Inclusion Works

7/26/2019 Inclusion Works

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Inclusion Works!Creating Child Care Programs

That Promote Belongingfor Children

with Special Needs


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Publishing Information

Inclusion Works! Creating Child Care Programs Tat Promote Belonging forChildren with Special NeedswasdevelopedbytheChildrenDevelopmentDivision,CaliforniaDepartmentofEducation.ItwaseditedbyFayeOng,

workingincooperationwithomCole,Consultant,QualityImprovementOffice.ItwaspreparedforprintingbythestaffofCDEPress:thecoverandinteriordesignwerecreatedandpreparedbyCherylMcDonald;typesetting

wasdonebyJeannetteReyes.ItwaspublishedbytheDepartment,1430NStreet,Sacramento,CA958145901.ItwasdistributedundertheprovisionsoftheLibraryDistributionActand Government CodeSection11096.

2009bytheCaliforniaDepartmentofEducationAllrightsreserved

ISBN9780801116896

Ordering Information

CopiesofthispublicationareavailableforsalefromtheCaliforniaDepartmentofEducation.Forpricesandorderinginformation,pleasevisittheDepartmentWebsiteat http://www.cde.ca.gov/re/pn orcalltheCDEPressSalesOfficeat(800)9954099.AnillustratedEducational ResourcesCatalog describingpublications,videos,andotherinstructionalmediaavailablefromtheDepartmentcanbeobtainedwithoutchargebywritingtotheCDEPressSalesOffice,CaliforniaDepartmentofEducation,

1430NStreet,Suite3207,Sacramento,CA958145901;FAX(916)3230823orbycallingtheCDEPressSalesOfficeatthetelephonenumbershownabove.

Notice

TeguidanceinInclusion Works! Creating Child Care Programs Tat PromoteBelonging for Children with Special Needs isnotbindingonlocaleducationalagenciesorotherentities.Exceptforthestatutes,regulations,andcourtdeci-sionsthatarereferencedherein,thedocumentisexemplary,andcompliance

withitisnotmandatory.(SeeEducation Code Section33308.5.)
http://www.cde.ca.gov/re/pnhttp://www.cde.ca.gov/re/pn


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Contents

A Message from the State Superintendent of Public Instruction v

Acknowledgments vii

Introduction viii

1 Including Children with Disabilities or Other Special Needs:

A Rationale 1

IdentifyingChildrenwithDisabilitiesorOtherSpecialNeeds 4

LearningAboutIndividualChildren 5

2

Comparing Inclusive Child Care and Quality Child CareSettings 7

PromotingInclusivePractices 9

3 Creating Inclusive Child Care Settings 11

FactorsforSuccess 12

DailySuccess 13

CommonModifications,Adaptations,andSupport 15

4

Identifying and Finding Help 19

ReferraltoaSpecialist 20

alkswithParents 20

DocumentationofConcerns 21

SupportingtheFamilybyProvidingAccesstoServices 22

SupportingaFamilyTatDeclinesServices 24

HealthandMedicalSystems 24

LocalSpecialEducation/EarlyInterventionServiceSystems 25

5

Collaborating for Inclusion 27ContributingtoCollaboration 29

WorkingwithSpecialists 32

CoordinationwithSpecialistsandFamilies 32

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Examples of Inclusive Child Care Strategies 336 Strategy1:EnvironmentalSupport 34

Strategy2:MaterialsAdaptation 38

Strategy3:ActivitySimplification 40 :ChildPreferences 42 Strategy4

Strategy5:SpecialEquipment 44

Strategy6a:AdultSupport 46

Strategy6b:AdultSupport49

Strategy7:PeerSupport 52

Strategy8:InvisibleSupport 54

Appendixes

AppendixA:ApplicableLaws 58

AppendixB:Resources 63 AppendixC:AgreementForm 76

AppendixD:CaliforniaChildrenEnrolled

inSpecialEducation 77

Endnotes 78

Glossary 79

Bibliography 83

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A Message from theState Superintendent of Public

Instruction

IampleasedtopresentInclusion Works: Creating Child Care Programs Tat

Promote Belonging for Children with Special Needs,apublicationIbelievewill

contributetotheefforttobringthebenefitsofhighqualitycareandeducation

toallofCaliforniaschildren,includingthosewithdisabilitiesorotherspecialneeds.

Manyfamiliesrelyonchildcarefromthetimetheirchildrenareinfantsandwellintotheschoolyears.Childcarecanbearichexperienceinwhichchildrenandtheir

familiesgainasenseofbelongingtoasupportivecommunity.Researchshowsthatall

childrencanbenefitfromparticipatinginhighqualitychildcareprogramsthatwork

closelywithfamilymembersandprovidetheirchildrenwithenvironments,materials,

andrelationshipsthatenrichlearninganddevelopment.Itisimportantthatwe

providethekindoflearningenvironmentsandcarenecessaryforallchildrentobe

successfulintheearlyyearsaswellasinschoolandlaterinlife.

Approximately10percentofchildrenbetweenthreeandthirteenyearsofagereceive

specialeducationservicesinschool.Itiscriticalthatchildrenwithdisabilitiesor

otherspecialneeds,andtheirfamilies,areincludedinqualitychildcareprograms

thatarethenaturalenvironmentsoftheirpeerswhoaretypicallydeveloping.

Childrenlearnfromtheirinteractionswithotherchildrenandtheirsurroundings

whiledevelopingasenseofsecurityandselfesteemfromcaringrelationshipswith

programprovidersandstaff.

Everyonebenefitsfromqualitychildcareprogramsthatprovideinclusivecare.

Childrenwhohaveadisabilityorspecialneedgettoknowandinteractwithtypically

developingpeers,whiletheirfamiliesbenefitfromprogramsandservicestheyneed

toachievetheirgoals.Childrenwhoaretypicallydevelopingbenefitwhentheyhave

theopportunitytogettoknowtheirpeersintheclassroom.Andeveryonelearnstoknowoneanotherashumanbeingswithstrengthsandchallenges.

Tepurposeofthispublicationistoprovideguidanceandprovenstrategiesthat

promotebelongingandinclusionforallchildren.Buildingonresearchandthe

experienceofyearsofeffectiveimplementation,thishandbookcontainsstoriesand

examples,aswellasbackgroundinformationandresourcesthatsupportstrategies

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forsuccessfulinclusion.Byprovidingthebenefitofhighqualitychildcareand

educationtoallofCaliforniaschildren,wewillcontributetoclosingtheachievement

gapbetweenstudentswithdisabilitiesandstudentswithoutdisabilities.

Ihopethatthestoriesandstrategiesinthisdocumentinspireyoutoopenyourheartsandprogramstoallchildrentosupporttheiroptimalgrowthand

development.

JOC

State Superintendent of Public Instruction

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Acknowledgments

hecreationofthispublicationinvolvedindividualsfromWestEd,the

CaliforniaChildcareHealthProgram,theCaliforniaDepartmentof

Education,andotherrepresentativesfromthefieldwhocontributedtheir

expertiseandtimetothewritingofthismanual:*

Linda Brault, PrincipalWriter,WestEdCenterforChildandFamilyStudies

Abby J. Cohen, NationalChildCareInformationCenter

Lyn Dailey, CaliforniaChildcareHealthProgram

Robert Frank, CaliforniaChildcareHealthProgram

Eva Guralnick, CaliforniaChildcareHealthProgram

Judith Kunitz, CaliforniaChildcareHealthProgram

Melissa Ryan,CaliforniaChildcareHealthProgramPamm Shaw,CEIAN/WestEd

Marsha Sherman, CaliforniaChildcareHealthProgram

Rebeca Valdivia,WestEdCenterforChildandFamilyStudies

California Department of EducationEllen Broms, Consultant,SpecialEducationDivision

Meredith Cathcart,Consultant,SpecialEducationDivision

Tom Cole, Consultant,ChildDevelopmentDivision

Cecelia Fisher-Dahms,Administrator,QualityImprovementOffice,ChildDevelopment

Division

Mary Hudler, Director,SpecialEducationDivision

Greg Hudson,Administrator,SouthernFieldServices,ChildDevelopmentDivision

Michael Jett, FormerDirector,ChildDevelopmentDivision

Camille Maben, Director,ChildDevelopmentDivision

Mary Smithberger, Consultant,ChildDevelopmentDivision

Gwen Stephens, FormerAssistantDirector,ChildDevelopmentDivision

Michael Zito, HeadStartCollaborationOffice,ChildDevelopmentDivision

Other ContributorsChris Cleary,ChildCareLawCenter

Jan Kearns, ShastaCountyOfficeofEducation

Paul Miller, riCitiesChildCareCenters

Susan Sandall, EarlyChildhoodResearchInstituteonInclusion(ECRII)PhotographersJenn Bartell Jan Paluck

Jennifer Cheek Pantalon Joe Sanberg

Julie Espinoza Sheila Signer

Mark Lang Sara Webb-Schmitz

*Affiliationswereaccurateatthetimeofthedevelopmentofthedocument.

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Introduction

hepurposeofthishandbookistohelpchildcareproviderslearnstrategies

thatpromoteinclusionofandasenseofbelongingforallchildren.Childcareproviderswhoarenotaccustomedtoenrollingchildrenwith

disabilitiesorotherspecialneedsintotheirprogramswillbereassuredbythe

followingconsiderations:

Childcareproviderscansuccessfullyincludechildrenwithdisabilitiesorother

specialneedsintheprogramwhilepromotingbelongingforallchildren.

Majormodificationstotheirprogramorfacilityprobablywillnotbeneededin

ordertoincludechildrenwithdisabilitiesorotherspecialneeds.

Assistanceandsupportformoresignificantchangesintheirprogramorfacility

maybeavailable.

Aninclusivechildcareprogramisrewardingforallthechildren,families,andstaffinchildcareprograms.

Childcareoffersarichenvironmentwherechildrenlearnfromtheirinteractions

withotherchildrenandfromtheirsurroundingsandwheretheybenefitfrom

caringrelationshipswithprogramprovidersandstaff.Allchildren,including

childrenwithdisabilitiesorotherspecialneeds,deserveaccesstoqualitychild

careprograms.Teinformationinthishandbookisdesignedtosupportefforts

atmakingchildcareprogramsaccessibleandinclusive.Mostofthesuggested

accommodationscaneasilybemadewithlittleornocost.Tehandbookincludes

provenstrategies,storiesofchildrenwithspecialneedswhoaresuccessfully

includedinchildcareprograms,andinformationonmakinginclusiveprogramspossible.

Tebiggestbarriertoincludingachildwithadisabilityorotherspecialneed

seemstobefearfearnotofchildrenwithspecialneedsbutforthechildren.

Providersareafraidofphysicallyhurtingachild,ofnotmeetingperceivedneeds,

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andofhavingtotellaparentIdonotknowhowtocareforyourchild.With

knowledge,however,thisfearfadesandcompetenceblooms.Inclusion Works!

offersafoundationfordevelopingthatknowledgeandisdesignedtoencourage

allchildcareproviderstoopentheirdoorsandtheirheartstochildrenwith

disabilitiesorotherspecialneeds.

