Making the Unfamiliar Familiar: Children with Disabilities in Child Care Settings

When child care providers have difficulties with children who have disabilities, it’s often a case of the provider simply never having worked with a child with a disability. Typically developing children are, of course, individuals – each their own flavor – but their profiles tend to fit into a range with which most providers are familiar. In the case of children with disabilities, a provider may be entirely unfamiliar with how to work with the child. There is usually a solution to this problem: Make the unfamiliar familiar. Here’s a scenario…

Joey is 4 years old and has autism. His parents have enrolled him in three different child care programs, but none of them has worked out. Finally, they decide to enroll him at Lucille’s program. She hasn’t worked with children with disabilities, but she comes highly recommended.

Before the first day, Lucille does some reading about autism and has two conversations with Joey’s parents. When the first day comes, though, she doesn’t know what hit her. Joey is almost entirely nonverbal – that is, until he gets frustrated (especially when he doesn’t want to share toys or join in activities). Joey throws tantrums, screaming and flinging objects around the room. Lucille is worried that she might not be able to work with Joey.

After another day like this, Lucille realizes she has to do something – after all, she wants Joey to thrive in her program. She calls in the parents and they have a long chat. Now that Lucille has spent time with Joey, she has some context and what the parents say makes more sense to her. They talk about some of his “triggers,” like sensory overload and how he needs time during the day to be totally on his own. Lucille also visits the Making Access Happen site. There, she learns about something called a Behavior Support Plan. Up until now, the children in Lucille’s program have never had behavior issues she hadn’t faced before. Joey’s a whole new flavor for her. She maps out a Behavior Support Plan for Joey – the idea is to prevent challenging behaviors by giving children substitutes for those behaviors. Lucille begins to feel optimistic.

The next day is again a challenge. Lucille realizes that this process will take some time, but now she feels armed with both knowledge and a plan. Within a week, she sees changes in Joey’s behavior. She’s set up an area that is just for Joey during a couple of points in the day and she’s had his parents bring in some of his favorite toys for Joey’s “alone” time. As Joey becomes more able to move through his day successfully, the other children start to befriend him. They like him and help him with tasks like taking off and putting on his coat. When Lucille sees Joey share one of his toys with another child, she recognizes it as the breakthrough.

As the weeks go by, there’s more and more time between Joey’s outbursts. He plays with the other children for longer stretches, his vocabulary is growing, and he’s using the other children as role models – learning about the daily routines and how to navigate his day. Lucille has regular meetings with Joey’s parents and his doctor, and adjusts Joey’s Behavior Support Plan as he changes and grows. Children who were once afraid of Joey now play with him and ask where he is during his infrequent absences. Having heard from Joey’s parents about his success with Lucille, another family contacts her about working with their child who also has a disability. This time, Lucille again expects challenges, but knows it will go more smoothly … because she has taken what was once unfamiliar and made it familiar.