It’s Our Outdoor Play and Safety Issue!

School is over and summer vacation is upon us. Time for…indoor screen time? That doesn’t sound right. But for many children, sitting in front of screens will be their primary summer activity. Children should be active for at least an hour every day, but on average, children spend four to seven minutes daily in unstructured outdoor play, compared to seven or more hours in front of a screen. Like everything, there is a time and place when some screen time is not a bad thing.

But—it’s summer! Sunshine! Fresh air! Playgrounds! Beaches! There are many reasons children need to play outside including physical, social and emotional factors. It’s fun, it’s healthy and it’s important.

Below are some benefits children experience from playing outside:

Practice Emerging Skills
Outdoors is the best place for young children to practice and master developing physical skills. While outdoors, children can practice motor skills such as running, jumping and leaping. For children with special needs, outdoor play can improve flexibility, muscle strength and coordination. Children can perform manipulative skills such as pushing a swing, pulling a wagon and carrying moveable objects. Being outside also helps children to improve body awareness, balance and motor skills.

Health Benefits
Sun exposure helps our bodies produce vitamin D, which plays a critical role in body processes including bone development. Immune systems get a boost as well from time spent in sunshine. Playing outdoors helps children get exercise and burn calories, which may help counter risk factors for obesity, hypertension and arteriosclerosis (which can show as early as age 5). Outdoor light also stimulates the pineal gland, the part of the brain that regulates the ‘biological clock’ which is critical for the immune system.

Cognitive and Social/Emotional Development
Unstructured outdoor play is the best way children learn to take turns and share. As they invent and play games, they improve communication, cooperation and organizational skills. The best way for children to learn how to plan, troubleshoot and multitask is though playing with other children. When they make up their own games, figure things out and amuse themselves, these important life skills are learned and practiced. When outdoor play is used as a teaching skill, children with communication challenges, problems with social skills, and sensory issues can reap many benefits.

Physical Benefits
For children with special needs, outdoor play provides a boost in self-confidence. As they overcome obstacles and improve physical skills, their self-esteem increases as well. When they experience personal satisfaction and accomplishment, that increase in confidence carries over into other areas of their lives. Physical play also helps reduce stress, which contributes to depression and anxiety.

Social Benefits
Children need to learn how to work together. Children with special needs often have problems with social skills, but outdoor play provides some additional social benefits. Behavior may improve and make it easier for these children to build friendships. They learn how to share, how to deal with conflict and how to work in groups, all while having fun in an outdoor, low-stress environment.

Appreciation for Nature/Sensory Skills Development
Aesthetic Awareness refers to a heightened sensitivity to beauty in the world around us. Outdoors is full of beautiful sights, sounds, smells and textures, all to be experienced through all senses. Seeing animals and birds, hearing wind moving through leaves, smelling fragrant flowers and earth, touching grass and trees, and even tasting a raindrop all provide opportunities for children to appreciate the world around them. Playing on screens uses only two senses—hearing and sight—which can negatively affect children’s perceptual abilities.

While free play is important and beneficial, planning or creating specific activities has much value too. Here are some fun ideas for outdoor time:

 -Nature walk: ask children to tell you what they are seeing, smelling and hearing; touch a rock or a leaf

-Obstacle course: set one up in your yard using old tires, cardboard boxes and more

-“Listening” walk: walk with your children and point out as many sounds as you can; bring along a tape recorder (or record on your phone) so they can identify sounds at a later time

-Parachute or sheet time: bring a parachute or old sheet outside and play games with it (shaking it, circling with it, bouncing foam balls on it)

-Music: bring music outside and dance with your kids in a natural environment

-“Water painting”: have children paint the side of building or wood fence with a brush and a bucket of water; get exercise while teaching about wet and dry, light and dark and evaporation

-Bubbles: chasing bubbles gives kids another chance to run

-Outdoor sensory table: create a toy car wash

-Swings: many local parks have adaptive swings for children with special needs

-Chalk: for children who love to color, outdoor chalk is a fun way to color; large chalk is good for children who have difficulty grasping

-Biking: even if your child cannot ride a bike, a tandem bike or bike with car seat or trailer is a great way to experience the outdoors

-Sandbox: like a large sensory bin, in this you can make castles, mud pies and more

-Picnic: have your child help prepare and pack the food; spread a blanket in the backyard and have fun

-Quiet time: even reading a book or napping can be enjoyed outside

-Playgrounds: these are a great place for kids to work on balance, motor planning, confidence and social skills

-Water (rain) therapy: for a wonderful sensory integration experience, let your children play outside in the rain—in clothes or swimsuits, with or without an umbrella; give them buckets to collect water and brooms to slosh it up with


With lots of outdoor play ahead, it’s also important to be safe. We’ve incorporated our list of safety tips, which includes information on topics such as sunscreen, dry drowning and more. With a summer full of beach and pool visits as well as time spent on the playground in the heat, we’ve put together a list of summer safety tips to be sure you enjoy the season safely. These tips apply to both children and adults; no one can have a good time if they’re sunburned or injured.