Tetermsandphraseslistedbelowareuseddifferentlybydifferentpeople.What

followsarethedefinitionsusedinthisbook.TeGlossaryatthebackmaybe

helpful.

Child care program.Anysettingwherechildrenarecaredforbypaidpersonnel

forlessthan24hoursaday.Tisincludeschildcareanddevelopmentcenters,

familychildcarehomes,inhomechildcare,afterschoolprograms,HeadStart

centers,andthelike.

Child care provider.Tepersonnelworkinginthevarietyofchildcaresettings

whomayalsobereferredtoasprovider,teacher,caregiver,orstaff.

Children with disabilities or other special needs.Includeschildrenwitha

specificdiagnosis,aswellaschildrenwhodonothaveadiagnosisbutwhose

behavior,development,and/orhealthaffecttheirfamilysabilitytomaintain

childcareservices.Tedisabilityorspecialneedmaybeasmildasaslightspeech

delayorascomplexasamixeddiagnosisofmotorchallenges,visionimpairment,

andcognitivedelays.Generally,thisdefinitionincludesthosechildrenwhoare

betweenbirthandtwentytwoyearsofagewhoareprotectedbytheAmericans

withDisabilitiesAct(seeAppendixA,ApplicableLaws).

Children who are typically developing. Childrenwhoaredisplayingdevelopmentandbehaviorintheexpectedrangefortheirage.

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Inclusion.Tefullandactiveparticipationofchildrenwithdisabilitiesor

otherspecialneedsincommunityactivities,services,andprogramsdesignedfor

typicallydevelopingchildren,includingchildcare.Ifsupport,accommodations,

ormodificationsareneededtoensurethechildsfull,activeparticipation,theyareprovidedappropriately.Teparticipationresultsinanauthenticsenseofbelonging

forthechildandfamily.

Family member or parent. Tepersonwithprimaryresponsibilityforraisingthe

child.Examplesincludemothers,fathers,fosterparents,andgrandparents.

Specialist.Anyoneprovidingintervention,therapy,ortreatmentservicestoa

childwithspecialneedsandhisorherfamily.Examplesincludespecialeducation

teacher,speechandlanguagetherapist,nurseconsultant,socialworker,andphysical

therapist.

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1Including Childrenwith Disabilities or

Other Special Needs:

A Rationale


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Children and families

want to be accepted

and included in their

community regardless

of ability.

herearemanyreasonstoincludechildrenwithdisabilitiesorotherspecialneedsinchildcare.Childrenandfamilieswanttobeacceptedand

includedintheircommunityregardlessofability.Teywanttotrulybelong.Butthekindofbelongingtheydesiregoesbeyondsimplybeingtogether.Teywantfull,unconditionalmembershipinfamilyandcommunity.AsNormanKunc,adisabilityrightsadvocate,hassaidsoeloquently,Wheninclusiveeducationisfullyembraced,weabandontheideathatchildrenhavetobecomenormalinordertocontributetotheworld.Instead,wesearchforandnourishthegiftsthatareinherentinallpeople.Webegintolookbeyondtypicalwaysofbecomingvaluedmembersofthecommunityand,indoingso,begintorealizetheachievablegoalofprovidingallchildrenwithanauthenticsenseofbelonging.1

Familiesofchildrenwithdisabilitiesorotherspecialneedhavethe

sameneedforchildcareasdootherfamilies.However,familiesof

childrenwithdisabilitiesorspecialneedsoftenfindthesearchfor

qualityandaffordablechildcareagreaterchallengeastheyfacethe

reluctanceofmanychildcareproviderstoenrolltheirchildren.Tis

situationmakesitallthemoreimportantthatchildcareproviders

strivetoincludeallchildrenintheirprogramssoasnottoincreasetheimmensechallengesthatsuchfamiliesalreadyface.

Childrenwithdisabilitiesorotherspecialneedsmaypresentunique

challenges,butthecaretheyneedisverysimilartothatneededby

anychild.Childrenwithspecialneedsspendmostoftheirtimedoing

whatotherchildrendo.Teyhavethesamecuriosity,desiretoplay,

andneedtocommunicateastheirpeersdo.Childcareproviderswho

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areprovidingindividualizedanddevelopmentallyappropriatechildcare

alreadyhavemanyoftheskillsneededtoservechildrenwithdisabilities

orotherspecialneeds.

Qualitychildcarecontributestotheemotional,social,andintellectualdevelopmentofchildrenandcanalsobeanimportantpartofschool

readinessandschoolsuccess.Childrenwithdisabilitiesorother

specialneedsbenefitfromqualitychildcarejustasmuchastypically

developingchildrendo.

Childrenwithdisabilitiesorotherspecialneedsbenefitfrombeing

ininclusiveenvironmentswithtypicallydevelopingchildren.Studies

haveshownthatinclusiveenvironments,withappropriatehelpand

assistance,allowchildrentoachievemorethantheydoinsegregated

environments.Whenchildrenwithdisabilitiesorspecialneedshaveall

oftheopportunitiesthatchildrenwhoaredevelopingtypicallyhaveandespeciallywhentheyareinanenvironmentwithchildrenwhoare

typicallydevelopingtheystrivetowardnewgoalsandachievements,

oftenattaininglevelsofabilitythatsurprisetheadultswhocareforand

aboutthem.

Childrenwhoaretypicallydevelopingbenefitfrominteractionswith

childrenwhohavedisabilitiesorotherspecialneeds,aswell.Inclusive,

supportiveenvironmentsteachchildrenaboutdifferencesandabout

respectingandvaluingotherpeopleregardlessofability.Childrenwant

tohelponeanotherastheygrow,andwhentheyseeadultstakesteps

tosupportachild,theywilltakestepstohelp

aswell.

Inclusive, supportive

environments teach

children about

differences and

about respecting andvaluing other people

regardless of ability.

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Although all children

need attention

and care, there are

children who will

require a greater

level of support and

thoughtful planning.

urningchildrenawayfromachildcareprogramsolelybecause

theyhaveadisabilityorotherspecialneedisaviolationoftheAmeri-

canswithDisabilitiesActandCaliforniasUnruhCivilRightsAct.

Unfortunately,familiescontinuetoberoutinelyrefusedchildcaresimplybecausetheirchildhasadisabilityevenwhentheirchild

doesnotneedanyspecialaccommodationsalossforthechild,the

family,andthechildcareprogramsthatturnthemaway.Allchild

careprovidersneedtoknowthatturningachildwithspecialneeds

awayfromachildcareprogrammayexposetheprogramtosignificant

liability.

IdentifyingChildrenwithDisabilitiesorOtherSpecialNeeds

Allchildrendevelopatdifferentratesandindifferentways.Some

childrenarebornwithspecialneedsthatcanaffecttheirgrowthand

development.Otherchildrenmaynotshowdevelopmentalproblems,

delays,ordifferencesuntillaterinchildhood.2Althoughallchildren

needattentionandcare,therearechildrenwhowillrequireagreater

levelofsupportandthoughtfulplanning:

Childrenidentifiedwithaspecificdiagnosisordisabilitybymedical

oreducationalprofessionals

Childrenwhomaynothaveadiagnosisbutwhosebehavior,

development,orhealthaffecttheirfamilysabilitytomaintainchildcareservices

Findingoutifachildisconsideredtohaveadisabilityorotherspecial

needcanbeacomplicatedtask.Differentagenciesoftenusevarying

criteriaforidentifyingconditionsandfordeterminingwhetherthe

childandfamilyareeligibleforservices.(Moreinformationon

eligibilitycanbefoundinAppendixA,ApplicableLaws.)Generally,

inorderforachildtobeeligibleforearlyinterventionorspecial

educationservices,heorshemustshowadelayinoneormoreareas

ofdevelopment.Inaddition,childrenidentifiedthroughtheearly

interventionsystemmaybeatriskofadevelopmentaldelay.Publicschoolsandtheearlyinterventionsystemarethemostcommon

agenciesforprovidingsupportandservicestochildrenwithdisabilities

orspecialneedsinchildcaresettings.

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obeeligibleforspecialeducationservices,childrenmustmeetcertain

criteriainoneormorecategoriesofdisabilities.Tesecategoriesare

broaderthanlabelssuchasDownsyndrome,cerebralpalsy,andso

forth.Childrenwiththesamediagnosismaybeplacedintoseveraldifferentcategories,dependingonotherfactors.

Mostchildrenfrombirththroughagefourteen(over70percent)

identifiedbyspecialeducationprofessionalsashavingadisabilityhave

delaysinlearningandcommunication(seeAppendixD,California

ChildrenEnrolledinSpecialEducation).Whatismoreimportantis

thatlearningdisabilitiesareoftennotrecognizedoridentifieduntil

childrenbeginformalschooling.Childrenwholearndifferentlyor

havedelaysinlanguagecommonlymanifestspecialneedsthrough

theirbehavioringroupsettings.Childcareproviderscanprovide

alanguage-richenvironmentandmakeaccommodationsbasedonknowledgeoftheindividualchild.

Terearefewerchildrenwithmoresignificantdisabilitiessuchasmental

retardation,physicalandmobilityimpairments,ormultipledisabilities.

Whenchildrendohavesignificantdisabilities,theyarelikelytobe

receivingspecializedservicesthatmaysupportsuccessinachildcare

setting.Childrenwhoareeligibleforandwhoreceiveearlyintervention

orspecialeducationserviceshaveindividualplanswithgoalsand

strategiesforcaregiversandproviderstouse.Forchildrenunderage

three,theplansarecalledindividualizedfamilyservicesplans(IFSPs);

forchildrenoveragethree,theplansarecalledindividualizededucation

programs(IEPs).Childcareproviderscanbeanimportantmember

ofanIFSPorIEPteamwhentheseplansarebeingdeveloped.More

informationaboutIEPsandIFSPsisavailableintheGlossary.

When serving an

individual child,

however, the

provider should

focus on the childsneeds, not the

disability or its

label.

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LearningaboutIndividualChildren

Child care providers

need to learn beyond

a textbook definition

and ask questions

with sensitivity and

understanding

particularly in talks

with parents.

Informationaboutaspecificdisabilitymaygiveachildcareprovider

ideasforhowtosupportachild(seeAppendixB,Resources).Whenservinganindividualchild,however,theprovidershouldfocuson

thechildsneeds,notthedisabilityoritslabel.Achildwithcerebral

palsy,forexample,maywalkwithlegbraces,useawheelchair,have

minorphysicalsymptoms,ordemonstrateadelayinusinglanguage.

Tepossiblevariationswithinthisonelabelaretremendous,

demonstratingthatnosinglelabelordiagnosiscanprovideenough

informationaboutaparticularchild.Childcareprovidersneedto

learnbeyondatextbookdefinitionandaskquestionswithsensitivity

andunderstandingparticularlyintalkswithparents.Providerscan

gofartowardsettingatoneofwelcomeandunderstanding.Whenafamilymembersharesachildsdiagnosis,agoodfollow-upquestionis

oftenAndhowdoesthataffect sdevelopment?

