Tips for coping with hospitalization with Chloe Krikac

From pet therapy to Seacrest Studios, CHOC Children’s offers a host of amenities to help children cope with their hospitalization. The child life department plays a key role in normalizing the hospital environment by making things like medical equipment and procedures feel less strange.

In this CHOC Radio segment, Child Life Specialist Chloe Krikac shares a little about the support provided to patients and families, in addition to offering tips to parents. Bringing comfort items, such as a favorite pillowcase or stuffed animal, and family photos is one suggestion Chloe offers parents and caregivers to help children feel more “at home” in the hospital. Although developmental age and health condition impact what information is provided to a child, the approach is the same: making sure patients understand why they are in the hospital and how the doctors and nurses are going to help them get better.

For more tips, listen to episode number 31 of CHOC Radio.

CHOC Radio theme music by Pat Jacobs.

Related posts:

  • Preparing your child for surgery
    Surgery is scary for kids and parents, alike, but not talking about an upcoming surgical procedure can create more fear and anxiety in children. In episode number 29, Child Life ...
  • Music Therapy at CHOC Provides Healing, Positive Diversion
    It is a known fact that listening to music can soothe one’s soul, but studies have shown that music can also promote the physical healing process. Some of the benefits that ...

Physical Therapy Increases Independence in Kids

In honor of National Physical Therapy Month, we spoke to Lauren Bojorquez, PT, DPT, who has been a physical therapist at CHOC Children’s for six years. She works with children with neurodevelopmental diagnoses, as well as patients with orthopedic diagnoses, and has expanded her practice to include the post-concussive population, oncology population, aquatic therapy, and inpatient acute coverage. Lauren is mom to two young daughters and enjoys keeping active by competing in sprint triathlons.National Physical Therapy Month

Q: Why did you want to work at CHOC?

A: This is my dream job! I work here at CHOC Rehab because I have always felt like I was called to work with children in my career. I love helping kids get back to the highest level of function they possibly can in order to make them more independent and have a better quality of life, and I love the team we have here in Rehab!

Q: What made you want to become a physical therapist?

A: I had a teammate in softball that tore her ACL [anterior cruciate ligament, a common knee injury] in her senior year of high school while we were playing together.  She received physical therapy and returned to sport in time to get a full-ride scholarship to college. I thought it was awesome that she was able to get back to what she loved to do, so I decided that was wanted I wanted to do for my career, and never looked back.

Q: What part of being a physical therapist are you most passionate about?

A: I’m most passionate about working with the kids with an oncology diagnosis here. They amaze me every day how they can go through such hard times, but when you can find what they are motivated by, they make such quick and fantastic progress here at CHOC, and they are so happy when they find their way back to doing what they love to do.

Q: What is unique to being a physical therapist, as opposed to other specialties?

A: The time we get to spend with each patient and family as a PT here at CHOC is 45 minutes to an hour of one-on-one time, one to two times per week. I think that makes it a really special bond with each child, and therefore it is a great job to have.

Q: What else should people know about physical therapy at CHOC?

A: I think that one thing that people do not know about physical therapists is the knowledge base we have. It is now required to have your doctorate to be a physical therapist. Each one of my co-workers is so smart and digs so deep to ensure that we have a good base of knowledge in neurology, orthopedics, cardiopulmonary, and integumentary systems, so that we can give our kids here at CHOC the best treatment possible. We have an amazing team that truly gives their whole heart to CHOC Rehab, and I’m proud to be a part of it.

For more information on CHOC Children’s Rehabilitation Services,  click here.

Calories In, Calories Out? — May Not Always Be the Simple Equation to Weight Loss

By Jessica Brown, RD, CSP, CNSC, clinical dietitian at CHOC Children’s

The appreciation for bacteria living in our gut, and how it affects our health, is quickly gaining traction. Studies have shown that the 100 trillion microbes that live in and on the human body, called the microbiome, play an important role in overall health, including diabetes, celiac disease, allergy and autism.

Growing evidence over the past 10 years has even linked the gut microbiome to obesity. A study published in Science, a leading scientific journal, in 2013 contributed to this association. Researchers transplanted germ-free mice with fecal microbiota from obese and lean adult twins. They found that those mice transplanted with the obese gut microbiota had an increase in body mass and fat accumulation compared to those transplanted with lean gut microbes. One of the proposed theories is that obese microbiomes can harvest or release more energy from dietary components, such as non-digestible fiber, which contributes to weight gain. Further, this study showed that a lean gut microbiome can displace an obese one, preventing weight gain, if they consumed a healthy diet.

