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

There are four key areas to consider as you plan and develop facilities and environments for inclusive child care: health and safety; program accessibility; physical accessibility; and training and support for administrators, parents and child care providers.

Health and Safety

Assuring safe and healthy environments for all children is a primary goal of any child care system. As children with disabilities are included in group care settings, appropriate policies and practices become critical, even though children with disabilities usually need exactly the same safeguards as other children. State, Territorial, Tribal, and local Child Care Administrators can promote healthy practices by establishing systems that are based on workable standards and encourage self monitoring and self assessment by providers.

The formulation of health and safety standards that will protect all children can be addressed by community or State task forces convened for this purpose. Guidelines have been developed and administrators might wish to utilize them. For example, Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of Home Child Care Programs was developed by the American Public Health Association and the American Academy of Pediatrics.

Another example of health and safety initiatives that support inclusive child care is the Healthy Child Care America Campaign, a collaborative effort sponsored by the Administration on Children, Youth and Families' Child Care Bureau and the Health Resources and Services Administration's Maternal and Child Health Bureau. The goal of the Campaign is two-fold: (1) create and maximize linkages between health care providers and the child care community; and (2) develop comprehensive and coordinated services to benefit children across the country. To support this goal, the Campaign has published Blueprint for Action, which contains steps that communities can take to promote healthy and safe child care. One of the ten steps asks communities to "expand and provide ongoing support to child care providers and families caring for children with special health needs."

The National Fathers' Network recently produced "Equal Partners: African American Fathers and Systems of Health Care," a video for health care and social service providers that explores ways that programs can include fathers in the process of providing services to children with special needs. The accompanying "Discussion and Resource Guide" contains self assessment tools that health and social service practitioners can use in evaluating the cultural competency of their programs, recommendations for enhancing the cultural awareness of programs, and resources for supporting fathers of children with special needs.

All guidelines, standards and action plans should be reviewed for consistency with the requirements of the Americans with Disabilities Act (ADA),1990; Section 504 of the Rehabilitation Act of 1973; the Individuals with Disabilities Education Act (IDEA),1990; and other applicable legislation.

Program Accessibility

The area of program accessibility addresses the issue of how the inclusion of children with disabilities will occur. The goal is for every child to be welcomed and valued as a unique individual. Therefore, policies and practices at all levels should reflect the values of inclusion and the benefits to all children, both children with disabilities and their peers.

Making child care programs accessible reflects both the rights of all children to be served in typical settings with their peers and the value of early intervention to children and their families. Early intervention should be tailored to the capabilities and needs of the child and the unique circumstances of the child's family.

Everyone benefits from program accessibility and early intervention

Benefits to the Child:

• More skills acquired more quickly because individualized supports and training are provided;
• Less need for special education or education in segregated settings;
• Prevention of secondary disabilities;
• Support in family participation and activities with other children; and
• Foundation for enhanced independence and productivity throughout lifetime.

Benefits to the Family:

• Skills gained by parents and other family members in implementing child's program at home;
• Reduced stress through supports and increased confidence; and
• Help with costs of special equipment, other disability-related expenses.

Benefits to Society:

• Reduced costs of special education;
• Increased productivity and contributions to society; and
• Prevention and remediation of costly secondary developmental problems and out-of home placements.

The South Dakota Early Childhood Inclusion Support Project, sponsored by the South Dakota University Affiliated Program, has established a Toy Lending Library to help early childhood professionals meet the individual needs of all children in their programs. The Library provides public and private schools and child care programs across the state with access to adaptive toys and feeding equipment. Resources in the library range from utensils with easy-to-grip handles to balls, dolls, and games that encourage small group play that is accessible to all children.

Physical Accessibility

Accessibility does not mean that every part of a child care center or family child care home must be physically accessible, but that the program services as a whole are accessible so that all children can participate in meaningful ways. Structural changes may be required if other alternatives, such as moving services to other parts of the facility, are not feasible.

Child Care Administrators can help by providing accurate information regarding accessibility standards for children. The Americans with Disabilities Act Accessibility Guidelines are currently being modified for children. Child care providers need clear guidance about legal requirements and realistic strategies for improving the accessibility of their facilities. Administrators can collect and disseminate examples of low or no cost barrier removal, accessible facilities and alterations, and efficient and cost-effective use of space.

Providers need information about altering existing facilities and designing new facilities. Providers also need to know about sources of facilities financing and technical assistance support. State plans might include provisions to link architects and child development experts to facilitate communication about environmental designs that benefit all children. Some States, such as New Jersey, have used Child Care and Development Block Grant funds to support facilities technical assistance and financing for child care, Head Start and other early childhood programs. Child care resource and referral agencies (CCR&Rs) can be a focal point for providing and/or sharing information about facilities training and technical assistance.

The Great Outdoors: Restoring Children's Right to Play Outside, by Mary Rivkin, emphasizes the need for every child to play outdoors. Throughout the text, photographs of children with and without disabilities are shown in a variety of outdoor play scenarios. The book includes an appendix of "Guidelines for Playground Accessibility."

Training and Support of Providers and Parents

All stakeholders need continuing training and technical assistance as they work to successfully include children with disabilities. Families and providers should be involved in the entire process of identifying training needs, developing a system to meet those needs, and designing, delivering, and evaluating the training and technical assistance. Training opportunities can support career advancement through such means as providing college credit, credit towards the Child Development Associate (CDA) credential, or continuing education units.

Resources can be pooled by sharing training opportunities among child care, Head Start, public school, and other agencies and programs that serve children with disabilities and their families. Training provides another opportunity to develop a coordinated system of services. Training programs should be evaluated and effective practices widely shared.

Training and technical assistance systems need to be user-friendly and customized to the specific needs of the community. Administrators should investigate opportunities for distance learning via satellite and on-line services. Distance learning can be particularly applicable for States, Territories and Tribes that deal with many child care providers in isolated rural areas.

The Family Center of Washington County in Montpelier, Vermont, conducts Child Development Associate (CDA) training courses for family child care, center-based preschool and infant/toddler providers, on Vermont Interactive Television, utilizing video conferencing on a state-wide basis. The instructor and participants are able to see and talk with each other at all sites. In this way, child care providers in rural areas receive intensive child care training, including small group work at each site.

The Delaware Early Childhood Center, in Harrington, Delaware distributed a needs assessment to child care providers in the community. They were asked to define what would be most helpful to them in working with children who have disabilities, in inclusive settings. The most critical need was for training in areas of child development and in working with children who have disabilities. The Delaware Early Childhood Center, with state and local funding, was then able to develop a series of training models in direct response to the findings of the needs assessment.

RECOMMENDATIONS

1. Develop universal health and safety standards that will protect all children.
2. Assure that all written policies and procedures reflect inclusive values.
3. Provide information about making facilities accessible.
4. Involve families and providers in the identification of training needs.
5. Develop readily accessible training and technical assistance opportunities.

A Mother's Story

We wanted to send our daughter Angela to our neighborhood child care center. Angela has cerebral palsy and uses a walker to get around. The child care center said they couldn't take her because the four-year-old classes were on the second floor and they couldn't afford to install an elevator. I met with the director and asked her if there were any lower cost changes they could make so that Angela could attend. The two- and three-year-olds were on the ground floor. The director agreed to move a four-year-old class to the ground floor so that Angela would be able to get into and out of the building. The whole center has been so welcoming and Angela is thriving. Now we are talking about how we can change the playground so Angela can use more of the equipment.