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  #1  
Old 12-28-2017, 06:18 AM
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Default Outside Therapists And Educational Services

Here is a question for you that I have not seen come up before.

Do any of you have daycare children that receive outside services in your home during the day? Like occupational therapy, speech therapy ect?
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Old 12-28-2017, 06:43 AM
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I have 4 kids receiving services at my home right now.

#1: Counseling/play therapy

#2: Counseling/play therapy and speech therapy

#3: Feeding therapy, speech therapy, early learning specialist, Occupational therapy, home health visits (physical therapy discontinued for him, but will probably start again in the future due to health setbacks).

#4: Feeding therapy, speech therapy, early learning specialist, Occupational therapy, home health visits, and physical therapy.

Honestly, as much work as it sounds like, it's not a big deal.
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Old 12-28-2017, 06:50 AM
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Originally Posted by Tigerlilly View Post
Here is a question for you that I have not seen come up before.

Do any of you have daycare children that receive outside services in your home during the day? Like occupational therapy, speech therapy ect?
This has come up several times on the forum....

Some providers are very involved in that type of thing and allow anyone connected to a child's development into their program/homes whereas other providers see it as a disruption or an attempt to push this responsibility off onto the provider.

While I don't think there is any one right or wrong way to approach it, whatever choice is made needs to be acceptable and comfortable for everyone.

Personally, I don't ban it all together but don't welcome them in either as it's a major disruption to our day and most of the times parents have wanted someone to visit here it was simply because it was easier for the parent so I've always said no but can't say I will always say no.

It honestly depends on the situation but so far in 2.5 decades, I haven't had a single situation where I was the last resort and had to host a therapist etc... here.

Some other threads about this topic
https://www.daycare.com/forum/showthread.php?t=79788
https://www.daycare.com/forum/showth...eech+therapist
https://www.daycare.com/forum/showth...eech+therapist
https://www.daycare.com/forum/showth...eech+therapist
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Old 12-28-2017, 06:57 AM
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I have had requests before.

The way I have handled it:
1. I ask if the service provider ASKED to observe during daycare.
2. If the answer is no- then my answer is no. If the answer is yes, then I request the name and phone number of the provider so that I may confirm and settle the conditions I am ok with.

My conditions:
1. The business/practitioner must be licensed.
2. The visit can be no longer than 20 minutes.
3. No more than 2 visits per month and it must have an end date.

Last edited by Snowmom; 12-28-2017 at 06:59 AM. Reason: sp
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Old 12-28-2017, 07:01 AM
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Depends on the situation. I've had 2 requests this year for therapy at daycare. 1 I said no, 1 I said yes.

Dcg was approved for ABA therapy. It was 5 hrs a day 4 days a week. I could not accommodate this schedule because they needed a separate area to conduct therapy in.

Dcb was approved for speech therapy 1 day a week for 1 hr. This I could accommodate because while they also needed a separate area to conduct therapy it was 1 hour as opposed to 5.
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Old 12-28-2017, 07:13 AM
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Originally Posted by Blackcat31 View Post
This has come up several times on the forum....

Some providers are very involved in that type of thing and allow anyone connected to a child's development into their program/homes whereas other providers see it as a disruption or an attempt to push this responsibility off onto the provider.

While I don't think there is any one right or wrong way to approach it, whatever choice is made needs to be acceptable and comfortable for everyone.

Personally, I don't ban it all together but don't welcome them in either as it's a major disruption to our day and most of the times parents have wanted someone to visit here it was simply because it was easier for the parent so I've always said no but can't say I will always say no.

It honestly depends on the situation but so far in 2.5 decades, I haven't had a single situation where I was the last resort and had to host a therapist etc... here.

Some other threads about this topic
https://www.daycare.com/forum/showthread.php?t=79788
https://www.daycare.com/forum/showth...eech+therapist
https://www.daycare.com/forum/showth...eech+therapist
https://www.daycare.com/forum/showth...eech+therapist
For whatever reason, the search function does not work on my device. Sorry
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Old 12-28-2017, 07:18 AM
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The only times occupational therapy was needed for any of my dck, it was for dck that only came 3 days a week (which meant there were two home days the therapist could work with) or because the mom said the dad was embarrassed from the therapy I told one of these they had to do it at home and I told the other the only time I could work with the therapist was between 6:30 and 7:30 AM. Obviously they didn't take me up on that.....so I did offer but put it with my schedule so it didn't interupt. I haven't been asked any time lately. I have one large room so there is not really a spot for the therapist to be secluded. Licensing told me to be "careful" with each situation to be sure I was in compliance.
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Old 12-28-2017, 07:20 AM
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Originally Posted by Tigerlilly View Post
For whatever reason, the search function does not work on my device. Sorry
Oh Hey... no worries...

Some one will always help in that department! The tags on the bottom of each thread are sometimes super simple and other times not so easy to connect to the topic but like I said, someone will always help link to other threads...

