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Inclusion: Integrating Special Kids in a Child Care Setting

The world of child care is ever-changing. As best practice standards evolve and new state and local licensing requirements are introduced, administrators face the challenge of balancing regulations with the everyday realities of running a center with limited budget, staff, and resources. One of the biggest changes facing us today may actually bring many rewards along with challenges: the inclusion of children with special needs.

While some centers have traditionally welcomed children with special needs, many other centers have been reluctant to accept them. Fears around what is involved in accommodating these children are common and understandable. But some simple, practical information can often put directors and staff at ease, and generate sincere enthusiasm about working with kids with special needs.

The passage of the Americans with Disabilities Act in 1990 established the right of children with disabilities to participate alongside their peers in all aspects of community life, including child care settings. While child care providers are rising to the challenge of working with these children, they find themselves in need of information about what the law requires, as well as practical information about how to include kids with special needs in their programs.

Who Are We Talking About?
When we speak of children with special needs, who are we talking about, and what constitutes a special need? The phrase can be defined very broadly to include kids with disabilities - emotional or physical or mental—as well as kids with learning disabilities, and kids who are gifted. Some children may have very mild issues, such as a speech impediment or difficulty with reading. Some may have a behavioral disorder, such as Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD). These needs may require as little from a provider with extra patience and understanding; in the case of ADD/HD, behavior intervention techniques and, in some instances, medication can help the child to fit into a program without much difficulty.

But some children may have needs which require more effort, and even some medical intervention, from providers, such as kids with asthma, diabetes, or kids who use a wheelchair or other assistive technical devices. A child who has a "developmental disability" is a child whose disability affects his or her mental and/or physical development, and his or her ability to perform such basic life functions as grooming, toileting, feeding oneself, walking, communicating, and establishing social relationships. Children with developmental disabilities include children with common disorders such as Down Syndrome, autism, cerebral palsy, and spina bifida, and also children with multiple disabilities and rare disorders.

Children whose disabilities are defined as developmental disabilities, and sometimes children with emotional and behavioral disorders, often qualify under state and federal laws to receive special education services through public schools from the time of infancy or early childhood. Child-care center directors who enroll a child with special needs may want to ask parents whether the child receives special education services. Children who receive such services may receive speech therapy, or other special assistance. Visits from therapists may be required during the course of the child's day (at no cost to the center). Such therapists are often willing to show interested staff how to work with a child to encourage development.

Directors may want to check with parents on whether the child has an IFSP (Individualized Family Service Plan), for kids aged birth to three, or and ISP (Individualized Service Plan), for older kids. These are plans for the child's education and socialization which are written by special education staff (and in the case of the IFSP, other agency personnel) with the cooperation of the parents. Parents may be willing to share these documents with providers, so that everyone can participate in the developmental, social, and educational goals set for the child.

History of the Movement to Include All Children
When faced with the prospect of including a child with special needs, those who work in child care may ask why such children should be involved in classrooms with other children-wouldn't they do better in programs designed especially for children like themselves? To understand why the law today requires us to include children with special needs in settings with typical children, it helps to understand some of the history of the inclusion philosophy.

In the 1950s, it came to public attention that conditions in institutions that housed people with special needs were less than humane, and were often cruel. So in the late 1950s and through the 1960s, parents and relatives organized themselves to lobby for children with special needs to be integrated into public schools during such activities as lunch or physical education, and for special education settings and institutions to be remolded into places where conditions were kinder and some real education could take place.

By the 1970s, formal organizations working for the rights of persons with special needs had developed, such as the Association for Retarded Citizens, now known in some states as "The Arc." Throughout the 1970s and 1980s, a philosophy developed that all individuals, regardless of ability, should have the chance to participate fully in community life. Children and adults who experienced life along with their peers developed skills, social relationships, and a quality of life that their institutionalized peers did not. Parents of kids with special needs began to push for "mainstreaming" in public schools—for inclusion of their children in classrooms with other children whenever appropriate. Federal laws such as the Education of All Handicapped Children Act of 1975 (Public Law 94–142), now known as the Individuals with Disabilities Education Act (IDEA; Public Law 101-476), and Section 504 of the Rehabilitation Act of 1973, were passed to require public schools to provide access for students with special needs to a "free and appropriate education."

