Teaching Infants, Toddlers, and Twos with Special Needs

information.

Introduction

Teaching Infants, Toddlers, and Twos with Special Needs is designed for all teachers and directors who work with infants, toddlers, and two-year-olds, including special educators and educators working with typically developing children. The content is specifically designed for and directed toward the needs of children with developmental delays, as well as for children who are at-risk for developing special needs. Philosophically, this book supports the understanding that all children can learn, regardless of the challenges they face. Placing children with special needs in environments with their typically developing peers has become more commonplace as continuing research confirms that children benefit and learn from each other and from their teachers. Each chapter in Teaching Infants, Toddlers, and Twos with Special Needs includes experiences and activities that are common in settings where infants, toddlers, and two-year-olds learn. Strategies are easy to use and apply to all children. Every attempt has been made to explain the jargon that professionals often use when discussing children with challenges, and to provide examples of how to manage the physical environment and enhance the overall development of young children with special needs.

Chapter 1:

What Do I Do First? Understanding Infants, Toddlers, and Twos

with Special Needs

Plan activities that encourage

positive interaction with peers.

How Are Infants, Toddlers,

and Twos with Special Needs

Different from Typical Children?

It is important to remember that all children learn at their own pace, and that they all have strengths and weaknesses. Children with special needs are, in many ways, more like their typically developing peers than many people realize. The term typical development implies that a child falls within a range of development similar to that of other children the same age. Even typically developing infants sometimes lag behind their peers. Therefore, it is important to understand and remember that this normal range is quite broad, and that children will fall somewhere within it. Development depends on many factors, some of which are inherited or genetic in nature, while others are environmental. There are also some conditions, diagnosed at birth, which can indicate that the child will have a developmental delay. For example, children with Down syndrome usually have physical characteristics that enable a physician to diagnose them immediately. Certain vision or hearing disorders are often evident at or shortly after birth.

Some conditions, such as autism spectrum disorder or cognitive delays, are often not diagnosed until after the child develops, often as late as age three or four. In some cases, it is difficult to tell if the delay is just a developmental lag or an ongoing condition. Therefore, the term developmental delay may be used. In other cases, a physician is hesitant to label an infant with a specific diagnosis because she believes the delay may be developmental, and that, under certain circumstances, the child may eventually catch up with his peers. With early intervention, such delays may be eliminated. Another factor, which might preclude an immediate diagnosis, may be that the physician suspects the child has a special need, but believes it is too soon to make such a diagnosis. She will instead use the term developmental delay, while continuing to observe the progress of the child. One thing is certain—whether the child has been diagnosed as having a developmental delay or is just considered at-risk for a delay—without a nurturing environment, and without caregivers who are well informed, that child will not reach his full developmental potential.

What Is the Difference Between a Developmental Delay and an At-Risk Infant?

When the term developmental delay is used, it refers to a significant difference between the level at which an infant, toddler, or two-year-old currently functions, and the expected range of development that is based on his chronological age. A developmental delay usually occurs in one or more of the following developmental domains:

• Cognitive

• Motor

• Sensory (including vision and hearing)

• Communication

• Social-emotional

• Adaptive (self-help)

On the other hand, a child may be deemed at-risk, which indicates there is evidence that his environment or some other factor places him in a category where he is likely to develop a temporary or permanent special need. For example, a child who is born to parents who are deaf will be considered at-risk for developing a speech and language delay, given that he may not have the same language learning opportunities available to him as a child who is born to parents who are not deaf. Children living in extreme poverty are also considered at-risk. Research has shown that they may not have access to the same level of health care, nutrition, and learning opportunities as other children. A child who either has a diagnosed condition or is suspected of having an undiagnosed special need is usually referred for early intervention services.

What Are Early Intervention Services?

