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Working with Children with Disabilities: Inclusion Works!, in partnership with Region 9 Head Start Association

Working with Children with Disabilities: Inclusion Works!, in partnership with Region 9 Head Start Association
Piret Leonetti, EdD
June 29, 2020

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Learning Outcomes

After this course, participants will be able to:

  • identify the meaning of inclusion and it’s importance in early childhood education.
  • describe the IDEA laws in order to better support children with disabilities.
  • recognize different developmental delay descriptors and how to respond and make accommodations for children with disabilities in educational settings.

Inclusion

Why Inclusion?

For children with special needs, an inclusive childcare program provides belonging, acceptance, and developmentally appropriate practices. Children with disabilities learn typical developing skills from their classmates, when and how to use the skills, and they have an opportunity to develop friendships with typically developing peers. They are provided opportunities to develop positive attitudes toward themselves and others who are different from themselves. Here are some suggested books that talk about inclusion and disabilities for children.

  • Arnie and the New Kid, by Nancy Carlson, talks about children with physical disabilities. 
  • The Lion who had Asthma, by Jonetta London, talks about children who have upper respiratory conditions.
  • Different Just Like Me, by Lori Mitchell, talks about a variety of disabilities.
  • Ian's Walk, by Laurie Lears, is a story about autism. 
  • I am Deaf, by Jennifer Moore-Mallinos, talks about children who are hard of hearing or deaf.

For the child who has a special need, seeing those books in their daily environment brings a sense of belonging. For children who are typically developing, visitors, parents, and staff gain additional information about different disabilities. 

What Inclusion Means

Inclusion means making all programs and settings, including educational programs or community activities in which typical children and their families participate, accessible, and available to children with disabilities in their families. Inclusion is integrating infants and young children with disabilities into typical educational settings and programs like family child care homes and center-based programs. It also means placing children with disabilities in the same educational programs and setting their parents will choose for them to attend if they did not have disabilities. Inclusion is providing opportunities for special education services to be provided within typical educational settings.

For example, a child with a certified Individual Education Plan (IEP) may be receiving speech therapy in the classroom or family childcare home or a child with an Individual Family Service Plan (IFSP) for occupational therapy may be receiving services provided by an early start agency at a family child care home.

Inclusion is providing adequate support and training to caregivers, service providers, and families. It is addressing parents' concerns and priorities for their infants, children, and adults.

Benefits of Inclusion

Everyone benefits from inclusive practices. Children with special needs benefit from inclusion because they are seen as a child first with special needs secondary, becoming more independent and self-reliant, making new friends, and learning appropriate social skills. Children who are typically developing benefit as they are learning to accept and become comfortable with individual differences. They are also gaining awareness of the ability to express caring, concern, and compassion. They will also experience increased self-esteem through helping others.

Parents and other family members benefit from inclusion as well as they expand the variety of social situations for themselves and their child. They experience a connection with a larger group of families within their community, reduce fears, and increase acceptance of people with special needs. Staff members, caregivers, and teachers benefit from inclusion as they expand techniques for individualizing activities, provide services for children with special needs and their families, and learn more about available resources. 

Special education specialists who might come and provide services in your classroom will gain understanding as they observe typical development and expectation in children and broaden their understanding of child development and group dynamics. For the entire community, the greatest benefits are preparing the next generation for life together, as well as increasing an individual's ability to contribute to society.

Federal Laws

Individuals with Disabilities Education Act (IDEA)

Federal legislation mandates special education for all eligible children. IDEA Part B provides services for children with disabilities, ages three to 21. Those children will have certified individual education plans or programs, also known as an IEP. Under IDEA Part C, services are provided for children birth to three years of age. Those children will have certified individual family services plans, also known as an IFSP.

Historical Perspective

  • Brown v. Board of Education (1954)
  • Civil Rights movement (1950s/1960s)
  • The Education for All Handicapped Children Act (PL 94-142)
  • Individuals with Disabilities Education Act (IDEA) (1990)
  • Americans with Disabilities Act (ADA)
  • Section 504 of the Rehabilitation Act of 1973

IDEA Reauthorization and section 504 of the Rehabilitation Act of 1973 require that individuals with disabilities are to receive a free and appropriate public education (FAPE) which must occur in the least restrictive environment (LRE) with supplementary aids and services when necessary.

The Americans with Disabilities Act (ADA) assures full civil rights to individuals with disabilities, including access to and accommodations in preschools and childcare settings. The ADA prohibits discrimination on the basis of disability in employment, state and local government, public accommodations, commercial facilities, transportation, and telecommunications.