By the 1990s, an "inclusion" philosophy had developed, advocating the inclusion of children with special needs in all school and social activities, with separate programming only as a last resort. The Americans with Disabilities Act of 1990 (Public Law 101-336) reinforced a growing public insistence that persons with disabilities be included in community life at all levels. The ADA is the law that ensures children with special needs access to child-care centers. It states that child care programs cannot discriminate against an individual (including employees!) because of disability. It defines a person with disabilities as a child or adult who:

  • has a physical or mental impairment which substantially limits one or more major life activities—such as self-care, manual tasks, walking, seeing, hearing, breathing, learning, or working;
  • has a record of such an impairment; or
  • is regarded as having an impairment.

What Does the ADA Require for Child Care Programs?
The ADA applies to all nursery schools, child care centers, extended-day programs for schoolchildren, family child care homes, and also programs renting space in a religious facility. (Programs operated by a religious organization are exempt, but are often covered by state human rights laws with requirements similar to those of the ADA.)

The ADA requires child care programs to remove architectural barriers when "readily achievable" and when doing so will not constitute "undue burden." The precise meaning of these terms will be defined by future court decisions, but for now providers can understand "readily achievable" to mean something accomplished without excessive difficulty and "undue burden" to mean something requiring excessive expense. Day care programs will want to make themselves aware of financial assistance for which they might be eligible, such as the Tax Deduction to Remove Architectural and Transportation Barriers to People with Disabilities and Elderly Individuals (Title 26, Internal Revenue Code, Section 190), and the Disabled Access Tax Credit for small businesses. Most architectural adjustments will require little expense or effort, and may include such things as lowering a shelf or coat hooks for children using wheelchairs, or building a ramp for access to the building. The ADA states that programs CANNOT:

  • charge a higher rate for a child with a disability;
  • deny admission because of an increase in insurance rates or cancellation of coverage;
  • deny services because of lack of staff training if training could be done at reasonable cost and is available; or
  • deny admission because of disability.

However, child care programs are NOT required to accept any child with a disability if to do so would pose hardship to the program. Each child must be considered as an individual. Under the ADA, a program can deny services to a child if:

  • necessary accommodations are too expensive or difficult to accomplish. But, the program must take into account available tax credits, resources available through school and county health programs, and other outside funding resources;
  • the child poses a direct threat to the safety of others (as with a child with a severe emotional or behavioral disorder) and the situation cannot be remedied by reasonable methods or modifications; or
  • the child's needs fundamentally alter the nature of the program.

In other words, the intent of the ADA is to be fair to child care programs, while requiring that they make every possible effort to include a child with special needs.

Child care providers have the right to expect help and direction from parents, and parental assistance in exploring resources that will aid in the inclusion of their child. At the same time, child care programs are expected to explore all possible options in terms of additional staff training or financial assistance, and to make any reasonable modifications or adjustments.

Preparing for the Big Day
Once your program has enrolled a child with special needs, and architectural and other physical accommodations have been made, how do you prepare for the child's participation?

It may help to understand something about the day-to-day life of a family in which a member has special needs. Parents of children with special needs find themselves in a maze of social services, all with complicated application processes. In spite of laws affecting special education, some parents find that special education programs can be uncooperative and unaccommodating. Strained family relationships are common in these families; often the needs of a child with disabilities are so great that they overwhelm those of other family members. In some families, even activities, goals, and plans revolve around the child with special needs. There may be enormous financial stress, and the family may find themselves isolated from the community, from friends, or even from relatives who are sometimes unable to face the situation and provide support.

Parents of a child with special needs experience a process of grieving for what the child might have been, and for the loss of dreams they had for the child. This grief may repeat itself when birthdays come, or when a friend's child reaches an age-appropriate accomplishment that the child with special needs cannot. The family may experience frequent medical crises, may make many trips to specialists, or experience several surgeries over the course of a year. Any way in which the child care provider can be sensitive to the unique difficulty in the lives of these families will surely be appreciated.

