CHILDREN WITH DISABILITIES OR SPECIAL NEEDS

National Network for Child Care's Connections Newsletter

Lesia Oesterreich, M.S.
Family Life Extension Specialist
Iowa State University

Copyright Access Information

Table Of Contents

The Americans with Disabilities Act
Some General Ideas to Help Children with Special Needs
Characteristics of Specific Disabilities and How You Can Help

Disabilities often are not recognized at birth but become noticeable as a child exhibits some type of developmental delay over time. Parents and child care providers are often the first to notice that there might be a developmental delay.

Occasionally you may be asked to care for a child with a disability. The disability may be already identified when the parents come to you, or it may have been noticed after the child became a part of your program.

THE AMERICANS WITH DISABILITIES ACT

It's illegal to discriminate against someone with a disability. The Americans with Disabilities Act (ADA) of 1992 is civil rights legislation designed to protect people with mental or physical disabilites from discrimination based upon that disability.

The Americans with Disabilities Act states that public accomodations must make reasonable modifications in policies, practices, and procedures in order to accommodate individuals with disabilites. A modification is not required if it would fundamentally alter the goods or services of a child care setting. Architectural barriers must be removed if "readily achievable." The term "readily achievable" means easily accomplishable and able to be carried out without much difficulty or expense.

Auxiliary aids and services must be provided unless that creates an "undue burden." "Undue burden" means significant difficulty or expense.

For example, making minor modifications of toys or equipment would probably not be an "undue burden," but hiring a full-time staff person for extra assistance would alter the fundamental structure of a family child care program and would most likely constitute "undue burden." You also should know that ADA prohibits charging parents more for the care of a disabled child.

In many cases children with disabilities can be cared for easily in a regular child care setting. Family child care programs are especially suitable for this situation because they already maintain a flexible program to meet the needs of multi-age groups. Adapting your program for a 2-year-old is not much different from adapting your program for a child with Down's Syndrome.

Children with disabilities benefit greatly from being with other children and from receiving consistent care from an adult over a period of years. Children without disabilities also benefit by learning how to assist, help, and respect a child who may have needs different from their own.

Children with special needs are like all children. They need to be physically comfortable, feel loved and secure, and have opportunities to play that help the body and mind grow and develop. Existing toys and equipment usually are adequate or easily adapted to their needs. Often, these children are not so different. They need more time to learn and practice skills; they need more praise and encouragement to gain the skills typical for their age group.

---

SOME GENERAL IDEAS TO HELP CHILDREN WITH SPECIAL NEEDS

Children with disabilities may have specific needs based on their impairment, but the following are some general ways in which you can help.

1. MODIFY TOYS

Regular toys can be modified or changed to suit a special need. For example, a child may have difficulty with stacking rings. Simplify the game by removing every other ring.

2. SET GOALS

Parents, consultants, and caregivers need to set goals together. Goals should be simple and should match the abilities of the child. For instance, choose a goal to get Chad to point at a toy rather than to get Chad to talk.

3. MAKE SLIGHT CHANGES IN THE ENVIRONMENT

Slight adjustments in the environment may make the time that a child with special needs spends in your home easier and pace for play may help an overactive child. A child with poor vision will benefit from a room that is kept constant. Children who have difficulty standing alone can crawl into cubes or barrels without tops. They then can pull themselves up, hang on to the edges, and watch others from this new, upright point of view.

4. MODEL APPROPRIATE BEHAVIORS

Children with disabilities are sometimes hesitant to play with others. You can model appropriate play behaviors by being a play partner. As the child becomes more comfortable, you can invite other children to join your play activity.

5. TEACH SPECIFIC SKILLS TO A CHILD WITH DISABILITIES THAT WILL HELP HER SEEK PLAYMATES AND BE A PLAYMATE

Learning how to look directly at another child when speaking or how to say "May I play?" are big steps for some children.

6. TEACH NONDISABLED CHILDREN HOW TO INTERACT WITH CHILDREN WHO MAY HAVE A DISABILITY

Model understanding and acceptance through actions and words. Teach children specific skills. For instance, a gentle touch on the shoulder of a child with a hearing impairment, or a direct look at him while talking, are effective ways of getting his attention.

7. LOOK FOR STRENGTHS AS WELL AS NEEDS

Provide opportunities and activities that will support those strengths. Avoid becoming too focused on a child's disability. Treat each child as a whole person. Every child needs to feel successful and capable.

8. CONSULT WITH PARENTS, HEALTH CARE PROFESSIONALS, AND EARLY CHILDHOOD SPECIALISTS

Parents and specialists can provide specific information and suggestions for working with a child who has disabilities.

---

CHARACTERISTICS OF SPECIFIC DISABILITIES AND HOW YOU CAN HELP

The following information may be useful to you in determining the specific handicap that a child may have, either when you are considering accepting the child in your care or if she is already in your care.