Inclusive Environments

To the maximum extent possible, children with disabilities, including children in public or private institutions and other care facilities, are educated with children who are not disabled, and special classes, separate schooling, or other removal of children with disabilities from the general education environment occurs only when the nature of the severity of the disability of the child is such that education in the general class with the use of supplementary aids and services cannot be achieved satisfactorily. This statement is from Section 612 (a) (5) (A). It is our responsibility as early childhood educators to provide inclusive environments to the extent possible.

Adapting environments is necessary to meet the needs of all children. Clearly defined activity areas must be made accessible and appropriate for all children who might use them. Materials in the classroom or family childcare home environment can be modified and adapted to provide to the learning of skills by children with disabilities.

Qualities of an Inclusive Environment

  • Early childhood educators, specialists, and parents work together so that goals for a child with a disability or other special need are met in a typical early childhood setting to the greatest extent possible.
  • The child has access to and participates in all curriculum and activities.
  • Support services are available to the provider/staff to help best meet the individual needs of the child.

It is important to take note that to successfully deliver classroom curriculums, promote learner growth, and meet the goals of students served in an early childhood setting, teachers must have a basic understanding of the unique learning needs of all students, including those with disabilities. Early childhood educators who have received training in special education topics are generally more positive about inclusion than those who enter the teaching field with limited knowledge of special education. Research does indicate that the provision of basic special education knowledge and training to early childhood educators improves attitudes towards students with special needs, a better awareness of inclusion, personal exceptions, and improved outcomes for students with disabilities who are served within these settings.

Making Accommodations

Making accommodations to your program need not be difficult or expensive. Develop a plan of action, and consider the following:

  • Evaluate your recruitment, enrollment, and employment policies, as well as procedures to make sure they are non-discriminatory. 
  • Assess the physical accessibility of your family childcare home or center. Accommodations might be as simple as rearranging furniture or installing a ramp or handrail.
  • Look for ways to accommodate children, staff, and families with disabilities.
  • Change daily routines to match a child's needs.
  • Lower a coat hook for accessibility, if needed.
  • Change the room layout or lighting for children with challenging behaviors.

Head Start Requirements for Disabilities

Many of you might work with Head Start programs, either early Head Start, regional Head Start, or migrant Head Start programs. If you do, then understanding the Head Start requirement for disability services is central to your work. If you are new to Head Start, please browse the Early Childhood Learning and Knowledge Center at HTTP://eclkc.ohs.acf.hhs.gov. Review the Head Start Program Performance Standards. These standards require that 10% of your funded enrollment will serve children with disabilities. It's important to take note, it is not 10% of your class size, it is overall funded enrollment.

Serving Children with Special Needs

When providing inclusive services to children with special needs it is important to bond with the children. Have an individualized and intentional focus and form relationships with parents. Make sure you have an inclusive and adaptive classroom or family childcare home environment. It is also important that program administration supports staff.

Developmental Delays

Overall Developmental Delays

Descriptors

To begin, what is developmental delay? A developmental delay is when a child does not reach his or her developmental milestones at the expected times. Developmental milestones are the set of functional skills or age-specific tasks that most children can do at a certain age range.

For example, what are some of the developmental milestones children should reach by two years of age? Let's look at cognitive milestones. By the age of two, the child should be able to find objects even when hidden under two or three covers, begin to sort by shapes and colors, and begin make-believe play. Looking at language development, most toddlers can say up to 50 or even more words by age of two. The child is starting to combine simple two-word sentences, such as baby crying or more please. Looking at physical development, by the age of two, the child is able to pull or carry toys when walking behind them, throw and kick a ball, and climb on playground or furniture. 

A developmental delay is an ongoing major or minor delay in the process of development. Delays can occur in one or many areas, for example, gross or fine motor, language, social, or thinking skills.

How to Respond as an Educator and Caregiver

When you first notice that a child in your program might have a delay, discuss your concerns with the child's parent or caregiver along with the importance of submitting a possible referral for further action. This further action might include an evaluation and assessment from either part B or C service providers. It is important to understand that there are timelines that go along with the referral process. You have two handouts available that provide guidance on the steps in the referral process.  One is the Early Start referral process for an Individual Family Services Plan (IFSP). The other is the Individualized Education Program (IEP) Process/Timeline.  Both of these documents are specific to California, but the process is the same everywhere. Your state may have a different name for the early start agency, but it will serve children ages zero to three.

