1. Healthy Inclusion: Caring for Children with Special Needs in Child Care © The National Training Institute for Child Care Health Consultants, 2013 1

2. 2  Name  Agency  Date

3. Introductions  Please share your name and one thing that is special or unique about you. © The National Training Institute for Child Care Health Consultants, 2013 3

4. 4 Learning Objectives  Understand observation and screening for a child who may have special needs.  Identify benefits and challenges to early childhood inclusion.  Consider ways to partner with other professionals to support children with special needs.

5. Children with Special Health Care Needs “Children who have or are at increased risk for chronic physical, developmental, behavioral, or emotional conditions who require health and related services of a type or amount beyond that required by children generally.” (Pediatrics, 1998) © The National Training Institute for Child Care Health Consultants, 2013 5

6. Prevalence  Fourteen percent of children under age 18 in the U.S. have special health care needs.  At least one CSHCN is present in 21.8% of households with children.  Among preschool children (ages birth through five), just under eight percent have special health care needs. © The National Training Institute for Child Care Health Consultants, 2013 6

7. Observation  Watch for developmental milestones and signs of delay.  Observe how a child plays, learns, speaks, and behaves.  Bring significant concerns to the child’s parents/guardians and primary health care provider. © The National Training Institute for Child Care Health Consultants, 2013 7

8. Screening Process  Child care facilities should have a system of developmental screening with all children that can be used l near the beginning of a child’s placement in the program, l at least yearly thereafter, and l as developmental concerns become apparent to staff and/or parents/guardians. © The National Training Institute for Child Care Health Consultants, 2013 8

9. Developmental Screening  Typically consists of l a brief health exam, including hearing and vision evaluations, and l the completion of a checklist to determine how the child is developing in other areas: gross motor, fine motor, cognitive, communication, social and emotional, and self-help. © The National Training Institute for Child Care Health Consultants, 2013 9

10. Early Intervention  All states have an early intervention system that identifies and provides services to children with special needs.  Public Law 99-457 requires public schools to extend special education services to children as young as three.  Eligibility and services provided vary by state. © The National Training Institute for Child Care Health Consultants, 2013 10

11. Inclusion  Inclusion means supporting values, policies, and practices that support the right of every infant and young child and his or her family, regardless of ability, to participate in a broad range of activities and contexts as full members of families, communities, and society (DEC/NAEYC, 2009). © The National Training Institute for Child Care Health Consultants, 2013 11

12. Reasons to Include CSN  Social Reasons  Educational Reasons  Legal Reasons © The National Training Institute for Child Care Health Consultants, 2013 12

13. Legal Reasons - IDEA Individuals with Disabilities Education Act  Part C requires states to create early intervention services for children birth to age two who are identified as having developmental delays or who are at risk for developmental delays.  Part B requires special education services be provided by the public school system to CSN ages three to five years. © The National Training Institute for Child Care Health Consultants, 2013 13

14. States are Required to:  Find and identify CSN,  Provide a multidisciplinary evaluation,  Provide related services,  Encourage parental involvement and consent, and  Inform participants of their right to confidentiality. © The National Training Institute for Child Care Health Consultants, 2013 14

15. IDEA Requirements  Infants and toddlers enrolled in Part C receive an Individualized Family Service Plan (IFSP).  Children enrolled in Part B receive an Individual Education Program (IEP).  A special services team that includes the child’s family develops the plans. © The National Training Institute for Child Care Health Consultants, 2013 15

16. Legal Reasons - ADA Americans with Disabilities Act  Prohibits the discrimination of persons with disabilities  Includes private programs such as family child care homes, child care centers, nursery schools, and preschools © The National Training Institute for Child Care Health Consultants, 2013 16

17. ADA Requirements  Eliminate eligibility criteria that screen out a child with a disability.  Make reasonable modifications in policies, practices, and procedures.  Provide aids and services for children with disabilities affecting hearing, vision, or speech.  Remove architectural barriers. © The National Training Institute for Child Care Health Consultants, 2013 17

18. Challenges of Inclusion  Values and Beliefs  Personnel Preparation  Policies  Resources © The National Training Institute for Child Care Health Consultants, 2013 18

