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Daycare Center and Family Home Forum>Disabled Child Starting Soon
frgsonmysox 10:27 AM 03-14-2013
I have an 18 month old starting soon who is paralyzed from the waist down and has a shunt in her head. At the moment she doesn't require cathing or anything, the main thing is we have to make sure she doesn't get hit in the head.

I was planning on buying her a new highchair just for her, so she can participate with the other kids, but is up high and out of harms way, plus since she is paralyzed this will help prop her up and give her a playing and work surface (the tray), and I can wheel her around as if she were in a wheelchair. Eventually she will be in a wheelchair, and since she can't have anyone even accidentally hitting her head without serious ramifications I felt this was the safest option for her while still allowing her to participate in all activities.

After reading the restraining threads, I'm a bit worried. I'm not licensed, in Nebraska most people aren't as it really doesn't make a lot of sense to get licensed here, so I have no one to ask. Is it wrong to keep her in the HC most of the day?
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daycarediva 10:40 AM 03-14-2013
I would see what the parents say to that. If it were me, I think it's a reasonable accomodation and in her best interests.

Can she sit unassisted? If she can, then I would get her out and sit her down with pillows around her, even gated off from the other children so that she has some floor time.
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Willow 10:47 AM 03-14-2013
The shunt actually isn't that big of a concern. I'm quite sure it's the parents making a bigger deal out of that than she actually medically requires. The reason she has the shunt (brain or skull malformation, previous trauma, hydrocephalus) may be a catalyst as to why you have to be more careful with her head, but the shunt in and of itself isn't cause for extra precautions. Brain or skull malformations - completely understandable, previous trauma - completely understandable. In either of those situations though I'd make the argument for a helmet if she's going to be in a daycare setting. If however it's merely an issue of a defect in her ventricles she'll be just fine, treat her like any other child as far as avoiding melon knocks.

If you're not licensed you don't have to worry about licensing regs or what the state would say about the set up.

I'd say if it's what the parents think is best and is necessary then go for it.

I'd be far more worried about lack of circulation and things like blood clots though if she ends up sitting most of the day like that. Maybe get a note from her doc outlining exercises you can do out of chair to prevent that as well as any signs of trouble to watch out for.
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Meyou 10:54 AM 03-14-2013
What do they do at home? My stepdd has a shunt and although she's not paralyzed she wears leg braces and was essentially immobile as a baby.....except that she dragged herself everywhere even in leg casts!

I would see what Mom and Dad do and go from there. Tummy time in a safe area like a superyard may be great for her for example. I would plan for a separate floor playspace and go from there. She'll probably be bored in a high chair all day.

I would also talk to mom and dad about exactly how delicate she and her shunt are...my stepdd goes to gym class, swims and does pretty much everything an average kid does....we just are extra careful if she does get a bump watching for symptoms that the stunt is knocked loose. We honestly don't think about it at all unless she has a headache or something else wonky going on.
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rmc20021 11:58 AM 03-14-2013
I had a 3 yo who was a shaken baby as an infant and had a major head injury and shunt. Most of her life she would rock violently when on the couch or in the bed. I don't think she was a head banger.

Her foster parents didn't want to take any chances of the rocking creating any problems for her and insisted she not do it, even though the ped had told them it was a self soothing method and didn't seem concerned about it.

She could be quite active and likes to 'wrestle' with older foster siblings at home.

I don't think being put into a high chair for limited periods of time thoughout the day would be too terribly big of an issue, but I don't think I'd let her sit in it for more than about 30 minutes at a time, several times throughout the day, then let her have some floor time.in between high chair times.
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frgsonmysox 12:18 PM 03-14-2013
Yeah, I was still planning to give her floor time when I can sit with her one on one and make sure she is protected and safe. I hadn't thought about the floor yard. Thats a great idea and I'll definitely look into that! That would be a wonderful solution, so she can pull herself around by her arms (I'm not sure if she can do that or not....) and not sit in the chair all day.

The mom has just expressed that she absolutely cannot be hit in the head, and with other kids running around I'm worried because things happen. I don't want to harm this child accidentally. Her mom hasn't gotten the job yet, so she isn't starting immediately, but I want to be completely prepared for when she does. I'll also ask her about the helmet idea. She didn't tell me if she could sit or not, so I'm not sure. She told me she was paralyzed from the waist down. I keep asking the mom to bring her over so we can meet prior but so far she hasn't.
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itlw8 05:58 PM 03-14-2013
I thinkt he chair is one option but not for long periods of time. Talk with her therapist. but I would guess she needs to be down on the floor as much as possible. a low tranistion chair with a tray would be better for inclusion.

Do you have a resourse and referal agency ? Childcare Aware is ours and they have inclusion specialist that will come out and give you information on ways to adapt your program.
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Tags:18 month old, disabled child, paralyzed child, special needs, therapist
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