But still....don't apologize for a topic already discussed... life changes, members change and ideals and approaches do too so everything daycare related worth talking about is worth bringing back up!
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Old 12-28-2017, 08:56 AM
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I welcome therapists with open arms. I let them know my facility is small and I can not give them privacy, but they can give therapy in my living room. The children arenít allowed in there after theyíve learned to walk, so itís usually open for them. I have two kids each seeing 3 therapists a week for an hour at a time. One has Cerebral Palsy and a feeding tube, he is 2 1/2 and cannot walk. The other was a preemie and has microcephaly. She is going to be 2 in a month and is still learning in to hold her head up and control her neck muscles. Itís essential for these two children to have their therapies spread out over the course of a week to maximize effectiveness. And itís also essential for me, as their main caregiver during the day, to see what is being worked on so I can work on it with them during the day. These two children NEED therapy to be constant nearly 24-7...even if itís just in the way I hold them to encourage the neck muscles to work etc. Itís only disruptive until the other kids get used to it. I go about my day as if they arenít here for most of the visit then check in with them at the end to see if I need to update how Iím doing things.
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Old 12-28-2017, 09:05 AM
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I had one parent ask me about a speech therapist coming to my home and I did not think it was a good idea here, one the other kids get way to hyper when someone else is in the home which would make that child needing the therapy not do well, plus it wouldn't be fair to my family to have someone go into the other part of our home to do the session with the child.
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Old 12-28-2017, 10:26 AM
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I have 1 family right now that has been evaluated and they think he's autistic. They asked if the therapist could come here and see him interact with other kids. I wasn't keen on that because first of all, the kids will not act like they normally act with her here. You guys know how they all act out when someone is here and secondly, can you just let anyone in? What do their qualifications have to be to be around all of the kids?
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Old 12-28-2017, 10:42 AM
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I have a (unasked for) reputation for being a special needs daycare. I have a child with cancer, one with cerebral palsy, several with trauma histories (neglect/abuse), others with developmental or social issues. 2 are tube fed, many receive nebs regularly, 2 need daily med administration. I am so involved in the care of 2 of them that I have full access to their medical teams (I have power of attorney to receive information and even make decisions on medical care in their mothers' absence).

I didn't ask for this, but it keeps my roster full and my days usually fly by (they're busy!). I can certainly understand why someone would NOT want this in their lives/businesses, but I am also a foster parent...no such thing as privacy with foster parenting, it seems! I have regular visits from social workers, licensing, food program, anyway, so what are a few more from therapists? LOL.
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Old 12-28-2017, 11:04 AM
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Originally Posted by lovemykidstoo View Post
I have 1 family right now that has been evaluated and they think he's autistic. They asked if the therapist could come here and see him interact with other kids. I wasn't keen on that because first of all, the kids will not act like they normally act with her here. You guys know how they all act out when someone is here and secondly, can you just let anyone in? What do their qualifications have to be to be around all of the kids?
You can always ask about their organization and specialty but I would not worry that the therapists do not have appropriate background checks.

I have hosted many providers from Early Intervention and I have never once suspected that they were not able to be around the children, these therapists often visit children in a childcare setting.

If you don't have the space to accommodate it, just tell the parents. Perhaps they can find a daycare center that would be willing to work with them.

I understand how it can feel like you are losing your privacy but if you don't want to deal with it just tell the parents and let them move on to a daycare that will allow the services. It is too important for a child to receive therapy as early and as much as possible, for the child to miss out on the opportunity would be a horrible.
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Old 12-28-2017, 11:44 AM
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You can always ask about their organization and specialty but I would not worry that the therapists do not have appropriate background checks.

I have hosted many providers from Early Intervention and I have never once suspected that they were not able to be around the children, these therapists often visit children in a childcare setting.

If you don't have the space to accommodate it, just tell the parents. Perhaps they can find a daycare center that would be willing to work with them.

I understand how it can feel like you are losing your privacy but if you don't want to deal with it just tell the parents and let them move on to a daycare that will allow the services. It is too important for a child to receive therapy as early and as much as possible, for the child to miss out on the opportunity would be a horrible.
I totally agree. For a kid that needs multiple therapies a week, spread out for max benefit....one parent would have to quit working to stay home. Thatís not realistic in most cases. They need childcare where their child can get the help they desperately need. All of the therapists that come here, also visit kids in state preschool and headstart.
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Old 12-28-2017, 05:18 PM
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Default Therapists in daycare setting

According to classes that I have taken for our training hours that are required by DHR, you CANNOT separate a child and therapist by putting them in a separate room away from the other children because it's considered as a way for the child to not interact with their peers while the therapist is present.
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Old 12-28-2017, 07:29 PM
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According to classes that I have taken for our training hours that are required by DHR, you CANNOT separate a child and therapist by putting them in a separate room away from the other children because it's considered as a way for the child to not interact with their peers while the therapist is present.
Wouldnít that depend on the therapy? Some therapies donít have a social component. like physical therapy.
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Old 12-29-2017, 05:16 AM
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Originally Posted by Georgiads View Post
You can always ask about their organization and specialty but I would not worry that the therapists do not have appropriate background checks.

