Special needs children

[Rhonda]

Good morning,

I was just wondering if anyone has any experience with accepting children with special needs that the child should grow out of into childcare?

I'm interviewing a family that has a child who has some physical challenges and food aversions. The physical challenges will likely just mean the child requires more time than the average child to meet the physical milestones. I've don't know anything about a food aversion.

My main questions:
Do you charge more until the child gains mobility?
With a food aversion, I would have the parents supply all the food?

Is there anything else I should be thinking about? I'm going into this interview with an open mind, and I have no experience because normally I don't accept children with any special food requirements because I am not a peanut free home and my family has our own allergies which limits the foods I can serve.

Thanks in advance.

[cfred]

I had always found myself avoiding children with special needs. However, one sort of 'snuck up on me'. I have a little girl (now 18 mos) old, who started with me at 3 months. Her oxygen supply was cut at birth so there is some brain damage and weakness on the right side. At 3 mos, it was hard to say where she really was or would end up. As it turns out, she is in fact special needs.....and my most prized little sweetheart. I absolutely love her. She has significant delays in motor skills, muscle function, hearing loss and we're trying to ascertain where she is cognitively. There does seem to be some delay with her processing time. She has several food sensitivities (wheat, dairy, eggs, most meats, almonds). Part of my schtick is specialized diets catering to sensitivities and vegan/vegetarian options, so it's not a problem for me. Like you, I do not cater to peanut allergies. I don't allow any life threatening allergies. So far as food goes, if they're happy to send food, then have them do that. If you want to broaden your professional horizons and add a desirable component to your business offerings, then you can, as I did, research the dietary needs and come up with variations to your typical menus to support them.

All I can tell you is that while it's a bit more inconvenient, but you might be surprised how easily you fall into the groove of the different care style. One thing I do is allow for therapists (she has physio and hearing therapists) to do appointments here at daycare. This way I can speak with them personally and have them teach me different strategies for working with the child. It's a great learning tool and offers a chance to pick someone's brain who deals with this stuff for a living.

I do not charge more. As I said, it's part of my schtick...what I use to set myself apart. That said, I do charge more than other providers in this area. I think charging more would be completely acceptable, depending of the level of extra care they require. I think I'd be inclined to meet with the family and the children to see how you mesh and how demanding their needs are. You want to be sure you can manage the other children as well as the new children. One really good thing is that odds are, this family gets turned away a lot from other providers. Don't be surprised if they are dream clients who truly value you and your willingness to give them a chance

[playfelt]

For sure you would need more advice. For a physical limitation make sure you are equipped to be able to lift/carry the child longer than you normally would. The child may become 30 pounds and still be unable to climb stairs or not be toilet trained and need to be changed at 4 years old. My daughter didn't pull to a stand till she was 4 years old, started cruising at age 5 and took her first real steps at age 6 - that was a lot of lifting and carrying and my back and knees have paid for it but there wasn't really much else we could do. From that standpoint it would be for such a short time you likely wouldn't suffer any lasting effects if you lift and turn carefully. Brianne is now 20 years old and I am over 50 so my age is part of the sore back and knees as much as she is.

For the food aversions it is likely to certain textures so you may find you are feeding the child puree food instead of table foods and being careful when mashing a food such as a banana that the chunks are only a certain size. If the parents will provide for at least the first little while till you get comfortable with what child can eat that helps a lot. For Brianne she has trouble chewing and swallowing so everything must be mashed (ie like it has been pre-chewed as gross as that sounds - a magic bullet is your best friend) and everything must be very moist - we add applesauce or yogurt to the top of all her meals making sure that the yogurt on the tip of the spoon is the first taste she gets and that sort of gets spread over the top of the spoonful of food as she puts it in her mouth or should I say we put it in her mouth as her hand eye coordination is poor so just easier to feed her, watch for wrong size lumps as I go etc.

[Rhonda]

I used to work in a daycare centre that catered to children with special needs. That wasn't the intentions of the daycare it was a daycare centre that catered to young families in need (such as single teen mothers) or families with special needs. While the daycare centre part was running, the board room had courses for the families to assist with their special needs, from cooking to mental health. It seemed most of the children in care had special needs whether they be physical, cognitive or emotional. I was one of the preschool teachers and had a group of 8 children. I can honestly tell you they were the hardest group of children I have ever had. I came home emotionally and physically tired and physically bruised or bitten most days. That was 7 years ago, and I lasted 2 months in that daycare centre. I went back to home daycare and haven't worked with a special needs child since.

However, I have a space and I have interviewed a few families but just don't get that special vibe from any of them, plus my heart isn't in to interviewing, but the space does need to be filled and I'm sure the perfect family isn't going to fall on my lap. When I received this beautifully written email from this family, I couldn't say no to the interview. I tried everything to force myself to do it, wrote email after email, and I couldn't send them, I even sat on the emails for days trying to force myself to send it. All I could think about was how already I was emotionally attached to this family (I have been rather emotional lately) and that this family might be the perfect family for me, so I couldn't turn them away. I told them I would like to learn more, but I couldn't guarantee to accept the child.

