Inclusion Frequently Asked Questions for the Center For Inclusive Child Care

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Inclusion F.A.Q.

Question: What is Spina Bifida?  back to questions list

Answer: Spina Bifida is the most frequently occurring birth defect affecting approximately one out of every 1,000 newborns. Sometime in the first month of pregnancy, the unborn child’s spine fails to develop completely. Surgery to repair the newborn’s back may be performed within 24 hours after birth to minimize the risk of infection and to preserve the existing function in the spinal cord

The causes of Spina Bifida is unknown, however researchers have discovered that folic acid, a common B vitamin, can help reduce the risk of having a child with a neural tube defect like Spina Bifida. Women of childbearing age are recommended to take 0.4mg (400 micrograms) of folic acid every day. This is 100% of the RDA and is found in over-the-counter multi-vitamin supplements as well as in dark leafy green veggies, whole grains and other foods like soy beans, peas, green beans, rice and orange juice. Inclusion of a child affected by Spina Bifida or any special need, is essential to the child’s development. Here are some great ways to help a child with Spina Bifida feel welcome and have a sense of belonging in an inclusive classroom: · Adjust the height of furniture such as tables & easels so that it is wheelchair accessible. · Add support chairs in interest centers so that the child can sit independently and interact and socialize with peers. · Widen pathways in and outside the class, add railings and ramps.

Question: What is meant by inclusion?   back to questions list

Answer: The Council for Exceptional Children states that inclusion "as a value, supports the right of all children, regardless of their diverse abilities, to participate actively in natural settings within their communities". Inclusion is characterized by a feeling of belonging, not by mere proximity, as in mainstreaming, but in children of all abilities learning, playing, and working together. With successful inclusion, all children are actively involved, physically accessing play and work locations, and have options from which they can choose personally. Inclusion is a process, not a placement.

Question: What is respite care?  back to questions list

Answer: Respite Care is short-term relief for the primary caregiver of an individual who has a disability. The purpose of respite care is to provide caregivers with an opportunity to take a break from the intensive demands of their daily caregiving responsibilities to enable them to continue to provide on-going care in the home. The type, amount, and duration of service is predetermined and approved by the county of residence. Respite care services may be provided in the client’s home or in a contracted center-based setting.

Question: What is a neuropsychological evaluation?  back to questions list

Answer: A neuropsychological evaluation is a comprehensive assessment of cognitive and behavioral functions using a set of standardized tests and procedures. Mental functions that are tested include, but are not limited to intelligence; problem solving and conceptualization; planning and organization; attention; memory; learning; language; academic skills; perceptual and motor abilities; emotions, behavior, and personality. A neuropsychological evaluation is done by a psychologist who has specialized training and experience in the field of neuropsychology.

Question: What is the purpose of a neuropsychological evaluation?   back to questions list

Answer: Neuropsychological evaluations are recommended when impairment in cognitive functioning or behavior is suspected to be brain-based. This type of evaluation is used to rule out conditions such as traumatic brain injury, strokes, developmental learning disabilities, attention deficit disorders, psychiatric or neuropsychiatric disorders, seizure disorders, medical illness, the effects of toxic chemicals or chronic substance abuse, and conditions that cause dementia such as Alzheimer’s Disease. The results of a neurological evaluation can be used to confirm and clarify a diagnosis; provide a profile of strengths and weaknesses to guide planning for educational, vocational, or rehabilitation services; document changes in functioning since prior evaluations; assess the effects of treatment received since prior evaluations; determine what strategies and further treatment may be appropriate; make referrals to other specialists.

Question: Why isn’t punishment an effective behavior guidance strategy?   back to questions list

Answer: Punishment is a penalty for wrongdoing, imposed on purpose by someone in power who intends it to be unpleasant (Coloroso, 1995). It may come in the form of reprimands (e.g., "no hitting") or mild punishments (e.g., time out) following the form (e.g., hit) of the behavior. Little time or attention may be given to observing behaviors, particularly the events and information surrounding behaviors.