Try to focus on the child's capabilities and uniqueness. Most parents come to view their child not as a burden on the family, but as a challenge and even as a blessing-someone who has brought the parents to their full potential in terms of community leadership, advocacy, spirituality, and parenting ability. These children are deeply loved.

Parents may be very sensitive to the choice of language you use when discussing their child. Try to use what is known in the disability community as "people first" language-language that emphasizes the humanity of the child before the disability. For example, say "child with a disability" instead of "disabled child," "children with Down Syndrome" for "Down's kids," or "child in a wheelchair" rather than "wheelchair-bound child."

Providers will want to prepare the other children in the program for their new classmates as well. There are several children's books available which discuss children with special needs. Try to make the inclusion of this child a class responsibility, so that everyone will share in the successful inclusion of the child. Be careful not to be overly protective of the child. Let him or her have the dignity of risk, and experience failure and success as other children do.

Everyone Benefits from Inclusion!
All children benefit when all children, regardless of ability, are served together in an inclusive environment. The children with special needs learn social skills, and learn at a rate they would not in segregated settings. But just as importantly, children without special needs learn tolerance for differences, and show improved self-concept and growth in developing healthy socialization skills.

All of us benefit from a community life where all are welcome, regardless of ability. The lessons of tolerance and appreciation for difference are lessons we can all use from time to time, regardless of our ages!

Arc National Headquarters, (1992).Q&A: Child Care Settings and the Americans with Disabilities Act(Information Sheet).

Bilken, C., Corrigan, C., and Quick, D., (1989). Beyond Obligation: Students' Relations with Each Other in Integrated Classes. In D. Lipsky and A. Gartner, Eds.,Beyond Separate Education: Quality Education for All.

Greater Minneapolis Day Care Association, (1993).Child Care for Children with Special Needs: A Booklet to Help You Choose Early Childhood Care and Education.

Leuchovius, D. (1993). ADA Q&A Factsheet-Child Care Centers, PACER Center. Minnesota Child Care Resource and Referral Network, (1992). Child Care for Children with Special Needs: A Resource and Referral Guide.

PACER Center (Parent Advocacy Coalition for Education Rights), (1992).Parents can be the key: A handbook on rights and responsibilities in special education for parents of children with disabilities.

Peck, C.A., Donaldson, J., and Pezzoli, M., (1990). Some Benefits Nonhandicapped Adolescents Perceive for Themselves From Their Social Relationships with Peers Who Have Handicaps, Journal of the Association for Persons with Severe Handicaps,15 (2), 241–249. U.S. Department of Education, (1992).Summary of Existing Legislation Affecting People with Disabilities.

Resources for Further Information for Information on the ADA and Inclusion
The Arc National Headquarters
500 East Border Street, S-300
Arlington, TX 76010
(817) 261-6003, (817) 277-0553 (TDD)

Office on the Americans with Disabilities Act - Civil Rights Division
U.S. Dept. of Justice
PO Box 66738
Washington, D.C., 20055-998
(202) 514-0301, (202) 514-0383 (TDD)

PACER Center (Parent Advocacy Coalition for Education Rights)
4826 Chicago Avenue South
Minneapolis, MN 55417-1098

(612) 827-2966 (Voice and TDD)

Good Books for Teachers
Integrated Child Care: Meeting the Challenge by Sarah A. Mulligan, Kathleen Miller Green, Sandra L. Morris, Ted J. Maloney, Dana McMurray, Tamara Kittelson-Aldred

Resource for Teaching Young Children with Special Needs by Penny Duner

Adapting Early Childhood Curricula: Suggestions for Meeting Special Needs by R.E. Cook and V.B. Armbruster


Books for Children
What If You Couldn't—A Book of Special Needs by Janet Kamien

Don't feel Sorry for Paul by Bernard Wolf

Our Brother Has Down Syndrome by Shelley and Cairo

My Friend Leslie—The Story of a Handicapped Child by Maxine Rosenberg