There are multiple influences to our microbiome at an early age, including what type of birth, (C-section versus natural birth), what type of feeding (formula versus breastmilk), and early exposure to antibiotics. Other influences include our environment and diet.

Eating a high-fiber diet, rich in fruits and vegetables and low in meats, refined carbohydrates, and artificial sweeteners has been shown to increase the beneficial bacteria in our gut.

Prebiotic foods such as asparagus, artichokes, garlic, leeks, onions, oats and lentils have been shown to keep our microbiome healthy. Fermented foods such as sauerkraut, kimchi and kefir are also beneficial.

A recent report published in the Diabetes and Metabolism Journal summarized multiple studies that demonstrate the potential benefits of probiotics – live bacteria and yeasts that are good for your digestive system — on the prevention and treatment of obesity and inflammation. It is important to realize that there are multiple strains of probiotics, and each strain has different effects. The effects of probiotics and obesity deserves further attention before specific recommendations can be made in the health care setting.

With the increasing prevalence in obesity, it is exciting that the manipulation of gut flora may be an integral part of weight loss and disease prevention in the future. So, it may not be just about how many calories you eat and how much you exercise that determines your weight, but what you eat and the health of your gut bacteria.

Learn more about CHOC Children’s Clinical Nutrition and Lactation Services.

Related posts:

  • Avoid Becoming Thank-“full” this Holiday
    By Sarah Kavlich, RD, CLEC, clinical dietitian at CHOC Children’s  Today, in many American households, the Thanksgiving celebration is centered on gratitude and sharing a bountiful meal with family and friends. ...
  • Back to School Nutrition
    By Janelle Sanchez, RD, CLEC, clinical dietitian at CHOC Children’s Nutrition can improve your child’s academic performance, as well as provide the energy needed for an entire school day. Check out ...
  • Quick Tips to Help Children Maintain a Healthy Weight
    In a recent report, the American Academy of Pediatrics (AAP) updated recommendations on childhood obesity prevention. Along with diet modifications and reducing screen time, the AAP encourages pediatricians to work ...

CHOC Patient Inspired to Become CHOC Doc

Vanessa Avina, with her father and Dr. Chang.
Vanessa Avina, center, with her father and Dr. Chang.

At 6 years old, Vanessa Avina was more interested in viewing the monitor for her echocardiography (heart ultrasound) than watching a cartoon during her doctor’s visits. Her CHOC pediatric cardiologist Dr. Anthony Chang recognized her curiosity and through the years nurtured her interest in the field of medicine. When Vanessa was 17, Dr. Chang encouraged her to participate in the hospital’s Sharon Disney Lund Medical Intelligence and Innovations Institute’s (MI3) internship program. Vanessa jumped at the chance and is now—two years later—majoring in pre-med biology at California State University, San Bernardino.

The MI3 internship program is designed to offer the brightest high school and college students in Southern California with meaningful experiences in medicine. Interns have the opportunity to shadow CHOC physicians as they conduct rounds in the hospital and see patients in the clinics. They research and present exciting topics related to the future of pediatric medicine, and attend special field trips, including this year meeting Dr. Eric Topol. A practicing cardiologist, professor of genomics and director of the Scripps Translational Science Institute in La Jolla, Dr. Topol is one of the top 10 most-cited researchers in medicine. His special interest is digital innovative technologies designed to reshape the future of medicine.

Vanessa particularly enjoyed meeting Dr. Topol and learning how he focuses on the most important development in health care today – putting the patients at the center of everything clinicians do. She’s quick to point out that her mentor, Dr. Chang, and the other CHOC physicians she has met share that viewpoint.

“It’s clear that CHOC physicians put patients and families first, and partner with them to advance treatment and care.   I experienced that as a patient and I have witnessed that time and again throughout my internship,” said Vanessa.

While Vanessa isn’t quite sure what field of medicine she wants to pursue, her experience with CHOC has solidified her interest in pediatrics. “I’ve learned so much from so many CHOC subspecialists.  They’ve truly sparked my interest in so many different specialties, from infectious diseases to oncology. They’ve especially inspired me to continue to realize my dream of practicing pediatric medicine, bringing hope to children and their families,” explained Vanessa.

A college sophomore, Vanessa knows she has a long road ahead of her, including medical school, residency and fellowship. But the 19-year-old, who will be the first in her family to graduate from college, is determined to become the kind of physician her mentor, Dr. Chang, would want her to be.