Forexample,ifaparentcallsandsaysImlookingforapreschool

formychild.ShehasDownsyndrome.Isyourschoolgoodfor

her?Tefollowingresponsewouldbeappropriate:Ourschoolhas

manywonderfulthingstooffer.Itmaybeagreatplaceforyouand

yourdaughter.Iwouldlovetohearmoreaboutherinterestsand

strengths.ImsurethatyouhavemanyquestionsthatIcananswer

foryou.Inordertohelpmeaddressthesequestions,mayIaskhow

herDownsyndromeaffectsherdevelopment?Tisapproachcanhelpassureafamilymemberthatthechildcareproviderissincerely

concernedaboutthesuccessofthechildandisinterestedinproviding

appropriate,individuallytailoredcare.

Teresponsefromtheparentwillhelpthechildcareprovider

determinewhataccommodationsmightbeneeded,whatother

questionsmaybeappropriatetoask,andwhetherspecialistsare

involvedorneeded.(Chapter4presentsinformationonworking

collaborativelywithspecialists.)

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2Comparing InclusiveChild Care and

Quality Child Care

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Quality child care is

evident when each

child grows and

learns, families feel

confident and secure,

and providers are

qualified and stable.

Manychildcareprovidersaresurprisedtolearnthatthereisverylittledifferencebetweeninclusivechildcareandgeneral,qualitychild

care.Qualitychildcareisevidentwheneachchildgrowsandlearns,familiesfeelconfidentandsecure,andproviders

arequalifiedandstable.Currentresearchprovidesanumberofdescriptions:

Qualitychildcareenablesayoungchildtobecomeemotionallysecure,

sociallycompetent,andintellectuallycapable.Tesinglemostimportant

factorinqualitycareistherelationshipbetweenthechildandthecaregiver.

Childrenwhoreceivewarmandsensitivecaregivingaremorelikelytotrust

caregivers,toenterschoolreadyandeagertolearn,andtogetalongwellwith

otherchildren.Tequalityofcaregiver-childrelationsdependsinpartonthe

sensitivityofthecaregiverandinpartontheratioofcaregiverstochildren,

thenumberofchildreninagroup,andtheeducationandtraininglevelsof

thecaregiver.Aqualityprogramalsoattendstothebasicissuesofhealthand

safetyandemphasizesapartnershipbetweenparentsandcaregivers.StartingPoints3

...Childcaresituationswithsafer,cleaner,morestimulatingphysical

environmentsandsmallergroupsizes,lowerchildadultratios,andcare

giverswhoallowedchildrentoexpresstheirfeelingsandtooktheirviewsinto

accountalsohadcaregiverswhowereobservedtoprovidemoresensitive,

responsive,andcognitivelystimulatingcarequalityofcarethatwas

expectedtobeassociatedwithbetterdevelopmentaloutcomesforchildren.

TeNationalInstituteofChildHealthand

HumanDevelopment4

ChildCareAware,anorganizationsupportedbytheChildCareBureauoftheU.S.DepartmentofHealthandHumanServices,has

identifiedfivekeyindicatorsofqualityinclusivechildcare:5

Apositiveandhealthylearningenvironment

Terightnumberandmixofchildrenandadults

rainedandsupportedpersonnel

Adevelopmentalfocusonthechild

Parentstreatedaspartners

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Teseindicatorsareclearlypartofallqualitychildcareprograms.

TedevelopmentallyappropriatepracticesidentifiedbytheNational

AssociationfortheEducationofYoungChildren(NAEYC)provide

additionalindicatorsofquality.NAEYCpositsthattheuseofdevelop-

mentallyappropriatepracticesresultsinhigh-qualitycareforall children,includingthosewithdisabilitiesorspecialneeds.

Professionalsconstantlymakedecisionsthataffectthewell-beingand

educationofchildren.Whenthesedecisionsarebasedonthefollowing

threeimportantkindsofinformationorknowledge,developmentally

appropriatepracticesarecertaintoemerge.6

Age appropriatenessreferstowhatisknownaboutchilddevelopment

andlearningandtheactivities,materials,interactions,orexperiences

thatwillbesafe,healthy,interesting,achievable,andchallengingto

children(dependingon,andvaryingwith,theageofthechildren).

Individual appropriatenessrelatestowhatisknownaboutthe

strengths,interests,andneedsofeachindividualchildinthegroup.

Cultural/social influencesarewhatachildcareproviderknowsabout

theculturalandsocialcontextsinwhichchildrenlive.Payingattention

totheseinfluencesensuresthatlearningexperiencesaredesignedtobe

meaningful,relevant,andrespectfuloftheparticipatingchildrenand

theirfamilies.

Infantsandtoddlersingroupcarebenefitfromaneducatorwhois

lovingandresponsive,respectsthebabysindividuality,andoffersgood

surroundings.7

Sincemostdefinitionsofqualitycareincludemeetingtheneedsofthe

individualchild,qualitychildcareisgoodforallchildren.And,not

surprisingly,high-qualitysettingshavemoresuccessfosteringasenseof

belonging,physicaldevelopment,andintellectualabilitiesinchildren

withdisabilitiesorspecialneeds.

PromotingInclusivePractices

Individual

appropriateness

relates to what is

known about the

strengths, interests,

and needs of each

individual child in

the group.

Brochures,parenthandbooks,andotherwrittenmaterialregularlyused

inachildcaresettingcansetthetoneofinclusionandbelonging.Ifa

programsexistingdocumentsalreadyincludephrasesthatemphasize

welcomingallchildrenorembracingdiversity,itisrelativelyeasyto

addstatementsthatincludediversityofability,aswell.Teinclusive,

welcominglanguageinthestatementsbelowsuggestwaystopresentthe

goodnewsofaninclusiveprogram:

Ourearlychildhoodteachersstrongknowledgeofchilddevelopment

helpsthemtoteachallyoungchildrenwhatevertheirtalents,interests,

andabilities.

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How people are

alike and different

naturally arises in

a child care setting;

a caregiver can take

advantage of these

opportunities to

discuss them.

Wetakeprideinourinclusiveprogram.Ourteachersadapt

activitiestoincludeallstudents,recognizingthattheirindividual

goalsmaybedifferent.Attimes,ourprovidersandchildrenmay

receiveassistancefromspecialists,suchasspecialeducators,physicaltherapists,andotherschoolorearlyinterventionpersonnel,who

recognizetheindividualinterestsandstrengthsofchildren.

Tefollowingexamplesaretakenfromanonlinebrochureforan

existingcenter.8

TeNationalChildResearchCenterprovidesacollaborative

approachtopreschooleducationinanenvironmentthatnurtures

thewholechild,fosterspartnershipswithfamilies,andiscom-

mittedtotheinclusionofchildrenwithspecialneeds.

Ahighlytrained,multidisciplinaryfacultyemploysdevelop-

mentallyappropriatepractices,supportedbyongoingprofessionaldevelopmentandsoundresearch.Essentialtoitsroleasamodel

ofearlychildhoodeducationisthecreationofadiverse,respectful

community.Bothwithinandbeyondtheschoolcommunity,

NCRCseeksopportunitiestoadvocateforallchildrenandtheir

families.

Evenifchildrenwithdisabilitiesarenotcurrentlyenrolledinachild

caresetting,providerscanstillpromoteinclusivepractices.Oneway

istohavepictures,books,andmaterialsthatpresentchildrenwith

disabilitiesinageneralsetting.Howpeoplearealikeanddifferent

naturallyarisesinachildcaresetting;acaregivercantakeadvantageoftheseopportunitiestodiscussthem.Languageuseisalsocritical

indevelopinganatmosphereofinclusion.Tebestpracticeisto

useperson-firstlanguagewhenoneistalkingaboutpeoplewith

disabilities.Tispracticesimplymeansputtingthepersonbeforethe

disability:achildwithautismratherthananautisticchild.

Teprocessofexploringinclusionwithfamilies,colleagues,and

childrenwillsuggestotherwaystoexpandinclusivepractices.For

example,planningstaffdiscussionsonspecificchangesinphilosophy,

attitudes,andpracticesgoesfartowardincludingchildrenwith

specialneedsinachildcaresetting.Outsidetheimmediatechildcare

setting,adultswithdisabilitiesinacommunitymightcontributeto

acareprovidersexpandingknowledgeofissuesrelatedspecifically

toinclusionandtodisabilitiesingeneral.Additionalresourcesare

availableinAppendixB,Resources.

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3Creating InclusiveChild Care

Settings


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Programs that are

committed to quality

and diversity often

see belonging and

inclusion as the

starting point forall children.

Programsthatarecommittedtoqualityanddiversityoftenseebelongingandinclusionasthestartingpointforallchildren.TeAmericanswith

DisabilitiesActandCaliforniasUnruhCivilRightsAct(seeAppendixA,ApplicableLaws)makeitillegalforachildcareprovidertorefusetoserveachildsolelyonthebasisofadisability.Tereis,however,asignificantdifferencebetweenproviderswhoenrollchildrenwithdisabilitiesorotherspecialneedsbecauseitisthelawandproviderswhoreachoutandwelcomeallchildrenintotheircare.

FactorsforSuccess

Agreatdealofresearchhasbeenconductedonwhatmakesinclusion

ofallchildrenwork.TeEarlyChildhoodResearchInstituteon

Inclusion(ECRII),anationalresearchprojectfundedbytheU.S.

DepartmentofEducation,identifiedthefollowingsixfactorsasthe

keytoinitiatingandimplementinginclusivepractices:9

1. Providersorstaffmembersarepassionateaboutmakinginclusion

work.Tisfactorwasthestrongestandcouldincludeproviders,

teachers,programadministrators,andevenadistrictsdirectorof

specialeducation.

2. Avisionofinclusivepracticedevelopedovertimebyrespecting

andconsideringtheviewsofeveryoneinvolvedinimplementationissharedbyall.

3. Stateandnationalpoliciespromptprogramstobecomeinclusive.

Oneexampleisthe1972policythatrequiredthat10percentof

aHeadStartprogramsenrollmentbemadeupofchildrenwith

disabilities.Someeffectiveprogramsarealsofoundinstatesthat

havestatelevelpoliciesaboutinclusion,aswell.

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4. Additionalmoney,trainingbyqualifiedconsultants,orothertype

ofsupportisprovidedforinclusivechildcareprograms.

5. Attheprogramordistrictlevel,supportisgiventoenhance

collaborationandcommunicationamongpeopleinvolvedinprovidinginclusiveprograms.

6. Apassionatecommunityofindividuals,suchasparentsorother

communityadvocates,workstosparkinterestinimplementing

inclusiveprograms.

DailySuccess

Aseachchildisunique,soiseachchildcareprogram.Tereisno

magicformulaformakinginclusionworkbeyondthecreativity,

energy,andinterestthatmostchildcareprovidersalreadybringtotheirwork.Teiruniquenessnotwithstanding,everyprogramisableto

successfullyincludechildrenwithdisabilities.Andeachmakesitwork

childbychild,daybyday.Acandoattitudeamongtheproviders

helpstoprovidethenecessaryenergyforcomingupwithsolutionsto

theinevitablechallenges.Italsohelpstohaveanenthusiasticattitude

onhowtomakeinclusionworkratherthantosimplyfulfillalegal

obligation.