Whether a child has been diagnosed with a developmental delay or a specific special need (Down syndrome, cerebral palsy, and so on), there are laws that determine what services he is entitled to receive. The Individuals with Disabilities Education Act (IDEA) (Public Law 101-476) outlines very specific guidelines that local school districts are required by law to follow when providing for the needs of children with disabilities. The Program for Infants and Toddlers with Disabilities (Part C of IDEA) is a federal grant program that assists states in operating a comprehensive statewide program of early intervention services for infants and toddlers with disabilities serving ages birth through

2 years, and their families. In order for a state to participate in the program it must assure that early intervention will be available to every eligible child and its family.

Part C of the IDEA specifies eligibility requirements and sets the criteria for services for children birth to 36 months.

Each state decides if it will serve children who have been diagnosed with developmental delays only, or if it will also serve children with at-risk conditions. In addition, a lead agency for Part C is designated by each state. For example, in some states, the lead agency may be the Health Department, while in other states it may be the state’s Department of Education or some other government agency. Any child from birth to 36 months can be referred to the lead agency for an eligibility determination. Referrals to the lead agency can come from community members, family members, teachers, care providers, or medical personnel. Once a child has been referred to the lead agency, that agency has, by law, 45 days to complete an eligibility ruling. Every state must provide a toll-free phone number for its Part C lead agency.

After a referral, the child is assigned a service coordinator, who has the responsibility of working with the family, medical personnel, and other members of a multi-disciplinary team, to coordinate services for which the child is deemed eligible. Each state is responsible for developing its own eligibility standards; eligibility testing is done by a qualified professional, such as a medical doctor, early interventionist, speech-language pathologist, or developmental pediatrician—usually, at no cost to the child’s family. Eligibility is determined with the input of all team members, with the child’s parents also included in this multi-disciplinary team. Most states consider a child eligible if he has a diagnosed disability or if he is delayed in one or more of the following domains: cognitive, physical, sensory, communicative, social-emotional, or adaptive.

Many states provide early intervention services for young children who have an established at-risk condition, as well as those with developmental delays. An at-risk condition describes an infant, toddler, or two-year-old who has a condition placing him at higher risk for a developmental disability. At-risk conditions may include such factors as low birth-weight and premature birth, and may include infants with respiratory distress or seizure activity during the first weeks of life.

If a child is considered eligible for early intervention (Part C of the IDEA services), the service coordinator works with the family and other professionals to develop an Individualized Family Service Plan (IFSP), a plan written by a team including the child’s family. The IFSP outlines the types of services a child will receive (early intervention, speech therapy, occupational therapy, etc.). This plan is reviewed and updated every six months prior to the child’s third birthday or until the child is no longer eligible for special education services. When the child turns three he is transitioned into Part B and assuming he is still eligible for special education a new plan called an Individualized Education Plan (IEP) is then developed. For all children with special needs, services are provided in the child’s natural environment or where the child might have spent his time if he did not have a disability. In most cases for children younger than 36 months, the natural environment is at home. However, if both parents work, the natural environment may be a preschool or a private home care provider.

Holding a toy with both hands

is an important concept.

By law, the IFSP must contain the following information:

• A statement of the child’s present level of functioning, as determined by an appropriate assessment of the developmental domains;

• A family statement outlining the priorities, concerns, challenges, and outcomes that are deemed important for the child’s development;

• An outcome statement, with timelines, that details what the plan is for the child. For example, to be able to speak 20 words by a certain date, or to be able to bring his hands to midline, and so on;

• A specific list of the early intervention services needed by the child and his family, which might include support in the areas of speech therapy, nutritional counseling, or physical therapy;

• A statement of the intensity, duration, and method in which early intervention services are to be provided to the child and his family;

• Information about the natural environment where services will be provided, and a statement of justification, if those services will not be provided in the natural environment;

• The name of the service coordinator, usually employed by the lead agency, who is in charge of implementing and monitoring the IFSP and its components;

• An outline of the ongoing review, evaluation, and any needed plan revisions; and

• A statement about what is planned for the child when he turns three—usually referred to as a transition statement.

