Default Style Register
Daycare.com Forum
Daycare Center and Family Home Forum>Sensitive Topic: Terming a DCK with special needs
Unregistered 05:03 AM 04-24-2015
I've signed out for privacy, as I have a very sensitive situation, and not exactly sure how to proceed. I've cared for a DCB with Down Syndrome for a little over a year. I absolutely adore this child and really do want the best for them, however, I no longer feel my program is the best fit. This is heartbreaking for me, as I really love this family.

I have run a registered in home daycare for 10 years now. I enroll children from newborn to age 4, normally 8 full time children at a time. I don't enroll older, as I do not provide a curriculum or school age care. Because of the amount and varied ages of children I care for, all activities are done as a group and I can not provide one on one activities. When I enrolled DCK, DCPs were adamant they wanted their child in normal program with children that did not have special needs. In the beginning, DCK was not too far behind developmentally than the other children. It was very easy to incorporate him into all of our activities, as there were no special requests. Gradually, as the delays have become more noticeable, requests have been made. I have always been willing to help, as I want to see this child thrive, but in the past couple months, it's just been too much I schedule the PT, OT, ST, and AEA teacher for home visits at my home (as parents are too busy to have them at their home), I have been instructed to work with DCB on sign language (which I do not know or teach), special exercises to help with muscle development, and other various activities to help with learning. I am not trained in special education, nor agreed to perform these services upon enrollment. I've tried my best to accommodate, but it's become quite difficult to focus on my group as a whole when I have to devote so much one on one time to DCB. I guess the breaking point this week was when DCPs asked me to begin potty training with DCB. DCB will be 2 this Summer, and is not yet walking or talking. My contract specifically states that I will not begin potty training in my home, nor practice "infant elimination techniques". I will only reinforce what is being done at home, and the child must be able to communicate when they need to go. Because DCB is not walking or talking, and can not get to the toilet by themselves, and only goes when you sit them on the toilet and they randomly go, I consider this "infant elimination".

The family pays the same rate as everyone else, but I am having to spend a lot more attention with DCB, which takes away my attention from the others. Because of space, I am not able to have an assistant or care to have a full time teacher accompany the child. So as much as I adore this child, I know my program is no longer the best fit How would you handle this sensitive situation with the family?
Reply
Thriftylady 05:15 AM 04-24-2015
If it is taking away from the rest of your group, you may need to term. I would first have a conference with the parents and let them know that you did not agree to all the extra things, and you just can't provide them. Let them know you will try to incorporate DCB into care, but that means he must be able to be treated like any other child. It is tough.
Reply
NeedaVaca 05:32 AM 04-24-2015
Lots of things stood out to me in your post but I really got stuck on the "parents are too busy" part...I'm sorry but too busy to take care of your child? That really bothers me. There is no reason they can't figure out a way to do therapy at their house, it's very important for them to be involved! Potty training and he's not even 2 yet? What are they thinking?? That is rare for boys period and in my experience, children with Down Syndrome potty train much later than most. I think it's time for this family to find one on one care for this child, it sounds like too much for group care at this point.
Reply
spedmommy4 05:35 AM 04-24-2015
I'm going to weigh in on this only because my background is special education and my advice is, tread carefully. There are federal ADA laws that protect everyone identified with special needs from being refused services. I would have a sit down with the parents.