Somechildrenneedsmallchangestothecurriculumorminorsupports

inordertogetthemostoutofcertainactivities.Tesesortsofthings

mayconsistoffairlysimpleaccommodations,suchasprovidingaspecialplaceorquietactivityforachildwhoisunabletoparticipateinlarge

groupactivitiesormakingavailableaspecialsnackforachildwho

needstoeatmorefrequentlythanthetypicalmealorsnackschedule.

Otherchildrenmayrequiremorespecificadaptationsthatmightnotbe

readilyapparent.Avarietyofcommunityresourcescanbehelpfulin

determiningwhatthosemightbe.Tefamily,forexample,isalwaysthe

firstandmostimportantguideforwhatachildmightneed;afterthat,

anareaspecialistoralocalworkshopmightbe.Beyondtheimmediate

community,aworldofliteratureinbooks,periodicals,andWebsites

devotedtodisabilitiesandinclusioncaninformachildcareprovideraboutappropriateadaptationsforachildwithaparticularconditionor

need.RefertoAppendixB,Resources.

Programsthatbeginwithahighquality,developmentallyappropriate

foundation;apositiveattitudeonthepartofthecareprovider;

appropriateadultchildratios;supportiveadministrators;andadequate

There is no magic

formula for making

inclusion workbeyond the creativity,

energy, and interest

that most child care

providers already

bring to their work.

13


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One of the biggest

roles for a care

provider is to

facilitate a sense

of belonging and

inclusion.

trainingfortheproviderwillbeinagoodpositiontocreativelysolve

problemsforachildwithdisabilitiesorotherspecialneeds,exactlyasit

doesforchildrenwhoaretypicallydeveloping.Ifachildalreadyhasan

establisheddiagnosis,trainedinterventionpersonnelmaybeavailable

toassistinthisprocess.Oneofthebiggestrolesforacareprovideristo

facilitateasenseofbelongingandinclusion.Severalhelpfulstrategies

areasfollows:10

Startwiththeassumptionthatallchildrenarecompetent.

Adapttheenvironmentsothatitisdevelopmentallyappropriate,

challenging,andfitstheneedsandinterestsofeachchild.

Whiletheremaybeaneedtosupportachildsmasteryofaspecific

skill,keepthewholechildinmind,particularlythechildssocial

emotionalexperience.

Considerthefollowingquestionswhenadaptinganactivityforachild

withspecialneeds:

Doesthechildhaveanopportunitytobeincontrolofthelearning

experience?

Isthereabalancebetweenadultinitiatedlearningandchild

initiatedlearning?

Canthechildmakechoiceswhilelearningtheskill?

Isthechildabletoinitiatehis/herowneffortstopracticetheskill,withsupportgivenbythechildcareprovider?

Isthechildgainingselfconfidenceandshowingthejoyof

accomplishmentwhilelearning?

Isthereroomintheactivityforthechildtomakediscoveries?

14


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CommonModifications,Adaptations,andSupports

Eachchildisanindividual,andmodifications,adaptations,accom-modations,andsupportsshouldbedesignedwithasinglechildin

mind.However,researchersfromtheEarlyChildhoodResearch

InstituteonInclusion(ECRII)havefoundthatmanychangescanbe

groupedintocategoriesofmodifications.Severalofthesecategories

areusedinvariouschildcareprogramsthatincludechildrenwith

disabilitiesorspecialneeds.11Temostcommoncategoriesand

briefdescriptionsareincludedbelow.Moredetailedillustrations

andstoriesareinchapter5,ExamplesofInclusiveChildCare

Strategies.

1STRATEGY

Environmental Support

Alterthephysical,social,ortemporalenvironmenttopromoteparticipation,engagement,andlearning.

Examples:

Useaphoto,picture,orobjecttosignalthenextactivity.

Makeboundariesforactivities(e.g.,marksectionsofthefloor

withtape,provideatrayorboxlidforartactivities).

Freesurfacesofbumpsorsmooththemwithlipsandramps.(See detailed story on page 34)

2STRATEGY

Materials Adaptation

Modifymaterialstopromoteindependence.

Examples:

Addknobstowoodenpuzzles.

Usefabricselfadhesiveclosuresondressupclothes.

Placenoslipplacematsunderdisheswhenchildreneator

servethemselves.

(See detailed story on page 38)

Alter the physical,

social, or temporal

environment

to promote

participation,

engagement,

and learning.

15


27/94

Replace materials

that may be difficult

to use with ones

that are simpler and

can serve the same

function

3STRATEGY

Activity Simplification

Simplifyacomplicatedtaskbybreakingitintosmallerparts

orreducingthenumberofsteps.

Examples:

Giveachildmaterialsforataskonepieceatatime.

Preparematerialsforeasieruse(e.g.,peelthebackgroundoffstickers

andbendthemsotheyliftoffeasily).

Replacematerialsthatmaybedifficulttousewithonesthatare

simplerandcanservethesamefunction(e.g.,useasqueezebottle

insteadofapumpdispenser).


4STRATEGY

Child Preferences

Capitalizeonachildsfavoriteactivities.

Examples:

Observeachildsinterestsand

thenprovideadditionalmaterials

ortoysthatmatchthem.

Usethechildspreferredactivities,

suchasmusic,tosupportefforts

tolearnotherskills.

Findwaystobuildonachilds

preferredactivitieswhen

introducingnewideas.(See detailed story on page 42)

16


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5

6

STRATEGY

Special Equipment

Useadaptivedevicestofacilitateparticipation.

Examples:

Ensurethatprovidersknowtheproperuseof

adaptiveormedicalequipment,suchashearing

aids,glasses,ornebulizers(followinglicensing

requirementsandpediatricianorspecialist

recommendations)andtheneedforvigilance

byadultswhenthisequipmentispresent.

Allowallchildrentoparticipateinactivities

byprovidingappropriateseatingorother

equipment,suchasaplasticchairnearthe

watertableforachildwhousesawheelchair.

Usepicturecardsorelectronicswitch

activatedspeakingdevicesforchildren

whocannotspeak,allowingthemto

communicatetheirchoices.


STRATEGY

Adult Support

Employdirectadultinterventiontosupportachildsefforts.

Examples:

Assignaprimarycaregivertoachildsothat

theassignedadultisabletoknowtheunique

needsofthechildandwaystosupport

him/her.

Providedirectinstructionorguidancetoa

childwhilehe/sheislearningorpracticing

tasks.

Learnspecificwaysofinteractingorcommunicatingwithachild,suchas

signlanguage.

(See detailed stories on pages 46 and 49)

Provide direct

instruction or

guidance to a

child while he/she

is learning or

practicing tasks.

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Pair a child with a

certain disability

with a child who

does not have that

disability during

certain activities,

ensuring that the

child with special

needs is sometimes

the helper and notalways the one being

helped.

7

8

STRATEGY

Peer Support

Useclassmatesasmodelstohelpchildrenlearn.

Examples:

Pairachildwithacertaindisabilitywith

achildwhodoesnothavethatdisability

duringcertainactivities,suchaseating,

classchores,andsoon,ensuringthatthe

childwithspecialneedsissometimesthe

helperandnotalwaystheonebeinghelped.

Facilitatechildrensinteractionsand

observationsofoneanotherinsmallgroups.

eachchildrenspecificwaystoengageandinteractwithachildwithspecialneeds.


STRATEGY

Invisible Support

Arrangenaturallyoccurringeventstoassistinclusion.

Examples:

Stockthedressupcenterorkitchencornerwithsufficientitems

somorechildrencanparticipateinapopularactivitywithoutcompetition.

Assignrolesduringchildrensplay,suchashavingachildwith

limitedmobilitybeinchargeofpumpinggasasthechildren

ridingbikesgoby.

Commentonchildrensplayinwaysthatencouragefurther

interaction.


18


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4Identifyingand Finding

Help


31/94

CChild careproviders areoften the first tonotice a child

who is learning,

communicating,

or developing

in a way that is

different from other

children in their

care.

hildcareprovidersareoftenthefirsttonoticeachildwhoislearning,communicating,ordevelopinginawaythatisdifferentfromother

childrenintheircare;orachildcareprovidermaybethe

firstpersonwhomfamilymembersapproachwiththeirconcerns.Whenacriticaldifferenceisnotedaftercarefulobservationandinterventionwithaparticularchilddoesnotseemtobeworking,thenextstepinvolveslookingforadditionalhelptofosterthechildssenseofbelonging.

Althoughthishelpcancomefromthefamily,moreexpertiseisoftenneeded,suchasadviceorinsightfromthechildspediatricianorhealthcareprovider,orfromthechildstherapistorotherspecialist.

ReferraltoaSpecialist

Whenachildcareproviderrecommendsthatafamilyseekhelpfrom

apediatricianorspecialists,oriffamilymembersgrantachildcare

providerthenecessarypermissiontoseekhelp,thechildcareprovider

ismakingareferral.Areferralrequirestalkingtotheparentsofthe

childfirst.Teymustgivetheirwrittenpermission(consent)before

seekingotherassistance.Parentssometimeswanttopursueassistance

themselves.

alkswithParents

Communicatingconcernsaboutachildtotheparentsisoftena

difficultstep.Successismorelikelyifthisstepistakenfroman

alreadyexistingrelationshipthatisbuiltontrustandrespect.Even

whenthisrelationshipisinplace,childcareprovidersstillneedtoplan

20


32/94

whattheywillsayaboutconcernsforthechild.Anytechniquesused

foreffectiveparentconferencescanapplyhere.Adiscussionofthis

natureshouldtakeplaceinaprivatelocation,withadequatetime

allowed,and,ifapplicable,bothparentsinattendance.Tefirststepistoaskthefamilymembershowtheyseethechildand

thentosharethepositivequalitiesobservedwithinthecaresetting.

Attheoutset,itishelpfulforchildcareproviderstoletthefamily

knowthat:

Teyshareconcernsforthechild.

Teirintentistosupportthechildsdevelopment.

Inordertodothis,theyneedtogetsomeideasforhowtobestmeet

thechildsneeds.Iffamilymembersdifferintheirviewofthechild,

beopentotheirperspective,askquestions,gatherinformation,and

invitethemtobeyourpartnerinmeetingtheneedsoftheirchild.

Whendonerespectfully,thiscommunicationcanleadtoafruitful

exchangeofideasandultimatelyhelpforthechild.

DocumentationofConcerns

Whenitistimetoshareconcernsaboutachild,clearcommunication

becomesvitalcommunicationwithconcreteexamplesandwithout

judgment.Forinstance,ratherthaninsistthatachildisbehaving

badlyandbotheringotherchildren,aproviderwouldbemore

effectivebylettingtheparentsknowthatcertainobservationshavebeendocumented:theirchildhasahardertimesittingstillthando

otherchildren,doesnotcopewellwithtransitions,andhashadfive

incidentsofhittingotherchildrenduringthelastweek.

When it is time

to share concerns

about a child, clear

communication

becomes vital

communication

with concrete

examples and

without judgment.

21


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An inclusive child

care provider lets the

appropriate family

members know that

everything will be

done to support

the child and to

incorporate any

new ideas into the

programs procedures,curriculum, and

activities.

