Healthy Advice for Parents Choosing Summer Camps Now

As this winter's deep freeze continues to chill much of the country, the warm breezes of summer may seem a long way off. But thoughts of summer are filling the minds of millions of parents of school-age children right now, as they face looming January and February deadlines to sign their kids up for summer camp. More than 10 million American children attend camp each year.

As parents ponder the glossy brochures and surf the web sites of soccer camps, music camps, computer camps and traditional all-around camps, a University of Michigan Health System expert advises them to keep their children's health in mind.

No matter what kind of camp a child might attend, parents should ask camp organizers the same basic questions about how they keep kids safe, handle medical emergencies, and deal with routine health needs, says Edward Walton, M.D., a UMHS pediatric emergency medicine specialist who studies camp health issues.

And if a child has special health needs -- from allergies and asthma to more serious conditions -- or if the camp will be physically demanding, parents should make sure they understand the camp's ability to handle preventive and emergency care.

"Camp is a great experience for kids, and helps them grow and develop emotionally and socially," says Walton, whose own children just signed up for the same camps he and his sister attended when they were young. "But when choosing a camp, parents need to make sure they're comfortable entrusting organizers with their child's health. Asking a few questions now can help you have peace of mind this summer."

Walton recently presented findings from a U-M study of camp health in Michigan at the American College of Emergency Physicians annual meeting, evaluating the medical training of camp health officers and the availability and use of medical support near the camp. He notes that Michigan is one of the nation's more proactive states for summer camp health, with state laws requiring annual licensing, a dedicated camp health officer, and first-aid training for many camp staff.

Even so, Walton and his colleagues found that out of 129 Michigan camps, half had a camp health officer with paramedic training or less. A roughly equal number had registered nurses on staff.

Two-thirds of camps surveyed reported that ambulances responding to an emergency at their facility would go to a small or rural hospital, and more than a third said it would take an ambulance 10 or more minutes to get to their camp.

"There's a lot of variation, so parents should be sure to ask questions," Walton says.

He also advises that parents check whether a camp they're considering is accredited with the American Camping Association, which has even more stringent health requirements than state laws. Walton, a clinical assistant professor in the U-M Medical School's Department of Emergency Medicine, is also a member and educator with the ACA.

As parents consider their children's options, Walton offers the following list of questions to ask.

What's the camp's philosophy?

Is it a general camp or a specialized one? How much physical activity do campers have, and what's the potential for injury during those activities? If it's a sports camp, are trainers and coaches prepared to handle sprains, strains, heat stroke and other emergencies?

Who supervises the children? What's their age, experience, and first-aid training?

Inexperienced or young counselors may not be able to respond as well in an emergency as more experienced or trained ones. And instructors in especially risky activities -- such as horseback riding, swimming, water sports and adventure hiking -- should have more training in safety measures and first aid. Walton notes that the majority of the small number of deaths that occur each year at American camps are caused by drowning. Parents should also ask about whether the camp conducts background checks on counselors and other staff.

What kind of medical staff works at the camp? What are the medical facilities nearby?

Ask if the camp you're considering has a nurse or person with emergency medical training on site at all times, and how quickly they are available in emergencies, Walton advises. Also, ask about the nearest hospital and urgent care clinic, and the local ambulance service.

What's the supervision for trips away from camp?

Field trips are often an exciting change of pace for campers, but parents should ask about the ratio of chaperones to campers, and the requirements for drivers of vehicles campers ride in.

How are campers' medications and special dietary needs handled?

More children than ever use prescription medications for asthma, behavior and mental health disorders, allergies, diabetes and other conditions. Awareness of food allergies and dietary restrictions is also rising. Parents should check on how camps store and dispense daily medications, whether they allow asthma inhalers and "epi pens" to be kept in cabins for asthma attacks and allergic reactions, and whether they can tailor meals to meet special diet needs. Walton also cautions parents not to see summer camp as a time for their child to take a "medication holiday" and halt their use of behavioral drugs like Ritalin. The new experiences and social situations of camp don't mix well with a sudden change in medication.

Do I need to buy extra health insurance? Will my insurance cover local medical care?

Many camps require parents to buy additional insurance coverage for their children, or to provide proof that the child is covered by an existing policy. And, many HMOs and other insurance plans require special permission or immediate notification for medical care delivered in areas outside a local "network" of doctors and hospitals, even for emergencies. Walton advises parents to check with both the camp and their own insurance company.

If my child has a chronic condition, is the camp prepared to handle it?

Many parents of children with diabetes, asthma, epilepsy, and other chronic conditions know that medicine and special precautions make it possible for their child to have a normal life most of the year. But camp can present special challenges, especially if a child needs routine medicines or foods, or might suffer an emergency that camp counselors don't know how to handle. Parents should be realistic about their child's health and choose a camp that can handle day-to-day issues such as insulin shots, and crises such as seizures.

What's the camp's policy about phone calls, and homesickness?

Psychological well-being is just as important as physical health, Walton notes, and he urges parents to find out whether their child will be allowed to call home if he or she is feeling homesick. But parents should resist the temptation to retrieve a homesick child from camp immediately, he adds; they should talk with counselors first and see if they can address the issue. And, they should avoid sending mixed messages by saying, "I wish you were home."

A lot can be done to address homesickness before camp even begins -- starting with a realistic assessment of whether a child is ready to go to a sleep-away camp. Young children should try sleepovers with friends or relatives before being signed up for camp. If they do plan to go to camp, parents should talk frankly with them in the weeks before they leave about how it's all right to miss home, while emphasizing the fun and new experiences camp will bring.

Walton also recommends that parents read "The Summer Camp Handbook" by psychologists Christopher Thurber, Ph.D., and Jon Malinowski, Ph.D. for more information on the psychological aspects of sending a child to camp. Coincidentally, both authors are friends of his from when all three attended summer camp together.