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Toddler with Cerebral Palsy

  • 1.  Toddler with Cerebral Palsy

    Posted 06-24-2017 10:33 AM
    Does anyone have any experience with a toddler (18 months) with Cerebral palsy in a toddler (12-24 months) classroom? This child cannot hold her head up and needs to be fed puréed food. She receives physical, occupational, and speech therapy and uses a stand support for 20-30 minutes at a time. Parents are adamant that she remain in the infant room (6 weeks-12 months). We tried to have a team meeting regarding transitioning this child to the toddler room, but parents refused. They are primarily concerned with the child's safety. Any advice or suggestions are appreciated.

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    Kathy Pelosi
    Warminster PA
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  • 2.  RE: Toddler with Cerebral Palsy

    Posted 06-25-2017 04:50 AM
    If your center has written policies in place on age grouping and transitions, quote the handbook to the parents.
    Ask the parents to observe the room their child should be transitioning to.
    The 12-24 month room is probably one of the safest in the center because you would not have it any other way with waddlers turning into toddlers.
    It sounds like the child will be well-supervised
    given the amount of time she will spend in PT OT and Speech Therapy.

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    Patricia Jack
    Boulder City NV
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  • 3.  RE: Toddler with Cerebral Palsy

    Posted 06-25-2017 01:12 PM
    Hi Kathy,
    I'm a retired Preschool Special Ed. teacher w/ a MA in ECSE.  I had a student with CP for three years and was involved in his transition into and out of preschool.  I also have a friend/student with multiple disabilities (still needs to be spoon fed at 26 yrs. old) who I have seen go through the system from infancy to adulthood.I was his case manager for elementary grades.  It is very common for families of  children with significant disabilities to fear the next step for their child.  
    Ideally, the team with the spec. ed. case manager would be gradually introducing the parents to the next transition.  (It is the law for spec. ed students ages of 2 and 3)  Often, parents have very valid reasons for holding a child back.  It is good if you can acknowledge the family's perspective.  Maybe make a pros and cons chart for yourself or your center on having the child transition.  Are there issues for your program that make it hard to keep him/her with the infants?  What are your reasons for wanting the transition? The important issues should be shared with the case manager and parents when you are planning a meeting.  Having said that, I would try to honor the parent's wish if possible while also working on a transition. Writing down their concerns can be a great way to validate without committing to the accommodations they are requesting.  I assume the child has a one on one care giver at your center at least some of the time. Maybe the child can visit the toddler room for brief periods to see what that environment has to offer for him/her, such as circle time and music.  This info can be shared with the family.  Finally, the child may not be COGNITIVELY delayed and so that  point may help parents see the benefit of interacting with same age peers/programming.
    Good luck and I hope this helps.  Emotions run high when caring for kids with special needs.  Remember that for you this will pass, but for the family, this is their life.
    Karen Larson
       





  • 4.  RE: Toddler with Cerebral Palsy

    Posted 06-25-2017 01:58 PM
    Karen, thank you for your input. You made some valid points. This is a very emotional issue with the family and the move is an especially difficult transition. The child's physical needs are well met in the infant room. Spending some time in the toddler room will help to build the child's cognitive, social and emotional skills.

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    Kathy Pelosi
    Warminster PA
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  • 5.  RE: Toddler with Cerebral Palsy

    Posted 06-25-2017 09:45 PM
    It is almost certain that the parents/guardians, in consultation with their provider of Early Intervention and their Service Coordinator, have laid out their goals as well as the services being offered to them in an IFSP (Individualized Family Service Plan).  You should politely ask for a copy of that so that you can be on board with the child's and family's goals.  The law under which IFSP services are delivered is clear that whenever possible, the toddler should be receiving services in a natural setting where s/he would be if did not have a disability. An infant classroom is NOT a natural environment for a toddler.  I would be very respectful of the family's wishes, but I would ask for an opportunity to more fully explore the pluses and minuses of moving the child up to be with other agemates, in keeping with the goals on the IFSP.

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    Dale Fink
    Dale Fink
    Williamstown MA
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  • 6.  RE: Toddler with Cerebral Palsy

    Posted 06-26-2017 07:21 PM
    Dale, thank you for your input. I have respectfully requested a copy of the IFSP and met with the parents. I explained why staying in the infant room would not be the best situation to build the child's cognitive and social skills. We have agreed to set up a schedule to have the child spend time in the toddler room for the next three weeks as part of the transition process. We will revisit the progress at the end of three weeks. Neither the center nor the parents can afford to provide an aide for the child. Does anyone know how to acquire funds for a classroom aide? The child's safety in a room of active toddlers remains a paramount concern.

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    Kathy Pelosi
    Warminster PA
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  • 7.  RE: Toddler with Cerebral Palsy

    Posted 06-27-2017 12:46 PM
    Certain states that I know of (e.g., California through its Regional Centers, Vermont through its Dept. of Health), do sometimes offer support for extra staffing to facilitate inclusion of infants or toddlers in inclusive early childhood settings.  You need to find out what agency is the "lead agency" for early intervention in PA  (also known as Lead Agency for Part C services under IDEA).  The local provider of EI may or may not be familiar with the options to do this. The first conversation should be with the EI provider and then if they aren't familiar, it may be worth speaking with someone at the state level.  The parent will need to play an active role in advocating for this as part of meeting the goals of their IFSP.  However, be advised that the odds for gaining the support you are seeking are not good in most states.

    If someone does authorize funding for an extra staff person, another discussion needs to take place, as it should not be assumed it is for "one on one" support.  It may be to lower the ratio for all children and allow all teaching staff to have extra time to provide the necessary accommodations and support for the target child. This is a very non-stigmatizing way to support inclusive practices. It is a model I first discovered and observed (and wrote about) in Alberta, Canada, around 1990. If you are familiar with the Reggio Emilia model, you will also know that their commitment is not to hire 1:1 "aides" but instead to add another teacher when a "child with special rights" is placed in a classroom.

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    Dale Fink
    Dale Fink
    Williamstown MA
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  • 8.  RE: Toddler with Cerebral Palsy

    Posted 06-27-2017 08:48 PM
    Dale, thank you for another great suggestion. I am familiar with Reggio Emilia, but was not aware of their position on 1:1 aid. I agree this is stigmatizing for the child with special needs and I like your suggestion for lowering the child-teacher ratio of the classroom to accommodate the additional needs. This might be a viable option.

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    Kathy Pelosi
    Warminster PA
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  • 9.  RE: Toddler with Cerebral Palsy

    Posted 06-26-2017 09:02 PM
    Hi Kathy

    No, I have not had a situation like this before. It is always difficult for parents to make new transition. I believe you have to show the parent why this transition is good for their child. Good luck!!!!

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    Petra Wickham-Charles
    Brooklyn NY
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