Research has shown that these punishment approaches may be effective temporarily but in the long-term have negative effects on children (Sobsey, 1990). One long-term effect of punishment is that it could cause the child to have a negative relationship with the person who delivers the punisher. A second negative effect of punishment is that it could cause the child to act out the behavior on other children. A third negative effect of punishment is that it can cause the behavior to increase rather than decrease.

As researchers learned the negative effects of punishment, they began studying alternative approaches to behavior guidance. This new research has suggested that practitioners should attend to outcomes of children’s behavior rather than forms of behavior. Thus, form is what behaviors look like and outcomes are what behaviors get. For example, Suzie hits her friend Tom in housekeeping. Tom begins to cry and leaves the housekeeping area. In this example, hitting is the form and Tom crying and leaving housekeeping are the outcomes or "payoff" of the behavior. For more information on guidance strategies, see www.inclusivechildcare.org.

Question: What is a developmental Red Flag?   back to questions list

Answer: Red flags are behaviors that should warn you to stop, look, and think.

• Look for patterns or clusters of a behavior.
• Observe a child in a variety of situations.
• Compare the child’s behavior to a "norm" of six months younger and six months older.
• Note how much the child has grown in past 3–6 months—has he/she progressed?
• Know the normal patterns of growth and development.
• Keep in mind the factors that may be influencing the development.

Question: How do I tell a parent I have concerns about their child?   back to questions list

Answer: It can be very difficult for parents to hear concerns about their child’s development or behavior. Communicate to the parents that you really do care about their child and try to arrange a time to talk with them when children will not be present.

Use a "positive sandwich" approach by sharing with the child’s parents an example of a positive quality you have observed in their child, a positive interaction you have observed or had with their child, or something you really like about their child. Then share with them specific examples of developmental and/or behavioral concerns and how this impacts the child while in your care.

It is important to share specific examples of the strategies that you have tried to help the child be successful in your child care environment. Remember to give them some time to process and respond to the information that you share with them. Follow the sharing of your concerns by again sharing something positive about their child and reiterate that their child’s success is important to you.

Question: How do I get consent from a child’s parents for consultation services?   back to questions list

Answer: When talking to parents about consultation services, it can be less threatening to parents to communicate to them that you would like to have an objective observer spend some time observing in the child care environment to provide you with suggestions, ideas, and strategies to help their child be successful. Share with them written information about the consultation services and assure them they will have an opportunity to talk with the consultant at any time. The consultant will share with them the same information that is shared with you.

Question: What is Oppositional Defiant Disorder?   back to questions list

Answer: Oppositional Defiant Disorder, as defined by the American Academy of Child and Adolescent Psychiatry, is an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the youngster’s day to day functioning. Symptoms of Oppositional Defiant Disorder may include frequent temper tantrums, excessive arguing with adults, active defiance and refusal to comply with adult requests and rules, deliberate attempts to annoy or upset people, blaming others for his or her mistakes or misbehavior, often being touchy or easily annoyed by others, frequent anger and resentment, mean and hateful talking when upset, and seeking revenge. The symptoms are generally seen in multiple settings, but may be more noticeable at home or at school. There is no known cause of Oppositional Defiant Disorder, but biological and environmental factors may play a role.

In order for a child to be diagnosed with Oppositional Defiant Disorder, the pattern of behaviors must persist for at least 6 months, extend beyond the expectations of normal childhood misbehavior, and result in significant social or academic problems. Oppositional Defiant Disorder can coexist with other disorders such as Attention Deficit Hyperactive Disorder (ADHD), learning disabilities, mood disorders such as depression or bipolar disorder, and anxiety disorders.

Treatment plans for children with Oppositional Defiant Disorder may include individual psychotherapy, family psychotherapy, behavioral therapy, social skills training, and parent training programs. Medications may be of assistance if the behaviors coexist with another condition.

