Chapter Thirteen:Special Topics in Safety,

Nutrition, and Health

Policies for Special Topics

Inclusion of Children with Special Needs Children with Chronic Illnesses Children with Stress Children from Drug-Abusing Families

Inclusion of Children with Special Needs into Child Care

Americans with Disabilities Act (ADA, 1990) Federal legislation to protect people with

physical or mental disabilities Disability defined—“a physical or mental

impairment that substantially limits a major life activity”

Applies to all child care except nanny and ecumenical care

Carefully look at Figure 13-1 Review ADA Goal Figure 13-2

Benefits of Inclusion Encourages acceptance Lessens discrimination For child with special needs, offers

opportunity to play and grow Better developmental progress in

mainstreamed child care Better interaction skills More advanced play Become more self-reliant

For the other children, being around children with disabilities can help them

Learn empathy See that diversity is not so scary

Allows all to see that they are more alike than different

Caregivers benefit by learning to be More patient More self-confident

The Team Approach Individualized Family Service Plan (IFSP)

Provides for an organized goal and delivery of services

One person designated coordinator Contact person designated coordination of

child care with plan Team effort should continue at site All people in plan should share information Needed training should be provided

Supporting the Child with Special Needs Environment

Adjusting the physical environment Adjusting the environment for emotional

needs Toys should be safe and durable Toys should provide opportunity for

learning, interaction, exploration, and engagement

Toys should be adapted if necessary

InterventionCaregiver intervention may be necessary if

child is Exhibiting lack of success Exhibiting frustration

Caregiver intervention may include Helping child learn how to use or play

with toys Encouraging other children to assist child Teaching specific skills such as eye

contact or appropriate language Modeling acceptance and understanding

Caregiver intervention should be activity based and include

Functional skills Generalizable skills

Children with Chronic Illnesses

Chronic illnesses or conditions Affect more than 30% of population

under age of 18 years May range from mild to severe May require continued treatment

Chronic illnesses include Allergies Asthma Diabetes Mellitus HIV/AIDS Seizure Disorders Sickle Cell Anemia

General guidelines for the caregivers Understand the major chronic

illnesses Recognize the symptoms, reactions,

and triggers Have identifiers of reactions for

chronic illnesses of children in care posted prominently

Understand what actions to take in a crisis situation

Remain calm

Children with Stress

Examples of stressors in a child’s life (see Table 13-2) Divorce/single parent/stepfamily

adjustments Birth of a sibling Separation anxiety New care situation Cultural considerations, including

language Poverty

Children’s reaction to stress may be Physical Emotional Behavioral

Physical reactions include Headaches Stomachaches Bouts of diarrhea Language difficulties Appetite fluctuations from norm

Emotional reactions include Regressive to aggressive behavior Withdrawal Clinginess and dependency Inability to make decisions Escaping into fantasy Being fearful or nervous

Behavioral reactions include Acting out = temper tantrum

violent behavior Vandalizing toys Biting or hitting Difficulty with social interactions Frustrated easily Use of colorful language to express

anger

Caregivers need to Be alert to stress as a factor in

children’s behavior Structure environment to support

child Protective

Give child Security Sense of control Feeling of self-worth

Provide predictable routines Provide quiet place to retreat from

world Help children transition from one

activity to another Help children identify their emotions

and feelings Role modeling Dramatic play Books Discussions

Redirect anger, frustration, and aggression

Reinforce positive behaviors Use team approach

Caregiver + parent Be predictable and consistent with

children and parents

Working with Children From Drug-Abusing Families

Prenatal exposure to drugs can cause the following developmental difficulties

Inability to organize playSporadic masteryLearning problems/StrategiesDifficulty with motor skills Impaired ability for language

development or communicationLack of sense of self

The Recovering Family The Actively Abusing Family The Foster Family

Establishing a relationship with the Family

Working with the Children

Implications for Caregivers

Education Cultural Competence Supervision

Reality Check: Attention Deficit/Hyperactivity

Disorder (AD/HD)

Two basic symptoms Inattention Combination of hyperactivity and

impulsive behaviors

Begins between ages of 2 and 6 years

More likely to be a boy

Symptoms include difficulty in focusing attention, transitioning, and easily distractible (see page 425 for list of symptoms)

Cause is unknown but there are links Several areas checked during diagnosis

Physical exam Family medical history Parent/teacher interview Observation

Caregivers can control and monitor environment to help child be more successful

See list on page 426