National Child Care Information Center. (1997). Passages to Inclusion: Creating Systems of Care for All Children. Washington, DC: Department of Health and Human Services.

Child Care Administrators at the State, Territorial and Tribal levels will be leaders in the move to create quality inclusive systems of care for all children. Their challenge is to create collaborative, comprehensive systems that are responsive to the diverse needs of the children and families they serve. Critical issues to consider in the administration of inclusive practices include the following: defining inclusive practices; comprehensive services; family-centered systems; and coordinated planning and delivery of services.

Defining Inclusive Practices for Early Childhood Settings

All children have a right to and can benefit from developmentally appropriate early childhood programs. Based on the ethics of inclusion, developmentally appropriate programs have the potential to create communities of learning where all children and adults collaborate and learn in ways that are responsive to individual, cultural and family differences.

Inclusive practices include:

• Programs responsive to each child's individual capabilities and needs;



• Materials and equipment appropriate for children of varying abilities, interests and needs;



• Curriculum that includes rich opportunities for play and is responsive to the needs of the whole child - including cognitive and language, socio-emotional and physical development;



• Activities and instructional practices that are based on on-going child assessment, and reflect an appropriate balance between child-initiated and teacher-directed activities;



• Daily schedules that allow children to explore and develop sustained engagement with materials and peers and that support individualized transitions from one setting to another;



• Environments that foster social interaction, collaborative projects, interdependence, and independence;



• Family involvement in program planning and implementation and program activities for children and family members that reflect cultural diversity; and



• On-going program evaluation to assure that inclusive practices are being followed and goals for children are being achieved.

Comprehensive Services

All children, including those with special needs, benefit from a holistic approach to their development and care. Comprehensive services in child care settings would include: (1) on-site health care including services for children with complex health care needs; (2) transportation; (3) specialized educational and therapeutic services; (4) nutrition services; and (5) social services. Providing comprehensive services in child care settings assures safety, learning, and cost-effectiveness. Child care resource and referral systems may be able to play a pivotal role in fostering linkages among providers and other agency partners.

To deliver comprehensive services, providers need to have the support of a comprehensive team of interdisciplinary specialists; access to routine and periodic health and developmental screenings; and the opportunity to participate in cross-disciplinary, integrated training (pre-service and in-service). Program volunteers and staff should be oriented to the range of services available and in how to use a resource directory of partnering agencies.

Child Care Plus, in Fairfax, Virginia formed a collaborative partnership with the Office for Children, the visiting Nurses Association, and the Arc of Northern Virginia to develop training to child care providers in homes or center settings. visiting and hospital based nurses, and registered dietitians deliver the training, which focuses on working with children who have complex health needs, such as severe asthma, allergies, or who are fed through a gastronomy tube. All-day training sessions are held on Saturdays.

Family-Centered Systems

Recognizing families as fundamental to the social, emotional, and educational development of children necessitates that we view families as intrinsic to the process of developing systems of quality care for all children rather than primarily as "clients" or recipients of services. Child care options should respond to the diversity of families seeking care with flexibility and sensitivity.

The following are among the features that could be included in family-centered systems of care to support inclusion:

• A central point of entry to the delivery system or source(s) of information about services. Parents and family members should be able to find out about available services in a convenient, well-known location (e.g., child care program, school, Head Start, family resource center, or health center). Child care resource and referral agencies can respond to telephone referrals and assist parents to obtain information and services for their children with special needs.



• Outreach to address special populations. For example, homeless families, teen parents, and fathers should be made aware of inclusion options responsive to their unique situations. Methods of information dissemination should take into account literacy levels, geographic and social isolation, language differences, and other barriers that must be overcome if all families are to learn of the spectrum of services.



• Services available at times that respond to the family's circumstances. Some families will require school-age child care, others care during non-traditional hours, part-time care, hourly care, sick child care, or respite care.



• Parent involvement. Parents should have opportunities to participate in key aspects of child care programs. Most importantly, they must be involved in any program decisions related to their child's special needs and that otherwise affect the health and welfare of their child. Parents can make an important contribution to program decision making. Parent education in child development and related topics should be available. Mechanisms should be developed to enable parents to give feedback to Child Care Administrators and to register their degree of satisfaction with program services.

In Project EXCEPTIONAL in Rohnert Park California, Training of Trainer workshops are jointly conducted by a parent/educator partnership team. Training participants attend as community teams, with a family member of a child with a disability, an early intervention specialist, and a child care and development professional included. Local training teams are encouraged to build on resources in their communities and to replicate the parent/educator partnership model in the delivery of their local Project EXCEPTIONAL training.