Itisespeciallyimportantthatobservationsbesharedwithoutlabels

ordiagnoses(forexample,attentiondeficitdisorder).Mostchildcare

providersarenotqualifiedtoprovidesuchadiagnosis,anddoingsooftengetsinthewayofthenextstepinthereferralprocess.Onthe

otherhand,specificobservationsanddescriptionsofwhatishappening

willbehelpfultoanyspecialistswhobecomeinvolved.

SupportingtheFamilybyProvidingAccesstoServices

Familiesoftenneedandappreciatesupportingettinghelp.Many

familiesreportfearthataproviderwillrejecttheirchildorthem

iftheirchildneedsextrahelp,whichmaymakethemreluctantto

approachachildcareproviderwiththisneed.Aninclusivechildcare

providerletstheappropriatefamilymembersknowthateverything

willbedonetosupportthechildandtoincorporateanynewideasinto

theprogramsprocedures,curriculum,andactivities.Wheneverything

isinplacetoreferthechildtoanearlyinterventionprogram,local

schooldistrict,orpediatrician/healthcareprovider,thefamilyneeds

tobeallowedtotakethelead.Forthosefamiliesthatwanttoactively

exploreadditionalsourcesofsupportfortheirchild,achildcare

providercanthentalkwiththemaboutwheretogoandhowtoobtain

furtherassessmentand/orpossibleservices.

Tisisthepointatwhichthechildcareproviderismakingareferral.

Inthisprocess,itisgenerallyappropriatetoreferthefamilyto

theirpediatricianandtoalocalearlyintervention/specialeducation

resourceatthesametime.Informationaboutthesekindsofservicesis

availablewithinmostcareprograms,localearlyinterventionservices,

specialeducationservices,andotherresources.Bysharingconcrete

22


34/94

observationsandpertinentinformationthroughouttheprocess,achild

careprovidersucceedsinhelpingfamilymembersclarifytheirquestions

abouttheirchildandgivingthemanideaofwhatthereferralwill

accomplish.Callingresourceagenciesinadvancetogetinformationfortheparents

canbeveryhelpful.However,noonecanguaranteeeligibilityor

servicesfromanotheragencytoafamily.Abetterapproachforachild

careprovideristodescribewhatmighthappenafterthereferraland

whatthepossibleoutcomesmightbeonthebasisofpastexperience.

Achildcareprovidercanalsooffertobeasourceofinformationtothe

referralsource.Confidentialityissuesaresacred,soparentsmustgive

permissionforanyone,includingachildcareprovider,totalkabout

theirchildwithreferralsources.InCalifornia,theChildCareHealth

Line(8003333212)isalsoavailabletoprovidersandfamiliestofacilitatethelinkageswithspecialserviceproviders.Mostcommunities

alsohaveCaliforniaEarlyStartFamilyResourceCenters(seeAppendix

B,Resources)tohelpparentswithlinkagesandanunderstandingof

theirrightstoservices.

Whenfamilymemberswantaccesstootherresources,theyneed

toconsiderimportantissues,suchasinsurance,linguisticfluency,

culturalpractices,transportation,andanypreviousuncomfortableor

negativeexperienceswithauthorityfigures,suchasteachersordoctors.

Commonly,achildcareproviderhelpsafamilyobtaintheservicestheir

childneedsbysettingtheprocessinmotionforthem.Atthesametime,itisimportantthatthechildcareprovidernotdotoomuchforthe

familyorfeelresponsibleforresolvingeveryissue.Teprovidercanbe

morehelpfulforeveryoneinvolvedbyfocusingonsupportingthefamily

asitmovesthroughtheprocess.Findingwaystomeetthechildsneeds

willbestservethefamilyandthechildinthelongrun.

Confidentiality

issues are sacred,

so parents must

give permission for

anyone, including a

child care provider,

to talk about their

child with referral

sources.

23


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Child care providers

must remember that

everyone moves at

a different pace and

accepts information

differently.

SupportingaFamilyTatDeclinesServices

Sometimesfamilymembersmaychoosenottopursueresourceswhen

theyfirsthearachildcareprovidersconcernsabouttheirchild;ortheymaybeopentoinformationyetnottakeactionimmediately.Child

careprovidersmustrememberthateveryonemovesatadifferentpace

andacceptsinformationdifferently.Tesedifferencesareoftengreatly

influencedbyafamilysemotionalresponse,whichgreatlyaffects

whattheyareabletohearandunderstand.Processingandintegrating

thisinformationwilltaketime.Teideathattheirchildmaybe

differentfromotherchildrenishardforsomefamiliestoaccept.Unless

behavioralorotherissues,suchasmedicalurgency,makesitimpossible

tocareappropriatelyforthechildwithoutassistance,childcare

providersmustallowafamilytoproceedonitsowntimeline.Achildcareprovidersroleunderthesecircumstancesistosupportafamily

inunderstandingtheinformationthathasbeenshared,torepeatthe

informationwhenevernecessary,andtoremindthemthatadditional

resourcesandinformationareavailablewhenevertheywantit.

Ifachildcareprovidersownjudgmentoremotionsinterferewith

theabilitytorespectthefamilyasthedecisionmaker,thechildcare

providershouldseekpersonal/professionalsupportandthensuggest

thatthefamilydiscussthiswithsomeoneelseaswell.Ifachild

careproviderbelievesthatafamilysrefusaltoseekhelpconstitutes

negligence,thenthatproviderhasanobligationtobeclearwiththefamilyaboutthecriticalnatureoftheconcernspresented.Atthat

pointitistimeforthechildcareprovidertoproceedwithareferral,

independentofthefamilysinvolvement.

Inmanycases,itisappropriatetohaveafamilytalkaboutconcerns

withtheprimaryhealthcareprovider.Someissuesfacedbychildren

withdisabilitiesorotherspecialneedsaremedicalandrequirecareful

followupbyahealthcareprovider.

HealthandMedicalServiceSystemsAlthoughsomehealthcareprovidershavelittleknowledgeofthe

assessmentandserviceissuesthatareessentialtoworkingeffectively

withchildrenwithspecialneeds,othersspecializeinthisarea.Parents

andprovidersmustbeproactivetoensureagoodmatchbetweenchild

andprimaryhealthcareprovider.

2424


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Oftenitisagoodideaforareferraltobemadetothespecialeducation/

earlyinterventionservicesystemwhilethereferraltothehealthcareproviderisbeingmade.Becausethereferralprocesstakestime,referring

toonlyonesystem(suchashealthcare)maydelayadmissiontothe

other(suchasearlyintervention).Referralsarebestmadedirectlyby

thefamily.Ifaprovidermakesareferral,thefamilymusthaveprovided

clearpermission.

LocalSpecialEducation/EarlyInterventionServiceSystems

Localspecialeducation/earlyinterventionservicesystemsarerequiredbylawtoengageinchildfind.Tistermmeansthatanactiveand

ongoingeffortneedstomadebythespecialistsystemtoidentify

childrenwhomaybeeligibleforservices.Someareasmayprovidefree

screeningsatlocalchildcaresettings,whileothersmaysendoutreach

materialstochildcareandmedicalagencies.Notallchildrenwith

differencesintheirdevelopmentwillqualifyforservicesfromspecial

education/earlyintervention.Appropriatescreeningandassessment

aregenerallyrequiredtomakethisdetermination.Teseprocedures

areprovidedtofamiliesfreeofcharge,asaremostspecialeducation

services.Afterareferralismade,thespecialeducation/earlyinterventionagency

has60calendardays(45forchildrenunderagethree)tocomplete

theassessment,determineeligibility,andholdameetingtoplanfor

services,ifneeded.Again,referralsarebestmadedirectlybythefamily.

Ifaprovidermakesareferral,thefamilymusthaveprovidedclear

permission.

Not all children

with differences in

their development

will qualify for

services from special

education/earlyintervention.

25


37/94

Even if a child is

not found eligible for

special education

services, the team

providing the

assessment may

have suggestions for

ways to support the

childs growth and

development.

Ifachildcareprovidersuspectsthatachildinacaresettingmay

havespecialneeds,thatindividualshouldencouragethechilds

parentstocallthelocalschooldistrictorthespecialeducation

programofthecountyofficeofeducationtorequestanassessment.Forconcernsregardingchildrenfrombirthtoagethree,familiesmay

calltheCaliforniaDepartmentofDevelopmentalServices(800515-

BABY[2229]).Teywillbeprovidedwithinformationonresourcesin

theirlocalcommunity,includingtheregionalcenterortheirCalifornia

EarlyStartFamilyResourceCenterforparenttoparentsupport.

Onceareferralisreceived,representativesofthoseagencieswilltalk

withthefamilyandmayscheduleanassessmenttoseeifthechild

qualifiesforservices.Knowingthebestpersontocontactandhisor

hertelephonenumberinaschooldistrictcanbeofgreathelptothe

family.TelocalCaliforniaEarlyStartFamilyResourceCenter(seeAppendixB,Resources)usuallyhasthisinformation.Tereare

severalimportantthingsforparentstoknowwhentheycontactthese

agencies:

Teagenciesoperateunderlegaltimelinesforrespondingtoparents

requestsforconsiderationofearlyinterventionorspecialeducation

services(parentsmaywanttoputtheirrequestinwritingiftheyare

havingdifficultygettingaresponse).

Parentsmustgivewrittenpermissionfortheirchildtobetestedand

receiveearlyinterventionorspecialeducation.

Allservicesareconfidentialandprovidedatnocosttothefamily.Evenifachildisnotfoundeligibleforspecialeducationservices,

theteamprovidingtheassessmentmayhavesuggestionsforwaysto

supportthechildsgrowthanddevelopment.Parentsmightappreciate

beingmadeawareofthispossibilityandbeencouragedtotake

advantageoftheinformationprovided.Additionally,theassessment

teamwillbeabletogiveguidelinesformonitoringthechildsprogress

asthechildbecomesolder.Guidelinesarehelpfulincasethefamilyor

othersbecomeconcernedoverlaterdevelopingbehaviorsorchallenges

withthechild.

Ifthechildreferredisfoundeligibleandbeginstoreceiveservices,

thechildcanbenefitfromthechildcareproviderworkingwiththe

specialistswhoprovidetheservice.Tespecialistscanthenbecome

consultantstothechildcareproviderandthefamily.Tenextchapter

offersideasforwaystomaximizethiskindofcollaboration.

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5Collaborating

for Inclusion


39/94

28

The primaryrole of a child

care provider is

to nurture and

support the childs

development in a

loving and caring

manner.

oeffectivelymeettheneedsofchildrenwithdifferingabilitiesandlearningcharacteristics,childcareprovidersmayneedtoexpandthewayinwhichthey

reachouttofamiliesandlinkwithspecialists.Tesetwo

groupsofpeoplehaveimportantinformationtoshareandcanserveasresourcestosupportchildreninaprogram.Teirsuggestionsinvariablyenricheffortsatinclusion.Specialiststhemselvesmayevenbeabletovisitacarefacilityandoffersomeonsiteguidance.

Providinginclusivechildcaredoesnotmeanaproviderorevenagroup

ofprovidershastodotheworkalone.Everyonehasaroletoplay.

