Living Abroad with Special Needs: An Expat Mom's Perspective

I am a single expat mom with 4 children.  Two of them, my twins, have special needs: Asthma, ADHD and Autism.  I’d like to share my experience as a parent living abroad and raising kids with special needs.

I am a proactive mom when it comes to my child’s health.  The moment a doctor tells me something is wrong, or gives me specific instructions to improve something about their health, I have always successfully jumped into action to “fix” it, even if I needed to proactively fine the answers on my own.

Initially, my heart broke when I first realized these particular needs, asthma, ADHD, and autism,  weren’t “fixable” and our lives would forever be changed.  I am embarrassed to tell you how much I spent worried and thinking it would all just go away.  One of my first worries as an expat was deciding if we should  continue to live abroad, or move back to the USA, our home country, for special services.  

That was almost 9 years ago now, and we are a strong and happy family.  We are still living abroad.  How have I emerged as the expat mom I am now, thriving abroad with my kids?  What adjustments did I have to make being abroad?  Today, I want to share 6 areas I focused on when making my decision to continue abroad.

There was a time, when my daughter was very young, I wondered why she was so quiet outside of the house, why she reacted outrageously at times, why she didn’t play with others like her brothers did.  I didn’t really believe anything was wrong.  Just some little idiosyncrasies here and there.  Nothing majorly alarming.  Others made mention of how shy she was, or that she liked to read alone for hours at a time, at such a young age…how sweet and quiet she was…how amazing!   In fact, there was a time I didn’t believe anything could be wrong.  I felt annoyed by some of their intrusive comments and angry that children and teachers were beginning to treat her differently.

I was an expat teacher in Saudi Arabia when my daughter's preschool teacher began to make observations and comments around my daughter not participating in circle time.  She was exhibiting behaviors that were different from the other children.  The teacher was fantastic.  Patient and kind, we  spent time trying to find out what was going on. We worked on strategies for her to help her adjust and participate in circle time or play with other kids.  Teachers and specialists started to discuss her in school teacher meetings.   Lots of data collection about her progress.  Things got worse in kindergarten, where the teacher, who was not equipped with strategies, tried to apply the same strategies that worked for other kids, to my daughter.  It was a disaster for my daughter.  Not so much for my happy-go-lucky son who let everything roll off his back. 

Because we were abroad, our resources looked different than at home in the USA.  There were no “laws or policies” around what services should look like for a child with needs.  I can attest, as an educator at the Saudi Aramco school, we had amazing resources to choose from.  There was a wide range of teacher and staff training around how to work with kids with special needs.  Some staff had never experienced autism, or knew what ADHD was.  In their home countries, these differences “don’t exist”.  Some staff were experts and were able to pivot and use their expertise around neurodiversity.  

Before I began my journey with my twins, our educational team at the school had very clear steps that expat parents should take as they began to investigate how best to help their child.  One of the very first steps we recommended to families who were in the beginning stages of finding out about new learning issues with their child was to get a diagnosis in their home country.  This was because there were very little to choose from in our Middle Eastern location. Also, it took a long time, and the earlier you get information, the faster effective learning can begin.

It was around this time when my twins were in kindergarten that I decided to take my own advice…that come summer break, we would fly home to the USA for a diagnosis, I researched and found a specialist in Boston.  Here, the doctor would observe, recommend, diagnose, and help my daughter and I with some answers.  We turned this into a super fun vacation where we took a train across the entire country.  It turned out to be an unforgettable family trip.  

This was a good “first step” in the process for us.   

Upon returning abroad, back to our expat home in Saudi Arabia, we shared the information with the school, and began implementing some new strategies at school and home.  It was a great step in the right direction.  Advocating for the special needs of your child abroad looks different in a few ways.  One way it looks different is that there are no laws or policies to guide educators to try strategies.  Another way it looks different is you might do virtual meetings, appointments, or virtual therapy sessions.  You might have to fly to a neighboring country for a service. You might have to collect and keep data on your own, on your phone, on notebook paper or your laptop, without the help of an educator or specialist.

