| Children
With Special Needs
Patti
Lucarelli, RN, MSN, CPNP
Child Care Health Consultant Coordinator
With
more and more young children being diagnosed with
serious health or developmental problems, it is
very likely that you will be including a child
with special needs in your child care program.
Who
is a child with special needs?
According
to the National Health and Safety Performance
Standards : Guidelines for Out-of-Home Child Care
Programs, children with special needs are “children
with developmental disabilities, mental retardation,
emotional disturbance, sensory or motor impairment,
or significant chronic illness who require special
health surveillance or specialized programs, interventions,
technologies, or facilities” (2002).
What
are some of these special needs?
Some
of the most common types of special needs that
children may have are:
| 55958.
|
developmental
delays, developmental disabilities |
| 55959.
|
cognitive
delays or disabilities |
| 55960. |
behavioral
or emotional handicaps |
| 55961.
|
children
with hearing loss or impairment |
| 55962.
|
children
with visual impairment |
| 55963. |
children
with speech and language impairments |
| 55964.
|
children
with traumatic brain injuries |
| 55965. |
children
with autism |
| 55966.
|
children
with physical disabilities |
| 55967. |
children
with orthopedic impairments and |
| 55968.
|
children
with special or chronic health care needs
such as asthma, diabetes,
cancer, HIV or other diseases which may require
specialized attention and medical care. |
What
is Inclusion?
Inclusion
is defined as the opportunity for a child with
special health or educational needs to participate
actively in programs and activities along with
children who do not have special needs. This participation
is in “natural settings” within the
child’s community, meaning that this would
be the setting for this child had he or she not
had a disability. Inclusion has been shown to
not only benefit the child with special needs,
but also the other children in the child care
setting, and the families, teachers and the community
as well.
Why
is Inclusion so important?
There
are many ethical, social and educational benefits
for inclusion of children with special needs.
But the legal reasons for inclusion may be the
ones that sometimes get overlooked, and are worth
paying attention to. The Individuals with Disabilities
Act (IDEA) was passed in 1986 and it extended
the special education services provided in public
schools to children ages 3 - 5 years old with
special needs. The IDEA also specified that these
services be provided to children in their most
natural environments or the least restrictive
environment. Then in 1991, the Americans with
Disabilities Act (ADA) was passed, which makes
it illegal to discriminate against persons with
disabilities in employment, public services, public
accommodations, and transportation. The three
main principles of the ADA which can be applied
to child care settings are:
| 56043. |
Individuality
of the needs and limitations of the child |
| 56044.
|
Reasonableness
of the accommodation to both the child and
the program |
| 56045. |
Integration
of the child with the other children in the
program |
What
do these laws mean for child care providers?
First
of all, child care providers cannot deny care
to a child with special needs simply because of
that child’s disability. Second, each child’s
needs must be evaluated and determined on an individual
basis. And third, the child care provider or center
must make reasonable accommodations to assist
that child to be integrated into the child care
program.
What
is your obligation as a child care provider/center?
As
pointed out above, the child care provider is
obligated by law to evaluate the child’s
individual needs, identify ways in which the setting
can reasonably accommodate these needs and then
proceed with making these accommodations. However,
if the accommodation that is needed is unreasonable,
and may prove to be a undue burden to the center
or provider, then and only then, can care be denied.
So
what is required?
| The
ADA requires that child care programs consider
making changes in the following areas: |
| • |
Eliminating
eligibility criteria that screen out children
with special needs |
| • |
Examining
and revising policies, practices and procedures
that discriminate against children with special
needs |
| • |
Eliminating
physical barriers that prevent access to the
program’s services and activities |
What
else does the child care provider / center staff
need to know?
It would be helpful for the staff to meet with
the family and the child before the child begins
care, and become familiar with the child’s
routine and special care needs. Having the child’s
health care provider (pediatrician or nurse practitioner,
etc.) available either by phone or in person can
also help ease the transition. In addition, if
there are any therapists nurses, or other care
providers who will be working with the child during
the time the child is in the program, these health
care professionals would also provide additional
support and information to assist in this process.
The facility also needs to develop written policies
and procedures specific to caring for the child
with special needs. And finally the facility needs
to become familiar with the child’s Individual
Family Service Plan or IFSP.
What
is an IFSP?
The
IFSP is the individual plan that has been developed
for the child with special needs which ensures
appropriate and timely services for the child.
It also provides for coordination of the child’s
care and services in a team approach with the
child and family at the center of the plan.
|
|