I have hosted many providers from Early Intervention and I have never once suspected that they were not able to be around the children, these therapists often visit children in a childcare setting.

If you don't have the space to accommodate it, just tell the parents. Perhaps they can find a daycare center that would be willing to work with them.

I understand how it can feel like you are losing your privacy but if you don't want to deal with it just tell the parents and let them move on to a daycare that will allow the services. It is too important for a child to receive therapy as early and as much as possible, for the child to miss out on the opportunity would be a horrible.
I guess I wasn't asking about what qualifications the therapist has to have to come to my home for my own concerns, but rather licensing. I've read several times how providers don't care for parents coming in and spending time around other peoples children, so that's why I was asking if there was a licensing rule.

The child I was referring to that is in speech therapy comes here 2 days a week for 4 hours each time, so it's not as if this child is here 50 hours a week and they can't fit their therapy in at home. If a therapist wants to see how he interacts with other children, I completely understand that. My concern is that the kids act up when someone else is here, so their play during that time is not characteristic of how they normally behave. I have offered to video tape a natural day without distractions so they can truly get an idea of how he interacts.
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Old 12-29-2017, 07:28 AM
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Originally Posted by lovemykidstoo View Post
I guess I wasn't asking about what qualifications the therapist has to have to come to my home for my own concerns, but rather licensing. I've read several times how providers don't care for parents coming in and spending time around other peoples children, so that's why I was asking if there was a licensing rule.

The child I was referring to that is in speech therapy comes here 2 days a week for 4 hours each time, so it's not as if this child is here 50 hours a week and they can't fit their therapy in at home. If a therapist wants to see how he interacts with other children, I completely understand that. My concern is that the kids act up when someone else is here, so their play during that time is not characteristic of how they normally behave. I have offered to video tape a natural day without distractions so they can truly get an idea of how he interacts.
Some therapies have a social component where they work with the child to communicate with peers. The therapists that come into my home all have livescan/immuniztion/TB test on file with their agency, who also files those with licesensing.
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Old 12-29-2017, 05:31 PM
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No because its in compliance with the ada. Not necessarily license requirements
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Old 12-31-2017, 03:14 PM
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I was a special needs center for several years. My house had a revolving door for the ECI therapists. I loved them and never hesitated to let them in. That said, I never had more than 3 kids in care at one time, so it was easier than if I had had 5 or 6.

I didn't mean to do special needs, but one of my dc kids developed problems, so it started. I readily agreed for 2 reasons. None of my parents have had the type of jobs that they could take off for an hour in the middle of the day. Also, these kids spend 50+ hours a week with me. I was in charge of their therapy. I sat with the therapists while they worked with the kids and taught me how to do it. Then, I taught the parents what they needed to know. When a child needs therabrushing every 2 hours or certain physical therapies, it was up to me to meet their needs. I would have felt like I was not doing my best for them if I had declined. All therapies were scheduled through me, and the parents rarely even talked to them unless there was a question.

I don't have any S/N kids at the moment. Some aged out, one moved away, and my last one overcame her difficulties and is no longer considered special needs.

I think that the best part is how much I learned. Our ECI has a policy of blending into the daycare. Other than play therapy, they keep the child in the main room and everyone takes part, especially OT. Once they found out I was involved, they sent me videos, books, webinars, etc. I have learned so, so much, and I really like it. At one point, I considered going back to school for OT, but at my age, it just wasn't sensible. I found that I am really good at managing and doing the therapy.

Even though I am not doing it officially, I still use it. I have one child that is very sensory, as many kids are. I use the things I learned for him, and it helps.

I have 2 openings coming up this fall, and I hope, hope, hope that I can fill them with another s/n child and welcome the therapists back.
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Old 01-02-2018, 05:35 AM
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I am sure all states differ but here in MD we must allow ( we can not deny any therapy visits) a therapist to visit a child and have therapy in a child care home .
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Old 01-02-2018, 06:16 AM
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I am sure all states differ but here in MD we must allow ( we can not deny any therapy visits) a therapist to visit a child and have therapy in a child care home .
Can I ask how is that worded in your regulations?
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Old 01-02-2018, 10:49 AM
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Can I ask how is that worded in your regulations?
I know that if I deny it I have to be very careful of my wording to be ADA compliant. I generally allow it, but if I can't my go-to reason is "schedule conflict".
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Old 01-02-2018, 11:27 AM
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I know that if I deny it I have to be very careful of my wording to be ADA compliant. I generally allow it, but if I can't my go-to reason is "schedule conflict".
Does your state require you to allow outside therapists to come into your program?

I don't know.....I understand ADA compliancy but I don't see anywhere in those laws that state we HAVE to accommodate these visits during program hours...kwim?

I like the "scheduling conflict" response as a viable and legal "out".