It sounds like they initially came in wanting inclusive education but now they want a one on one in an inclusive setting. That is NOT practical in a family child care home. Share your concerns. Say, I really love having dcb here and so do the other kids but I work alone and cannot fit xyz into the day. What are your suggestions for making this work? If they don't have any, then you have your opening for "it sounds like this may not be a good fit for him at this point in time" without parents getting overly upset. In these sensitive situations, parents NEED to see your point of view.
Reply
Unregistered 05:40 AM 04-24-2015
I'm just heartbroken, because I've grown really close with this family...but the expectations are just too much I had to have a talk with them last week, because 3 of the 4 teachers showed up at the same time last week. 2 of them I did schedule, but the parents just told the 3rd to come when they did. So I had 3 extra adults here for an hour, I have to pay attention to the sessions and answer each teachers questions...the other 7 children were free playing in the same room, but were bouncing off the walls trying to show off for our guests It was way too chaotic. 3 of the 4 teachers contact me to schedule, for some reason the 4th keeps contacting DCM, and DCM schedules her to come to my house without asking or telling me
Reply
NeedaVaca 05:49 AM 04-24-2015
Originally Posted by Unregistered:
I'm just heartbroken, because I've grown really close with this family...but the expectations are just too much I had to have a talk with them last week, because 3 of the 4 teachers showed up at the same time last week. 2 of them I did schedule, but the parents just told the 3rd to come when they did. So I had 3 extra adults here for an hour, I have to pay attention to the sessions and answer each teachers questions...the other 7 children were free playing in the same room, but were bouncing off the walls trying to show off for our guests It was way too chaotic. 3 of the 4 teachers contact me to schedule, for some reason the 4th keeps contacting DCM, and DCM schedules her to come to my house without asking or telling me
Wow...you should really just put a stop to the therapy sessions at your house, it's not fair to the other kids in your care (or you). They are putting their parental responsibilities on you IMO.
Reply
spedmommy4 05:52 AM 04-24-2015
Originally Posted by Unregistered:
I'm just heartbroken, because I've grown really close with this family...but the expectations are just too much I had to have a talk with them last week, because 3 of the 4 teachers showed up at the same time last week. 2 of them I did schedule, but the parents just told the 3rd to come when they did. So I had 3 extra adults here for an hour, I have to pay attention to the sessions and answer each teachers questions...the other 7 children were free playing in the same room, but were bouncing off the walls trying to show off for our guests It was way too chaotic. 3 of the 4 teachers contact me to schedule, for some reason the 4th keeps contacting DCM, and DCM schedules her to come to my house without asking or telling me

Wow! That would be overwhelming for the kiddo too! Poor guy. I worked in early intervention for six years and that is not what it's supposed to look like. They should be coming in and supporting his play in your setting, interacting with the other kids to model and support peer interactions, and the only "exercises" they should be leaving for you should be things that can be easily integrated into his (and your) daily routine. The activities they leave should be stress free. (For example, practicing requesting more during snack time) I would probably also tell the therapist that the activities need to be routine based so you can fit them into your day. Give them all a copy of your schedule and let them figure it out.
Reply
nannyde 05:53 AM 04-24-2015
I wouldn't worry about the ADA. The criteria to exclude is if the care of the child significantly alters your program. It does so you are fine.

Meet with them and tell them you can't host any services in your home. Give them one week to set the appointments on their clock. If all three workers can come at the same time then they can meet the parents at the same time. Also tell them that you can not do any therapy treatments for him. Then go to....

Tell them if he continues at your house he needs an aide just for him. You can't afford to hire an assistant for him so they need to fund that.

Those two things will be enough. They will just put him in a center.

They are going to be very upset. The love they have for you will be tested. Now they have a VERY good deal. They don't have to do anything and he gets everything on your watch. It's time they take over and do.

Give them a month to find care and a week to do the therapy switch. Stop discussing his special needs with them and just care for him in the group the best you can for the time it takes them to find another you.
Reply
NightOwl 06:05 AM 04-24-2015
So hard.... I'm sincerely sorry that your have to deal with this heartbreaking situation. I think you're doing the right thing by terming, no matter how hard it is. I would suggest you tell them much of what you told us, that it's become too overwhelming to properly care for him and that the others are not getting the same amount of attention that they deserve to be getting from you. I think, if you explain it gently and professionally, they will understand. Just give them plenty of notice, maybe a month, because it will be more difficult for them to find an appropriate place for him.
Reply
spedmommy4 06:06 AM 04-24-2015
FYI for everyone . . . If your licensed . . .it applies

http://www.ada.gov/childqanda.htm

Number 7 speaks to a kiddo that needs extra attention due an identified disability.
Reply
Blackcat31 06:14 AM 04-24-2015
Originally Posted by spedmommy4:
FYI for everyone . . . If your licensed . . .it applies

http://www.ada.gov/childqanda.htm

Number 7 speaks to a kiddo that needs extra attention due an identified disability.
Yes, but the key word is "reasonable"

Families can't expect providers to care for children they are not equipped to care for. The ADA applies but within reason.