Teprimaryroleofachildcareprovideristonurtureandsupportthe

childsdevelopmentinalovingandcaringmanner.Partnershipsformed

withotheradultswhoarecaringforthechildtheparents,healthcareproviders,orspecialistscancomplementtheeffortsofallconcerned,

especiallywheneveryoneconcentratesonaparticularstrength.Whenthe

expertiseofmanyarecombined,ideasdevelopandstrategiesemergethat

arebetterthanthoseanyonepersoncouldhavedevelopedalone.12Te

resultistheessenceoftruecollaboration.

Forcollaborationtobesuccessful,thefollowingelementsareessential:

Respect for family members knowledge and experience with the

child.Familymembersareaprovidersfirstandbestresource;they

shouldbeincludedintheplanningandimplementationofcarefor

theirchildren.

Clear and regular communication. Plannedmeetingsandinformal

conversationsarearrangedwitheveryoneinvolvedinachilds

development.Teseoccasionsareidealopportunitiestodiscusswhat

worksandwhatneedsimprovementandtopracticeallimportant

communicationskillsaskingquestions,listeningcarefully,and

sharingconcerns.Ifwhatisdiscussedneedstobereflectedinthe

individualizedfamilyserviceplan/individualeducationprogram


40/94

(IFSP/IEP),thechildcareproviderneedstospecificallyaskhowthat

willhappen.

Time reserved for collaboration.Commonly,nearlyeveryoneinvolved

insupportingachildwithadisabilityorspecialneedwillbepressedfortime.Tecommitmenttocollaborationincludesanunderstanding

thatreservingthetimetoplan,interact,communicate,andevaluatewill

actuallysavetimeinthelongrun.

An investment in the inclusive program.Allprovidersneedtobeactively

involvedindevelopingtheinclusiveprogramandfeelpersonallyinterested

initssuccess.Ifteacherssupportinclusivepractices,buttheprograms

administratorsdonot,themostvalianteffortsarenotlikelytobe

successful.

Collaborative efforts with the family and specialists to obtain appro-

priate assessment and the support services that can be provided in aprogram. Ifachildiseligibleforspecializedservices,achildcareprovider

canandshouldparticipateinIFSPorIEPmeetingsandintheplanning

anddeliveryofservicesifaparentrequeststhecaregiversparticipation.

Sometimesaspecialistwillbeabletocomeintothechildcareprogram

regularly;atothertimesthespecialistwillbeabletoserveasanoutside

consultant.Additionalsuggestionsforwaystoobtainandutilize

specialistsareincludedinchapter4,IdentifyingandFindingHelp.

Contributing to Collaboration

Terearemanywayschildcareproviderscontributetocollaborationwith

familymembersandspecialists.Oneofthegiftsachildcareprovidercan

bringtocollaborationaroundaparticularchildistofocusonthechild

firstnotonthedisabilityorchallengingareas.Someadditionalideasfor

waystocollaboratearelistedbelow.

Gather multiple perspectives. Childcareprovidersoftenhaveagreat

understandingandperspectiveonwhatisimportantforachildfrom

theirknowledgeofchilddevelopmentandtheirobservationsofother

childrenintheprogram.Tefamilymembershaveaverydifferent,

deeperknowledgeofthechild,whilethespecialistsofferinsightbasedontheirtrainingandexperience.

Seek assistance as soon as possible.Ifthereisconcernaboutachildwith

disabilitiesorspecialneedswhoisincludedinachildcareprogram,a

childcareproviderwouldbewisetodocumentconcernsandworkwith

thefamilyandspecialiststogetsupport.Sometimesproblemsininclusion

arisefromaninappropriateorinadequateresponsetoachildsunique

characteristics.

Commonly, nearly

everyone involved in

supporting a child

with a disability or

special need will be

pressed for time.

2929


41/94

While it is difficult

to know what you

do not know, a childcare provider should

develop strategies

for reflection and

selfassessment when

concerned about

a child and take

appropriate steps for

support.

Be open to learning.Whileitisdifficulttoknowwhatyoudonot

know,achildcareprovidershoulddevelopstrategiesforreflection

andselfassessmentwhenconcernedaboutachildandtakeappropriate

stepsforsupport.Temoreaproviderhastoworkwithchildrenwhohavedisabilitiesorotherspecialneeds,themoresophisticatedhis(or

her)questionswillbecome.

Provide the modifications or adaptations recommended.When

workingwithspecialistsorfamilies,achildcareprovidermustbe

preparedtocarryouttheirsuggestionsforsuccessfulinclusion.Te

providermustalsoinformothersifmoreclarificationordemonstration

isneededtoimplementthestrategy.Insupportofthis,itisimportant

tohaveaplanthatenablesachildcareprovidertomonitorand

evaluatetheeffectivenessofanintervention.

Know the applicable laws and regulations. Childcaredirectorsandprovidersworkingfromafamilyhomeshouldhavespecifictraining

inthelawsrelatedtospecialeducationandearlyintervention,aswell

asinthefederalAmericanswithDisabilitiesAct(ADA)andrelevant

Californiastatutesondisabilities(seeAppendixA,ApplicableLaws).

Knowledgeoflicensingregulationsandofwhenandhowtoapply

forwaiversforservingchildrenwithdisabilities(especiallythosewith

specialhealthcareneeds)isalsocritical.

Be familiar with community resources.Childcareproviderscanfind

outwhichagenciesinthecommunityprovideservicesand/orsupport

tochildrenandfamiliesandgettoknowtheindividualsfromthoseagenciesanddeveloprelationshipswiththem.Knowledgeofresources

thatmaybenefitthefamilyofachildwithspecialneedscanmakea

hugedifferenceinthequalityofsupportortheappropriatenessofa

referralthatachildcareproviderisabletogiveachild.

Gather more information.Itmaybeappropriatetogetspecific

trainingrelatedtoanindividualchildsdisabilityorspecialneed.It

mayalsobedesirabletotakeadditionalworkshopsandcourseson

inclusion;seektechnical,onsitesupport;and/orparticipateinpeer

groupsfocusedoninclusion.

Working with Specialists

Parentsareachildcareprovidersfirstandmostimportantresource.

oobtainotherspecialistresources,achildcareprovidermusthavethe

parentswrittenconsent.Ortheparentmustrequestthespecialistto

contacttheprovider.13

30


42/94

Achildcareprovidermay,ofcourse,useotherstaffmemberstodo

problemsolvingwithoutspecificparentalconsent,buteveryoneshouldbe

respectfulandawareofconfidentialityissueswhendoingthis.

Individuals Available as Resources

Manydifferentagenciesprovideservicesforyoungchildrenwith

disabilitiesorspecialneedsandtheirfamilies:schooldistricts,early

interventionagencies,regionalcenters,publichealthagencies,family

resourcecenters,therapycenters,andsoon.

Specialistsworkingwiththechildandfamilymaycomefromawide

varietyofbackgrounds:specialeducation,speechandlanguage,early

intervention,behavioral/mentalhealth,nursing,socialwork,vision,

occupationaltherapy,physicaltherapy,deafandhardofhearing,assistivetechnology,andsoon.

Tesespecialistsmaybewillingtoprovidestaffdevelopmentattherequest

ofthechildcareprogram.(Iftheinformationsharedbythespecialists

raisesquestionsaboutaparticularchild,thefamilymustbeincludedin

anydiscussionorvisits.)

Ifachildisalreadyreceivingservicesfromanearlyintervention

program,specialeducationprogramatapublicschool,ortherapistsor

otherproviders,achildcareprovidermayaskthefamilyforpermission

tocommunicatewiththeserviceproviders.Afamilymayalsoask

specialiststoprovideservicesorsupporttotheirchildwithinthechildcareprogramitself.

Howtoassistachildinparticipatingmorefullyinachildcareprogram

isnotalwaysselfevident.Almostallchildcareprovidersespecially

thosewhoareexpandingtheirinclusiveeffortsneedideasfor

A child care

provider may

use other staff

members to do

problemsolving

without specific

parental consent,

but everyone

should be respectful

and aware of

confidentiality

issues when

doing this.

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Working together

often leads to

discovering the

best way to shareinformation and

discuss how to best

meet the needs of

the child, the family,

and the child care

program.

communicatingwithchildrenwithspecialneeds.Teyalsowanthelp

inpositivebehavioralsupporttechniquesandgenerallywelcomeany

otherkindofsupportthataspecialistcanprovide.

Linkingspecialistswithachildcareprogram,inpartnershipwithfamilies,expandsinterventioneffortsandhelpstosecureevengreater

positiveoutcomesforallchildren.

Specialists as Resources

Specialistsactasconsultantswhosupportandprovideresourcestochild

careprogramsandfamilymembers.Specialistscan:

Shareinformationspecifictoachildwithspecialneeds.

Provideservicestoachildwithintheprogramorclassroom.

Exchangeinformationontypicaldevelopment. Givesuggestionstobeimplementedintothedailyroutine.

Observethechildandgivefeedback.

Demonstratetechniques.

Suggestresources,agencies,andservicesavailableinthecommunity.

Findanswerstoquestions.

Providewritteninformation.

Includethechildcareproviderintheeducationaldocumentsforthe

childandfamily(theIFSPforchildrenunderagethree,ortheIEPfor

childrenoveragethree).

SpecifyintheIFSPorIEPaplanfordirectconsultationwiththechildcareprogrambythespecialist.

Coordination with Specialists and Families

Tebestwaytocoordinatechildcareeffortswiththoseofspecialists

andfamiliesdependsontheneedsofthechild,thefamily,andthecare

provider.Ideally,thefamily,provider,andspecialistmeettogetherto

discussthespecialistsroleinthechildcareprogram.Workingtogether

oftenleadstodiscoveringthebestwaytoshareinformationanddiscuss

howtobestmeettheneedsofthechild,thefamily,andthechild

careprogram.Afterthespecialistsrolesinthissettingarearticulated,

alongwithanyspecificagreementsonthepartofthefamilyorchild

caresetting,itwouldbewiseforthechildcareprovidertorecordthe

agreementsinwriting.Oncethoseareestablished,theneveryoneinvolved

mayalsowanttodeterminewhentheagreementswillbereviewed.A

sampleagreementformisprovidedinAppendixC,AgreementForm.

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6Examples of

Inclusive Child Care

Strategies


45/94

I

1

34

nclusivechildcaretakesplaceinmanydifferentways,dependingonthesettingandtheneedsofthechildrenintheprogram.Tischapteroffersseveralcasestudies

thatillustratetheuniquestrategiesdifferentprogramshave

usedtomeettheneedsofthechildren.Althoughavarietyofstrategiesisusedineachcasetosupportthesenseofbelongingandinclusionofthechildrendescribed,oneprimarystrategyishighlightedforeach(alsoseechapter3,CreatingInclusiveChildCareSettings).Testudiesarebasedonrealchildrenandprograms,withnamesandidentifyingdetailschangedtomaintainconfidentiality.Tesestudiesaredesignedtoinspireandencouragechildcareproviderswhoareworkingtodevelopinclusivesettings.