19. Activity: Inclusion Graffiti  Take a few minutes to walk around the room and complete the sentences on the flip charts with your own ideas. © The National Training Institute for Child Care Health Consultants, 2013 19

20. Medical Home A partnership approach to providing quality and cost- effective health care services for children (AAP, 2002)  Accessible  Family-Centered  Continuous  Comprehensive  Coordinated  Compassionate  Culturally Effective © The National Training Institute for Child Care Health Consultants, 2013 20

21. Integrated Intervention  Therapy is integrated into the daily routines and activities of the child.  Allows child care staff to observe strategies and adaptations used by therapists to practice targeted skills.  Then, child care staff can help the child use and practice the same skills daily. © The National Training Institute for Child Care Health Consultants, 2013 21

22. Family Centered Services  Recognize that family is constant in a person's life;  Facilitate family/professional collaboration;  Honor racial, ethnic, cultural and socioeconomic diversity of families; © The National Training Institute for Child Care Health Consultants, 2013 22

23. Family Centered Services (continued)  Recognize individual family strengths and respect different methods of coping;  Share complete and unbiased information with families on a continuing basis and in a supportive manner;  Encourage family-to-family support and networking; © The National Training Institute for Child Care Health Consultants, 2013 23

24. Family Centered Services (continued)  Recognize and meet developmental needs of infants, children, and their families;  Create policies and programs that offer families emotional and financial support; and  Offer accessible, flexible, culturally competent and responsive services. Adapted from: Handbook of School- Family Partnerships 2010. © The National Training Institute for Child Care Health Consultants, 2013 24

25. Supporting Transitions  There is a six-month transition period as a child moves from Part C to Part B.  Family and child care staff are required to participate in evaluations and meetings.  A team of professionals will complete an evaluation that must include comprehensive, formal and informal information from multiple sources. © The National Training Institute for Child Care Health Consultants, 2013 25

26. Supporting Transitions (continued)  Parents/caregivers need information about their child's potential services and about the transition process.  Child care staff might help by sharing information about the child’s needs, learning style preferences, necessary supports, and future goals. © The National Training Institute for Child Care Health Consultants, 2013 26

27. Activity: Working with Families of CSN  Divide into three groups.  Choose a recorder and a reporter.  Consider your assigned topic (time, work, or mental health) and how having a child with a special need might require changes or create challenges another family may not have. © The National Training Institute for Child Care Health Consultants, 2013 27

28. Program Considerations  A child care facility should make sure that all staff members have had training and understand that child’s special health care needs and have the skills to work with that child in a group setting. (CFOC 1.4.2.2) © The National Training Institute for Child Care Health Consultants, 2013 28

29. Partner with a Child Care Health Consultant Modify toys. Make changes in the environment. Model appropriate behaviors. Teach children to seek playmates with and without special needs. © The National Training Institute for Child Care Health Consultants, 2013 29

30. Partner with a Child Care Health Consultant (continued) Help typically developing children interact with children who may have special needs. Assist families in finding resources in the community. Consult with parents, health care professionals, and early childhood specialists as needed. © The National Training Institute for Child Care Health Consultants, 2013 30

31. Care Plan  The facility should work with the child’s family and care providers to develop a care plan at the time of enrollment.  The plan should identify the extent of the child’s needs and how those needs may relate to accessibility, medical requirements or other issues.  Plan must address emergency response. © The National Training Institute for Child Care Health Consultants, 2013 31

32. One Good Tip  Turn to the person sitting next to you and share one tip that you learned during this training about how to successfully include a child with special needs in the child care setting. © The National Training Institute for Child Care Health Consultants, 2013 32

33. © The National Training Institute for Child Care Health Consultants, 2013 33 Learning Objectives  Understand observation and screening for a child who may have special needs.  Identify benefits and challenges to early childhood inclusion.  Consider ways to partner with other professionals to support children with special needs.

34. Evaluation  Please take five minutes to complete the evaluation.  Thank you! © The National Training Institute for Child Care Health Consultants, 2013 34