After you have completed screenings and identification and held meetings with the parents, consent is required from the parents to do any testing. Once a referral is submitted for children birth to age three, an evaluation must be completed within 45 calendar days to determine the child's eligibility. The child's assessment for services planning will identify family concerns, priority resources, and then the professional early start team will conduct a formal evaluation of the child. After evaluation, the team will need to review the developmental levels and services needed by the child and determine outcomes. Then they develop a written plan with identified services and every six months they will meet to review the set individual goals for the child. An IFSP meeting takes place annually. Closer to the child turning three, there is a transition plan to exit early start to your local school district who will then take services over.

Make sure you teach in small steps, give clear directions, and speak slowly and clearly, using only a few words. Move the child physically to the task by modeling activities so he or she can feel what to do. Stand or sit close to the child to help as needed, providing visual and auditory support. Help the child organize his world by providing structure, consistency, and by labeling things with pictures and words. This is providing cognitive support. When moving from one activity to the next, let the child know ahead of time and allow plenty of time for the transition. Work closely with agencies and personnel who provide specialized services. These specialists are a great resource for answering questions and brainstorming when problems arise.

Speech and Language Delays

Descriptors

The developmental delay descriptors for speech and language are made up of five components: 

  • Attention and listening 
  • Receptive language
  • Expressive language 
  • Speech
  • Interaction skills 

Let's talk about each of those components. Thinking about attention, a child needs to be able to attend to relevant things in their environment in order to be able to learn. They need to be able to listen and attend to relevant sounds or activities and to focus on the sound or activity for long enough in order to learn from it. Receptive language is the ability to understand the content of what is said, including the facts, the significance, indicated by tone of voice, body language, and possible subtleties of language, including inference. For example, a child with a delay in receptive language may not seem to understand or respond to what people say.

Expressive language is the ability to choose the right words to communicate a message (content). It is the ability to use grammatical constructions such as word order, word endings, and verb tenses. It also includes the ability to use language to perform a variety of purposes such as greetings, describing, arguing, etc. For example, a child with a delay in expressive language may have difficulty expressing his or her needs using typical words or motions or may not articulate letter sounds clearly. When you have a preschooler and their articulation is not clear, that is a sign to see if a referral is needed. 

Speech is the ability to use speech sounds to build up words, saying sounds accurately and in the right places.  It is the ability to speak fluently, without hesitating, prolonging, or repeating words or sounds.  It is the ability to speak with expression and a clear voice, using pitch, volume, and intonation to support meaning.

A child with speech, language, and communication delays might struggle to say words or not understand words that are being used. They may have difficulties holding a conversation or have a very limited vocabulary. Earlier, I gave you an example that typically developing children by age of two will have 50 or more words in their vocabulary. If you have a child who by age two only is saying mama or dada or more, those will be the concerns to consider. As with other skills and milestones, the age at which kids learn language and start talking can vary. Many young toddlers happily babble mama or dada well before their first birthday and they say about 20 words by the time they are 18 months old.

Interaction skills includes the ability to take turns with other speakers, maintain conversation, change the subject, and adapt to fit the flow of the conversation. It also includes the ability to hold a continuous stream of speech for explanations or narrative and to able to talk through the idea or argument. It is also the ability to predict, infer, and make connections (reason) as well as to be able to use language in social situations (functional language).

How to Respond as an Educator and Caregiver

As an educator and caregiver, you must be a good listener and observer. Engage infants and toddlers in shared conversations by reading their sounds, gestures, facial expressions, and body language. Give directions using as few simple words as possible in complete sentences. Use everyday activities such as singing songs, reading books, visuals, and dramatic play to encourage language development. Another great example that toddlers and preschoolers enjoy is puppet play. Talk about what you or the child are doing as you are doing it together.

Cognitive Delays

Experts divide the types of cognitive impairment into four categories: mild intellectual disability, moderate intellectual disability, severe intellectual disability, and profound intellectual disability. Clinical diagnoses of cognitive disabilities include autism, Down Syndrome, traumatic brain injury (TBI), and even dementia. Less severe cognitive conditions include attention deficit disorder (ADD), dyslexia (difficulty reading), dyscalculia (difficulty with math), and learning disabilities in general. General cognitive delay descriptors include the following:

  • Child does not play ”pretend” games (pretend to feed a doll or talk on the play phone).
  • Child does not point to objects to show interest and/or use index finger to point.
  • Child does not look at objects when another person points to them.
  • Repeats actions over and over again (lines up items or sorts by specific attribute, i.e. color).
  • Child has difficulties adapting when a routine changes.
  • Child does not respond to his/her name.