STRATEGY1

Environmental Support

Setting: Family Child Care

Child: Li

Age: Three years

BACKGROUND

Liisthreeyearsoldandlivesinabeachcommunity.Aquiet,sweetnaturedlittlegirlwithalotofdetermination,shewasborn

prematurelyand,asaresult,hasasignificantvisualimpairment

andmilddelaysinlanguageandcognitivedevelopment,including

difficultyinfeedingherself.Liliveswithherparents,ranand

Phuong,andisanonlychild.ShehasbeenattendingtheJackson

FamilyChildCarehomesinceshewasfourteenmonthsold.Lis


46/94

parentshadpreviouslyusedransmothertocarefortheirdaughter,

butwhenthegrandmotherdevelopedhealthproblems,theyneeded

tofindothercare.Althoughnervousaboutusingsomeonewhowas

notamemberofthefamily,theybothneededtowork.TefamilyfoundtheJacksonhomethroughtheirearlyinterventionprovider,

whohadprovidedserviceattheJacksonhomeinthepast.

erryJacksonhas12childrenenrolledinhercenterandemploys

twohelpers,oneinthemorningandoneintheafternoon.erry

hadprovidedcareforanotherchildwhohadbeenbornprematurely;

however,thatchildhadneedsdifferentfromLi.errywonderedhow

shewouldaddressLisvisualanddevelopmentalneeds.Teideas

fromtheearlyinterventionspecialisthadbeenhelpfulincaringfor

thepreviouschild,soshewasoptimisticabouttakingadvantageof

thesameresourceinprovidingeffectivecareforLi.SERVICES

LireceivedEarlyStartearlyinterventionservicesspecifiedinan

IFSPuntilshewasthreeyearsofage.Troughthisservice,anearly

interventionspecialistmadevisitstotheJacksonfamilychildcare

homealternateweeks,andavisionspecialistmademonthlyvisits.

Teearlyinterventionteamvisitedherathomeonalternateweeks.

Teearlyinterventionistandservicecoordinatorworkedwiththe

familyandproviderindesigningatransitionplansinceservice

providerschangewhenachildreachesagethree.

Lihadmadeatransitiontoreceivingservicesfromthelocalschool

districtthroughanIEP.erryJacksonwasabletoattendtheIEP

meetingwiththefamily,theearlyinterventionist,theservice

coordinator,andrepresentativesfromtheschooldistrict.After

Li received

Early Start early

intervention

services specified

in an IFSP until

she was three

years of age.

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developmentoftheIEP,theteamdiscussedwheretheservices

wouldbeprovided.TefamilyrequestedthatLiremainatthe

Jacksonhomewithsupportfromthedistrict,asthefamilyhad

becomequitecomfortablewiththisarrangement.Beforethisinstance,theschooldistricthadnotprovidedservicesinafamily

childcarehome,butthepersonnelagreedonthearrangement.

STRATEGY

BecauseLihasavisualimpairment,theenvironmentwasthe

primaryareathatneededmodification.Shecouldmakesome

visualdistinctions:shecouldseeshapessixinchesawayandcould

distinguishbetweenstronglycontrastingcolors.However,many

environmentalmodificationswereneededinordertosupport

herinclusion.Itwasimportantthatthemodificationsweremade

noticeabletoLi.First,furniturewasmovedsothatitdefinedtheborderbetweenthefamilyroomanddiningroom,whichwasup

onestep,thusprotectingLifromtrippingonthatstep.Additionally,

largeremovablestickerswereplacedontheslidingglassdoorthat

ledoutside,ensuringthatLiwouldnotwalkintotheglass.Tetoys

thatLilikedtoplaywithwerekeptinthesameplaceeveryday,and

otherchildrenwereencouragedtoreturnthemtothesameshelfin

ordertoassistLiinlocatingthemindependently.Containersoftoys

wereacolorthatcontrastedwiththetoysinside.Tisstrategyalso

helpedLifindwhatshewasinterestedin.

oysandmaterialsthemselvesneededmodification,aswell.For

example,Lilikedtoplaywithcontainersandtakethingsinandout.

Manycontainerswereadaptedsothattheedgesweremorevisible:

apermanentmarkerorcoloredtapewasappliedtodarkentheedge.

Lialsoneededclearcontrastbetweenherfoodandtheplateorbowl

shewasusing.Soerryplannedwhichcolorofplatesandbowls

touse,dependingonthefoodbeing

served.Beyondherneedforcontrasting

colors,Lipreferredthatherfooddidnot

havemixedtextures(e.g.,acasserole).

Asanaccommodation,erryworkedwithranandPhuongtodevelop

ideasformenus.erryalsoaskedthe

specialistforresourcesonfeeding

childrenwithspecialneeds.

36

The toys that Li liked

to play with were

kept in the same

place every day, and

other children were

encouraged to return

them to the sameshelf in order to

assist Li in locating

them independently.


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Inadditiontoherownlearning,errymadesurethatbothhelpers

hadachancetolearnfromthespecialists,sinceLisneedsrequired

theattentionandinvolvementofeveryoneatthecenter.Forexample,

anadultneededtokeepaspecialeyeonLiwhenthechildrenwereallplaying.ohelpeveryoneinthelearningprocess,errykeepsalist

onhandasquestionsarise.

Onethingeveryonelearnedwasthattheactivitiesneededtobe

adjusted.errynoticedthatLiwashesitanttojointhelargergroups.

errymadeaspecialpointofkeepingthegroupssmallbyhaving

morethanoneinterestingactivitygoingonatatime.Tespecialists

offeredhelpfulideasaboutwaystoencourageLitouseherbody

whenmovingthroughtheenvironment.Anorientationandmobility

teacherfromtheschooldistrictwentsofarastocreateanobstacle

coursethatLiespeciallyenjoyed.Asitturnedout,alloftheotherchildrenseemedtoenjoyitaswell.

errywasabletoparticipateinoneoftheIFSPmeetingsandwas

activelyinvolvedinplanningforthetransitiontoschoolservicesand

theIEPforLiatagethree.Withtheknowledgeshehadgainedfrom

theearlyinterventionspecialistsandthedevelopingrelationshipwith

thepreschoolspecialists,errywassurethatshecouldcontinueto

provideaqualitylearningenvironmentforLi.

SUPPORTING FACTORS

Tefamilyhadastrongrelationshipwiththechildcareprovider. Techildcareproviderhadapriorrelationshipwiththespecialist

andwascomfortableaskingforhelpandideas.

Tespecialistswereabletovisittheenvironmentwherethechild

spentmuchofhertimeandofferideasformodifications.

Allprovidersatthechildcarewereinvolvedinprovidingsupport

andcreatingmodificationsforLi.

Techildcareproviderwasabletoplayanactiveroleinthe

planningmeetings(IFSPandIEP)andinthediscussionon

transition.

Asaresultoftheabovefactors,Liandherfamilyreceivedcontinuityincareandservicesandexperiencedasmoothtransitionbetween

earlyinterventionandspecialeducation.

An orientation-

andmobility

teacher from the

school district went

so far as to create

an obstacle course

that Li especially

enjoyed.

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As Danny became

more interested in

playing with the toys

and children in the

center, the providers

realized they needed

help in making the

materials accessible

and usable for him.

2STRATEGY2

Materials Adaptation

Setting: Militar y Child Care Center

Child: Danny

Age: Two and one-half years

BACKGROUND

Dannyistwoandonehalfyearsoldandlivesonamilitarybase.

alkativeandsocial,Dannywasbornwithspinabifida,aspinal

defectthataffectshisabilitytomovehislegsandcontrolhisbladder

andbowels.Healsohashydrocephalus(increasedfluidaroundthe

brain),whichhasbeentreatedwithashunt(atubethatallowsfluid

todrainandbeabsorbedintohisbody).Hehasbeenhospitalizedseveraltimesforsurgeryonhisshuntandfeet,butnotinthepast

eightmonths.Dannyseemsrelativelyhealthynow.Hewearsleg

bracestokeephislegsstraightandprotected.Hemovesbyrolling

andscootingonhisbottom.Hetalksquitewell,mainlyinphrases

oftwoorthreewords.Althoughheseemstounderstandwhatissaid

tohim,hedoesnothavealongattentionspan.Heliveswithhis

mother,Crystal,whoisintheMarineCorps.Hebeganattending

thechildcarecenteronthemilitarybasewhenhewastwentytwo

monthsold.

SERVICES

Dannyreceivesearlyinterventionservicesfromapublicschoolearly

interventionprogram.Heisvisitedweeklybyanearlyinterventionist

atthechildcarecenterandoccasionallyathome.Heisalsoseen

inhishomebyphysicalandoccupationaltherapistsfromtheearly

interventionprogram.Tedoctorsonthebaseandattheclinicof

thelocalchildrenshospitalallcloselyfollowhismedicalcare.

STRATEGY

AsDannybecamemoreinterestedinplayingwiththetoysand

childreninthecenter,theprovidersrealizedtheyneededhelpinmakingthematerialsaccessibleandusableforhim.Attheinvitation

ofthestaffatthecenter,thetherapistsandearlyinterventionistmade

visitstoobserveDannyintheenvironmentandthenheldameeting

withCrystalandtheproviderstoshareideas.

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Asaresultofthesuggestions,materialsatthecenterweremodifiedin

severalways.Sometoysandartsupplieswereplacedonlowershelves

togiveDannyeasieraccess.Aftercarefulobservationofhisinterests,

theprovidersmovedtoycarsfromatabletoptothefloor.AtableeaselwasplacedonthefloorsothatDannycouldsitandpaint.Nonskid

backingwasaddedunderneaththepainttraysothatthepaintdid

nottipasDannyscootedovertoit.Tesensorytablewaswaisthigh

tochildrenwhowerestanding.TistablewasusedonlywhenDanny

hadanadultavailabletoholdhimorgetachairforhim.Since

sensorytoyswereahighinterestactivityforDanny,smallertubswere

filledwithhisfavoritesensorytoysandmaterialsandmadeavailable

onlowshelvesforhimwheneverhewanted.Becauseheavytoyswere

difficultforDannytoholdwhilescooting,lighterweighttoysand

blockswerealsoprovided.Tetoysenabledhimtoinitiateplaywith

otherchildrenandjoinintheirplay.

Inaddition,Dannywasencouragedtoaskhisfriendsandteachers

forhelpwhenhewantedsomething.Teprovidersagreedtopay

attentiontohisrequestsandinterestswhenconsideringother

materialstoadapt.HisIFSPteam(consistingoftheparent,specialist,

andchildcareprovider)alsodecidedtoexploresometypeofwheeled

toythatDannycouldusewhenhewantedtojointheotherchildren

ridingtricycles.Afterhearingalloftheseideas,Crystalbecame

interestedinalsogettingawheelchairforDanny.

SUPPORTING FACTORS

Techildsinterestswereobservedandrespected.

Specialistswereavailabletoobservethechildandgiveideas.

Materialswereprovidedinadifferentformorwereadaptedto

meetthechildsneeds.

The toys enabled

him to initiate play

with other children

and join in their

play.

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The Head Start

teachers are interested

in learning how to

modify materialsso Carlos can play

alongside his peers

in the class.