If a child has therapy due to an ADA protected disability and I decline to host a therapist here within daily routine I don't see that as non-compliant.

fwiw~ I have no idea.. I'm just trying to figure it out.

I see the connection but I'm so B&W about most rules that I usually make my decisions based on specific wording etc.. so I am wondering if it's the ADA that would say you HAVE to accommodate or the state's child care laws.
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Old 01-02-2018, 11:46 AM
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It's considered a reasonable accommodation, which the ADA requires us to make when possible. My old house was too small so they had to be right in the middle of my play area, thus I could only accommodate play-based therapy that included the whole group. This isn't a state regulation but has been won in case-law in our state.

I came across the case law when fighting for an IEP for my own child years ago...I can't easily dig it up at this point. It caught my eye in my reading because it applied to small private facilities.
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Old 01-02-2018, 12:20 PM
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It's considered a reasonable accommodation, which the ADA requires us to make when possible. My old house was too small so they had to be right in the middle of my play area, thus I could only accommodate play-based therapy that included the whole group. This isn't a state regulation but has been won in case-law in our state.

I came across the case law when fighting for an IEP for my own child years ago...I can't easily dig it up at this point. It caught my eye in my reading because it applied to small private facilities.
Can you cite the case law for in home facilities if you know of any. By small facilities are you referring to a center?
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Old 01-02-2018, 12:48 PM
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Can you cite the case law for in home facilities if you know of any. By small facilities are you referring to a center?
I can't cite it, I read it years ago in a law book so I don't have online references. It was for small private facilities including family child care homes. It said that the only requirement is space, that it doesn't require more staff, or supplies or any increase of cost on the part of the business so it's not reasonable to decline it unless you don't physically have space for another adult to be in your licensed areas. There were caveats for therapies that required privacy (which none that I can think of under ADA would) or that take a lot of physical space.
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Old 01-02-2018, 12:53 PM
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Also this was case law at the state level. I didn't read anything that took it to the federal level because it wasn't my focus. My focus at the time was getting accommodations for my own child in school and after-school care. The child I was fighting for is now 22 years old so I don't even have her IEP handy to see my reference list.
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Old 01-02-2018, 03:35 PM
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My experience is that daycare is chosen as the place to do EL intervention because that is what is best for the parents and the service providers schedule.

I wonder why the service providers don't accommodate the child's and family's schedule or the parents don't accommodate the service providers schedule? To me that seems more in line with the ADA then having services during child care with other children and adults present.

The service providers need to change their business model to early mornings, evenings, and weekends to accommodate the special needs child home schedule.

I have hosted a couple workers and it didn't turn out well. It was a big time suck and the expectation to relay information to parents and to be the go between from therapist to parents resulted in way too much patent conferencing and documentation.

The therapies the child received weren't affecting the child's success in my setting. I didn't need to be involved in any way.

I don't worry about being ADA compliant if the child's reason for therapy doesn't affect their daycare setting.

I would have to require the parents to exhaust every avenue to get their child help without involving the daycare before i would consider it. This would mean working with their employers to schedule before or after work therapy times, accessing other companies to provide services within hours they aren't working, and enlisting friends and relatives to host when their or the service providers schedule doesn't jive with the parents work hours and off work hours.
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Old 01-02-2018, 04:25 PM
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Originally Posted by nannyde View Post
My experience is that daycare is chosen as the place to do EL intervention because that is what is best for the parents and the service providers schedule.

I wonder why the service providers don't accommodate the child's and family's schedule or the parents don't accommodate the service providers schedule? To me that seems more in line with the ADA then having services during child care with other children and adults present.

The service providers need to change their business model to early mornings, evenings, and weekends to accommodate the special needs child home schedule.

I have hosted a couple workers and it didn't turn out well. It was a big time suck and the expectation to relay information to parents and to be the go between from therapist to parents resulted in way too much patent conferencing and documentation.

The therapies the child received weren't affecting the child's success in my setting. I didn't need to be involved in any way.

I don't worry about being ADA compliant if the child's reason for therapy doesn't affect their daycare setting.

I would have to require the parents to exhaust every avenue to get their child help without involving the daycare before i would consider it. This would mean working with their employers to schedule before or after work therapy times, accessing other companies to provide services within hours they aren't working, and enlisting friends and relatives to host when their or the service providers schedule doesn't jive with the parents work hours and off work hours.
A child's ability to walk, hold her head up, sit up, eat etc all definitely affect her at daycare. The therapists that come here are helping with those things...and helping the children interact and play with their friends. I just go on about my day...but it's written in their goals and special ed plans that they need to get their help at daycare to be most effective. It's about what helps the child, not what helps the parents. I have one that is 2 years old and can't hold her head up for more than 30 secs at a time, or sit up, let alone roll over or crawl or walk etc. And another with CP who is learning how to physically navigate around playing children without being knocked over etc.
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Old 01-02-2018, 06:36 PM
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A child's ability to walk, hold her head up, sit up, eat etc all definitely affect her at daycare. The therapists that come here are helping with those things...and helping the children interact and play with their friends. I just go on about my day...but it's written in their goals and special ed plans that they need to get their help at daycare to be most effective. It's about what helps the child, not what helps the parents. I have one that is 2 years old and can't hold her head up for more than 30 secs at a time, or sit up, let alone roll over or crawl or walk etc. And another with CP who is learning how to physically navigate around playing children without being knocked over etc.
I can see when you take medically fragile children you will need support. That's a different level of special needs care than I believe the OP is referring to.

