Alaska Center for Resource Families Web Based Course
Printable Version
Not all of the important links used in this course are able to be printed out in this printable copy. Therefore, you are advised to visit these links in addition to reading the material below to get the full content of the course. These links include some of the material used in the final questionnaire.
LINK #1: How To Fit A Bike Helmet (http://anchoragebikehelmets.org/_wsn/page4.html)
LINK #2: How To Wear A Helmet (http://www.howtoadvice.com/WearHelmets)
LINK #3: Strategies for Working with Individuals with FASD (http://stonesoupgroup.org/fas/strategies.html)
LINK #4: “Head Injuries” from Kids Health (http://www.kidshealth.org)
LINK #5: CONCLUSION of "FASD and the Use of Helmets" Course and Questionnaire
It’s summertime! Alaskan children are anxious to get outside, ride bikes, play soccer, skateboard, and play. With recent attention drawn to severe head injuries to children, there is increased support for the use of helmets for children in active play. In 2005, the Municipality of Anchorage, Alaska, made it mandatory that all children under 15 years old wear a helmet when riding a bike.
Every year about 800 people die in the U.S. from bicycle crashes. Most of them die from head injuries. Many survivors suffer brain damage, which can lead to learning disabilities or personality changes. Hospital emergency room studies show that a bicycle safety helmet can prevent such devastating injuries about 85 percent of the time. So you don’t want your child riding a bike without one, even on your block, the sidewalk or a bike trail.
Families caring for children with Fetal Alcohol Spectrum Disorders (FASD) face additional challenges when trying to help their kids learn to ride and stay safe on bicycles. In 2006, the Southcentral Foundation FAS Diagnostic Clinic wrote a unique pamphlet called FASD and the Use of Helmets. This pamphlet forms the basis of this web based course presented by the Alaska Center for Resource Families.
The pamphlet FASD and The Use of Helmets was written by Michael Baldwin and Kelly Adams and is funded with a grant from the State of Alaska Department of Health and Social Services, Division of Behavioral Health to the Southcentral Foundation FAS Diagnostic Clinic in Anchorage, Alaska. The text of the pamphlet is used here with the permission of the author and has not been altered except in formatting.. However, additional resources and exercises have been added to develop a more complete course for parents.
Fetal Alcohol Spectrum Disorders is an umbrella term used to describe the range of lifelong effects that can occur in an individual whose mother drank alcohol during pregnancy. An individual who is born with a Fetal Alcohol Spectrum Disorder has a damaged Central Nervous System that is often seen through problems with their cognitive functioning and/or motor skills. It is important to wear protective head gear during some recreational activities to protect against any further brain injury.
For many recreational activities, such as bike riding, skateboarding, ice skating, riding a 4-wheeler, etc., wearing a helmet can reduce the risk of a head injury and may even save someone’s life. During a fall or collision, the helmet absorbs most of the impact energy instead of the head and brain. When participating in these types of recreational activities it is extremely important for an individual with FASD, and all others, to protect their head and brain by wearing a helmet.
This is a review of some of the issues related to wearing a helmet that an individual with FASD may experience, and that a caregiver should consider. There are different helmets for different activities. While the issues may be similar for the different types of helmets, this paper will focus on issues that might arise with using bicycle helmets.
Taken From FASD 101: Disabilities of Discover: Insights into Brain Based Disorders Developed by the University of Alaska Anchorage, Family and Youth Services Training Academy in partnership with the State of Alaska, Department of Health and Social Services Office of FAS.
FASD stands for Fetal Alcohol Spectrum Disorders. FASD is an umbrella term that includes all the conditions related to prenatal alcohol exposure.
Fetal Alcohol Spectrum (FAS) is a medical diagnosis for a permanent condition caused by prenatal alcohol exposure that is characterized by four categories: a history of maternal drinking, growth deficiencies, signs of central nervous damage, and a special pattern of facial features. FAS is a condition included under the larger continuum of Fetal Alcohol Spectrum Disorders (FASD).
The disability for individuals with an FASD lies in how the brain was impacted by prenatal alcohol exposure. An individual who does not show any of the characteristic facial features can still experience serious brain disabilities. These brain differences are permanent. Individuals can grow and learn, but it is important to recognize that FASD results in a brain based disability.