I have had to learn to advocate and create plans for my daughter using what was at my fingertips as an expat.  

As an expat, how do you know if bringing your child with special needs abroad will work for your family? I’ve listed 6 broad areas families should think about as they make their decision:

1. Research and Planning: Begin by conducting your own thorough research on the destination of where you are headed to live.  One question you need to ask yourself, if being hired by an organization:  Will the company who is hiring you need to know about these needs of your child?  The more upfront you are in the beginning, the more prepared the company, and the school will be, when your child arrives.  I remember a handful of times, a new student would show up without any indication there was a special need.  More than one family was sent back to their home country less than six months later, because the school was not equipped to help the child.   Other times, the child had a very rough start and lost months, if not years, of learning.   To ensure accessibility and availability of necessary resources, such as healthcare facilities, therapy services, and educational support, I highly recommend letting key people know, or joining online or live groups active in your new expat community.  For example, Facebook groups, WhatsApp groups, or groups on other platforms you use.  Unfortunately, this can be difficult because you don’t know who to talk to yet and you are at risk of getting spotty information.  These groups, once you find the right ones, will prove to be invaluable.  
   
   
2. Healthcare and Medication: Start by getting key diagnosis work done, before you leave, in your home country.   Have the report ready for school or other specialists.  This is a huge time saver.  We advised expat families at the schools I worked at to find a specialist or doctor back in their home country to help them seek  answers and data they were looking for.   It took months, or more, to get appointments and their questions answered. These families either left mid-year to collect data, or they had to call months in advance, to book appointments.  This meant a loss of weeks or months of class time.  When we received the information, it helped teachers and specialists target and put the right action steps into place, fast and efficiently. 
   
   Another consideration is access to medications or medical supplies, and local healthcare services. My son needs a specific medication for his asthma.  Bali, our current post, doesn’t always carry it.  I flew with my son to Singapore when his asthma was getting the best of him.  Here, with an expert asthma doctor, we explored options that would work in Bali. 
   
   
3. Education and Support Services: Explore the availability of special education programs, therapies, and support services in your destination country. What barriers may impact your child's education and support?  Private schools abroad don’t normally accept students with needs.  Of course, schools are evolving and are changing the landscape of who they serve.  I witnessed international schools in the past ten years educate their staff to work inclusively and effectively with all students, build new purpose specific facilities, and spend money on specialized services and curriculum.  And you, as a parent, will most likely have many choices.  Here in Bali, I have learned about different learning options, such as homeschool and worldschooling, two options I would have never considered as a traditional school teacher.  However, each child’s educational needs can be met here in Bali, as well as when we lived in China and Saudi Arabia. 
    
4. Community and Social Support: This is a powerful one.  Seek out support groups or online communities for yourself or your child. It took about 6 months to meet others who belonged to groups specifically geared towards having children with neurodiversities.  By joining those groups, I started meeting others in different groups.  It was all about immersing myself and getting to know other expats struggling with neurodiversity.  In the past year, I joined a neurodiversity group of parents.  I found them through word of mouth from another parent with a child who had ADHD.   I was flabbergasted!  It took me so long to find them!  Why?  Partly, because I don’t talk about these things with people I don’t know.  Partly because I am an introvert.  My advice to you is not to keep to yourself, because after gaining these new connections, I felt stronger and more ready to engage and live our amazing life as expats. These groups are filled with parents who have walked the path you are now beginning and have had, sometimes years of opportunities to try different doctors, specialists, and teachers in your new community.  Most recently,  I found an asthma specialist for my son in this group. He had since moved back to Ireland, but he let me virtually call him for advice when my son was at his worst.  I also began opening up to some new possibilities I had never considered.  For example, one parent started offering mindfulness for kids, which helped focus my daughter at school. 
   
   Don’t be afraid to begin talking to others who have had similar issues, try out their recommendations, and then, make the best informed decision for you and your family.  If you are like me, and don’t like sharing your private life in public spaces, you’ll still find answers during expat coffees and get togethers.  I “lurked” for a long time, listening to others and reading posts, my ears perking up when stories similar to mine were discussed.
   