It's a business decision to provide medical care to daycare kids.

I'm assuming these children also have daily intervention by specialist at home during evenings and weekends? If not, then why are the service professionals and parents choosing to have the therapy done at daycare instead of at home.

I'm not referring to adhering to the service plan but specifically the worker working with the child at daycare rather than at home.
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Old 01-02-2018, 07:23 PM
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Default My experience with an Autism Diagnosis

In my experience with Autism the therapist only work from 8 to 5 pm. If both parents work full time days there would be no way the sessions could take place in the home. In my area there are a couple of options for center based services but the children in those centers are closer to school age at the youngest.

It is really important to have as much therapy as early as possible for ASD. I respect any business owner who does not want to deal with it. If that is the case please tell the family they would be better served in a daycare center that could accommodate them, it could change the outcome of a childís life.
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Old 01-03-2018, 06:45 AM
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In my experience with Autism the therapist only work from 8 to 5 pm. If both parents work full time days there would be no way the sessions could take place in the home.
And that's what needs to change. How does a business that serves the children of working parents stay in business when the hours they work both the child and parent aren't at home or the parents can't bring the child to them?

That is the problem here.

The businesses that want to serve children of parents who are home with their children, work evenings and weekends or the children are at relative's houses during the week can have their business hours during the hours you stated.

If they want to serve children who are not on site at home or relative's then they need to adjust their model to accommodate.

Home child care does this. There are a certain number of providers who work evenings and weekends to accommodate parents who work odd hours. Why can't the specialist do the same?

This isn't a daycare issue. Whatever services are being done at daycare can be done at home before daycare, after daycare, evenings and weekends. The concept that the worker wants to view the children in the child care setting doesn't exist with children who are served at the family home. There's an understanding there are only siblings or no other children at all.

I just don't see this as having ANYTHING to do with child care.

I can see centers having the physical space to give a small area for therapy and the staff being thrilled to have one less kid during the time. I can also see therapist wanting to do the therapy with the other kids in the room and that would be something I would object to as a center owner. If they can serve a singleton child at home with their parents with the same treatment then they can serve the child without the age mates. I would never allow it in the classroom nor would I agree to a treatment plan that could be done exclusively at home. There would have to be very strong evidence that whatever therapy or plan that was supposed to be done at daycare would harm the child if it were done exclusively at home. That's a very high bar.

Providers who want to offer the hosting service are another option. The decision to do so shouldn't be defaulted onto the provider because the service providers refuse to adjust their business to meet the needs of their clients or because parents refuse to adjust their work place/schedule/work hours to meet their needs of their child.

Bottom line is that it's EASIER for the parents and the service providers to do it at daycare. Easier does not rise to the level of meeting ADA accommodations that force the provider to accommodate when the parents and providers won't.
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Old 01-03-2018, 06:53 AM
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In my experience with Autism the therapist only work from 8 to 5 pm. If both parents work full time days there would be no way the sessions could take place in the home. In my area there are a couple of options for center based services but the children in those centers are closer to school age at the youngest.

It is really important to have as much therapy as early as possible for ASD. I respect any business owner who does not want to deal with it. If that is the case please tell the family they would be better served in a daycare center that could accommodate them, it could change the outcome of a childís life.
While I understand fully where you are coming from, I don't think it's fair for to say the family would be better served in another program....

Also, most parents DO work the same hours as clinics (Drs), dentists and eye doctors etc but that doesn't stop them from taking time off to take care of their family's needs kwim?

A huge benefit of therapy for a child is parent involvement. Parents really should be an active and open participant in their child's therapy. Taking the time off work to do this is simply a parental responsibility in my eyes (not including special circumstances) and it's not something I am generally inclined to accept as my responsibility when I am caring for a GROUP of children.
One child's needs shouldn't outweigh the needs of others.

But that doesn't automatically mean a child that needs therapy is better off finding a different program. It just means the parent needs to find a better way of managing their child's needs.

fwiw~ I am not referring to situations where it's a known and expected thing for a child. ie programs that take medically fragile or special needs children.
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Old 01-03-2018, 11:36 AM
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Default Parental Involvement is Definitely Best if Possible

My son was diagnosed with ASD at 23 months. Luckily I have a homedaycare so I can have therapists visit on a rotating schedule. Itís really the only reason I have t gone back to working outside the home.