You may suspect cognitive delays if you see some of the red flags listed above. A child with cognitive delays may prefer to play by themself, will not respond to your voice, and might need lots of visual cues and use a lot of repetition. 

How to Respond as an Educator and Caregiver

To respond to a child with cognitive delays, use strategies to make directions and learning expectations clearly understood. Provide directions in language the student can understand. Make sure to use visual cues such as hands-on demonstrations and modeling, objects, and pictures as needed to help the child to better grasp the direction. Prompt and guide the child through the performance sequence. Check to be sure that you have the student's attention before giving directions. You can also gently touch the shoulder of a child to get their attention or give the child extra time to respond. Routines are very important. The best routines have a predictable beginning, middle, and end. Use visual supports such as pictures and props to teach children routines. Help them stay engaged and keep them from having a lot of time transitioning between different activities.
 
Also, for children who have cognitive delays, it is important to utilize peers who do not have disabilities that can model positive, pro-social, and communication skills and demonstrate everyday routines that young children with disabilities can imitate. Classmates can help children develop social relationships and increase their motivation to be part of classroom activities. It is also important to think about the noise level in your classroom. Managing noise in the classroom plays an important role in both learning and behavior. Loud classrooms affect a child's ability to understand increasingly complex language. Carpets and other sound-absorbing materials such as wall hangings or heavy drapes and chair legs with tennis balls on the bottom of metal legs all help reduce classroom noise.
 
Modifying materials in the classroom can have a big impact on independence and help children who have cognitive disabilities. One example is to add pencil cribs to crayons and markers to make them easier for children who also have motor difficulties to hold. Determine where individual children need more support. Children with cognitive disabilities might benefit from timers. Depending on the child, timers can be a good way to remind a child it is time to end one activity and begin another. Finding a timer that provides a warning before time expires is ideal, otherwise the timer might be anxiety-provoking and cause more problems than the benefit. Children with cognitive delays may benefit fidget toys in your classroom. A fidget is an item that the child can hold that might help with attention, calming, and focus, or depending on the fidget and a child, it also can be a distraction. Examples include a stress ball, string, or a small car with wheels.
 
I would like to share an example of a time I used a fidget with a child.  I was working with a child with autism in a preschool classroom setting. This child had a very short attention span. During group time, teachers provided this child with a little basket that held fidgets, such as squishy balls and strings. The basket had the child's picture on it and all the other children knew that this child needed special help. This child was able to quietly reach into the basket and pick an item to hold. We know that these toys can help them to stay engaged and also helps them focus.

Physical Disabilities

Descriptors

Children who might be in your program might a variety of physical disabilities, including a spinal cord injury. Spinal cord injury often causes a permanent physical disability. They might have cerebral palsy, cystic fibrosis (CF), epilepsy, multiple sclerosis (MS), Tourette Syndrome, spina bifida (SB), or Prader-Willi Syndrome (PWS).

How to Respond as an Educator and Caregiver

If you have a child with a physical disability, consider the physical space of your classroom. Are there any obstacles that prevent the child from moving safely in the area? Are the pathways wide enough to accommodate special equipment such as walkers and/or wheelchairs? Know the child's strengths and needs so independence is realistically encouraged and supported. Assist a child with activities he may not be able to do alone such as kicking a ball. Ask any therapists involved with the child to show you proper positioning techniques and also how to use and care for special equipment.

Deaf or Hard of Hearing

Descriptors

According to the Center for Deaf and Hard of Hearing Education and revisions made in 2017 to Guidelines for the Assessment and Educational Evaluation of Deaf and Hard of Hearing Children, deaf or hard-of-hearing, which may be referred to as hearing impairment, means

1. A disability that, with or without amplification, adversely affects the student's

  • Ability to use hearing for developing language and learning
  • Educational performance
  • Developmental progress

2. The hearing levels may be

  • Permanent or fluctuating
  • Mild to profound
  • Unilateral or bilateral

3. Students who are deaf or hard of hearing may use

  • Spoken language
  • Sign language
  • A combination of spoken language and signed systems  

How to Respond as an Educator and Caregiver

Find out from the parents the degree of child's hearing loss and what that means for the child. Ask the child's parents how to use and care for the hearing aid or their special equipment. Support the child socially. Be sure you have the child's attention before giving instructions. Face the child and speak in full sentences. Use visual cues such as pictures or gestures as you talk.