There is so much to think about! Cfred, the child is working with therapists, so I would have to learn how that would interfere with daycare. New territory for me, didn't even think about the therapists coming to daycare.

PlayFeltPlus I am worried about the physical aspect of things. I am not prepared to be carrying around a child who lacks mobility. But it is my understanding the child is small and already scooting. I do have a magic bullet, but I like your suggestion to have the parents send food until I learn and feel comfortable with everything. I had never even heard of food aversion until this family emailed me.

I've started a list of questions to ask during the interview. I just want to go into the interview with as much information as possible so I can make an informed decision and what is best for my family as well.

[playfelt]

I have issues with therapists coming to daycare depending on how and what they do and what the intended outcome is. The ones that come and work with the child but also include the other children so it just becomes a normal part of play work the best. Issues I have had with some is they needed to work one on one with the child so it either meant I had to take the other kids to the basement playroom and leave them upstairs which was my preferred or the therapist would ask to go downstairs so they could use a particular thing and while I let them it annoyed me.

What worked the best was to have the parent take time off and keep the child home on therapy days but then once every couple months the therapist would come to daycare and observe and work with the child here but it was then looking at ways to better encourage the child to interact with the group. That was when I could ask for help I needed. I was always free to give my questions to the mom so she could ask them at the next visit she had.

The other negative thing about the therapies is you have to consider the other children in care and if the frequency and duration of visits will impact the group and how negatively such as preventing a trip to the park on certain days so you are home when therapist comes, can she only come during naptime, etc.

Ask the mom about previous daycare experience, interviews, what the most common concerns of potential caregivers seems to be as you want to be sure you are considering all angles of the situation and making an informed choice for everyone.

I agree that when you agree to work with a family dealing with a less then ideal situation you do often get one of the best most grateful families ever. Be prepared for them to need some emotional support along the way because it won't be smooth sailing for sure but the difference you can make in this child's life in even a few short months could mean so much down the road. At the same time do not let guilt or empathy sway you into taking on the child if you think his needs could best be met in a different situation. That also does the child an immense service.

[Rhonda]

So much to think about PlayFelt!!!

Because my emotions have been running wild, I really do feel for this family. But yes, one of my questions will be if keeping a nanny and providing socialization through play groups would not be a better option for the family.

I do have lots of concerns with regards to how having a therapist come into my daycare will interfere. I don't have a secondary place to allow the therapist to work one on one with a child. In a pinch, I do have the learning room which is gated off.

If you were to accept a child into your care, would you increase your rates or keep them the same? From what I read in the email the child is at least 2-4 months behind in most areas of development (except maybe cognitively), which seems to me is a lot for a child under the age of 16 months. But, I do know that each child develops at their own rate and by the time the child is 2 one may never know the child was delayed as an infant.

[cfred]

When I have therapists come in, as you said, it really depends on what they're doing. The physiotherapist takes the girl into our rec room in the basement for her hour, while the daycare carries on as usual. Then she brings her to show me what they've been doing and what I can do to help, to discuss her progress and areas of concern. Her hearing specialist is wonderful! She does her thing with the whole group as there are lots of games associated to what they're doing. I get to see first hand how to help, with the therapist explaining things along the way and allowing me to participate. The other kids get to join in which is lots of fun for them as well as making the little girl feel like she's just part of the group rather than 'different'. As the children get older, I would think this may lend to their development of empathy and tolerance.

For me, it's worked. But as Playfelt said, you have to consider many different factors that could arise later should you decide to take this on. With my little gal, it's been a slow process of issues developing so I've been getting used to it over a long period of time. I didn't have to make any quick decisions....it just evolved.

Good luck with whatever route you choose

[kimmills]

Hi cfred, that's very brave of you and its also very encouraging that you have taken the initiative to give the care and guidance to a special needs child. Hats off to you and all others who for such children.

[playfelt]

If you charge different rates for different ages then for sure the child would stay at each rate based on development rather than age - when I did infant/toddler /preschool rates the time to change rates was when walking and feeding self table foods and only using cup at daycare move to toddler rate then stayed at that rate till completely potty trained to reach the preschool rate. So a child that is 4 but not potty trained and needs to be fed by me would be on the infant rate still.

If you don't have different rates then you could see about a rate differential if the parents are willing. Remember if they are supplying foods or keeping child home on therapy days but still paying you that you are in a sense being reimbursed extra money the other families aren't paying.

[Rhonda]

Unfortunately, the family decided not to come for an interview, saying they found someone else.

It's kind of frustrating these days! In my area finding children is very difficult. I've seen good caregivers quit because they couldn't stay full. Yet, I just heard today a caregiver I know was over in numbers and received a warning.

I am having a hard time getting interviews and half of them cancel before even arriving saying they have found someone else.

Oh boy, a little depressed tonight