For example,

I will NOT make physical accommodations to my home.
I will NOT enroll a child with a peanut allergy

The OP of this thread has done MORE than the family, the ADA or the law can require her to do. She cannot be forced to provide services she is incapable of providing (OP I don't mean you are incapable...I just mean in regards to the list of things you are being expected to provide)

I specifically state in my handbook that I am a GROUP care provider and being a group care provider means that I will not take on a child that requires care/attention that takes away from my ability to provide equal care and attention to the other children I have enrolled.
Reply
Unregistered 06:20 AM 04-24-2015
These parents disgust me. I have a son with Autism and I quit my job in management to be home for all of his therapy in the day. I worked nights and weekends for years to do this for my son. I was climbing the ladder, in what was a career, really fast and I gave that , and the money, up to do what was best for T. I can't believe how selfish some parents are.

Monkey Toes
Reply
NightOwl 06:27 AM 04-24-2015
The words "does not fundamentally alter the program" is the key here. Her program HAS been altered due to the attention needed by this child. She has went above and beyond and then some. You won't have any issues with ADA. Also, there is no assistant provided by the parents, another clause mentioned in #7. Op is totally on her own in this.
Reply
Blackcat31 06:34 AM 04-24-2015
http://www.tomcopelandblog.com/2012/...hild-care.html

You must care for children with disabilities unless:

*Offering your services to the child would impose an “undue burden” (meaning "significant difficulty or expense")

**************************************************************
A parent with an autistic child wants to enroll her child in my program. I can't possibly provide one-on-one care for this child and care for the other children in my program. What should I tell her?

You need to find out what it would take to accommodate the needs of this child in your program. Find out from the parent or child's doctor what type of caregiving this child needs. If the child is mildly autistic, it may be possible to care for this child along with your other children with some extra training. If the child is severely autistic, it may only be possible to provide adequate care if the child receives one-on-one care.

In that case, you should find out how you might find another person to come to your program. If there are volunteers that will help, you will have to enroll the child. If there are no volunteers, you should find out how much it will cost to bring in a paid helper.

Depending on the condition of the child and the number of hours of outside help that is needed, it might cost you hundreds of dollars a week. You do not have to provide care if doing so would impose a significant expense to you. Hundreds of dollars a week would be a significant expense.

In this case, you would tell the parent,"The only solution for me to be able to provide care for your child is to pay someone else hundreds of dollars a week. I can't afford this, so I'm sorry but I can't care for your child." If the parent volunteers to pay for the helper, you would have to enroll the child.
Reply
Unregistered 07:05 AM 04-24-2015
Originally Posted by Blackcat31:
http://www.tomcopelandblog.com/2012/...hild-care.html

You must care for children with disabilities unless:

*Offering your services to the child would impose an “undue burden” (meaning "significant difficulty or expense")

**************************************************************
A parent with an autistic child wants to enroll her child in my program. I can't possibly provide one-on-one care for this child and care for the other children in my program. What should I tell her?

You need to find out what it would take to accommodate the needs of this child in your program. Find out from the parent or child's doctor what type of caregiving this child needs. If the child is mildly autistic, it may be possible to care for this child along with your other children with some extra training. If the child is severely autistic, it may only be possible to provide adequate care if the child receives one-on-one care.

In that case, you should find out how you might find another person to come to your program. If there are volunteers that will help, you will have to enroll the child. If there are no volunteers, you should find out how much it will cost to bring in a paid helper.

Depending on the condition of the child and the number of hours of outside help that is needed, it might cost you hundreds of dollars a week. You do not have to provide care if doing so would impose a significant expense to you. Hundreds of dollars a week would be a significant expense.

In this case, you would tell the parent,"The only solution for me to be able to provide care for your child is to pay someone else hundreds of dollars a week. I can't afford this, so I'm sorry but I can't care for your child." If the parent volunteers to pay for the helper, you would have to enroll the child.
And sometimes this is the only solution. But that's why I say, bring it to the parents. A parent who feels like their child is being excluded from a program (especially one they've come to love) can get really upset. I've seen it happen. Problem solving conversations can be really helpful and prevent a situation becoming negative.

Spedmommy4 (forgot to login)
Reply
Blackcat31 07:19 AM 04-24-2015
Originally Posted by Unregistered:
And sometimes this is the only solution. But that's why I say, bring it to the parents. A parent who feels like their child is being excluded from a program (especially one they've come to love) can get really upset. I've seen it happen. Problem solving conversations can be really helpful and prevent a situation becoming negative.

