This article originally appeared in the May-June 1997 Children's Advocate newsmagazine, published by Action Alliance for Children.

Care for Special Needs

By Leslie Weiss

When Monique Hill learned that her two-and-a-half-year-old son, Dominik, had a developmental disability, she knew he needed more attention than he was getting in his child care center.

"The teachers weren't able to give him the one-on-one he really needed," Hill recalls. "He wasn't able to understand what they were saying to him, so he started to act up."

Enter Bananas, the child care resource and referral agency for Northern Alameda County. Bananas is in the second year of a three-year federal grant to get kids with special needs into child care with other youngsters. The grant is one of only three of its kind nationwide.

"Just because your child has disabilities doesn't mean you don't want the same things other parents want," says Ginger Barnhart, who runs the Bananas "inclusion" program. "Children with disabilities often do much better in terms of their own development if they're in an inclusive program" with other children.

For Dominik, Barnhart started by providing training for the staff at his child care center — that's a large part of what the inclusion program is about. In addition to specialized training for both providers and parents, the program facilitates networking among all the people involved in caring for a child with special needs — child care providers, doctors, therapists, school staff, and, of course, parents. "All the people who are working with the child get to talk to each other, which doesn't always happen," Barnhart says.

The grant also pays for on-site physical therapy or even medical care (such as tube feeding or nebulizer treatments for asthma). This way, parents don't have to make special trips to get their children to hospitals or clinics, nor do their children need to be removed from child care.

And there's a bonus to ensuring that special-needs youngsters stay in child care with other children: Those other children get to know people with disabilities, which goes a long way in breaking down stigmas and misconceptions about disabled people. Keeping the child in the regular classroom, of course, also relieves parents from having to come up with in-home care or other expensive alternatives.

"Many of those [parents] are stuck with having a home-care provider, or quitting work and staying home with their child — and going on welfare," notes Barnhart, whose own 15-year-old son has Down's syndrome.

In the era of welfare reform, Barnhart says, resource and referral agencies like Bananas expect to see a greater need for child care coupled with fewer family resources to pay for it. For children with special needs, the costs will be even greater. As it stands now, the inclusion program has a waiting list of 70-80 children. In a recent three-month period, approximately 100 parents of children with disabilities received referrals and counseling from the Bananas inclusion project and about 35 child care providers received assistance with caring for disabled children.

Outreach to increase the pool of child care providers who can care for special-needs children is another important element of the inclusion project, Barnhart says. When the Americans with Disabilities Act passed, Bananas surveyed hundreds of providers and found, to its surprise, that many had some level of experience caring for children with special needs. Bananas now keeps track of which providers have experience with specific disabilities — an important element in making good referrals.

The greatest obstacle to inclusive child care, Barnhart says, is fear. Other parents are afraid their children will get less attention if a child with special needs is present. Or the provider fears she can't handle a disabled youngster.

"I understand that kind of experience. The solution to it is exposure," Barnhart says. Support, she adds — from literature to training to information on health and safety — is also essential to teach providers how to care for children with disabilities.

"Anything that parents have figured out how to do, probably child care providers can figure out how to do," Barnhart adds. "The problems you get into are with places where they expect the child to get with the program instead of vice versa. That's just not good child care."

That's a problem parents of disabled children should note. But it's not the norm. Generally, Barnhart says, providers are willing to work with special children, given the time, support, and knowledge that the inclusion program — and the parent — can help provide. Patience, adds Dominik's mom, is the key.

Dominik, after referrals from Bananas, received behavioral and speech therapy. Bananas also helped Hill find a smaller child care center, where Dominik received the extra attention he needed. Now, 18 months later, the four-year-old is back in his original preschool, where his sister goes. His language skills have improved dramatically and, for the first time his mother says, "He's excited about school."