Information processing deficits are a common manifestation of how the brain is impacted by prenatal alcohol exposure. These may include:
- Trouble with abstract reasoning
- Impaired ability to generalize
- Problems with judgment
- Over- or under- sensitivity to sensory information
- Difficulty with memory
- Speech and language impairment
- Difficulty with predicting
Because individuals with an FASD have difficulty with information processing, they are often more successful with modifications in the environment and modifications in expectations, more visual and physical cues, structure, and the availability of an “external brain” or person who helps them understand and negotiate the world around them. Each individual will be affected differently. Therefore it is important to use strategies specifically tailored for the individual and how he is uniquely impacted.
Some people who have an FASD may have smaller stature and/or a smaller head size. A proper helmet fit should be secured at the time/place of purchase.
Once the proper fit is obtained, it may require time to become accustomed to the actual fit and/or feel of the helmet. It is normal for there to be some adjustment time; however one should forget that he/she is wearing it most of the time. This is just like a seat belt or a good pair of shoes. Foam padding is usually provided to attempt to help with proper fitting. Also, helmets fit differently with certain hairstyles.
SENSORY ISSUES: Children with FASD may have problems with processing and understanding information from their senses (sight, hearing, smell, touch, taste). They could be over or under sensitive in one or more of these areas, which may cause problems for a youngster’s willingness to wear a helmet.
For instance, sunlight may sometimes be too bright for them and the helmet doesn’t offer much, if any shade. The feel/fit of the strap under the chin or the side straps may be irritating. Putting a helmet on a person’s head may produce some unpleasant sound from the helmet coming in contact with the hair/head.
Helmets may cause the head to sweat underneath them, even though the helmets are designed to allow for ventilation of the head area. This could cause the head to feel uncomfortable and hot. Sweating may also cause the helmet to slide around. Sun burn on the head could occur because of the ventilation holes (for those without hair).
MOTOR COORDINATION: Some children have problems with motor skills and functioning. Gross motor skills, the use of the large muscles of the body, are shown in balance, clumsiness and coordination.
Keep in mind that the helmet will make the head slightly heavier. This means that the person’s center of gravity may be a little off, causing him or her to have problems with balance. Watch out for falls because of top-heaviness.
Fine motor skills involve the muscle control required to make small, precise movements, such as fastening helmet straps. A person with fine motor skill problems might have problems fastening or unfastening straps, and may need help.
ATTENTION AND CONCENTRATION: Children with FASD often experience problems with attention and concentration. Teaching how to properly wear a helmet may take longer because of limited attention span and concentration. Poor attention and concentration may mean that care may not be taken with putting the helmet on correctly each time.
LEARNING DELAYS: Many children experience delays in their cognition, memory and learning. A bicycle helmet is different from a motorcycle helmet, which is different from a football helmet, which is different from a hockey helmet. There may be some resistance to the need for a change in head gear. So, there may be some difficulty remembering or understanding the need to wear different helmets for different activities. The child may not understand why a helmet is needed at all.
Memory may be poor – they may forget to wear it, or how to put it on, or where they left it last. It may take a longer period of time for your words to make sense to the person. There may be difficulty with following multi-step directions. Poor planning and organizational skills may mean not having the helmet when needed.
There may be difficulty understanding cause and effect and the use of poor judgment may cause them to choose not to wear a helmet. It may be very hard to apply knowledge to new situations (generalize), which may lead to not wearing a helmet, or the right helmet, at the right time.
A helmet protects your brain when you fall. It has a plastic shell on the outside and foam inside. It has a strap to keep it on when you fly through the air. It only covers your head, and the rest of your body is still exposed. So you still have to be careful. It is better not to crash at all, then to crash wearing a helmet. But if you do crash, a helmet works to absorb the force, which protects your head, which in turn protects your brain. Helmets work to prevent head injuries which becomes even more important for children whose brains are still developing.
The foam crushes when you hit the road. That cushions the blow, and usually saves your brain. The shell makes it skid on the street so your neck does not get jerked. The shell also keeps the foam in one piece. If the strap is not right, your helmet can slip to the side or to the back.
Find a helmet that fits you. That's really the most important part. That will keep it on your head while you fly through the air or over the handlebars. Work on the straps to get the fit just right. You will probably need somebody to help you do that.
You don't have to pay a lot for a good helmet. But be sure it fits you, you like it and you will wear it. Your helmet is good for only one bad crash. That damages the foam and you have to replace it.
1. Which Alaska community has a mandatory helmet law?
a) Kenai
b) Anchorage
c) Wasilla
d) Fairbanks
2. The ______ makes the helmet skid on the street so your neck does not get jerked.
a) Foam
b) Shell
c) Straps
d) Plastic
3. Some people who have an FASD may have __________ stature and/or a _____ head size
a) Smaller
b) Larger
c) Misshapen
d) Oval
4. When fitting your helmet, your helmet should:
Have loose fitting straps
Lean forward to keep the sun out of your eyes
Sit level on your head.