Question: What does EBD mean?   back to questions list

Answer: EBD stands for Emotional/ Behavioral Disorder (EBD). The definition most often used, comes from the National Mental Health and Special Education Coalition:

1. The term emotional or behavioral disorder means a disability that is:
   1. characterized by behavioral or emotional responses in school programs so different from appropriate age, culture, or ethical norms, that responses adversely affect educational performance, including academic, social, vocational or personal skills;
   2. more than a temporary, expected response to stressful events in the environment;
   3. consistently exhibited in two different settings, at least one of which is school-related;
   4. and unresponsive to direct interventions would be insufficient.
2. The term includes such a disability that co-exists with other disabilities.
   You might see a child:
   
   1. Hit or fight
   2. Disturb others
   3. Throw toys or furniture
   4. Talk loudly, swear, scream
   5. Temper tantrums
   6. Destroy property
   7. Ignore or argues with teacher
3. The following can be some of the characteristics of internalized behavior.
   Plays alone
   
   1. Complains of being sick or hurt
   2. Immature
   3. Withdrawn
   4. Fearful without reason

Question: What is Challenging behavior?   back to questions list

Answer: Challenging behavior can be defined as actions produced by a child that:

1. Result in self-injury or injury of others,
2. Cause damage to the physical environment,
3. Interfere with the acquisition of new skills, and/or
4. Socially isolate the child (Doss & Reichle, 1991).

Challenging behaviors may take many forms. Included are:

1. self-injurious behavior such as scratching, biting, head banging, punching, face slapping, pinching, etc.
2. aggression such as hitting, scratching, kicking, biting, and pinching others; and knocking over objects
3. tantrums such as persistent crying, loud vocalizations, screaming, and whining
4. social avoidance such as looking away and leaving group activities
5. self-stimulatory behavior such as body rocking, and hand flapping.

Challenging behaviors can range in severity from mild to very significant behaviors that are disruptive or cause harm to the child herself or others. Challenging behaviors also serve a number of purposes. It is important to know what function the behavior serves.

Question: What is bullying?   back to questions list

Answer: According to Kaiser and Rasminsky (2003), bullying is a special form of aggressive behavior. Olweus describes it as "a person is being bullied when she or he is exposed, repeatedly and over time, to negative actions on the part of one or more other persons". Bullying can take several forms including physical abuse, verbal bullying, relational bullying, as well as direct or indirect bullying. It usually takes place out of the site of grown ups, although it may also occur right in a classroom when a teacher is present. Bullying is a learned behavior and may be unlearned and even prevented. (Kaiser, Raminsky, 2003). Resources on bullying may be found at www.pacer.org.

Question: How can I support a child who doesn’t play?   back to questions list

Answer: Play problems can occur for many possible reasons. A child may have a lack of skills due to a diagnosed special need. Lack of positive play experience may also be a factor that contributes to the existence of a play difficulty. A child may have a lack of confidence in social situations due to past unsuccessful interactions and therefore no appropriate experiences on which to build new productive play skills.

Play Intervention Strategies:

Curriculum

Use materials and activities to assist the child in play situations.

• find a favorite toy or theme and incorporate it into play through activities and toys or equipment.
• Give the child a new or extra exciting item and have them introduce it to the group or be the first one to play with the item. The item should be interactive, encouraging social connectedness and interactions.
• Set up the environment for success by placing toys and materials at the child’s level for easy access. Place favorite items near the child or place the child in an area that will create the greatest success. For example, have the child who needs sensory experiences begin play at the sand table with some new strainers or funnels.

Peer Interaction

Orchestrate successful experiences through peer play combinations.

• pair a child with a peer who is a positive model, using appropriate play skills and patience.
• Assign play groups. Decide and play which children should be together.
• Find peers with similar interests and set up an activity centered on that interest.

Teacher Interaction

The caregiver will play a major support role in the play and interactions of the child with play difficulties.

Direct: Set up the situation for success by directing play activities, games or activities that require adult direction and support. This will give the child immediate reinforcement for positive interaction by giving the child a script to follow verbally and the support of a caring adult. The adult will be available for feedback and redirection when things seem to be falling apart or to point out positive choices and outcomes which will build skills and confidence for the child.

Indirect: Shadowing a child during play is an easy way to monitor the interaction but not take over. This is a wonderful way for a child to gain confidence and experience success in play, feeling more independent but not feeling overwhelmed.
      A caregiver is there to assist with communication and next step suggestions if necessary. This can be done through simply whispering suggestions, using physical touch to direct the child, subtly redirecting the play without completely stepping in to the interaction. Once the support is given the caregiver steps back and allows the child to take the lead.