My son has 2 therapists doing ABA who come at least 4 times each every week for 2 hour sessions. He also has 3 therapists from Early Intervention who come 1 time per week for 1 hour.

Sometimes therapists have cancellations and call me to see if I want an extra session!

At a minimum my son has 20 hours per week of therapy. I definitely could not work around it and work a job outside of my home. The sessions are through out the week, some in the morning and some in the afternoon. The psychiatrists recommended 30 hours but I feel lucky that I was able to find a great provider who could give me close to 20 hrs of ABA.


I personally prefer home based child care for younger children but I think in the case of an Autism diagnosis the priority is to get the maximum amount of therapy at a young age.

I am constantly making accommodations for my son, I did not previously have experience with ASD. I would definitely do this for another child now that I know about it because I personally understand the needs of ASD kids and their families.

Iím sure other home providers are great at what they do but t is a big commitment and it can be disruptive, that is why I would say that the families might do better in a Center that has the space and staff to allow the therapists to come in through out the day.
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Old 01-03-2018, 02:58 PM
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The only child I cared for who had therapies was when I was a nanny. He had autism and his behavioral and occupational therapist would come a few times a week. Mom scheduled this specifically so she could be there, because she wanted to be a part of it and because she wanted to know how she could help at home when the therapist were gone. It was much more one-on-one than a daycare setting and I think he got a lot out of it. In a daycare setting, I think he would have been too distracted to concentrate on what they were asking of him. Honestly, the therapist were really just role models for what Mom and Dad were supposed to be doing the majority of the time, since they are the ones spending the majority of the time with him. He got far more out of the continual therapy that is parents provided because they knew what to do by watching the actual therapists. I really think parent enrollment is important for therapy to actually work.
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Old 01-03-2018, 08:24 PM
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One problem with doing therapy after hours is that the kids are tired by the end of the day. Most if my kids were in bed within 2 hours or less of leaving my house. Tired cranky kids don't handle therapy well

The kids I had all needed therapy throughout the day. One had a weighted vests that was on 2 hours, off 2 hours. One had special shoes to be worn in a schedule. One was a pediatric stroke survivor. He needed a constant eye to teach him how to move to get the most benefit from his muscles. Working parents can't meet these needs. I can. Since they spend most of their waking hours here, I have a responsibility to do this as part of quality care. It isn't for everyone, but it worked well for me.
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Old 01-04-2018, 03:29 AM
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One problem with doing therapy after hours is that the kids are tired by the end of the day. Most if my kids were in bed within 2 hours or less of leaving my house. Tired cranky kids don't handle therapy well

The kids I had all needed therapy throughout the day. One had a weighted vests that was on 2 hours, off 2 hours. One had special shoes to be worn in a schedule. One was a pediatric stroke survivor. He needed a constant eye to teach him how to move to get the most benefit from his muscles. Working parents can't meet these needs. I can. Since they spend most of their waking hours here, I have a responsibility to do this as part of quality care. It isn't for everyone, but it worked well for me.
I don't provide service to children who only spend two waking hours in the evening with their parents. I also base my rates on when the child is picked up. The earlier the pick up after nap the way cheaper the daycare. This draws early departure kids who have four to five hours of awake time with their parents at night. They don't go to bed early because they have had a long and deep sleep afternoon nap. When their parents pick up they are well rested and ready for action.

The kids I care for have a pretty even amount of awake time with their parents as they do in care so there isn't any reason why the therapist can't come to their home before daycare, after daycare, and on weekends.

We are talking about therapist coming to the home not the therapy that needs to be done. If a child has an every two hour order then they would have about two or three occurrences in a day when I would assist. If they arrived at eight then I would do the vest at ten and two.

Children need AWAKE time every day with their parents. A significant amount every day. Children who spend a significant amount of awake time with their parents daily are, ime, much easier to care for than children who have two hours plus the morning rush. I target the families who get up and spend time in the morning with their kids by having a family breakfast, and pick up early or stay up later if they pick up later. Being tired isn't an issue at all. After daycare is their time to cut loose, run house, run the town, and spend time doing things with their parents.
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Old 01-04-2018, 03:56 AM
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I agree with both sides here. It's definitely up to an individual provider. I also think parents should be heavily involved to promote learning and support. I've had a couple dcks in recent years that needed an hr. weekly but nothing like what some of you describe. It's disruptive to the dc but beneficial to the dck. And I'd accept outside support on a case by case basis. As part of our care for these children, at the very least, I believe we need to know how to support any particular individual needs. And it's about supporting the families too; if it creates an extreme hardship for them to constantly miss work then I'd be very apt to help. Or the possibility of working with the dck at dc AND at home, if a lot is required.JMO
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Old 01-04-2018, 06:54 AM
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I am sad that so many providers accept that working parents can't fit parenting into their day as a reason.

As a parent, I'd do whatever I have to do for my child.

I quit my job (w/awesome benefits and excellent $) and dropped out of college (2.5 yrs in) to take care of my child.