Move slightly from side to side
5. It is important for a child with an FASD to wear protective head gear during some recreational activities to protect against any ___________ .
Interference with motor coordination
Head or brain injury
Fines from the police
Sensory overload
6. Keep in mind that the helmet will make the head slightly __________________ causing the center of gravity to be off possibly causing problems with balance.
Lighter
Heavier
Sweaty
Tilted
A child with a FASD should always wear a helmet when riding a bicycle. There is no way to get around that. Given the range of possible issues, it may take some creative problem solving to protect your child. A list of possible strategies for caregivers is provided below.
OTHER IDEAS:
Let kids help choose the helmet in a bright color or let them decorate it with stickers or paint. This may help them to like the helmet more and make it "cooler to wear."Children whose parents wear a helmet when they ride are much more likely to put on their own helmet, even when parents aren't around.
Put a checklist or a picture board near the bicycles and teach children to use it every time they go for a ride..
Make up a simple song or a rhyme to help children remember what to do when going for a ride. It can be something simple like: "Face It Forward, Lay It Flat, Buckle Up and Give It a Slap." Teach children what each part means. Face It Forward means make sure it is facing the right way. Lay It Flat means place the helmet level to your head, not leaning back or too far forward. Buckle Up means get the straps right and tight around your chin. Give it a Slap means make sure the helmet does not move from side to side. If you open up your mouth to yawn, you should feel the helmet pull down on your head.
Stone Soup Group in Alaska has an excellent listing of strategies to consider using with individuals with an FASD. Look through this listing to see what you might be able to use with your child. LINK #3 is Strategies for Working with Individuals with FASD . (http://stonesoupgroup.org/fas/strategies.html)
One mother of children with special needs writes her suggestions of teaching children about bike safety and bike helmets.
In our family, we talk about what the bike helmet is for because many of my kids have no use for them due to the sensory issues. We talk about how a helmet protects their brain when they fall. The foam crushes when you hit the road and it will cushion the blow, and usually will save your brain. The shell of the helmet will make you skid on the street so your neck does not get jerked. If the strap is not on right it can slip to the side or back and then your head can hit the road and the pavement is very hard.
One of the other things we have done is to cut out pictures and glue them on a poster board by the different reasons for wearing a helmet. A picture of the helmet and a picture of the brain, a picture of the cushion part of the helmet, a picture of just the shell. We had a child have an accident, and we had pieces of the helmet. So we decided to make a poster, and included a picture of one of our own children having the straps fastened on their helmet.
But bike safety is more than just wearing a helmet. The way we teach things like obeying stop signs is to be a good role model. We ride with our children, and when we do something, like stop at a stop sign, we let them know why we stopped. When we check behind before turning or moving over, we always say what we are doing.
We also have rules like “never ride in the middle of the street.” Under 12 years of age, our children don’t even ride a city block by themselves. They always ride with a partner. If they are under 10, they ride with an adult or one of the teenagers who have proven they follow good bike safety. We talk to the kids about how riding on the street can be very dangerous, and that the danger may not always be about how you ride, but possibly from the driver of the car. A driver talking on a cell phone may not see you and their reaction time is slower.
To review, think of your own child or a child you know. Fill out the Individualized Assessment Form by clicking on the button below. Answer the questions on the form to develop an strategy specific to a child you are working with. You can either print out the page and fill in by pen or type in your responses and print for future reference. (This form is your own personal review. It will not be submitted for review.)
Name of Child:
Is your child affected or challenged in any of the following sensory areas? How does this affect his or her ease in wearing a helmet or learning to ride a bike?__ Hearing or Sounds
__ Sight
__ Touch or Feel
__ Taste
__ Smell
How might this affect your child in learning bicycle or helmet safety? (Type In Below)
Can you think of a way to help lessen the sensory effects if your child is overly sensitive in an area or help him be more aware if he is under-sensitive in an area?
Is your child challenged in any of the following areas?
__ Fine Motor Coordination Problems
__ Small Motor Coordination Problems
__ Attention Difficulties
__ Trouble with Concentrating or Focusing
__ Learning or Memory Problems
__ Oppositional Behavior
What suggestions or strategies offered in this self study course might help me with some of these challenges? Can I develop some visuals or chants or learning aids that will help my child learn better? Is there some kind of routine I can start using with him? Write out three (3) strategies that you have learned in this chapter that might work with your own child.