1.Lather on the sunscreen
Sunscreen should be applied right after children are up and dressed. Since sunscreen takes at least 15 minutes to get absorbed and start protecting you, if you wait until your children (and you!) are already in the sun, you’re behind the eight ball. Remember to re-apply after swimming and throughout the day, even if it’s cloudy out. UV rays can penetrate through fog and haze. If your child is going to camp, be sure to pack extra sunscreen (spray sunscreen is easier for little hands to use) and show your child how to use it. And be sure to use enough. Most of us don’t; a good rule of thumb is we need about a shot-glass full to protect our whole body. Less is definitely not more here.

2.Drink that water!
The importance of drinking fluids (preferably water) cannot be overstated. During warm weather, and especially when we sweat, our bodies lose fluid rapidly. Children often can’t tell if they need water, and by the time they are thirsty they are likely already a bit dehydrated. Teach them the importance of drinking fluids and be sure they take adequate breaks during outdoor activities.

3.Watch for heat illness
When our body is exposed to more heat than it can handle, several heat related illnesses may occur. Heat exhaustion and heatstroke are two such illnesses, and both can be very dangerous especially in infants and young children. For heat-related illness, the best defense is prevention:

-Never leave infants, children or pets in a parked car—ever

-Dress infants and children in loose, lightweight, light-colored clothing

-Schedule outdoor activities carefully, for morning and evening hours (avoiding heat of day)

-Stay cool with cool showers or baths

-Seek medical attention immediately if someone you know has symptoms of heat illness

When we lose excessive amounts of salt and water and the result can be heat exhaustion. Symptoms include severe thirst, fatigue, headaches, nausea, vomiting and sometimes, diarrhea. Other symptoms include profuse sweating, clammy/pale skin, dizziness, rapid pulse and slightly elevated temperature. Anyone experiencing heat exhaustion should be moved to a shaded or air-conditioned area, given water or other cool (non-alcoholic) beverages, and apply wet towels or take a cool shower.

Heat exhaustion can turn into heatstroke if not treated. When our body is having difficulty sweating and our temperature rises quickly, you may experience heatstroke. This happens when our body cannot get rid of excess heat. Having very hot skin and being confused are two symptoms. Getting rid of excess body heat is critical. Call for emergency help immediately. The person should be moved into the shade into a half-sitting position. Spray the victim with water and fan them vigorously; if humidity is higher than 75%, apply ice to their neck, armpits or groin.

4.Be safe in the water
According to Injury Facts 2017 (, an average of nine people die from drowning in the U.S. every day. Drowning is a concern for young children, and teens and young adults too. Some basic water safety precautions for young children include:
-Never leave your child alone near water; if you must leave, take your child with you

-Find age-appropriate swim lessons for your child (remember that lessons do not make a child “drown-proof”)

-Always keep your eyes on your child; never rely on a lifeguard to watch your child

-Don’t let children play near pool drains and suction fittings; hair, fingers/toes, and swimsuits can get caught and become part of the suction

-Remember that even rivers and lakes have undertows

-Always keep a first aid kit handy

-Get trained in CPR

-If a child is missing, check the water first

5.Know about dry drowning/secondary drowning
Many parents think once their children are finished swimming and away from water they can relax. Not necessarily so. There is a term that should be in every parent’s vocabulary. The following are excerpts from an article from, by Dr. Kathleen Berchelmann explaining the term “dry drowning” and what you need to know:

“There is some debate about the definition of the term “dry drowning.” Usually this term refers to situations where some water got in a child’s lungs and the child has a severe inflammatory reaction to the water hours after the incident. This phenomenon is also called “secondary drowning” or “near drowning.” There is another phenomenon, also sometimes called “dry drowning” in which suffocation occurs but no water ever entered the lungs. In these rare situations the larynx (voice box) spasms and stays shut, causing involuntary suffocation. Sometimes this spasm is triggered by water droplets hitting the larynx, or a sudden high-speed submersion under water such as off a high-dive or a high-speed water slide. This latter form of dry drowning generally doesn’t occur when kids are simply swimming or playing in the pool.”