Before the child’s third birthday, a transition conference is held to determine if the child is eligible to continue receiving services through the public school. Under IDEA, public schools are mandated to provide services for children with disabilities between the ages of 3 and 21. Part B of IDEA provides services for children ages 3–5; these services are the responsibility of the child’s local school district.

What Types of Developmental

Delays Might I See in My Classroom?

For the purposes of this book, the term developmental delay will be used to describe all types of disabilities that may be encountered in a setting serving infants, toddlers, and two-year-olds. However, there are some types of developmental delays that are seen more common. These include (but are not limited to) infants with:

• Cognitive delays, as observed in children with Down syndrome or mental retardation;

• Physical delays, as with infants, toddlers, or two-year-olds who have cerebral palsy or motor issues;

• Communication delays, such as those observed with infants, toddlers, or two-year-olds who do not develop speech skills or do not communicate;

• Sensory impairments, such as with infants, toddlers, or two-year-olds who experience vision or hearing loss. While rare, this also refers to children who are dual sensory impaired, meaning the child is both hearing and vision impaired; and

• Social-emotional delays, as seen in children with autism spectrum disorder.

What Types of Tests or Assessments Will I Be

Expected to Give?

Toddlers enjoy activities that involve

jumping and throwing.

Generally, assessments administered for eligibility purposes are given by professionals, such as early interventionists or developmental specialists. However, you may be asked to administer a test designed to determine how the child is functioning developmentally. These tests are usually given as checklists that determine how the child is functioning in specific domains. Popular developmental assessments include the Denver Developmental Screening Test, the Carolina Infant-Toddler Curriculum Test, and the Developmental Assessment of Young Children (DAYC). In addition, you may be asked by the child’s early interventionist or service coordinator to complete a checklist about the child’s eating and/or sleeping habits or about his self-help skills. The National Early Childhood Technical Assistance Center has information about assessments that you might use to help plan for a child with developmental delays. See www.nectac.org/topics/earlyid/screeneval.asp for more information.

What If a Child Has Not Been

Diagnosed with a Special Need?

Even if a child has not been diagnosed with a disability, you and the child can still benefit from the strategies presented in this book. Some specific disabilities (such as autism spectrum disorder) may not be diagnosed before the child is three. Please keep in mind that even if a child has some of the characteristics of a specific disability, the diagnosis must come from a medical professional. You may suggest that a parent call their local Part C service provider and request an evaluation, or with the parent’s permission, you may contact that agency on behalf of the family. However, whether or not a child is ultimately evaluated is a family decision.

Where Do I Begin?

After you have learned that a child with special needs will be in your classroom, the first step is to develop an attitude of full inclusion. You should develop both a philosophy and an attitude that all children can learn, and that children learn best in settings with their typically developing peers. Think about the following statements, as you prepare to become involved in the life of an infant, toddler, or two-year-old with a developmental delay:

1. An infant with a developmental delay is not broken. In other words, that child does not need to be repaired or fixed before he can benefit from being in a setting with his peers. It is important to recognize that every child is unique, regardless of the challenges he faces.

2. Young children grow up in a world where everyone is not the same. Even infants, toddlers, and two-year-olds can learn to be tolerant and accepting of others, especially those with developmental delays.

3. For your program to be successful, it must reflect a team approach to planning for an infant, toddler, or two-year-old with developmental delays. You should welcome and encourage the input and ongoing involvement of all participants, especially the child’s family.

4. Inclusive programs model the belief that all children are entitled to experience developmentally appropriate materials and exemplary classroom practices that value the child’s strengths and work to improve the child’s weaknesses.

5. It is important to understand that no single method, process, or product works for every child. This includes an understanding that working with infants, toddlers, and two-year-olds with developmental delays is about following a process, and not about buying a specific product.

6. Quality programs for