Chapter 8: Children with Special Health Care Needs and Disabilities
8.2 Inclusion of Children with Special Needs in the Child Care Setting
184.108.40.206: Inclusion in All Activities
All children should be included in all activities possible unless a specific medical contraindication exists.
RATIONALEThe goal is to provide fully integrated care to the extent feasible given each child’s limitations. Federal and state laws do not permit discrimination on the basis of the disability (i.e., Americans with Disabilities Act [ADA] and Section 504 of the Rehabilitation Act) (4,5).
Studies have found the following benefits of inclusive child care: Children with special needs develop increased social skills and self-esteem; families of children with special needs gain social support and develop more positive attitudes about their child; children and families without special needs become more understanding and accepting of differences and disabilities; caregivers/teachers learn from working with children, families, and service providers and develop skills in individualizing care for all children (6).
COMMENTSCaregivers/teachers may need to seek professional guidance and obtain appropriate training in order to include children with special needs, such as children with severe disabilities and children with special health care needs such as chronic illnesses, into child care settings. These may include technology-dependent children and children with serious and severe chronic medical problems. The child care health consultant should be involved in the transition and enrollment process in order to support individual accommodations and the care of children with special health care needs. Every attempt should be made, however, to achieve inclusion if the parent/guardian so wishes.
The facility should pursue mechanisms available to supplement funding for services in the facility. These resources usually require the parents/guardians’ consent and may require that the parents be actively involved in the pursuit for funding. Even so, caregivers/teachers can and should discuss options with the parents/guardian as potential sources of financial assistance for needed services. These sources might include:
- Medicaid, including waiver funding (Title XIX);
- Private health insurance;
- State or federal funds for child care, education, or for Children with Special Health Care Needs (Title V);
- IDEA (particularly Part C funding);
- Community resources (e.g., volunteers, lending libraries, and free equipment available from community-based organizations);
- Tax incentives (credits and deductions are available under federal law to most for-profit child care programs).
Section 504 is a civil rights law, and protects children from discrimination. It provides for supports and accommodations so a child can access the curriculum. In order to qualify for supports, a child must have a physical or mental impairment that substantially limits at least one major life activity such as walking, hearing, seeing, breathing, learning, reading, writing, etc. Section 504 requires an evaluation from multiple sources. There is no federally mandated plan, nor do parents/guardians have to be involved in the creation of the plan. We know from best practice, however, that parents/guardians should be active participants in plans to care for their children. Section 504 provides for accommodations during testing and for accessibility. It does not provide for the individual plans and protections that are provided under IDEA. For more information, go to http://www.wrightslaw
Another resource for parents/guardians and caregivers/teachers are the Protection and Advocacy Centers funded by the federal government to protect rights of persons with disabilities.