Spedmommy4 (forgot to login)

Reply
Shell 07:38 AM 04-24-2015
Originally Posted by Unregistered:
These parents disgust me. I have a son with Autism and I quit my job in management to be home for all of his therapy in the day. I worked nights and weekends for years to do this for my son. I was climbing the ladder, in what was a career, really fast and I gave that , and the money, up to do what was best for T. I can't believe how selfish some parents are.

Monkey Toes
I could be wrong, but it seems the parents are in denial or are purposely ignoring their child's needs. Potty training a two year old that can't walk?!!
I get parents want their special needs child in a "typical" environment, but they need to be a part of it and not pawn it off on the provider.

OP, I think you have great advice from pp's that know more about the laws than I do, but you've done so much for this child. What they are asking of you is above and beyond, and requires a 1:1 aide.
Reply
spinnymarie 10:51 AM 04-24-2015
ITA - I wouldn't tell them it's not the right fit anymore, but I would tell them all the things I can no longer do: potty-training, therapy on your clock. And if that doesn't push them to find someone else I'd bring up the need for a one-on-one aide at their expense.
Reply
nannyde 10:52 AM 04-24-2015
I have never come across a single case where the DOJ (Department of Justice) has sued a home child care for refusing a child with special needs.

You have to have a group of clients that can pay a percentage of the care of the special needs child. If you only have eight parents paying the amount of money to cover the labor portion of the care of the child would cause the eight parents to just switch child care. If he needs therapy work by the provider and one to one care for activities and toilet training it takes TIME and time is money. If that time can't be compensated by the parents of the daycare, the provider can't do it. The doj doesn't expect the provider to do the special needs care for free.
Reply
kitykids3 12:31 PM 04-24-2015
I had a similar situation not too long ago but not to the extent of yours. I had a child that had some developmental issues and some autistic tendencies. They had one of the weekly therapy sessions at home and then the other at my place every week. He also needed a special mat and cushion for his chair, was not trained for the bathroom (despite being 2, but couldn't even communicate to be able to be toilet trained). Therapist wanted me to do special exercises with him which I rarely had time to do. I was given suggestions of making up picture cards and picture schedule (which I don't have time to do) etc. to help him communicate cuz he rarely listened/understood and couldn't talk. He was in his own world 99% of the time. It got to the point I couldn't handle it anymore, especially his outbursts and not being able to communicate. When the therapist came every week (which by the way he was only here 2 days a week) it was such a disruption cuz all the other kids wanted to play with her. Him being here was a disruption cuz he needed help and guidance with every single thing and would have screaming outbursts every day. He took so much one on one time that I realized it was affecting the quality of the care the other kids got so I knew I had to let him go. I was trying to find a way to do it, but then they asked if they could add a day and that was my opportunity - 'sorry but I can't add another day. I don't have the room'.

One day I had to call dad to pick him up because he had been screaming for an hour and it's in policies to send any kid home when doing that. He wasn't happy about that but I explained I can't have that here or his outbursts multiple times every day. Then he started a conversation on what I need to help him and we tried for a while. Still was to the point that I did not have the time for the extra attention he needed one on one or money to hire an assistant for him.

I don't personally think you need to (or should) list the things you can't do for him. Like many of us, just give a letter that says you can no longer care for him as such and such a date. If you list reasons and they have to do with accommodating his special needs, they may use that against you, so I would recommend not doing that. Have you tried having a conversation with them, tell them it is their responsibility to schedule (they are the parents) and have therapy at their place and that you can't provide sign language and you won't potty train their child as per your regular policies because he just isn't ready to, and that you can't teach sign language because you don't even know it?

Tell them what you can provide and what you can't regarding their requests and then let them decide what they want to do. If they stay but still request things such as that, then unfortunately you have to let go. It took me a while to get to that point but I had to ask myself and realize it just wasn't getting better enough and it wasn't fair to the other kids/families. You've got to look out for the group.
Reply
Rockgirl 12:41 PM 04-24-2015
Our licensing reps have told us we can say, "I do not have the staff for that."
Reply
Reply Up