“Dr. Chang is an incredible doctor. He’s so smart and innovative. He also has an amazing bedside manner. He has been such an inspiration to me, motivating me to continue on with my dream of working at CHOC,” said Vanessa.

Related posts:


CHOC Walk in the Park: Justin’s Helpers

As it celebrates its 25th anniversary, CHOC “Walk in the Park” has raised more than $24 million to fund education, research and adoption and utilization of the latest technologies to advance the health and well-being of children. This year, 15,000 people will participate in the largest pediatric children’s walk in the country. Walkers participate to support a variety of causes and patients and many teams have a deeply personal reason for participating.

Tricia and Colby Helper’s son Justin was born with lissencephaly, a rare brain disorder that, for Justin, brings seizures, chronic lung disease, and gastrointestinal complications, and usually at least three stays per year at CHOC.

For the past eight years, Justin’s family has been by his side as he bravely fights this chronic illness. This will be the fourth year that their team, Justin’s Helpers, will participate in CHOC Walk to support Justin.

“We were just so thankful for the hard work CHOC has done to keep him stable and let him come home,” Tricia said about getting involved with CHOC Walk. “No one really wants to go to the hospital, but CHOC is a warm, positive and inviting environment. It’s our home away from home.”

Over the past three years, Justin’s Helpers, formerly Team Jussy Bear, has raised more than $16,000. The 2015 team is made up of more than 90 members. The team hosts a bunco game night fundraiser at Justin’s family’s home, in addition to partnering with local organizations that support Justin’s journey. Joining that support group this year are Justin’s sister’s Girl Scout Troop 11304, as well as St. Lucy’s Priory High School in Glendora, Calif., where Tricia attended and later was a counselor for 10 years, before leaving to care for Justin full-time. Justin and Tricia recently paid a visit to St. Lucy’s, where they educated students and staff on Justin’s condition, and shared stories on their involvement with CHOC Walk.

CHOC Walk: Justin's Helpers

The day of the Walk can be an emotional one for Justin’s family and friends, but they always aim to make it a fun and memorable day for their team as well.

“It takes you back and you really feel that community,” said Tricia. “It’s a community that feels the support and love from everyone around them. They’re there to support the child they’re walking for, and for the hospital as well. It’s a wonderful feeling”

For more information on CHOC “Walk in the Park,” click here.

CHOC Walk in the Park: Insider Tips for Event Day

The 25th annual CHOC “Walk in the Park” is around the corner. With 15,000 Walkers expected at this year’s Walk, here are some tips to help teams and individual walkers have a fun morning.

Parking & Meeting Up

  • The Mickey and Friends Parking Structure will open the morning of the Walk at 5 a.m. Parking is free for registered CHOC Walk participants, even if you will be staying at the Disneyland Resort for the entire day.
  • The tram does not run to and from the parking structure the morning of the Walk, so allow time to walk from the structure to Disneyland’s main entrance.
  • Talk to your team about a designated place where you will meet at the structure, in Downtown Disney or in the esplanade between Disneyland Park and Disney California Adventure Park.

Entering Disneyland

  • Because all participants will be arriving for the Walk at the same time, it is important to allow for extra time to get through the turnstiles and onto Main Street U.S.A. for the Walk’s opening ceremony at 6:15 a.m. You will want to budget even more time if you will be stopping in Downtown Disney for coffee or a snack.
  • Animals (except service dogs), roller skates, bicycles, scooters and skateboards are not allowed.

What to Bring

  • Because breakfast is limited in Downtown Disney before the Walk and food is not sold in the parks during the Walk, walkers should bring light snacks and drinks, especially for young children. Keep in mind that glass bottles and containers are not allowed, except for baby food jars and baby bottles.
  • Don’t forget your camera because there will be Disney magic, characters and surprises throughout the Walk. Selfie sticks are not allowed in Disneyland or Disney California Adventure.
  • Disneyland stroller and wheelchair rentals are not available the morning of the CHOC Walk, so be sure to bring what you will need with you.
  • Wagons are not allowed inside Disneyland or Disney California Adventure during regular park hours, but are allowed in the parks during the CHOC Walk. If you will be heading into the parks after the Walk, be sure to switch out your wagon for a stroller back at your car afterward.

