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Daycare Center and Family Home Forum>What to do With a Special Needs...?
Unregistered 11:17 AM 07-21-2014
I have a new family in my daycare, a 3 year old girl and 1 year old boy. The family did not tell me anything in regards to special needs, but I suspect he has Down syndrome. It's only his third week here (2 days per week), and I've already sent him home. He can't crawl yet and he has no mobility in his legs. His family also did no inform me that he has an inhaler and "maybe some allergies" as I just found out this AM. He cries 4 out of the 6 hours he is here.

I feel like I cannot provide for him. I desperately want to tell his family that I can't provide for special needs, but I obviously can't say that! What would your advice to be handle this type of situation? I'm at a loss of what to do, but I'm pretty close to terminating him because he needs more than what I can do for him.
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Blackcat31 11:24 AM 07-21-2014
Were the children not present when you interviewed the family?

I would think some of the things you mentioned would have been something noticeable during the interview.

Do you have a trial period?

If so, just say that you don't feel you are a good fit and leave it at that.

You aren't required to give a full on lengthy explanation as to why. Just that you aren't a good fit.
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coolconfidentme 11:30 AM 07-21-2014
I think I remember someone posting something about you CANNOT exclude base on special needs. You can based on policy violation.
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NightOwl 11:40 AM 07-21-2014
And you can based on them lying by omission.
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Unregistered 11:46 AM 07-21-2014
He was present at interview but he was sleeping. We have a trial period of a month, so this would be the last week.

Do the parents even know he's special needs? Or are they just in denial? These types of questions are in my policy handbook (medical, asthma, etc) but they did not fill it in!

I simply cannot tell them that I think he needs special needs, but I guess I will say he isn't a good fit.
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hope 11:47 AM 07-21-2014
I had a mom with twin boys interview with me a few years ago. She told me her children were special needs but definitely down played their issues. I agreed to do a trial day and Like you, I knew these boys needed more help than I could give. When I explained this to the mom she was very offended. I didn't intend to come across as mean. I really felt these boys needed specialists to care for them that could teach them.
I would avoid a reason and just give your two weeks.
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NeedaVaca 11:47 AM 07-21-2014
Just the fact that he's crying 4 out of 6 hours would be enough for me, he's obviously not a good fit.
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Leigh 12:09 PM 07-21-2014
Originally Posted by NeedaVaca:
Just the fact that he's crying 4 out of 6 hours would be enough for me, he's obviously not a good fit.

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Second Home 12:20 PM 07-21-2014
Originally Posted by NeedaVaca:
Just the fact that he's crying 4 out of 6 hours would be enough for me, he's obviously not a good fit.
Definitely
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NightOwl 12:27 PM 07-21-2014
Let me ask this, does he have a patch of darkish hair on his lower back, just above his bum? On the palm of his hand, there should be two main creases that come across from each side. Are those present? Or is it one line that goes all the way across? And lastly, his ears. Are the tips set lower than his eyes? These are all markers.

I understand you've had a bad experience so far, but I must say that parents and caregivers of children with downs describe them as being the light of their lives. They are notoriously happy and (at some point) very laid back, easy going kids. I'd hate for you to give up on him prematurely.
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NightOwl 12:40 PM 07-21-2014
And of course, the almond shaped eyes and tongue that is thicker than normal.
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EntropyControlSpecialist 12:42 PM 07-21-2014
Originally Posted by Wednesday:
Let me ask this, does he have a patch of darkish hair on his lower back, just above his bum? On the palm of his hand, there should be two main creases that come across from each side. Are those present? Or is it one line that goes all the way across? And lastly, his ears. Are the tips set lower than his eyes? These are all markers.

I understand you've had a bad experience so far, but I must say that parents and caregivers of children with downs describe them as being the light of their lives. They are notoriously happy and (at some point) very laid back, easy going kids. I'd hate for you to give up on him prematurely.
I greatly enjoyed working as an attendant for a child with Downs but when I began with her she was not laid back and easy going. No one had taught her anything nor was she on any table food (she was 3). It was A LOT of work and I don't know that I could have done it with a group of children as well. It just depends on how much work the parents have done with the child up until the point you get them, as it is with any child really. She was a precious little girl, though, and I did love her.
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nannyde 12:50 PM 07-21-2014
Does your state require a pre daycare physical?
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cheerfuldom 02:13 PM 07-21-2014
I would term.