In the Los Angeles County Fair Association Child Development Center, in Pomona, California, the parent advisory committee (PAC) is composed of parents of children enrolled in the center. The PAC assists in developing policy, organizing social and fundraising events, and evaluating and reviewing program activities. The PAC also disseminates information about the center and informs the public on current legislation and community actions that impact child care on the local, state and national levels.

Coordinated Planning and Delivery of Services

The needs of, and supports for, children with disabilities and their families are greater than any one agency's capabilities. State, Territorial, and Tribal administrators have many opportunities to collaborate with the multitude of agencies and funding streams that deal with children with special needs and to develop ways to establish formal and informal linkages with such agencies.

Child Development Resources (CDR), a private, nonprofit agency in Norge, Virginia, has an infant parent program that serves children, from birth to three years of age, with disabilities and developmental delays, and their families. Children who are enrolled frequently have complex needs, including special health needs. A service coordinator helps ensure that the children: receive necessary services from health care and other community agencies. The program, a contract service of the Colonial Community Services Board, receives financial support from United Way, fees and contributions. No family is denied services because of an inability to pay.

Multiple, disconnected systems continue to promote the segregation of children with disabilities. State and Tribal administrators can assist by promoting awareness, providing incentives, and coordinating and augmenting resources to support inclusive practices and systems.

Activities that promote coordinated planning and delivery of inclusive child care services include:

• Strategic planning and community needs assessment. Planning for inclusion encompasses a careful analysis of current needs, resources and barriers within the child care system at the community level and statewide. Strategic planning mechanisms should include the participation of self advocacy organizations and families with a need for child care. Needs assessment should take into account providers that are not including children with disabilities in child care services and the rationale for their actions. Strategic planning activities should include the major providers of child care and related services, such as child care providers, Head Start and the public schools.



• Use of Part H. Part H of the Individuals with Disabilities Education Act (IDEA) authorizes financial assistance to the States to develop and implement a statewide, comprehensive coordinated program of early intervention services for all infants and toddlers with disabilities and their families. Each State is responsible for designating a lead agency, and an Interagency Coordinating Council and developing a State Plan. Child care agencies should be a part of the Part H process for infants and toddlers, and these mechanisms could provide a foundation for inclusion activities focused on other age groups.



• Quality assurance. Mechanisms to assess quality and sufficiency of services should be built into the planning process. Performance benchmarks, data collection and opportunities to assess consumer (i.e., child and family) satisfaction should be given priority during strategic planning.



• Technical assistance. States, Territories, and Tribes are encouraged to provide technical assistance support to promote inclusion activities.

Child Care plus in Missoula, Montana, delivers Train the Trainer Institutes to support community-based efforts to provide training and technical assistance to early childhood professionals regarding issues of inclusion. Trainers from resource and referral agencies are recruited nationally to attend week-long training sessions. In turn, these trainers are available to deliver training in their own communities and to consult with providers about specific needs of children in local programs.

RECOMMENDATIONS

1. Develop a system that is based on inclusive practices.
2. Establish linkages with other agencies that serve children.
3. Strive to provide comprehensive services.
4. Develop family centered services.

A Director's Story

I remember how reluctant I was to enroll the first child with a disability who came to us. Derek, age four, had Down Syndrome. When his mother called to ask about openings in our program, she told me about his disability. Even though I had a lot of reservations, I encouraged her to visit our center and bring Derek with her. After her tour, we talked. I let her know that we didn't have any experience with children with Down Syndrome and I would need her help to gather information so that we could best meet his needs. I also told her that I was concerned about our group size and whether we would be a good place for Derek. Although I didn't mention it, I was worried that I might need another adult in his room and I knew our center couldn't afford that.

Derek's mother was very helpful. She said the program looked just right for Derek. She told me about his special education program and said that we could visit and speak with his teacher there. She also offered to have Derek's physical therapist visit us and address any concerns we might have.

We were lucky that our first experience was so successful. Derek's mother let us know that she didn't expect us to be experts. She wanted Derek to be treated like any other child and she was always available when we had questions.

The first few weeks were stressful. I was worried about how my staff and the other parents would react. We had a staff meeting to talk about our concerns. The teacher visited Derek's special education classroom and learned a lot. His physical therapist gave us some good ideas for the playground. The other parents did have questions and we added information about Down Syndrome to our parent bulletin board. Derek's mother also wrote an article about inclusion for our newsletter.