CHOC Walk in the Park

Team Spirit

  • An exciting addition to this year’s CHOC Walk weekend is the Ambassador’s Luau on Saturday, Oct. 10 in the Grand Ballroom of the Disneyland Hotel. The Luau is a festive and exotic Polynesian-themed event perfect for team building the afternoon before the Walk. For more information and to purchase tickets, click here.
  • Have fun with your team! Don’t forget, you can dress in school colors, wear matching t-shirts to support your loved one, or make signs to thank your supporters and help your team stand out in the crowd.
  • After the Walk, head over to the team photo area at the Downtown Disney Stage and get a team picture with Choco and the 2015 Honda Miracle Odyssey.

Downtown Disney CHOC Walk Festival

  • The fun doesn’t end when you cross the finish line. The CHOC Walk Festival will feature tons of great giveaways from CHOC sponsors, a DJ spinning great music, and the chance to purchase the 25th anniversary CHOC Walk in the Park hoodie, shopping bag, CHOC Kids Cards, CHOC Walk commemorative lapel pins and lanyards.
  • Don’t miss the CHOC Walk Selfie Squad who will be out throughout the festival and team photo area with CHOC Walk selfie signs and a helping hand for those big group pictures
  • Special discounts are available at many Downtown Disney stores and restaurants after the Walk. For a full list of businesses opening early for breakfast and discounts available the day of the Walk, click here.

More Fun In the Parks

  • Present your CHOC “Walk In the Park” wristband at a Disneyland Resort ticket booth to purchase special CHOCtober Disneyland Resort tickets. Purchase a 1-Day 1-Park ticket for $51 or a 1-Day Park Hopper ticket for $81 to use for admission back into the park on the day of the CHOC Walk or for your next trip to the Disneyland® Park and Disney California Adventure Park. Tickets are valid from Oct. 11, 2015 through Nov. 6, 2015 and do not have block out dates. A maximum of 5 tickets may be purchased per wristband.

You can learn more about CHOC “Walk in the Park or register to participate by clicking here. For real-time event information follow CHOC Walk on Facebook, Instagram and Twitter. You can also follow along with the fun by tagging your CHOC Walk photos online with #CHOCWalk.

Related articles:

  • CHOC Walk in the Park: Justin’s Helpers
    As it celebrates its 25th anniversary, CHOC “Walk in the Park” has raised more than $24 million to fund education, research and adoption and utilization of the latest technologies to ...
  • Thank you CHOC Walk Participants!
    One of the most fun CHOC Children’s events is the CHOC Walk in the Park – and I want to thank the thousands of folks who have participated in this ...
  • Choco, A Treasured Part of CHOC’s History…and Disney’s?
    It’s CHOC Walk time again! And as we anxiously wait for Sunday’s festivities, we can’t help but reflect upon the long-standing relationship between CHOC Children’s and our CHOC Walk host ...

New Car Seat Laws: What It Means for Your Family

Echoing longtime recommendations from CHOC Children’s and the American Academy of Pediatrics, children in California will soon be required to ride in rear-facing car seats until age 2, under new state legislation.


Set to go into effect in 2017, children are required to rear-face until age 2. The new law does not apply to children who weigh more than 40 pounds or are 40 inches or taller.

CHOC community educators, however, continue to recommend best practice for children and rear-facing seats. They encourage parents to keep in mind the following tips:

• Facing the rear is the safest way for a child to ride.
• Keep toddlers in a rear-facing convertible car seat at least until age 2 or until they reach the maximum weight and height for their seat.
• The harness straps should be snug and placed at or below the shoulder level.
• Children have outgrown their rear-facing car seat when there is less than one inch of space between the top of their head and the top of the car seat.

Motor vehicle crashes are the leading cause of death for children ages 1 to 14 in the United States. According to a 2007 study in Injury Prevention, children younger than 2 are 75 percent less likely to die or be severely injured in a crash when they’re riding in rear-facing car seats. They are also a major cause of permanent brain damage, epilepsy and spinal cord injuries. Many of the deaths and injuries can be prevented with the proper use of child restraints and seat belts.

CHOC child passenger safety technicians are available to answer car seat questions regarding current laws, how to select an appropriate seat for your child, and what you need to know to install and use the child restraint correctly.

For more information on child passenger safety, visit CHOC’s community education page.

Time to Re-Think the “All-Nighter”

CHOC Children's Sleep Disorder CenterOne of the most important investments you can make in your teen’s academic success won’t cost a dime. A good night’s sleep is essential to concentration, learning, memory-retention and problem-solving skills.

Despite the best intentions, students who regularly burn the midnight oil are actually undermining themselves. That’s because the brain needs enough hours of quality sleep in order to perform the essential functions related to learning.