VISUAL DISABILITIES

Children with visual disabilities often are delayed in their physical and motor skills. Often they will not be able to locate or pick up small objects that have been dropped. Helping children understand about space and size will further their development.

Characteristics:

• sometimes or always crosses one or both eyes
• has eyes that won't focus
• avoids bright lights
• blinks or rubs eyes a lot
• stumbles or falls a great deal, trips over small objects
• covers one eye
• tilts head to side or to front
• squints or frowns a great deal
• complains of dizziness, headaches, or nausea after doing intense work
• is unable to locate and pick up small objects that have been dropped
• may turn face away when being addressed; does not mean inattentiveness, but rather may have better peripheral vision
• if partial vision is possible, may be able to see shadow forms, color, or large pictures
• holds books or objects very close to her face

What you can do:

• Place sound-making objects (clocks, wind chimes, radio) in different parts of the house to help the child learn her way around.
  
• Encourage the child to find and sense different textures throughout the house: tile, carpet, wood, glass windows, plastered walls, marble counter top, etc.
  
• Look for toys and books with raised numerals, letters, or designs that children can touch and explore.
  
• Provide activities with sensory experiences. Children with visual disabilities learn through hearing and touch. Sand and water play, collages, play dough, and finger painting are good learning activities.
  
• Read aloud stories that have a predictable story line. You also may wish to choose stories that offer interesting descriptions of actions or objects.
  
• Follow up descriptions with concrete experiences. For example, after reading "The Three Little Pigs," the child might find it interesting to feel the difference between straw, sticks, and bricks.
  
• Cut out symbols, shapes, letters, and numbers from sandpaper or cardboard. Guide the child's hand over these shapes as you discuss them.
  
• Show the child how to make rubbings by coloring over an interesting texture.
  
• Be sure play areas are well lit so that children with limited vision can see better.
  
• Establish specific areas for play activities. Help a child become familiar with your room arrangement. If you decide to change the block area or art area, you will need to reorient the child to the new room arrangement.
  
• Provide toys and materials in colors that children with visual disabilities can see well.
  
• Tape raised cardboard labels of toy symbols on toy shelves to facilitate cleanup.
  
• Arrange the house for safe and free movement. Keep doors and cabinets closed.
  
• Teach non-disabled children to identify themselves and describe their art activities or building constructions in words to children with visual disabilities. Teach them also to call the child with visual disabilities by name to get his attention and to use specific words to describe objects such as a phone, hat, or car rather than this, it, or that.
  
• Expand the child's learning by talking him through an activity. Use descriptive words such as long, short, over, under, big, and little. Whenever possible, provide concrete experiences that illustrate these important concepts. For example, you might offer the child two balls and say, "The ball in your hand is big. Feel how big it is. But the ball in my hand is small. Would you like to touch it?"
  
• Encourage children to build with blocks horizontally. Children can feel shapes and lay them end to end or in different patterns without the frustration of falling blocks.

---

HEARING DISABILITIES

Children who have difficulty hearing need opportunities to learn how to listen and speak. Provide activities that encourage communication and language development. Children can develop important language skills with practice. Activities with very little verbal interaction are also very important. Art activities and block play offer good opportunities for satisfying play without heavy demands on language or communication.

Characteristics:

• does not respond when spoken to
• does not startle at loud noise
• does not wake up in response to sound
• coos or gurgles, but does not progress to saying words
• does not talk very much or at all
• talks, but is impossible to understand
• leaves out many sounds when talking
• talks in a monotone voice
• seems unable to follow verbal directions; often says "huh" or "what" - requires repetition
• interrupts conversations
• seems unaware that others are talking
• may hold head so that one ear is turned toward speaker
• alert and attentive to things that can be seen; disinterested in those he is expected to hear
• talks in a very loud or very soft voice

What can you do:

• Cut down on background noise from the radio, dishwasher, etc., when you are doing an activity. Use carpets, rugs, drapes, and pillows to absorb excess sound.
  
• Make eye contact before you start to speak. A gentle tap on the shoulder usually will get a child's attention.
  
• Talk in a normal voice. Use gestures and facial expressions to clarify your message.
  
• Provide earphones or set up a special area where a tape recorder can be played at a higher volume.
  
• Teach children in your program to use gestures and sign language.
  
• Encourage a child to talk about what she is doing. Ask open ended questions that will invite the child to practice using language.
  
• Use stories, songs, and fingerplays to enhance language development. Repeat favorite rhymes and songs to encourage confidence in developing language skills.
  
• Provide children with visual cues. For example, label shelves with a picture of toys to facilitate easy cleanup. Use pictures to illustrate the steps of a recipe during cooking activities.

---

MENTAL DISABILITIES

Children with mental disabilities generally will go through typical developmental stages but at a much slower rate. Characteristics vary with disabilities, but a few approaches can be applied to all kinds of disabilities.

