Quality Child Care

Including children with special needs into regular child care settings is becoming a trend in today's society. The benefits of inclusion (defined as having children of varying skills and abilities in the same class) far outweigh the negatives, as long as the director and staff are committed to making inclusion successful. It is beneficial to have at least one adult in the center who is specifically trained to work with children with special needs. An ongoing system of planning, training and support in special needs topics should also be in place.
 
The term "special needs" is a broad one and encompasses anything from a child with a heart condition to specific diagnoses such as Down Syndrome, cerebral palsy, autism or ADHD. Children with special needs can benefit greatly by having everyday opportunities to interact and play with typically developing peers. Children without special needs will also develop an awareness of diversity, empathy, self-esteem and the value of friendships with those who are different from themselves.

Challenges to Inclusion

The challenge to inclusion is that children with special needs may not have the required skills that other children in the center have, such as talking in sentences or being toilet trained. They may exhibit behaviors which require more re-direction, one-on-one support or program adaptations. The child care staff will need to make adjustments so that children with special needs can actively participate at their own skill level. Communication with a particular child's parents, therapists and other support personnel can be the key to successful inclusion. Inclusion can be appropriate for every child, but it is the program that must be ready for inclusion, not the child.
 
What do we need to do in order to ensure quality in the care of children with special needs? Basically we need to follow the same guidelines we use for providing care to typically developing children, with a few minor additions or adaptations.

Guidelines when Selecting Quality Child Care

LOW RATIOS: What is most important when dealing with children with special needs is that a ratio is provided that is in tune with the child's functional age, not their chronological age. If, for example, a child is 3 years old, but is physically, cognitively and socially more like a 2 year old, than you must be cognizant that this child will need much more one-on-one attention and care than the average 3 year old in the group.
 
SMALL GROUP SIZE: The smaller the group size the better. Most children with special needs learn better in very small groups with more individualized attention. The teacher may be able to modify the preschool group by including one child with special needs along with two or three typically developing children as role models. Typically developing children are usually not only willing, but are also great at assisting their peers with special needs.
 
STAFF QUALIFICATIONS: Directors and lead teachers should have prior experience and knowledge in working with children with special needs. If possible, at least one person in the center should hold a degree in special education or early intervention or a related field (PT, OT, speech, etc). All caregivers should receive ongoing training related to the care and education of children with special needs.
 
DEVELOPMENTAL CURRICULUM: The center should utilize a developmental curriculum (for example the Creative Curriculum) and be willing and able to adapt that curriculum to their diverse learning population. Teachers and caregivers should work closely with the children's parents, therapists and school teachers to implement the child's IFSP or IEP goals into the daily child care routine. The child's visiting therapists should be welcomed into the classroom so that the child's therapy can be observed. Child care staff are instrumental in reporting the child's progress back to his or her parents, therapists and teachers.
 
SAFETY/ENVIRONMENT: Changes in the environment may need to be made for children with special needs, such as accessible doorways and ramps for wheelchairs or gait trainers. Staff may need to rearrange classroom space to accommodate adaptive equipment such as a child's standing table or wheelchair. Bathrooms may need to be made accessible with special potty chairs, and nap time accommodations may be needed as well, such as adding a wedge under a sleeping mat.
 
TOYS/ACTIVITIES: Centers may need to purchase more adapted toys such as switch operated toys that are more easily used by children with physical limitations, or lighted/musical toys for children with visual impairments. It may be necessary to incorporate sign language into activities for children with hearing impairments or speech delays. Adapted utensils or cups may be required for meals and playground adaptations may be required such as special swings or bikes.
 
QUALITY REPORTING: The best test for quality in a center is the report from other parents, both parents with typically developing kids and those with children with special needs. Centers often survey parents once a year and their satisfaction and the progress of the children in the program with special needs will be a testament to the quality of care the center provides. Parents can also look for centers that have NAEYC accreditation (National Association for the Education of Young Children) or are enrolled in the Keystone STARS program (Pennsylvania). Keystone STARS centers can also access STARS technical assistance to help them address the needs of children in their centers.

Tamara Guo, M. Ed. Developmental Specialist
 

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