Outdoor Play and Sun Safety

Outdoor learning  is important for helping young children with and without disabilities to regulate attention (Szczytko et al., 2018) and improve learning engagement (Norwood et al., 2019) and contributes positively to foundational STEM skills such as spatial working memory (e.g. remembering the position of cards during a game of memory; Schutte et al., 2015). Yet, there may be hurdles to safe participation in outdoor learning for some children with disabilities, including sensory hypersensitivities which may cause difficulty with safety precautions such as sunscreen.

Sunscreen use is important: one in five U.S. citizens will be diagnosed with skin cancer in their lifetime (Guy et al., 2015). Although children are at low risk for developing skin cancer in childhood, sun safety behaviors in childhood can prevent the overexposure to UV rays which are responsible for skin cancers in later adulthood (Autier et al., 1994a,b). A childhood history of severe sunburn significantly raises one’s lifetime chance of developing skin cancer (Iannacone et al., 2012; US Department of Health & Human Services, 2014). Some children with disabilities may be particularly at risk for severe sunburn due to genetic skin conditions such as ichthyosis or Ehler-Danos syndrome, or due to developmental disabilities such as autism (Kanellis, 2020). Some children with autism and other developmental disabilities may display sensory hypersensitivity (Baranak et al., 2007) to”light ” tactile experiences like sunscreen application (Baranek & Berkson, 1994; Quinde-Zlibut et al., 2020). Sensory (e.g., autism) or physiological (e.g., icthyosis or similar dermatological disorders with acutely sensitive skin) difficulties associated with sunscreen application can make outdoor summer activity difficult for families. Following are several recommendations for supporting sun safety and helping children with disabilities benefit from outdoor play and to understand the scientific rationale for sun protection:

Universal:

• Limit outdoor time to morning and late afternoon hours outside peak sun exposure when possible.
• Reapply every 90-120 minutes- even”waterproof ” sunscreens need reapplication, and will need so even more frequently if you’re in the water (FDA, 2019)
• Seek the shade! Use a sun-tent or umbrella at the beach, and use playgrounds that have shady spaces under trees or sun sails.
• Don’t forget the hat! 13% of all skin cancers occur on the scalp. (Prodinger et al., 2018)

Individualized:

• Experiment with different textures of sunscreen- spray on, mineral/zinc stick, and lotions may be tolerated differently by children with different profiles of sensory sensitivity.
• Foreshadow how it will feel -“This may feel cold and sticky, but I’ll try to warm it up with my hands first! “. A fun song or video can familiarize your child. Familiar characters can help convey the idea: https://www.youtube.com/watch?v=z1eZpnH2sUU or https://pbskids.org/video/sid-science-kid/1568872756  or https://youtu.be/9CRH2oOuUD0?t=1001
• Apply lotion gradually €“ make it a game or solicit your child’s help to lotion different body parts. See who can do a leg the fastest!
• Consider a social story to help children who have sensory l hypersensitivity understand the need for sunscreen: https://www.skcin.org/downloads/georgeTheSunSafeSuperstar.pdf (Clifford, 2012)
• Schools and child care programs can consider using a free sun safety curriculum developed by researchers at the MD Anderson Cancer Center, the Sunbeatables: https://letsgo.catch.org/bundles/sun-safety (Tripp et al., 2009)
• For children who can’t tolerate sunscreen for physiological or sensory reasons, explore UV-protective clothing like rashguards, jammers, hooded sunshirts, and wetsuits.
• Use visual cues to help children apply sunscreen: https://starautismsupport.com/sites/default/files/FITS%20-%20Group%20-%20Life%20Skills%20-%20Sunscreen%20Application%20Practice.pdf

Most of all, have FUN! Outdoor learning supports children with disabilities to learn, participate with their peers, and benefit cognitively from STEM experiences that occur outdoors. Sun safety precautions can protect children from future risk of skin cancer while encouraging their present-day learning!