Including a Child with a Developmental Delay:
by Donna Michal
For years I've known a family and a staff group who worked through many of the challenges of including a child with a developmental delay in an early childhood program. Here is their story.
When I met Gloria, she was absolutely pleased with the child care she had arranged for her daughter, Stephanie, a charming, beautiful, brown-eyed 10-month-old with thick curly hair and a developmental delay. Gloria took Stephanie to a neighbourhood family day home provider three days a week.
About 18 months later, I received my first frantic phone call from Gloria. Stephanie's provider was moving out of province. The family day home agency didn't have any spaces in a home nearby -- but the agency staff had recommended a day care centre in the community. Gloria wanted some assurance that Stephanie would thrive in a day care environment. Would there be extra help for Stephanie (she was crawling and the other two-year-olds would be walking)? Who would help Stephanie with her language? How would she know what Stephanie ate each day? On and on the questions went. Gloria and her husband, Jack, made several visits to the centre, spent time talking to the director and staff and decided to enrol Stephanie.
Over the next three years, I kept in touch with Stephanie, her parents and the staff at the centre. I heard about the times of joy as Stephanie went to birthday parties with her day care friends, learned to ride a bike and began to talk. I also heard about the times of frustration when there were communication problems between parents and staff, when Stephanie had difficulty playing with other children, and those months when toilet training seemed an impossible dream.
Despite the challenges they faced, Gloria and Jack continued their commitment to work together with the staff and provide Stephanie with a positive early childhood experience. When I asked Gloria and the centre staff to tell me how they succeeded in "including" Stephanie in the day care centre program, they quickly outlined these five 'how to' points:
1. Ensure your program demonstrates good early childhood practices.
For example, do staff make observations of children and keep a record of each child's interests, achievements and areas for growth? If staff are already recording observations and planning experiences based on those observations, they will be ready to do the same for the child with a developmental delay. While the observations required may be more detailed (for example, when Stephanie was beginning to use words, staff would record different sounds she made to report to her speech therapist), staff will be familiar with building a program based on observed individual abilities. At one point, Gloria and Jack knew that Stephanie was having some difficulties eating. The staff observed that Stephanie was having problems picking up some finger foods. They planned a series of experiences in the playroom that gave Stephanie opportunities to practise picking up small objects. Because they used fun and colourful shapes and objects, many children in the playroom participated in the experience -- and had a great time!
Actually, the staff were able to provide all of the experiences for Stephanie's program right in the playroom. She worked along side the other children, learning with and from them and at the same time making friends. Even the speech therapist worked with Stephanie in the playroom. Whenever the therapist needed a few minutes with Stephanie alone, he used a natural transition time (e.g., outdoor time) when the other children were busy elsewhere.
2. Give the staff time to talk to each other for support, ideas and constructive feedback.
Staff need time to meet together as room teams and also as centre staff. Figuring out how to do this is a challenge in itself! The director in Stephanie's centre provided coverage during part of naptime so staff could eat lunch and plan program. It was important for all the playroom staff to be aware of Stephanie's abilities and needs as well as those of all the children. At this centre, each staff had six "primary" children. There was an additional part-time ECE staff member who assisted when Stephanie was there and was responsible for her primary care. All staff met weekly to plan for the next week and to discuss the particulars of their "primary" children. Just as Stephanie's staff spent time discussing a specific approach, which everyone needed to take to help Stephanie's communication, so too other staff discussed the particular needs of their primary children (for example, staff discussed a child with a new sibling and programming ideas to support that family change). Sometimes a specialist for Stephanie would attend a staff meeting so everyone could hear about specific program techniques. When Gloria and Jack wanted the staff to focus on toilet training, a behaviour specialist (and Gloria!) came to a staff meeting.
3. Listen to the child's parents.
Sometimes staff were stumped about something Stephanie was doing but, through consistent communication with Gloria and Jack, most problems were quickly solved. How often and what kind of communication is best between staff and parents? Parents and staff need to work out a mutually agreeable method. At one point, Gloria wanted to know what kinds of food Stephanie ate each day. The staff didn't have time to write down the food for each meal, so Gloria developed a checklist with food groups and amounts and the staff checked off items after each meal.