Characteristics:

• short attention span; easily distracted
• difficulty with transitions
• prefers to play with younger children
• afraid of trying new things
• difficulty in problem-solving
• does not remember things well
• may not be able to transfer learning to a new situation
• stumbles and falls because of poor body control
• speaks and uses language like a much younger child
• may repeat same movement over and over
• frustrated with change and transitions

What you can do:

• Keep verbal instructions simple.
  
• Break activities into small steps and give one instruction at a time.
  
• Practice activities over and over.
  
• Select activities that match the child's mental age and abilities.
  
• Show and tell a child how to do something by guiding hands and body through the motions of an activity.
  
• Provide opportunities to play near a child who is doing a similar activity. This can give the child with mental disabilities some ideas on how to use and explore the same materials.
  
• Make sure that there are obvious differences in size, shape, and color when sorting or classifying objects. Subtle differences between red and maroon or circles and ovals can be confusing.
  
• Limit the number of art materials or toys to avoid overwhelming the child with choices.
  
• Give plenty of warning when an activity is about to change or end.

---

BEHAVIORAL DISABILITIES

Children with behavioral disabilities often display one of three types of extreme behavior: withdrawal, aggression, or hyperactivity. Each type of behavior may require a different type of response.

Characteristics:

• uses aggressive behavior to deal with most situations
• withdraws or stays quiet and passive most of the time
• shows excessive activity, restlessness, or inability to stick with something
• regresses to babyish behavior whenever stress occurs
• cries a great deal, seems depressed and unhappy, laughs seldom
• shows extreme fear and anxiety
• doesn't seem to recognize basic feelings of happiness, sadness, anger, or fear
• always reacts in the same way, such as crying or hitting
• may not want to be touched

What you can do:

• Invite a withdrawn child to join others in an activity by watching others. As the child becomes more comfortable, demonstrate how to play with materials or toys. Encourage the child to play along with you.
  
• Watch for signs of aggressive behavior and intervene quickly. Teach problem-solving skills.
  
• Provide developmentally appropriate activities that are not overly difficult and that will help the child feel capable. Avoid activities that can be done only a certain way.
  
• Watch for periods when children are less excitable and in control. Use these times to present a new activity that requires some concentration.
  
• Keep stories and group activities short to match attention spans. Seat the child near you and away from distractions such as a nearby toy shelf.
  
• Avoid over stimulation. Limit the number of toys or materials you set out at one time.
  
• Provide adult guidance and structure. Help children to plan or organize an activity. For example, if a child wants to play "fire fighter," you might make suggestions that can help him organize props and invite other children to play.
  
• Announce cleanup time and other transitions ahead of time. Children with behavioral disabilities often have difficulty with transitions. Assign a specific task to the child during the transition.

---

PHYSICAL DISABILITIES

Children with physical limitations have specific needs depending on their particular disability. Playmates are usually eager to assist the children with disabilities. While you need to applaud and encourage helping behaviors, a child with physical disabilities also needs encouragement to do as much as possible on his own. This may mean that tasks and chores could take a little more time, but self confidence and independence are fostered by encouragement and patience.

Characeristics (small motor):

• poorly developed hand or finger coordination
• difficulty in picking up small objects
• difficulty in drawing or writing

Characteristics (large motor):

• stumbles and trips frequently
• difficulty walking or running, jumping or climbing
• poor balance
• difficulty in bouncing, catching, or throwing balls
• may be unable to release objects voluntarily

What you can do:

• Provide heavy, stable furniture and equipment that are not easily knocked over.
  
• Avoid area rugs. Arrange furniture and equipment to allow for a wide aisle.
  
• Provide a safe place for walkers, crutches, or canes so that other children do not trip over them.
  
• Provide objects that can be used for grasping, holding, transferring, and releasing. Objects should be age appropriate. For example, a bean bag made from dinosaur fabric is much more appropriate for a 5-year-old
  than a rattle or baby toy.
  
• Work with parents to find comfortable ways for a child to sit. A corner with two walls for support, a chair with a seat belt, or a wheel chair with a large tray across the arms are three possibilities that might work well.
  
• Make objects more steady. For instance, secure paper, mixing bowls, or wood blocks to the table or floor with tape so that they remain secure as the child paints, draws, stirs, or hammers.
  
• Provide materials of different textures such as play dough, fabric swatches, ribbon, corrugated cardboard, and sandpaper to encourage the sense of touch.
  
• Plan activities to encourage exercise and movement of all body parts. Work with parents and specialists to give special exercises for the child depending on her needs.
  

Reprinted with permission from the National Network for Child Care-
NNCC. Oesterreich, L. (1995).Children with Disabilities or Special
Needs. In L. Oesterreich, B. Holt, & S. Karas, Iowa family child care
handbook [Pm 1541] (pp. 192-196). Ames, IA: Iowa State University
Extension.

Any additions or changes to these materials must be preapproved by the author.

Contact Us | Non-discrimination Statement and Information Disclosures | © Iowa State University, 2002