3STRATEGY3

Activity

SimplificationSetting: Head Start Center

Child: Carlos

Age: Four years

BACKGROUND

Carlosisfouryearsoldandlivesinaruralcommunity.Although

outgoingandfriendly,heismorelikeatwoyearoldinmostareas

ofdevelopment.CarloswasdiagnosedwithDownsyndromeshortly

afterbirth.Hehadsurgerythatsuccessfullycorrectedaheart

problemwhenhewaseighteenmonthsold,andhehashadnoadditionalhealthproblems.

Carlosliveswithhismother,Maria,histwooldersisters,andone

olderbrother.HismotherspeaksprimarilySpanish,andhissiblings

arebilingual.Hisfourteenyearoldsisteroftencaresforhim.Carlos

wasenrolledintheHeadStartcenteratthebeginningoftheyear.

Heattendsfourafternoonsaweek.

SERVICES

Carlosattendsaspecialeducationclassthreemorningsaweek.He

attendedtheclasslastyearaswell.HismotherhadherotherchildrenenrolledinHeadStartandwantedCarlostoattendwhenheturned

four.Shehasaskedthathisspecialeducationteachersworkwiththe

HeadStartstaffsothatCarloscanreceivebilingualspeechtherapy

attheHeadStartcenterwithotherchildrenfromhisclass.

STRATEGY

Carlosplayswithtoyslikeachildyoungerthanfour.Heoftenput

toysinhismouthandhastroubleusinghishandsandfingerson

smallobjects.HisHeadStartteachersareinterestedinlearning

howtomodifymaterialssoCarloscanplayalongsidehispeersin

theclass.Teyalsowanttosupporthisgrowthanddevelopmentin

playingwithtoysandhissmallmusclemovement.OneoftheHead

StartteacherswasabletovisitCarlosspecialeducationclassand

getideasforsuitabletoysandactivities.TeHeadStartdisability

specialisthadpreviouslysupportedmanychildrenwithDown

syndromeandhadseveralideastocontribute.Carlosmotherand

hissisteralsohelpedbylettingtheteamknowwhathisfavoritetoys

wereathome.

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Tefirstandmostimportantmodificationwastocarefullyexamine

allofthetoysavailableintheclassroom,lookingforsmallparts

thatcouldbeadangerifCarlosputtheminhismouth.Anytoys

thatwereconsidereddangerouswereusedonlyundercarefuladultsupervision.Second,toysthatCarlosenjoyedwereprovidedinlarger

formalongwithsimilartoys.Providerswereinitiallyworriedthatthey

wouldbeforcedtousebabytoystomeetCarlossneeds,butthey

werepleasantlysurprisedathoweasyitwastofindageappropriate

materials.Forexample,inatubthatwasfilledwithoneinchcube

blocks,largerblockswereadded,somewithmagnetsorfabrichook-

andloopclosuresthatallowedCarlostosuccessfullystackthem.

Cars,trucks,andairplaneswithlargewheelsandremovablepeople

werebroughtinnearotherwheeledtoys.Cardboardbooks(somein

Spanish,othersbilingual)wereplacedalongsidethepaperbackbooks.

Somebooksweretakenapartandplacedinphotoalbums,resulting

inthickerpagesthatwereeasierforCarlostoturn.

Intheartsandcraftsmaterialsarea,threesetsofspecialloopscissors

wereborrowedfromspecialeducationpersonnel;theseallowed

Carlostocutwithminimumeffort;theextrascissorsalsoallowedhis

friendstotrythemaswell.Largermarkersandcrayonswereadded

tothesupply.Ducttapewaswrappedaroundthehandlesofsponge

paintbrushestomakethehandleslarger.WhilehelpingCarloswork

throughactivities,staffmembersgaveCarlosonlythematerialshe

neededforonestepatatimeandhelpedhimtothinkmethodicallythroughthedirectionsforanyactivity.Teyoftenfoundthatthey

onlyhadtosimplyrepeatdirectionsgiventotheotherchildrenbut

oneatatime.

TeteacherskeptCarlosandallofthesenewstrategiesinmindwhen

theythoughtofnewmaterialsandactivities.Asaresult,hecontinued

togainskillswhilehavingfunplayingwithhisfriends.Carlos

blossomedatHeadStart,andhisteachersfromthespecialdayclass

cametoobservehim.Teywereabletoencouragehisnewskillsin

thespecialeducationclassroomandlearnedsomenewthingsabout

Carlos.

SUPPORTING FACTORS

Tefamilywasinvolvedinplanningfortoysandmaterials.

Teinternalresourcesavailablesupportedaccesstovarioustoys.

TeHeadStartstaffandspecialdayclassstaffwereabletolearn

byobservingCarlosinadifferentsetting.

Some books were

taken apart and

placed in photo

albums, resulting

in thicker pages

that were easier

for Carlos to turn.

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4

Luke receives

services from the

resource specialist,

speech therapist,

and adaptive

physical educationteacher at school.

STRATEGY4

Child Preferences

Setting: On-Campus, After-School Program

Child: Luke

Age: Eleven years

BACKGROUND

Lukeisanelevenyearoldboywithcerebralpalsy.Heliveswithhis

mother,Joy,andyoungerbrotherinanurbancity.Lukehasalways

receivedsupportintheregularclassfromthespecialeducation

teacher.Lukehaslearningdisabilities,andhismobilityisaffected

bycerebralpalsy.Heisabletowalkandrunforshortdistances

butloseshisbalanceonoccasionandgetstiredwhenwalkinglongdistances.Heandhisbrotherattendanafterschoolchildcare

programonthecampusoftheirelementaryschool.14

SERVICES

Lukeisinthefifthgradeandreceivesservicesfromtheresource

specialist,speechtherapist,andadaptivephysicaleducationteacher

atschool.Hehasbeenattendingtheafterschoolprogramfor

twoyears.Inthepast,therehasbeenlittleoverlapbetweenthe

specialistsandtheafterschoolprogram.Atfirst,theafterschool

providerswereuncomfortablewithLukeslackofbalance,which

resultedinhisoccasionallyfalling.Becausetheproviderswanted

toavoidaninjury,theytriedtorestricthisoutdooractivityby

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placinghimwithagroupofyoungerchildrenwhentheoldergroup

wasoutsideoronfieldtripsintheneighborhood.Hedidnotlikethe

indoorgamesoffered,however,andstartedgettingintotrouble.

STRATEGY

Aftertalkingwithhismother,theafterschoolprovidersdecidedto

spendsometimetalkingwithLukeaboutwhatitwashewantedto

doafterschool.Teydiscoveredthathewantedtoplaybasketball

andgoonfieldtripswiththeoldestgroup.Healsowasgoodat

computergamesandwantedtheprogramtohavesomeforhimto

play.

InlookingcarefullyatLukespreferences,theprovidersclearlysaw

thathewasaskingtodoactivitiesdifferentfromwhattheafter

schoolprovidershadbeenofferinghim.TefirstthingtheydidwasobtainpermissionfromJoytotalkwiththeadaptivephysical

educationteacherattheschoolsiteandgetsomeideasforwaysto

handletheoccasionalfallsandthingstodoifLukewereinjured.

Ten,onfieldtripdays,hismotherbroughtinhisbicyclesothathe

couldgooutwiththegroupandkeepup.Next,theprogram,which

previouslyhadapolicyagainstcomputergames,obtainedsome

gamesforadonatedcomputerandmadeplayingthecomputergames

oneofLukeschoicesduringthetimehespentindoors.Lukenow

hadanopportunitytodemonstratehisskillatmanyofthegames.

Asaresult,hewasalsogivenleadershipresponsibilitiesforteaching

andsupervisingtheyoungerchildrenastheyplayedthosegames.

osupportcontinualeffortstoadaptLukesafterschoolsetting,the

familyalsorequestedthattheIEPspecifiesregularconsultationswith

theafterschoolprogramandreciprocalvisitstogaininformation,

ideas,andsupport.

SUPPORTING FACTORS

Lukewasabletoparticipateinhisprogramdevelopmentby

sharinghisinterestsandideas.

Teafterschoolchildcareproviderwasopentonewideasfrom

thechild,thefamily,andotheradultsworkingwithLuke. Informationwassharedbetweenthespecialeducationprogram

andthechildcareprogram,withconsultationsplannedforthe

future.

In looking

carefully at Lukes

preferences, the

providers clearly

saw that he was

asking to do

activities different

from what the

afterschool

providers had been

offering him.

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5

The mothers work

schedule allows her

to have one weekday

at home with Jessie

for the medical

and special service

appointments Jessie

needs.

STRATEGY5

Special Equipment

Setting: Family Child CareChild: Jessie

Age: Eleven months

BACKGROUND

Jessieiselevenmonthsoldandlivesinasuburbofahighly

industrializedCaliforniacity.Jessiewasbornprematurelyandwas

hospitalizedforthefirsttenweeksofherlife.Now,attheageof

elevenmonths,shehasmilddevelopmentaldelaysandachronic

respiratoryillness.Jessieliveswithherparents,DawnandKirk.

FindingappropriatechildcarewaschallengingforDawnbecauseJessierequiresdailymedicationsbymouthandnebulizertreatments

uptofourtimesaday.Jessiesparentsworkschedulesconsistof

longcommutesandfour,12hourworkdays.Withassistancefrom

alocalchildcareresourceandreferralagency,Jessiesmomfounda

licensedfamilychildcareprovider,Maya,whoserveseightchildren

nearJessieshomeandcanprovidecareduringtheextendedhours

neededbythefamily.

SERVICES

JessiereceivesCaliforniaEarlyStartearlyinterventionservices

accordingtoanindividualizedfamilyservicesplan(IFSP)developedbythelocalregionalcenter.Hermedicalcondition

iscarefullymonitored,andshehasmanyappointments.Te

mothersworkscheduleallowshertohaveoneweekdayathome

withJessieforthemedicalandspecialserviceappointmentsJessie

needs.Duringnaptimeatthefamilychildcareprovidershome,

anIFSPmeetingwasheldwiththeparents,theregionalcenter

servicecoordinator,adevelopmentalspecialist,andthechildcare

provider.ogethertheydevelopedaplanforearlyinterventionand

forcoordinatingservices,alongwithaspecialcareplanincaseof

emergencies.Atthismeeting,MayaexpressedsomeconcernaboutJessiesmedicalconditions.Shehadpreviousexperiencecaringfor

childrenwithspecialneeds,butnonewiththeseparticularissues.

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STRATEGY

Aftersigningappropriatemedicalreleaseformsandcheckingwith

licensing,DawntrainedMayatoadministerJessiesmedicationsand

nebulizertreatments.MayaalsocontactedthelocallungassociationandJessieshealthcareproviderforadditionaltrainingandinfor-

mationontheuseofinhaledmedications.Dawnworkedclosely

withthechildcareproviderandherbackupassistantstoensurethat

someonewhoknewhowtocareforJessiewasonsiteatalltimes.

TedevelopmentalspecialistfromtheEarlyStartprogramnow

visitsJessieatthechildcareprovidershomeonceaweektoprovide

ideasforpromotingJessiesdevelopmentalskillsandaddressingher

healthcareneeds

Inclusion Works

Documents

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