   
5. Flexibility and Patience: Traveling with special needs requires a high level of flexibility and patience, as unexpected challenges will arise. You will be living in a global community who have different backgrounds in education, religion, cultural biases, beliefs.  People might stare.  People might ask uncomfortable questions or make unsightly comments.   Children have gotten offended when my daughter ignored them, and sadly, came to the conclusion that she wouldn’t be a good friend.  Other children aren’t receptive to these differences, leaving my daughter out of games.  And teachers aren’t always trained to deal with these situations.  You need to consider how you can solve these issues abroad.  For me, my neurodiverse group shares these frustrations and works through these discussions together.  We are all expats, away from our home countries, and our stories resonate with one another.  It’s really great.  One way we solved an issue of training within the community was to hire a private specialist.  This specialist came to our school, The Green School and workshopped some scenarios for inclusivity.  The school itself began to hire more specialists for our kids.  It’s a work in progress. 
   
   
6. Safety and Security: Safety and security is paramount. Take extra precautions and plan for emergency situations, such as having a plan for communication and accessing medical care in case of emergencies.  I sent my son with an emergency nebulizer every day to school.  He has never needed it, but when another family member at our school had an asthma attack, the island of Bali wasn’t ready to meet her needs.

Sometimes living abroad isn’t the right fit.  Through the years, the expat families I’ve lived with or worked with, when first experiencing the knowledge of having a child with special needs, whether it be on the spectrum or severe ADHD, go through a common process.

I experienced this process as a special education specialist.  When first hearing there might be a big learning problem with their child, it went something like this: 

1. impact (anger/denial, “you are wrong”, guilt, blame…trying to change things),
2. acceptance (sadness, heartbreak, reflection) 
3. action (collecting data, recallibration, conversation, goal setting, action steps).  

Where a parent is in this process of acceptance and learning about their child’s special needs changes throughout time. 

So your experience might differ depending on which stage you are in.   Think about where you might be in the process of accepting and knowing about any special needs your child might have.  

For me, I was in Saudi Arabia when I first began noticing my daughters neurodiversity.  After the first meeting with the specialist team (that I was on), I felt immense guilt that I did something wrong, and blamed the teachers for their ineffectiveness (and I was a teacher in the same school!)  I got angry that other parents were not helping their children understand my child.  I have since accepted and continue to take action with the needs of my twins. The trip to the specialist in the USA years later was the result of my readiness to take action.  My daughter’s gifts are shining through and together, we now go about life as expats, with our chosen community of support.  

In my experience, there are different reasons expat families who face challenges with a child with special needs choose to stay in their new expat post, or decide to go home:

1. Age of the child
2. Severity of the needs of the child and family
3. Medical facilities
4. Availability of services in school or private services outside of school.
5. Belief systems: holistic services vs. western medicine for example
6. Ability to be independently proactive, level of tenacity, grit.

My first step after teachers began to comment about her “differences” was to get a diagnosis, as I mentioned earlier.  This diagnosis would guide special services at her expat school by using an individualized learning plan, or IEP.  The IEP was the result of the diagnosis and teacher collected data.   This was a step I recommended to parents as their child’s learning specialist, and now, here I was, beginning the path I had so many times, recommended for them.  And the question loomed, “Should I go back to our home country?

In conclusion, the journey of raising children with special needs as an expat has been one of constant adjustment and learning. Through the years, I've navigated the challenges of healthcare, education, and community support.  Not always the most graceful, and at times wanting to board a plane and get back to our home in the USA, I have always been able to provide the best for my twins. While living abroad presents unique challenges that require grit and tenacity to meet the requirements not only as an expat, but an expat with a child who has special needs, it has also provided us with a supportive community and a wealth of new experiences we would never have had otherwise.

As we continue our expat journey, I remain committed to staying present and ensuring that my children receive the care and support they need to thrive. Being an expat mom of children with special needs has its incredible challenges, but it has also taught me resilience, flexibility, and the importance of seeking support from others in similar situations.