He needed me.

I just couldn't imaging making my job (or anything) more important than my child.
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Old 01-04-2018, 08:23 AM
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I am sad that so many providers accept that working parents can't fit parenting into their day as a reason.

As a parent, I'd do whatever I have to do for my child.

I quit my job (w/awesome benefits and excellent $) and dropped out of college (2.5 yrs in) to take care of my child.

He needed me.

I just couldn't imaging making my job (or anything) more important than my child.
I think the idea that working parents can't fit parenting into their day is the genesis of the turning child CARE into early childhood education instead of care.

Once that became a foundation of "quality" then other parental responsibilities started showing up on the shoulders of child care.

This is just another avenue to remove parents from having to do the HARD parenting work and make the HARD choices like you made.

I gave up a very successful 21 year business in a fantastic set up I built from the floors up and moved to a little town with a kick high school for my teenager who could have never made it in the huge high school he was slated to attend after Jr High.

I gave him four years of really low child to adult ratios in class and a school where more than half of his teachers are male. I gave him a chance to play sports where he wouldn't have made first cut in the huge schools much less play.

I gave him a home four blocks from the school so he didn't have to be at a bus stop at 530 am to bus downtown and transfer to take another bus to school.

It changed my life dramatically. It changed it in a way that I don't know with certainty that I will be able to replicate my past success once his high school is over and I return to my home city.

I had to do it. I knew when he was born that I would have to move when he became a high school student.

Sometimes you have to sacrifice your whole way of life to do what your kids need. Sometimes you have to give up a high paying job. Sometimes you have to risk that you won't recover once your sacrifices are no longer necessary. Sometimes you have to live a life that doesn't suit you an iota or makes you terribly unhappy because it's perfect for your kid.

I'm over hearing how hard it is for working parents. If your kid needs something that changes your work and lifestyle you just do and figure out the rest as you move on.

Last edited by nannyde; 01-04-2018 at 08:34 AM.
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Old 01-04-2018, 08:41 AM
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I think the idea that working parents can't fit parenting into their day is the Genesis of the turning child CARE into early childhood education instead of care.

Once that became a foundation of "quality" then other parental responsibilities started showing up on the shoulders of child care.

This is just another avenue to remove parents from having to do the HARD parenting work and make the HARD choices like you made.

I gave up a very successful 21 year business in a fantastic set up I built from the floors up and moved to a little town with a kick high school for my teenager who could have never made it in the huge high school he was slated to attend after Jr High.

I gave him four years of really low child to adult ratios in class and a school where more than half of his teachers are male. I gave him a chance to play sports where he wouldn't have made first cut in the huge schools much less play.

I gave him a home four blocks from the school so he didn't have to be at a bus stop at 530 am to bus downtown and transfer to take another bus to school.

It changed my life dramatically. It changed it in a way that I don't know with certainty that I will be able to replicate my past success once his high school is over and I return to my home city.

I had to do it. I knew when he was born that I would have to move when he became a high school student.

Sometimes you have to sacrifice your whole way of life to do what your kids need. Sometimes you have to give up a high paying job. Sometimes you have to risk that you won't recover once your sacrifices are no longer necessary. Sometimes you have to live a life that doesn't suit you an iota or makes you terribly unhappy because it's perfect for your kid.

I'm over hearing how hard it is for working parents. If your kid needs something that changes your work and lifestyle you just do and figure out the rest as you move on.

This!
I have done the same. I now run this business because it is what was best for my children. I have had lots of people refer to me as the babysitter when I am much more than that. One of the parents referred to me as the stranger when I have been with her son 3 days a week for the last 1.5 years! I realize I provide a service and do that to what is best for my family and not everyone else. At the end of the day your family and children are the parent's responsibility. The daycare provider just needs to do what they agreed to when the parents sign up. One of my family's just asked if their kids can stay late on wednesday's(pick up is at 230 usually and wanted to stay until 4.) I told them no. Sorry but it doesn't work for me. (i have older kids coming in and hectic pick ups at that time do not want to add one more to the list)They will have to figure something else out or take turns keeping their kids so the other one can do it. I only have one assistant. This is why I will not take special needs children. I cannot accommodate them and would feel awful. There simply isn't enough of me to go around.Now if you take special needs children and offer that option to the parents then it is a different story.
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Old 01-04-2018, 10:59 AM
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Can I ask how is that worded in your regulations?

Looking for it .
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Old 01-05-2018, 07:50 PM
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"Children need AWAKE time every day with their parents. A significant amount every day. Children who spend a significant amount of awake time with their parents daily are, ime, much easier to care for than children who have two hours plus the morning rush. I target the families who get up and spend time in the morning with their kids by..."

In a perfect world, I totally agree, but in this tiny town, it is 1)hard to fill spaces, and 2) hard to get good jobs. My last 2 families worked an hour away. They pick up at 6 because they are doing the best they can. There are older kids who need attention for schoolwork, dinner, baths, etc. It is hard, but I believe it takes a village, and it is my responsibility as a provider and a "villager" to do what I can.
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Old 01-10-2018, 11:25 AM
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I am sad that so many providers accept that working parents can't fit parenting into their day as a reason.

