Healthy Inclusion:
Caring for Children
with Special Needs
in Child Care
© The National Training Institute for Child Care Health Consultants, 2013
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 Name
 Agency
 Date
© The National Training Institute for Child Care Health Consultants, 2013
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Introductions
 Please share your name and
one thing that is special or
unique about you.
© The National Training Institute for Child Care Health Consultants, 2013
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Learning Objectives
 Understand observation and screening for
a child who may have special needs.
 Identify benefits and challenges to early
childhood inclusion.
 Consider ways to partner with other
professionals to support children with
special needs.
© The National Training Institute for Child Care Health Consultants, 2013
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Children with Special
Health Care Needs
“Children who have or are at increased
risk for chronic physical, developmental,
behavioral, or emotional conditions who
require health and related services of a
type or amount beyond that required by
children generally.” (Pediatrics, 1998)
© The National Training Institute for Child Care Health Consultants, 2013
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Prevalence
 Fourteen percent of children under age
18 in the U.S. have special health care
needs.
 At least one CSHCN is present in 21.8%
of households with children.
 Among preschool children (ages birth
through five), just under eight percent
have special health care needs.
© The National Training Institute for Child Care Health Consultants, 2013
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Observation
 Watch for developmental milestones and
signs of delay.
 Observe how a child plays, learns,
speaks, and behaves.
 Bring significant concerns to
the child’s parents/guardians
and primary health care
provider.
© The National Training Institute for Child Care Health Consultants, 2013
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Screening Process
 Child care facilities should have a system
of developmental screening with all
children that can be used
 near the beginning of a child’s
placement in the program,
 at least yearly thereafter, and
 as developmental concerns
become apparent to staff
and/or parents/guardians.
© The National Training Institute for Child Care Health Consultants, 2013
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Developmental Screening
 Typically consists of


a brief health exam, including hearing and
vision evaluations, and
the completion of a checklist to determine
how the child is developing in other areas:
gross motor, fine motor, cognitive,
communication, social and emotional, and
self-help.
© The National Training Institute for Child Care Health Consultants, 2013
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Early Intervention
 All states have an early intervention
system that identifies and provides
services to children with special needs.
 Public Law 99-457 requires public
schools to extend special education
services to children as young as three.
 Eligibility and services provided vary
by state.
© The National Training Institute for Child Care Health Consultants, 2013
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Inclusion
 Inclusion means supporting values,
policies, and practices that support the
right of every infant and young child and
his or her family, regardless of ability, to
participate in a broad range of activities
and contexts as full members of families,
communities, and society (DEC/NAEYC,
2009).
© The National Training Institute for Child Care Health Consultants, 2013
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Reasons to Include CSN
 Social Reasons
 Educational Reasons
 Legal Reasons
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Legal Reasons - IDEA
Individuals with Disabilities Education Act
 Part C requires states to create early
intervention services for children birth to age
two who are identified as having
developmental delays or who are at risk for
developmental delays.
 Part B requires special education services
be provided by the public school system
to CSN ages three to five years.
© The National Training Institute for Child Care Health Consultants, 2013
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States are Required to:

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Find and identify CSN,
Provide a multidisciplinary evaluation,
Provide related services,
Encourage parental involvement and
consent, and
 Inform participants of their right to
confidentiality.
© The National Training Institute for Child Care Health Consultants, 2013
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IDEA Requirements
 Infants and toddlers enrolled in Part C
receive an Individualized Family Service
Plan (IFSP).
 Children enrolled in Part B receive an
Individual Education Program (IEP).
 A special services team that includes
the child’s family develops the plans.
© The National Training Institute for Child Care Health Consultants, 2013
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Legal Reasons - ADA
Americans with Disabilities Act
 Prohibits the discrimination of persons
with disabilities
 Includes private programs such as family
child care homes, child care centers,
nursery schools, and preschools
© The National Training Institute for Child Care Health Consultants, 2013
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ADA Requirements
 Eliminate eligibility criteria that screen out
a child with a disability.
 Make reasonable modifications in
policies, practices, and procedures.
 Provide aids and services for children
with disabilities affecting hearing, vision,
or speech.
 Remove architectural barriers.
© The National Training Institute for Child Care Health Consultants, 2013
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Challenges of Inclusion

