

Retrieved January 25, 2018, from

Federal Emergency Management Agency’s Community, Family Preparedness Program, American

Red Cross Community Disaster Education. (n.d.). Ready…Set…Prepare. Retrieved January 25, 2018, from

National Association of School Psychologists. (2015). Helping children after a natural disaster: Information for families and educators [handout]. Bethesda, MD: Author.

Weider, S. (2017, September 11). Helping Children with ASD, SPD and other Special needs through

Natural Disasters. Retrieved January 25, 2018, from

Wells, C. (2011, March). Emergency Preparedness for Families of Children with Special Needs. Retrieved   

January 25, 2018, from


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