Symptoms and warning signs of “dry drowning”:

Coughing: Any person who has persistent coughing after playing in the water is at risk for water in their lungs. Don’t go to bed worrying; take your child in for a medical evaluation.

Water rescue: Any person who was submerged in water and came up struggling, especially if he/she had to be retrieved from the water, needs medical evaluation.

Amnesia: Any person who was unconscious underwater or has limited memory of an incident that occurred in water needs immediate medical care.

Behavior change: If your child feels sick, acts too sleepy, or has a change in mental behavior after a day at the pool, take it seriously. The worst thing that can be done with a child who may have inhaled water is to put them to bed. They need immediate medical care.

Vomiting: Vomiting after a day of swimming can be due to waterborne infectious disease but can also be a sign of severe illness due to dry drowning. This is a sign stress from the body due inflammation. While dry drowning is extremely rare, it is important to know the signs and get immediate medical attention if someone is not behaving normally after swimming.

6.Keep mosquitos and ticks away
Outside time is fun time—that is until the bugs start biting, or your find a tick on your child. Some easy precautions can keep you and your children safe this summer. Use a good bug repellant with one of these ingredients: DEET, Picaridin, IR 3535 or oil of lemon eucalyptus. Many pediatricians advise using products that contain less than 30% of these ingredients on children. Ticks can live in backyards, as well as deep in the woods; be mindful of where you set up patios and playground equipment. Keep these areas a distance away from shrubs and bushes and consider professional tick control applied by a pest control expert. After a day outside, make it a practice to check for ticks on children, adults and pets. If you find one, use a fine-tipped tweezer to remove it. Call your doctor with any questions.

7.Have fun but be safe
Playground-related mishaps are common causes of injuries and visits to the emergency room. To keep children safe while playing outside, take adequate precautions and always have adult supervision when young children are playing outside.

Ensure that surfaces under playground equipment are safe and well-maintained. Watch young children around stairs and playground equipment. Gates on stairs can prevent a young child from falling down the stairs. Be sure children wear protective equipment for the sport of their choice and watch for signs of a concussion (including can’t recall events before or after a hit/fall; appearing confused; moves awkwardly; demonstrates behavior changes; headache/head pressure; nausea/vomiting; dizziness; sensitive to noise or light; feeling sluggish; feeling ‘off’). Symptoms usually appear shortly after an injury but can also take hours or days to show up. Consult your child’s doctor if you suspect or have been advised that your child has a concussion.


We are all looking forward to a summer full of beautiful weather with lots of fun time spent outdoors. With a little planning and precaution, you and your children will be safe and have a wonderful time! Remember, if you have an emergency or any serious concerns, contact your child’s doctor immediately.

Note: The information in this article is for informational purposes only. It is not an attempt to diagnose or treat any medical condition. Always consult your child’s pediatrician with any specific medical questions. MKSA is also available to answer questions about child development. Contact us at 516-731-5588 or


What to Do if Your Child Bites

Parents of toddlers are often concerned about a common occurrence—biting. You are not alone! Most toddlers and preschoolers bite at one time or another, and it is a normal developmental occurrence. Children bite for a variety of reasons. Sometimes toddlers bite due to limited language skills or ways to express their feelings. Preschoolers may occasionally bite when they are so overly tired or frustrated and have lost control. The good new is there is much that parents and caregivers can do to reduce, and ultimately eliminate biting.

Why does my child bite?
It’s important to remember that while your child may bite, try not to label him/her as a “biter.” Labeling a child can often result in the child assuming the identity assigned to them, which would increase biting behavior.

Some reasons toddlers may bite include:
-they lack language skills necessary for expressing important needs or strong feelings such as happiness, anger or frustration. Without words to express feelings, biting can serve as a substitute (“I am very mad at you!”, “You are standing too close to me,” or “I am so excited!”)

