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Child Care: Who Cares for the Children with Chronic Illness and Disability?

Article excerpt

Historically, child care (or daycare) has been treated very differently than education. While schools are mandated to provide educational programming for children with special health care needs, parents are responsible for providing daycare.

So what happens when children from birth to three-years-old need early intervention services?

That's one of the questions researcher, Lynne M. Lent, set out to answer in her regional study of "Child Care for Children with Special Needs from Birth to Three Years." She found mounting evidence that early intervention appears to be most effective when it is:

* part of a child's daily routine, and

* when the family's basic needs are met.

What she found is, regardless of the potential effectiveness, child care is seldom included in early intervention services.

Like most parents in the U.S. today, child care is a critical issue for families with children who have special health care needs, and it may be even tougher to find. However, it appears that the benefits of placing children with chronic illness or disabilities into the least restrictive child care setting far outweigh the barriers. Lent reports one success story:

Amy is a bright, active child who was born two months prematurely and diagnosed with cerebral palsy and seizures. Her child care providers remember that, when Amy started child care, her physical therapists came to the center and provided instruction about appropriate exercises and activities. "Open communication and commitment from everyone--parents, teachers, therapists and even the bus driver--made this a very successful experience," the care provider explained. Today, Amy, a high school student, works as an assistant at that same child care setting. She is bright, enthusiastic, and is great with young children.

There is no doubt, when parents and child care providers are committed to including all children in daycare, everyone wins.

Providers respond to questionnaire

Many providers said they believe that having children with special needs had a positive effect on all the children enrolled in daycare. They believe having children with special needs helped both children and adults to accept differences among people.

Still, more than one-third who responded to Lent's survey believe that the needs of children with chronic conditions caused the other children to be "short-changed." Some reported that parents withdrew their able-bodied children from the child care program. Some expressed concern about behavior problems. Still some did not know how to keep children from making fun of the child with disabilities.

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Clearly, the perceived barriers to providing care for children with chronic illness or disability could be improved through training; however, currently, most training of providers is done by the family. Lent's summary calls for including child care providers in the IFSP (Individual Family Service Plan) loop.

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When asked, those who provide child care to families with children who have chronic illness or disability say they are often left out of the development of Individual Family Service Plans (IFSP).

When asked, the same providers would like to be a part of the planning team and would like be trained to work with children with special needs.

Lent sent surveys to 1,014 licensed providers in one metropolitan county in Minnesota; she received 304 responses.

She asked providers 21 questions that included descriptions of the child care setting, services provided to children with special needs, participation in the IFSP process, communication and overall satisfaction. She also asked for recommendations to improve a provider's ability to service children with special needs.

Parents Respond

Parents of children with special needs who responded to this survey preferred small and large family daycare to centerbased daycare. …