Staff also asked Gloria and Jack for direction with yearly goals for Stephanie. One year Gloria wanted Stephanie to learn to ride a bike, communicate with words and put on clothing. Staff worked on these goals and incorporated other preschool skills within these goals (for example, staff provided colour and shape experiences with painting and decorating bikes). It is important for staff to work with parents on goals. Sometimes we think about "inclusion" as happening only in the child care setting. Stephanie's family wanted her to be included in their community, riding her bicycle up and down the front sidewalk with other neighbouring three- and four-year-olds.
4. Provide child, staff and parents access to the resources they need.
Because Stephanie was crawling and needed to be carried some of the time, the director and Gloria were able to arrange for an additional part-time staff member. As Stephanie needed additional assistance with gross motor skills and language, the director and Gloria arranged for a physiotherapist and speech therapist to visit Stephanie at the centre, meet with the additional staff and communicate strategies to the rest of the playroom staff. While this happened quite quickly for Stephanie due to existing government programs, it may not happen in the same way in other jurisdictions.
Parents and directors may have to take additional advocacy steps to secure needed resources. It is important to provide the additional services a child requires; it does not benefit anyone to try and include a child with a developmental delay in a program without the necessary services. Not every child with a developmental delay will need an additional staff person or speech and physiotherapy services. Parents, staff, specialists and the director must work together to determine and secure whatever resources the child requires.
Likewise, staff must have access to the information they require to provide the program the child needs. Staff may need additional materials and opportunities to attend conferences, workshops and specialized training sessions. Some of Stephanie's playroom staff attended a communication workshop to learn steps to foster her language development. The director found funds for this training opportunity and other resource materials the staff required.
Parents may also require additional resources. Gloria and Jack had lots of family to help them with evening and weekend child care, but found the centre was also a helpful resource. Gloria willingly paid her own fee to attend a workshop the staff was attending on communication.
Each child, family and group of staff will require different resources. It is essential that everyone involved with the child gather together at least yearly to figure out what resources are required to ensure the child's active growth and learning in the program.
5. Focus on the big picture -- and enjoy the children!
One day when Jack came to pick up Stephanie, he was thrilled to see her in the playground sandbox with two other girls. He spent a few minutes watching the children play and noticed how they were filling each other's buckets, dumping them and laughing with the pleasure of play and each other. When he was about to leave the centre, a staff member told him that Stephanie had been having difficulty using scissors again and did he think that maybe Stephanie could practise some cutting at home? Jack told the staff member what he had observed on the playground and that, in the long-term, he was more concerned about Stephanie's ability to play and make friends than her ability to cut paper. Initially, this comment shocked the staff person, but after reflecting on it and discussing it with other staff members, she saw his point.
Because some children with developmental delays need to work long and hard to achieve the basic preschool skills, it is easy for staff (and sometimes parents) to focus on the program and skills. We need to remember the development of the whole child in early childhood settings and the importance of fostering genuine relationships in the preschool years. It is important for staff to get to know and enjoy all the children. The staff spent individual time with Stephanie and visited her home (as they did for all the children) so they knew that she liked to play with stuffed animals, enjoyed swinging and music, ate lots of fruit and liked to be around other children.
As the director of Stephanie's centre said, "One of the many joys of working with young children is the excitement of watching budding flowers blossom." And Gloria and Jack would agree that Stephanie certainly blossomed during her years at the centre. We don't know the potential gifts and abilities of any child so we must provide opportunities for all children, whatever their abilities, to develop to their potential. Working together, Stephanie's family and centre staff did exactly that for her.
Donna Michal is on maternity leave from her position as Coordinator, Demonstration Day Care Centre and Chair of the Early Childhood Administration Program at Grant MacEwan College in Edmonton, Alberta.
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Recommended Resources
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This article appeared in Interaction (Winter 1997), published by the Canadian Child Care Federation. |
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Posted by the Canadian Child Care Federation, July 1997. |
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