As a parent, I'd do whatever I have to do for my child.

I quit my job (w/awesome benefits and excellent $) and dropped out of college (2.5 yrs in) to take care of my child.

He needed me.

I just couldn't imaging making my job (or anything) more important than my child.
I quit for my child, as well. His medical appointments weren't working with my job schedule, and I just wanted to be with him, anyway, as well as to focus on being a foster parent.

One of my DCM's attends therapy at my house (just feeding therapy regularly, but will make other appointments when she can). Therapists want to see kids in their natural environment, which is daycare for many kids (they spend more time with me than their parents). I especially can see the speech therapy at daycare, since communicating with other kids is a motivation for lots of kids.

It is unfortunate that more parents won't participate. When my foster kids get therapy, it is sometimes in the evenings, where we take them to the therapist. Several therapists do work evenings, but none of the FREE ones do (birth to three or school district).
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Old 01-10-2018, 01:52 PM
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I am sad that so many providers accept that working parents can't fit parenting into their day as a reason.

As a parent, I'd do whatever I have to do for my child.

I quit my job (w/awesome benefits and excellent $) and dropped out of college (2.5 yrs in) to take care of my child.

He needed me.

I just couldn't imaging making my job (or anything) more important than my child.
This! I also quit my job to make sure my son had everything he needed. I LOVED my job but there was no question, it was the right thing to do. My son has special needs and he comes first. You do what you have to do when you have kids.
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Old 01-10-2018, 01:57 PM
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While I understand fully where you are coming from, I don't think it's fair for to say the family would be better served in another program....

Also, most parents DO work the same hours as clinics (Drs), dentists and eye doctors etc but that doesn't stop them from taking time off to take care of their family's needs kwim?

A huge benefit of therapy for a child is parent involvement. Parents really should be an active and open participant in their child's therapy. Taking the time off work to do this is simply a parental responsibility in my eyes (not including special circumstances) and it's not something I am generally inclined to accept as my responsibility when I am caring for a GROUP of children.
One child's needs shouldn't outweigh the needs of others.

But that doesn't automatically mean a child that needs therapy is better off finding a different program. It just means the parent needs to find a better way of managing their child's needs.

fwiw~ I am not referring to situations where it's a known and expected thing for a child. ie programs that take medically fragile or special needs children.
Exactly. The job I quit was actually at 1st Steps. In my state parental involvement was mandatory for a certain number of sessions per month or they lost services.
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Old 01-10-2018, 05:50 PM
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I have a (unasked for) reputation for being a special needs daycare. I have a child with cancer, one with cerebral palsy, several with trauma histories (neglect/abuse), others with developmental or social issues. 2 are tube fed, many receive nebs regularly, 2 need daily med administration. I am so involved in the care of 2 of them that I have full access to their medical teams (I have power of attorney to receive information and even make decisions on medical care in their mothers' absence).

I didn't ask for this, but it keeps my roster full and my days usually fly by (they're busy!). I can certainly understand why someone would NOT want this in their lives/businesses, but I am also a foster parent...no such thing as privacy with foster parenting, it seems! I have regular visits from social workers, licensing, food program, anyway, so what are a few more from therapists? LOL.
As a parent of a special needs child - thank YOU for what you do and offer those daycare kids. You truly are an angel for their parents
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Old 01-10-2018, 05:58 PM
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Several therapists do work evenings, but none of the FREE ones do (birth to three or school district).
That has to be dependent on where you live. Here the FREE ones only work evenings because being a therapist isnít their main job. When my dd needed therapy, most only worked between 6-8pm or sundays
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Old 01-10-2018, 06:02 PM
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Here is a question for you that I have not seen come up before.

Do any of you have daycare children that receive outside services in your home during the day? Like occupational therapy, speech therapy ect?
I had one child that I allowed the speech & developmental therapist come to daycare. I loved the family and wanted to help. It quickly became too much of a disruption. The therapists were great, but taking 2 hours away a week from my day to make sure he had his therapy away from the group (he couldnít handle the distraction) was tough.

I was the one that gave them the schedule of what times worked with daycare and they happily worked around our schedule. The therapists would offer amazing tips to help dcb and at times even general tips for other Dcks.

The therapists lasted a little bit over a month and then we had to stop.
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Old 01-10-2018, 06:48 PM
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I am sad that so many providers accept that working parents can't fit parenting into their day as a reason.

As a parent, I'd do whatever I have to do for my child.

I quit my job (w/awesome benefits and excellent $) and dropped out of college (2.5 yrs in) to take care of my child.

He needed me.

I just couldn't imaging making my job (or anything) more important than my child.
Mom and I were talking about this today! There is no logic in it. Parenting should be a "natural" instinct....but
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