I had this exact situation happen too. mom brought little one for his day and he was clearly special needs with major delays. Mom never put him down during the interview and he was half asleep so i didnt see any warning signs. i did not get into a discussion on special needs. i just said that based on his first two days with me, i didnt feel that we were a good fit. what does your contract say about termination notice during the trial period?

what made me mad about my situation was that mom told me NOTHING about this yet within a few weeks, was posting ads for a nanny and her ad outlined his delays and needs....stuff she never told me! i would imagine that she went thru a few daycares before having to admit she couldnt hide his delays
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NightOwl 03:37 PM 07-21-2014
Originally Posted by EntropyControlSpecialist:
I greatly enjoyed working as an attendant for a child with Downs but when I began with her she was not laid back and easy going. No one had taught her anything nor was she on any table food (she was 3). It was A LOT of work and I don't know that I could have done it with a group of children as well. It just depends on how much work the parents have done with the child up until the point you get them, as it is with any child really. She was a precious little girl, though, and I did love her.
Yes and there are varying degrees of downs. It's like a spectrum similar to autism.
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BrooklynM 03:39 PM 07-21-2014
I would never term based on the child being special needs however there are 2 major issues-not telling you about an inhaler and the baby crying so much. I would let them know that since they didn't let you know about the inhaler that you need a medical form from his doctor and you would like permission to be able to speak to the doctor so you can provide the best care.

This can be a slippery slope so cover your bases. I'd be concerned they didn't tell you about an inhaler. That's negligent parenting in my opinion.
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nannyde 03:57 PM 07-21-2014
An inhaler for a baby?
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sharlan 04:03 PM 07-21-2014
Originally Posted by nannyde:
An inhaler for a baby?
Inhalers are the new Amoxicillan. They seem to be prescribed for EVERYTHING.
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SignMeUp 04:30 PM 07-21-2014
Originally Posted by nannyde:
An inhaler for a baby?
Yeah, I'd like to see anyone administer that!
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Cradle2crayons 07:56 PM 07-21-2014
Baby's can have inhalers. My daughter did as a baby and still does. They are administered with an aero chamber with a face mask. Of course it's not easy but it's doable. In the PICU we have little ones on preventative inhalers also.

You can't exclude JUST because the kid is special needs.

HOWEVER, if you are UNABLE to provide adequate or appropriate care, you can term without discrimination.

(1) lying about medical issues is a hugeeeee red flag and one I will and have termed for

(2) withholding information about medications

(3) the excessive crying defines "not a good fit"

"Dear dcm, after careful thought and consideration I am giving notice to end care due the fact I feel I'm not a good fit for your children. Your last day of care is xxxxx. I wish you luck in finding the right daycare to fit the needs of you and your children "

Signed dcp

End of story.
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SignMeUp 08:03 PM 07-21-2014
That's a new one on me. I've seen nebulizers with masks, and inhalers with chambers. But never an inhaler with a mask.

Edited to add this link: http://www.nationwidechildrens.org/h...pacer-and-mask
that shows a mask spacer being used with an inhaler.
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Meyou 01:36 AM 07-22-2014
My daughter was on an inhaler at 5 weeks. She was premature and had RSV which developed into asthma. Like a pp said you just attach an aerochamber and they breath it in through that.

Interesting that 10 years ago when my daughter needed the inhaler I had to special order the smallest aerochamber for her and now they are available over the counter at the pharmacy.
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Blackcat31 08:03 AM 07-22-2014
Originally Posted by Wednesday:
Yes and there are varying degrees of downs. It's like a spectrum similar to autism.
I've never heard anything like this....

People with Down syndrome have 47 chromosomes instead of the usual 46.

I don't see any variation there. You either have 47 chromosomes or you don't.

EACH child can have different levels of development but I don't think that has anything to do with Downs...just development.
Which IS different for every child.