“Studies have shown that people who are sleep-deprived have poor memory retention, and this is essentially what students are doing when they stay up past midnight cramming for a test the next day” said Dr. Neal Nakra, medical director of the CHOC Children’s Sleep Disorder Center. “Deep sleep, particularly Stage III (slow-wave sleep), helps the brain solidify the learning that took place that day.”

The average high-school student needs between eight to 10 hours of sleep every night. That means lights out by 10:15 p.m. for the student who gets up around 6:45 a.m. That’s a minimum eight hours, plus the 30 minutes needed to actually fall asleep.

But it may feel as though there are not enough hours in the day for teens balancing demanding college prep courses with a full slate of after-school activities. Dr. Nakra said he often sees chronic sleep deprivation in teens, particularly in high-achieving students.

Another common cause of poor sleep quality is the use of electronic devices right before bedtime. The light from phones, tablets, computers and electronic games actually stimulates the part of the retina that increases wakefulness.

For a Better Night’s Sleep
Dr. Nakra said the following steps will allow for a good night’s sleep without the need for medication in the vast majority of students:
• Review your teen’s academic and extracurricular schedule — is it simply too much?
• Discuss the importance of healthy sleep with your teen, and support him or her in making the tough decisions about which activities may need to be dropped.
• Set a consistent bedtime schedule, with time to relax before turning out the light.
• Remove all electronic devices from the bedroom.
• Turn off all electronics an hour or two before bedtime.
• Keep the bedroom quiet and cool, not too warm or chilly.
• Avoid caffeine or heavy meals two to three hours before bedtime.
• Be sure your teen gets daily exercise.

Daytime sleepiness, concentration difficulties and dropping grades are clear signs a teen may need more sleep. Moodiness, irritability, depression and even weight gain could also be clues.

School-age children require between nine and 11 hours every night. Dr. Nakra added that in this age group, symptoms of hyperactivity may be related to inadequate sleep. Hyperactivity or excessive daytime sleepiness may also indicate poor sleep quality, especially if associated with other symptoms including loud snoring, mouth breathing, frequent night awakenings or bedwetting.

“These may be symptoms of sleep apnea, which is a treatable sleep disorder,” Dr. Nakra said. “Excessive daytime sleepiness also needs medical attention.”

The CHOC Sleep Disorder Center provides clinical care and testing, including sleep studies, for pediatric sleep problems. Services are available at both our Orange and Mission Viejo hospital campuses. For more information, please call 714-509-8651.

Learn more about CHOC’s Sleep Disorder Center:

National Prescription Drug Take Back Day is Sept. 26

With prescription and over-the-counter (OTC) medication abuse remaining one of the fastest growing problems among teens and young adults, it’s important to ensure unwanted, unused and expired medications are removed from homes.

From 10 a.m. to 2 p.m. on Sept. 26, Orange County residents can safely, easily and anonymously empty their medicine cabinets at locations throughout the region participating in National Prescription Drug Take Back Day, held in conjunction with local law enforcement and the Drug Enforcement Agency. See below for a list of drop-off sites in Orange County.

Drug safety is important to practice year-round. Here are some tips to help your family take charge of medications in your home:

  • If you have to do something else while taking medicine, such as answer the phone, take any young
    children with you.
  • Be aware of any legal or illegal drugs that guests may bring into your home. Ask guests to store drugs where children cannot find them. Children can easily get into pillboxes, purses, backpacks, or coat pockets.
  • Do not call medicine “candy.”
  • Talk to your teen about prescription and OTC drug abuse. Ensure your teen understands that buying
    or using prescription medication without a doctor’s order is dangerous and illegal.
  • Keep your family’s medications in a secure location and secure the cap completely after each use.
    Set clear rules about taking the correct dosage at the right time. Ask friends and family to keep
    their prescription and OTC medications in a safe place, too.
  • Explain the purpose of each prescribed or OTC medication, including possible side effects. Although
    you may not have prescription medications in your home, your child’s friend or family might. Stress
    that it is both illegal and extremely dangerous to share any kind of medications.
  • Get to know your teen’s friends and their parents. Ensure you are all on the same page when it
    comes to drugs, alcohol and medications.
  • Check with your child’s school. When teaching about substance abuse, does it include prescription
    and OTC medications?
  • Discard all old and unneeded medications properly. Mix medications with used coffee grounds, dirt
    or kitty litter; add hot water; and place in the garbage. Never flush them down a toilet.