When teaching children who are hard of hearing or deaf, you can learn a few simple signs to support the child in your classroom. They don't have to be extended sentences, but simple ones as hello, welcome, and well done. You might learn signs for some of the routines that will help the child from one transition to another, such as going to eat, rest/nap time, or bathroom. That could really be beneficial for the child.

Make use of available technology, use lots of visual stimuli, and keep unnecessary noises to a minimum. Speak to children at a normal rate. When you have a child who is deaf or hard-of-hearing, look at the deaf student, not an interpreter. If you have an interpreter who comes to your classroom, always make eye contact and point to your lips and talk to the interpreter, but always have eye contact with the child. Remember that the interpreter will be a few words behind the speaker and it is always important to speak very clearly, but slowly.

Visual Impairments

Descriptors

In general, visual impairments are due to one of three broad causes. These include:

  • Structural impairments or damage to one or more parts of the eye 
  • Refractive errors, or an inability of the eye to sharply focus images on the back of the retina 
  • Cortical visual impairments which are due to damage to the brain that interprets visual information 

Children with visual impairments might have cataracts, glaucoma, amblyopia (also called lazy eye), strabismus (also called crossed eyes), optic nerve atrophy, bilateral retinoblastoma (a form of cancer), or albinism. Signs of possible vision impairments in children include:

  • Constant eye rubbing or chronic eye redness 
  • Extreme light sensitivity 
  • Squinting, closing one eye, or misaligned eyes 
  • Poor focusing or trouble following objects 
  • Inability to see objects at a distance 
  • Inability to read a whiteboard or blackboard or trouble reading

How to Respond as an Educator and Caregiver

For children with visual disabilities, use communication during activities such as dressing and eating to help the child get oriented. Think about the physical space of the room and be wary of sharp edges on tables, curled up edges of rugs, and other potential hazards. Once you have found an arrangement of furniture that works for the room, try not to change it too much as the child may rely on it to navigate to the room. It is important to give specific directions and use descriptive language.

Knowing the degree of the child's vision loss can assist in determining, selecting, and using specialized accommodations within your classroom. Children with visual impairments learn best through experience. Do not be afraid to give them extra time to learn and explore. Remember that the final product is not always as important as the learning process for children with visual impairments. Early childhood educators should allow students to experience natural learning and classroom exploration to provide them with multiple opportunities for independence and success.

I once worked with a child with visual impairment who was able to see colors. One of the things we did in the classroom to help him was to use large-print sight words. We also used Braille labels. You might be able to get them from your special education department, local school district, or the person that comes and helps the child, if the child has one-on-one assistance. We also used multiple textures and tactile markings, including stickers and object cues. The tactile markings were very beneficial for that child. One way we used those was to have extra cushioning in the spot where he sat.  In addition, his peers would help guide him to his spot. 

References

The Americans with Disabilities Act (ADA) ,www.ada.gov
 
Child Care Law Center, www.childcarelaw.org
 
Crawford, J. & Weber, B. (2017). Early Intervention Every Day. Baltimore, London, Sydney: Brookes Publishing.
 
Inclusion of Children with Disabilities, www.childaction.org
 
Pacer Center, Assistive Technology for Infants, Toddlers and Young Children with Disabilities, https://www.pacer.org/parent/php/PHP-c212.pdf
 
Supporting Inclusive Early Learning: Working Together for Inclusion and Belonging, www.cainclusion.org
 
Volmer, L. (1995). Best practices in working with students with autism. In A. Thomas & J. Grimes (Eds.), Best practices in school psychology (3rd ed., pp. 1031-1038). New York: Wiley & Sons.
 
Zero to Three, www.zerotothree.org

Citation

Leonetti, P. (2019). Working with Children with Disabilities: Inclusion Works!, in partnership with Region 9 Head Start Association. continued.com - Early Childhood Education, Article 23615. Retrieved from www.continued.com/early-childhood-education

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piret leonetti

Piret Leonetti, EdD

Dr. Piret Leonetti is an experienced Child Development Specialist with a history of working in the early intervention and education management industry. She started her ECE career as an early childhood special education teacher in Europe and continued her career in the United States in educational management as a program director, First 5 Commissioner, and child development specialist specializing in mental health and disabilities. She is also a certified Program for Infant and Toddler Care (PITC) trainer and researcher. Her most recent research study was selected to present at the International Society of Early Intervention conference in Sydney, Australia in June 2019.



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