There ARE 3 different types of Down Syndrome, they are - Full Trisomy 21, Mosaic DS and Translocation DS. Full Trisomy 21 is where all the cells have a third 21st chromosome in them.

Mosaic DS is where there are two cell lines. Meaning, there are some cells that have the normal 46 chromosomes and there are some cells that have an extra 21st chromosome to them, making 47 chromosomes. Thus, that is where the mosaic pattern comes from.

Translocation DS is where part or all of the third 21st chromosome is Translocated to another chromosome, usually chromosome 14. This only occurs in about 3-5% of the DS population.

Is that ^^ the differing degrees you are referring to?
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melilley 12:12 PM 07-22-2014
Originally Posted by SignMeUp:
That's a new one on me. I've seen nebulizers with masks, and inhalers with chambers. But never an inhaler with a mask.

Edited to add this link: http://www.nationwidechildrens.org/h...pacer-and-mask
that shows a mask spacer being used with an inhaler.
One of my dcb's has one of these. He's had it since he was a baby-he is now almost 2. Also, about 5 years ago, I had a dck who had one too.
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sahm1225 12:47 PM 07-22-2014
Originally Posted by Blackcat31:
I've never heard anything like this....

People with Down syndrome have 47 chromosomes instead of the usual 46.

I don't see any variation there. You either have 47 chromosomes or you don't.

EACH child can have different levels of development but I don't think that has anything to do with Downs...just development.
Which IS different for every child.


There ARE 3 different types of Down Syndrome, they are - Full Trisomy 21, Mosaic DS and Translocation DS. Full Trisomy 21 is where all the cells have a third 21st chromosome in them.

Mosaic DS is where there are two cell lines. Meaning, there are some cells that have the normal 46 chromosomes and there are some cells that have an extra 21st chromosome to them, making 47 chromosomes. Thus, that is where the mosaic pattern comes from.

Translocation DS is where part or all of the third 21st chromosome is Translocated to another chromosome, usually chromosome 14. This only occurs in about 3-5% of the DS population.

Is that ^^ the differing degrees you are referring to?
I'm guessing she meant as far as the development.

As for the inhaler, my dd was given one with a chamber mask when she was about 6 months. She had multiple lung infections and will most likely receive an asthma diagnoses (she's 2 1/2). The inhaler for her was only when she had a cold and it was every 4-6 hours. She's in my care, but I was given a medical form to give to her daycare/school. It explained when to use the inhaler & how to, plus that it was only when she showed symptoms of a cold & cough.

A parent 'forgetting' to mention an inhaler would be enough for me to terminate. That's not something you forget! I have a dck in my care that started at 2 and before enrolling his parents had a meeting w me about when to use the inhaler and how to.
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SignMeUp 01:09 PM 07-22-2014
Originally Posted by melilley:
One of my dcb's has one of these. He's had it since he was a baby-he is now almost 2. Also, about 5 years ago, I had a dck who had one too.
I'm glad to know about this. I have had no recent chronic asthma kids. The one who has an occasional problem stays home when she needs nebulizing.

I'm really curious if the inhaler/mask are effective for little kids. For my own child, we always found that nebulizing was more effective than the inhaler if child was really sick. For maintenance, the inhaler was okay. Child used a spacer with a chamber that deflated as the medication was inhaled, and whistled if breathed in too quickly.
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melilley 01:30 PM 07-22-2014
Originally Posted by SignMeUp:
I'm glad to know about this. I have had no recent chronic asthma kids. The one who has an occasional problem stays home when she needs nebulizing.

I'm really curious if the inhaler/mask are effective for little kids. For my own child, we always found that nebulizing was more effective than the inhaler if child was really sick. For maintenance, the inhaler was okay. Child used a spacer with a chamber that deflated as the medication was inhaled, and whistled if breathed in too quickly.
I'm not too sure. The dcb that I have needed to use his off and on. I honestly, most of the time, could never tell if he needed it, his parents would tell me when he needed it. They called it his rescue inhaler. He had a nebulizer at home too.
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Tags:down syndrome, special needs
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