Chapter Thirteen: Special Topics in Safety, Nutrition, and Health

Policies for Special Topics l Inclusion of Children with Special Needs l Children with Chronic Illnesses l Children with Stress l Children from Drug-Abusing Families

Inclusion of Children with Special Needs into Child Care Americans with Disabilities Act (ADA, 1990) l Federal legislation to protect people with physical or mental disabilities l Disability defined—“a physical or mental impairment that substantially limits a major life activity” l Applies to all child care except nanny and ecumenical care

l Carefully look at Figure 13-1 l Review ADA Goal Figure 13-2

Benefits of Inclusion l Encourages acceptance l Lessens discrimination l For child with special needs, offers opportunity to play and grow  Better developmental progress in mainstreamed child care  Better interaction skills  More advanced play  Become more self-reliant

l For the other children, being around children with disabilities can help them  Learn empathy  See that diversity is not so scary l Allows all to see that they are more alike than different l Caregivers benefit by learning to be  More patient  More self-confident

The Team Approach l Individualized Family Service Plan (IFSP)  Provides for an organized goal and delivery of services  One person designated coordinator  Contact person designated coordination of child care with plan  Team effort should continue at site  All people in plan should share information  Needed training should be provided

Supporting the Child with Special Needs l Environment  Adjusting the physical environment  Adjusting the environment for emotional needs  Toys should be safe and durable  Toys should provide opportunity for learning, interaction, exploration, and engagement  Toys should be adapted if necessary

Intervention Caregiver intervention may be necessary if child is  Exhibiting lack of success  Exhibiting frustration Caregiver intervention may include  Helping child learn how to use or play with toys  Encouraging other children to assist child  Teaching specific skills such as eye contact or appropriate language  Modeling acceptance and understanding

l Caregiver intervention should be activity based and include  Functional skills  Generalizable skills

Children with Chronic Illnesses Chronic illnesses or conditions l Affect more than 30% of population under age of 18 years l May range from mild to severe l May require continued treatment

Chronic illnesses include l Allergies l Asthma l Diabetes Mellitus l HIV/AIDS l Seizure Disorders l Sickle Cell Anemia

General guidelines for the caregivers l Understand the major chronic illnesses l Recognize the symptoms, reactions, and triggers l Have identifiers of reactions for chronic illnesses of children in care posted prominently l Understand what actions to take in a crisis situation l Remain calm

Children with Stress Examples of stressors in a child’s life (see Table 13-2) l Divorce/single parent/stepfamily adjustments l Birth of a sibling l Separation anxiety l New care situation l Cultural considerations, including language l Poverty

Children’s reaction to stress may be l Physical l Emotional l Behavioral

Physical reactions include l Headaches l Stomachaches l Bouts of diarrhea l Language difficulties l Appetite fluctuations from norm

Emotional reactions include l Regressive to aggressive behavior l Withdrawal l Clinginess and dependency l Inability to make decisions l Escaping into fantasy l Being fearful or nervous

Behavioral reactions include l Acting out = temper tantrum  violent behavior l Vandalizing toys l Biting or hitting l Difficulty with social interactions l Frustrated easily l Use of colorful language to express anger

Caregivers need to l Be alert to stress as a factor in children’s behavior l Structure environment to support child  Protective l Give child  Security  Sense of control  Feeling of self-worth

l Provide predictable routines l Provide quiet place to retreat from world l Help children transition from one activity to another l Help children identify their emotions and feelings  Role modeling  Dramatic play  Books  Discussions

l Redirect anger, frustration, and aggression l Reinforce positive behaviors l Use team approach  Caregiver + parent l Be predictable and consistent with children and parents

Working with Children From Drug-Abusing Families Prenatal exposure to drugs can cause the following developmental difficulties Inability to organize play Sporadic mastery Learning problems/Strategies Difficulty with motor skills Impaired ability for language development or communication Lack of sense of self

l The Recovering Family l The Actively Abusing Family l The Foster Family

l Establishing a relationship with the Family l Working with the Children

Implications for Caregivers l Education l Cultural Competence l Supervision

 Reality Check: Attention Deficit/Hyperactivity Disorder (AD/HD) Two basic symptoms l Inattention l Combination of hyperactivity and impulsive behaviors Begins between ages of 2 and 6 years More likely to be a boy

l Symptoms include difficulty in focusing attention, transitioning, and easily distractible (see page 425 for list of symptoms) l Cause is unknown but there are links l Several areas checked during diagnosis  Physical exam  Family medical history  Parent/teacher interview  Observation

l Caregivers can control and monitor environment to help child be more successful l See list on page 426