To participate in National Prescription Drug Take Back Day, here’s a list of drop-off sites in Orange County:

San Juan Capistrano City Hall
32400 Paseo Adelanto, San Juan Capistrano, CA 92675

Placentia Police Department
401 E. Chapman Ave., Placentia, CA 92870

Villa Park City Hall parking lot
17855 Santiago Blvd., Villa Park, CA 92861

University Hills Community Center
1083 California Ave., Irvine, CA 92617

Costa Mesa Police Department front lobby
99 Fair Drive, Costa Mesa, CA 92627

Buena Park Police Department front lobby
6640 Beach Blvd., Buena Park, CA 90622

Brea Police Department front lobby
1 Civic Center Circle, Brea, CA 92821

Huntington Beach Police Department front desk
2000 Main St., Huntington Beach, CA 92648

Mission Viejo City Hall
200 Civic Center, Mission Viejo, CA 92692

Lake Forest City Hall
25550 Commerce Centre Drive, Lake Forest, CA 92630

Seal Beach Police Department
911 Seal Beach Blvd., Seal Beach, CA 90740

Kaiser Permanente Anaheim Medical Center, office building 1
3460 E. La Palma Ave., Anaheim, CA 92806

Tustin Police Department, front parking lot
300 Centennial Way, Tustin, CA 92780

Buena Park Police Department, Ehlers Event Center
8150 Knott Ave., Buena Park, CA 90620

Santa Ana Police Department, west-end office
3750 W. McFadden Ave., Suite 1, Santa Ana, CA 92704

Orange City Hall parking lot
360 E. Chapman Ave., Orange, CA 92866

Kaiser Permanente Hospital parking lot
6670 Alton Parkway, Irvine, CA 92618

Oasis Senior Center, overflow parking lot
801 Narcissus Ave., Corona del Mar, CA 92625

La Habra Police Department front lobby
150 N. Euclid St., La Habra, CA 90631

Orange County Sheriff’s Department, Yorba Linda service station
20994 Yorba Linda Blvd., Yorba Linda, CA 92887

Fountain Valley Police Department parking lot
10200 Slater Ave., Fountain Valley, CA 92708

Fullerton Police Department drive-through on Highland Avenue
237 W. Commonwealth Ave., Fullerton, CA 92832

Laguna Hills City Hall
24035 El Toro Road, Laguna Hills, CA 92653

Westminster Police Department parking lot
8200 Westminster Blvd., Westminster, CA 92683

Cypress Police Department front parking lot
5275 Orange Ave., Cypress, CA 90630

Garden Grove Police Department
11301 Acacia Parkway, Garden Grove, CA 92842

Car Seat Safety for Children with Special Needs

The AngelRide carries infants who must lie down.
The AngelRide carries infants who must lie down.
Choosing the right car seat and installing it correctly can be confusing enough, but imagine the challenges that mount for families of children with special needs.

Traditional store-bought car seats may not work for children with certain conditions, and parents often must turn to specialty options that can be expensive with limited options.

“A lot of the families of patients with special needs will begin to see that and feel so overwhelmed,” says Elizabeth Perez, a CHOC Children’s community educator.

Parents and guardians should never attempt makeshift accommodation for children with special needs. Instead, Perez and her colleagues in CHOC’s Community Education department can help families in these unique circumstances navigate the process to select and acquire a car seat that fits their needs.

“Once we get that call, we meet with the family,” Perez says. “They will bring their seats and their vehicle, and we work to see what kind of seat they’ll need.”

Community educators can also help the family, as well as their clinicians and social workers, write letters to their health insurance provider to seek assistance for the family in purchasing the special car seats or accessories, which can be very expensive, Perez says.

Many conditions might make choosing a car seat more complicated, and require parents to find specially made seats, she says.

For example, children with cerebral palsy may have low muscle tone and trunk control and will have limited and less affordable options once they reach the upper weight limits of standard car seats.

Children with respiratory problems other conditions that prevent them from sitting up can face challenges as well, Perez says. In these cases, families might rely on “car beds,” which allow passengers to securely lie down on their backs, stomach or sides.

Children with behavioral challenges, autism, attention deficit hyperactivity disorder or cognitive impairment may also need special restraints in the car if they cannot stay secured in a car seat and risk distracting the driver. In these cases, harness system or travel vests might be helpful.

Also, children missing limbs or those wearing spica casts that immobilize the lower body can need special accommodations.

Contact CHOC’s Community Education department at 714-509-8887 for more information about car seat safety for children.