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Values and Beliefs
Personnel Preparation
Policies
Resources
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Activity: Inclusion Graffiti
 Take a few minutes to walk around
the room and complete the
sentences on the flip charts with
your own ideas.
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Medical Home
A partnership
approach to
providing quality
and costeffective health
care services for
children (AAP,
2002)







Accessible
Family-Centered
Continuous
Comprehensive
Coordinated
Compassionate
Culturally
Effective
© The National Training Institute for Child Care Health Consultants, 2013
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Integrated Intervention
 Therapy is integrated into the daily
routines and activities of the child.
 Allows child care staff to observe
strategies and adaptations used by
therapists to practice targeted skills.
 Then, child care staff can help the child
use and practice the same skills daily.
© The National Training Institute for Child Care Health Consultants, 2013
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Family Centered Services
 Recognize that family is constant in a
person's life;
 Facilitate family/professional
collaboration;
 Honor racial, ethnic,
cultural and
socioeconomic
diversity of families;
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Family Centered Services
(continued)
 Recognize individual family strengths and
respect different methods of coping;
 Share complete and unbiased
information with families on a
continuing basis and in a
supportive manner;
 Encourage family-to-family
support and networking;
© The National Training Institute for Child Care Health Consultants, 2013
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Family Centered Services
(continued)
 Recognize and meet developmental
needs of infants, children, and their
families;
 Create policies and programs that offer
families emotional and financial support;
and
 Offer accessible, flexible, culturally
competent and responsive services.
Adapted from: Handbook of SchoolFamily Partnerships 2010.
© The National Training Institute for Child Care Health Consultants, 2013
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Supporting Transitions
 There is a six-month transition period as a
child moves from Part C to Part B.
 Family and child care staff are required to
participate in evaluations and meetings.
 A team of professionals will complete an
evaluation that must include
comprehensive, formal and informal
information from multiple sources.
© The National Training Institute for Child Care Health Consultants, 2013
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Supporting Transitions
(continued)
 Parents/caregivers need information
about their child's potential services and
about the transition process.
 Child care staff might help by sharing
information about the child’s needs,
learning style preferences, necessary
supports, and future goals.
© The National Training Institute for Child Care Health Consultants, 2013
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Activity: Working with
Families of CSN
 Divide into three groups.
 Choose a recorder and a reporter.
 Consider your assigned topic
(time, work, or mental health)
and how having a child with
a special need might require
changes or create challenges
another family may not have.
© The National Training Institute for Child Care Health Consultants, 2013
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Program Considerations
 A child care facility should make sure that
all staff members have had training and
understand that child’s special health care
needs and have the skills to work with
that child in a group setting. (CFOC 1.4.2.2)
© The National Training Institute for Child Care Health Consultants, 2013
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Partner with a
Child Care Health Consultant
•
•
•
•
Modify toys.
Make changes in the environment.
Model appropriate behaviors.
Teach children to seek playmates with
and without special needs.
© The National Training Institute for Child Care Health Consultants, 2013
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Partner with a Child Care
Health Consultant (continued)
• Help typically developing children
interact with children who may have
special needs.
• Assist families in finding resources in
the community.
• Consult with parents, health care
professionals, and early childhood
specialists as needed.
© The National Training Institute for Child Care Health Consultants, 2013
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Care Plan
 The facility should work with the child’s
family and care providers to develop a
care plan at the time of enrollment.
 The plan should identify the extent of the
child’s needs and how those needs may
relate to accessibility, medical
requirements or other issues.
 Plan must address emergency
response.
© The National Training Institute for Child Care Health Consultants, 2013
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One Good Tip
 Turn to the person sitting next to you and
share one tip that you learned during this
training about how to successfully include
a child with special needs in the child
care setting.
© The National Training Institute for Child Care Health Consultants, 2013
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Learning Objectives
 Understand observation and screening
for a child who may have special needs.
 Identify benefits and challenges to early
childhood inclusion.
 Consider ways to partner with other
professionals to support children with
special needs.
© The National Training Institute for Child Care Health Consultants, 2013
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Evaluation
 Please take five minutes to complete the
evaluation.
 Thank you!
© The National Training Institute for Child Care Health Consultants, 2013
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