1.
2.
3.
These suggestions for more resources about helmets come from the Pamphlet "FASD and the Use of Helmets":
Local Fire Departments – some fire stations or departments may have programs to give away free bicycle helmets to children. Contact your local department for more information.
The U.S. Consumer Product Safety Commission has a brochure entitled, “Which Helmet for Which Activity?” This brochure can be obtained from the website www.cpsc.gov. Look under publications and click on Recreational and Sports Safety. Or call (800) 638-2772 to request a copy.
The city of Anchorage has a bicycle helmet ordinance. This website, http://www.anchoragebikehelmets.org, tells more about the ordinance, helmet distribution sites, bike safety and proper helmet fit. Check with your local government for specific information to your area.
http://www.helmets.org/index.htm#helmets is a very helpful site in answering questions regarding bike helmets and is maintained by the Bicycle Helmet Safety Institute.
FROM THE BICYCLE HELMET SAFETY INSTITUTE Excerpted from www. helmet.org
Safety is more than wearing a helmet. The Bicycle Helmet Safety Institute also advises parents to teach their children the top four rules of the road.
Rule 1: Never ride out into a street without stopping first. Nearly one third of crashes involving cars and young cyclists occur when children ride down a driveway or from a sidewalk into the street and in front of a car. Kids must learn to stop, look left, look right, look left again and listen to be sure no cars are coming before entering a street. Look left that second time because cars coming from the left are on the child’s side of the street and are closer. Use your driveway or sidewalk to demonstrate this. Have your child practice the entry, looking left, right and left again. Make sure that they never assume that drivers see them just because your child sees the driver.
Rule 2: Obey stop signs. Nearly one third of crashes involving cars and young cyclists happen when children ride through stop signs or red lights, into crossing traffic. Kids must learn to stop, look left, look right, and look left again at all stop signs, stop lights and intersections before crossing. Make sure they know the basics about stop signs and stop lights, and they always ride on the right side of the road, with same-going traffic. Then take your child to a controlled intersection and practice crossing safely. Explain that when riding in a group, each bicyclist must stop and make sure it is clear before crossing. Teach young children to walk their bikes through busy intersections. Remind them to obey traffic signals even if no one appears to be coming. While you are at it, explain one-way streets to them too.
Rule 3: Children should check over their shoulder before swerving, turning or changing lanes. Nearly one third of car-bike crashes involving children occur when a child turns suddenly into the path of a car. Kids need to learn to look behind them before swerving, turning or changing lanes. The best place to practice this is in a quiet parking lot or playground. Stand behind them while they ride along a straight painted line. The Bicycle Helmet Safety Institute recommends parents hold up numbered cards and have their children practice looking back over their shoulder and calling out the number on the card without swerving off the painted line. Children should not ride their bikes on the street alone until they can master this skill. If they can handle it, teach them signaling too, but signaling is too complicated a skill for younger kids.
Rule 4: Never follow another rider without applying the rules. Many fatalities occur when one rider blindly follows another. Running stop signs or red lights, riding out of driveways or zipping across lanes all seem natural to the second child in line because they are more focused on following the first rider than on the traffic or the rules. This will not be an easy lesson to absorb!
How Children See Traffic: (http://www.helmets.org/children.htm) Helping Children Be Better Pedestrians and Bicyclists This site from Helmets.org in Madison, Wisconsin, is a thorough article on how children see the world and offers ten suggestions for helping children to learn to be safe cyclists.
The Twelve Hazards Activity Page (Open in PDF or open in Microsoft Word. Transportation Alternatives from New York City has put together information about teaching children to ride bikes safely including this printable color page.
This course focused on the special challenges of teaching helmet use and bike safety specifically with children who have been prenatally exposed to alcohol. We hope you learned some practical ideas of working with your children and learned to appreciate the importance of "Keeping Your Helmet On!" For more references and resources, please go to the Bibliography Page.
We thank the Southcentral Foundation FAS Diagnostic Clinic in Anchorage, Alaska for their permission to use the publication FASD and the Use of Helmets as the basis of this course.
For Alaskan resource families only: If you wish to earn 2.0 Training Hours Credit for completing this course, you must complete the "Check Your Understanding" Questionnaire at the end of the course. The questionnaire must be done on line and either printed out and mailed back or completed and clicking Submit at the end of the course. You can go to the last page of the course by going to CONCLUSION and reading the instructions for completing the questionnaire.