-they are overtired

-they are teething

-they are overwhelmed by sounds, lights, or activity in a setting

-they need more active playtime

-they have a need for oral stimulation

-they are overwhelmed after intense play such as wrestling or tickling for an extended time

-they need more time to move from one activity to another

What are some solutions for biting?
Frustration/stress: watch for signs of increasing frustration; teach your child ways to show feelings appropriately and offer praise when he/she communicates appropriately

Teething: offer your child a teething biscuit, rubber teething ring or a partially frozen clean washcloth

Defense/Territorial: let your child know he/she is safe; ensure the area is not crowded, with plenty of space and toys

Attention-seeking: give your child attention when he/she is not biting, to make him/her less likely to bit for attention

Power/aggression: explain acceptable ways to interact with others; encourage positive behavior such as sharing and taking turns

How to discourage biting.
If you see your child on the verge of biting, there are strategies you can use to prevent biting:

  1. Distract your child with a book or toy. Shift your child’s attention to reduce the tension.
  2. Explain how your child can handle a situation that could lead to biting. You can say, “Johnny, it’s okay to tell Mary: ‘You are too close to me. I don’t like it when you touch my hair.’”
  3. Be sure there is ample space, equipment and toys to keep all children occupied and to minimize having to wait turns.
  4. Avoid overstimulation for a child who becomes easily frustrated. Keep groups small and make play periods shorter with less challenging activities.
  5. Teach cooperation throughout the day, demonstrating words and phrases children can use to express their desires and feelings. Praise cooperative behavior.
  6. Familiarize yourself with the child’s signals of rising frustration or anger.
  7. Teach children to share; this is a common trigger for biting. Use a kitchen timer to provide a visual reminder of how long they can play with a certain toy. In a classroom setting, be sure there is more than one of popular toys.
  8. Read books about biting. Ask your child how the characters might be feeling, and ask him/her what is happening in the pictures.

Some suggested books include:

-Teeth Are Not For Biting by Elizabeth Verdick

-No Biting by Karen Katz

-No Biting, Louise by Margie Palatini

What to do when your child bites
When a child bites, adults must intervene quickly, firmly and calmly. A child usually bites because he is out of control, which can be frightening to him. Parents and caregivers help a child the most by staying in control themselves. Reassure both the child who bit, as well as the victim. If possible, keep both children by your side as you inspect and wash the bitten area with warm, soapy water. By doing so, you demonstrate the consequences and seriousness of the behavior.

Young children may not understand that biting hurts. Make sure children understand that biting cannot be allowed and that you will stop it every time. A child who is out of control and frightened by his own behavior needs to know that adults will help take control until he/she is able to control himself.

In addition, many times when a child bites, adults pay much attention to him/her. Though it’s usually negative attention, it can still reinforce the behavior and cause it to continue rather than stop. When parents shift their attention to the child who was bitten, they communicate that biting will not result in more attention. Showing concern for the child who was bitten also teaches empathy.

When help is needed
Biting usually stops by age 3-1/2. If biting continues or increases in frequency, speak with your child’s pediatrician about the possibility of an assessment from a child development specialist.

We are available if you have any questions about your child’s development or behavior. We can be reached at 516-731-5588.


Some information shared courtesy of Children’s Home Society of California, and .

Safety and Injury Prevention for Children

As parents and caregivers, we always want to protect our children and ensure their safety. This means making sure indoor and outdoor environments are safe, and that we teach them how to protect themselves as well. This post, while not an inclusive list, covers several aspects of safety including household, outdoor, poison, fire and internet safety. If you have specific questions about your child’s safety, we recommend you first speak with your child’s pediatrician.

The first line of defense to keep your child safe begins in your home. Have you gotten down on the floor to take a look around, from a baby or child’s perspective? You’ll be surprised at what you see! Take a look at outlets, wires, tall bookcases, plants and more. If they are accessible, you’ll need to make adjustments so your baby cannot reach, pull or chew on any of these potential dangers.

Let’s go over some common danger areas in the home:

Windows: Window guards should be installed on all windows in your home. Be sure an adult can open them in case of fire. If a window is open more than four inches, a child can fall out. Screens offer protection from bugs, not from falling.

Blinds/Shades: There is a strangulation risk from corded blinds and shades! Ideally, install only cordless window treatments. Be sure to keep cribs, furniture and climbable surfaces away from any windows. Shorten pull cords to the shortest usable length. Tighten continuous-loop cords tight, and anchor with a tension device. Check manufacturer’s directions for more information.

Kitchen: Be sure to turn handles from pots and pans toward the back so they cannot be pulled off. Be sure to teach children that the stove and oven are not to be touched because they get very hot. Install a stove guard and knob covers. Knives must be kept out of reach of children. If you have a garbage disposal, warn children of its dangers.

Cabinets and drawers: Use safety latches so young children cannot open these. Even so, be sure to keep dangerous products (cleaning chemicals, medications) out of reach of children—safety latches are not guaranteed failsafes.

