With heightened security regulations and frequent delays, airplane travel can be an unpleasant ordeal for anyone.
For a child who becomes anxious in close quarters, may have trouble communicating and is sensitive to loud noises, it can be terrifying.
Those are common characteristics of autism, a developmental disability that affects about one in every 150 American children and one in every 94 boys, according to data from the Centers for Disease Control and Prevention.
The condition has been getting more attention in the past five years through advocacy groups such as Autism Speaks and the Autism Society of America. But it still gets negative attention: Last week, syndicated talk radio host Michael Savage said on his show that 99 percent of the time, a child with autism was just "a brat who hasn't been told to cut the act out." The comment drew protests from the advocacy groups.
His comments probably refer to the behavior autistic children can exhibit when they feel anxious, particularly in unfamiliar situations -- they can have meltdowns that involve crying, screaming or kicking. Last month, Janice Farrell of Cary, N.C., and her 2-year-old autistic son, Jarret, were removed from their American Eagle flight after Jarret began crying and screaming uncontrollably. (The airline says Farrell also refused to stow her bag in the proper place, which she denies.)
Airline travel, which is a necessity for many families, has many characteristics that can trigger such meltdowns. In addition to the break in the normal routine -- which many autistic children find stressful because they have trouble anticipating what will happen -- airplane travel involves sitting still for long periods and being surrounded by crowds, says Rebecca Landa, director of the Center for Autism at the Kennedy Krieger Institute in Baltimore.
"Take all the issues (normal adults) have with flying, magnify that by 100, and put that into a child's body," Landa says.
James Gillespie of Philadelphia, whose 14-year-old son, Brendan, has autism, says: "You will run into any number of well-intentioned people who just look at you as if you're a bad parent. There was a time that I was pretty defensive about it."
Both Landa and Kelly Ernsperger, who counsels families in the greater Indianapolis area who are coping with autism, recommend preparing children in the days leading up to the trip by making sure they know exactly what to expect.
"I encourage families to go online and try to get pictures of the airport terminals and planes and destination," Ernsperger says. These pictures, along with conversations about what the child will be doing, help families create "social stories" so children are better able to anticipate exactly what will happen to them.
Landa also recommends letting the child make some choices -- such as choosing his seat -- to defray some of the anxiety and creating simple rules to define the social situation. Gillespie made such a rule for Brendan to let him know what topics were off-limits on airplanes: terrorists, crashing and dying.
He and other parents say snacks and earphones for a child's favorite music or movies are also a must.
It's important to let the airlines know about the situation so they can accommodate the family as well. Many airlines have taken steps to make sure that flight attendants and airport employees are trained to assist customers with disabilities.
"A lot of it is just being forthright and making sure you prepare your child, and you prepare those people who are going to come in contact with your child," says Peter Bell, executive vice president for Autism Speaks.
The public can help too, Landa says. Her No. 1 rule: Don't judge.
"It's best to think, 'How can I be helpful?' " she says, whether that is refraining from making a critical remark or offering to hold something for the family.