Electric appliances/wires: Cover any unused electrical outlets with safety covers. Be sure cords are out of reach; children can pull on cords, making objects fall, or children can trip over cords. Lamps pose an overlooked safety hazard as they can be pulled down. Try using Velcro or Command tape to secure lamps to tables. Watch for floor lamps that tip easily.

TVs: While many of us mount flat screen TVs on the wall, many are on top of stands or in wall units. Climbing or standing children can grab hold of the TV and pull it down, with the risk of it falling on them. Be sure your TV is secured to any stand or unit if it’s not mounted on a wall.

Bookcases: These look like large ladders to children, so be sure to install anchors for bookcases. These secure the unit to the wall behind it, preventing children from climbing or grabbing on and having the unit fall on them.

Plants: Be sure to purchase only nontoxic houseplants and keep out of reach of young ones.

Fireplace: For safety tips, visit Consider adding a padded bumper around the hearth, especially if it’s a raised ledge.

Batteries: Many toys and household items contain small round batteries, which pose a choking hazard to children. They can also leak chemicals and cause burns. Keep devices that use these small batteries out of reach of children, or place a piece of duct tape over the controller so children cannot access the battery. Store loose batteries locked away as well. If you suspect your child ingested a battery, contact the National Battery Ingestion Hotline at 202-625-3333.

Small items: Be extra careful about any small items throughout the house—pen caps, jewelry, magnets, soda bottle caps—and keep them out of reach of young children.

Heating: Cover or block access to radiators and heat vents. Do not use portable electric heaters near children.

Laundry room: Never let children handle single-use detergent packets; keep them in the original container unless actively placing one in the washing machine, seal the container after use, and store the container in a locked cabinet. Use child safety locks on front-loading washers and dryers to prevent your children from opening them or crawling in, especially during use.

Fire safety: Make sure there is a working smoke and CO alarm outside every bedroom, on every floor, and in the garage. Test the alarms and changes the batteries each time we change the clocks. Keep flashlight and fire extinguishers in your home and know how to operate them. Teach children never to play with candles, lighters or matches. Do not overload any outlet with too many plugs; never run cords under rugs or carpet. For more fire safety tips:

Poisons: Open windows for ventilation when using cleaning products. Never use barbeques or other outdoor equipment indoors for cooking or heat! These can cause carbon monoxide poisoning. Lock up medicines, cleaning solutions, cosmetics and soaps out of reach of children. Teach children never to eat, drink or open products if they don’t know what they are. Know the poison control hotline phone number: 800-222-1222.

Outdoor safety is important too! Keep these tips in mind as the weather changes and more time is spent outdoors:

Streets: Teach young children to hold an adult’s hand and look both ways—twice—before crossing a street. Tell them never to run into the street to chase a ball or toy. Train your children to watch for cars backing out of driveways. Teach your child to use hand signals when on a bike.

Safety gear: Children should always wear a helmet and elbow pads when riding bicycles. For rollerblading and skateboarding, they should wear helmets, knee and elbow pads and wrist guards. Street safety rules apply here as well.

Sun safety: Babies younger than six months should be kept out of direct sunlight, as their skin is too sensitive for sunscreen. Babies older than six months must have sunscreen applied 30 minutes before going outside. Reapply every 2 hours, or after sweating or swimming.

Water: Never leave infants and young children alone near any water. They can drown in less than 2 inches of water—bathtub, bucket of liquid, toilet. Teach children 4 and older to swim, and supervise them at all times. If you have a pool or hot tub, be sure there is a locked fence at least 4 feet high enclosing it. Pool and beach toys are not appropriate flotation devices. For more details about water safety, see our previous post:

Important car safety information:

Use seats that meet or exceed Federal Motor Vehicle Safety Standards. For more information visit: Always use safety seats, even for short rides. Before installing a car safety seat, read the seat instruction manual and your car owner’s manual. You can get installation help with a car seat inspection and register your seat for recall notices: If your child’s seat has been in an accident, replace it with a new one. For special needs children, contact your child’s pediatrician for help with finding an appropriate seat.


In addition to these tips, be sure to take classes in infant/child CPR and first aid, keep a first aid kit handy, and have important phone numbers nearby for caregivers (poison control, pediatrician, fire department). For a comprehensive safety checklist, It’s easy to have fun, but more important to be safe! If you have any questions, contact your child’s pediatrician. We are also available if you have any questions about your child’s development or behavior. We can be reached at 516-731-5588.

Some information shared courtesy of Children’s Home Society of California,