Q: What experience have you of working with children with additional needs?
'I have looked after children with additional needs for most of my 12 years as a childminder. Years ago I looked after an autistic child with cerebral palsy, and then children with various other additional needs, including those that have not yet been diagnosed.
'I have also cared for children with global developmental delay, Down's syndrome and epilepsy. Currently at weekends I look after an autistic child who has cerebral palsy. We accept the children as they come along, whatever their abilities.'
'I looked after a boy with developmental delay, social and speech, for about a year. I liaised with the nursery for assessment and to get him on the road to help and support.
'At the moment I am caring for a boy with speech difficulties. We do speech work together and a speech therapist also works with him at nursery. I do lots of liaising with other organisations.
'I explain to the children that we're not all the same and some of us can't talk as well as others. It is up to us all to show how to be kind.'
'We had changes made to our house last year so that it is more easily accessible for disabled children. The playroom is now accessible to children in wheelchairs and the kitchen has been adapted with lever taps and safety equipment to make it a more inclusive environment for everyone.'
Q: Have you had to tell a parent that their child may have additional needs?
'Childminders have a different relationship with parents, we're more like an extended family. One boy's social skills were not what you'd expect of a child his age. His mum was frustrated and upset and his behaviour was having an impact on the whole family.
'I was able to have a chat and say that I did not think it was down to bad parenting or bad behaviour. I explained that I was not qualified to diagnose but, from my experience with other children, that I felt he had some aspect of Aspergers or autism.
'I stressed that this was just my opinion gained through reading and experience. The parent has now gone to the nursery, health visitor and GP, and things are moving forward.
'However, it was very tricky and I did question whether I was right to say something.'
'I have been childminding for 16 years so have a lot of experience. I noticed that there was something not quite right about the development of a three-year-old I was caring for.
I was able to have a chat with his mum and say that the child was not talking as he should and not getting on with the other children too well.'
'All children are the apple of their mother's eye. My youngest, who is 16 now, has a hearing impairment that was discovered when he was two. I was devastated, heartbroken. Then I realised that there is a lot worse that can happen to a child.
'It was a worrying time initially until I found out what support was out there. I am able to put myself in a parent's position and help them.'
Q: What are the challenges of working with children with additional needs?
'One of the greatest challenges when working in a group situation is that children with behavioural difficulties often need one-to-one support. This can detract from the needs of the other children if you are not careful. We have to work hard to get the balance right.'
'It is a challenge to get the children with additional needs to fit in with the other children. It's hard to try and give the ones with additional needs more of your time. Luckily I have now got an assistant so I can spend extra time one-on-one while she is doing an activity with the others.'
Q: What is rewarding about your work?
'Working with children with additional needs is a challenge, but it is rewarding to address their needs, such as enabling them to socialise. Seeing them accepted into a group is amazing - something that they may not otherwise have achieved without your support.'
'One boy was with us for respite care for five months. He had not mixed at all at his nursery, but he came on leaps and bounds with us.
'His first reaction was to run in and take toys off the other children, he had no speech and was aggressive. At the end of the five months he was not playing with the children but happily playing alongside them and without aggression. This was after time spent nurturing and working with him. He then went into nursery full-time and is now doing brilliantly.'
'Seeing children achieve something, no matter how small - when they give you a cuddle or say please or thank you, it's great.
'Then it's brill!'
'We have worked with one girl with autism and cerebral palsy for five years and have seen her develop physically and mentally. It is wonderful to watch her in a group of children now. She can hold her own.'
Q: Do you feel regarded as a fellow professional by others in the sector?
'We are sometimes required to go to core group meetings with educational psychologists and social workers and give our opinion on children's additional needs. Other professionals are always surprised and do not expect us to know what we do - what does she know, she's just a childminder?
'This attitude is something we often come up against.'
'We're getting there but I do still hear "babysitting" comments. We follow the EYFS and do all the planning and observation. One woman said she thought I just sat the children in front of the TV!'
'The professionals are great in our area and know what regulations and requirements we follow. We support the parents by going to the children's centre with them and refer them to the professionals so they know what an important job we do.'
'Others in the sector definitely don't see us as professionals. I would like to think that, over time, childminders will be seen as a valuable resource.
'I know it is something that the NCMA is trying to promote, but this will take a long time. A change in perceptions is a long way off.'
- What are your experiences of additional needs? To continue the discussion go to 'Have Your Say' at www.nurseryworld.co.uk
An Expert's View
By Mary Dickins, early years consultant (All Together Consultancy and London Metropolitan University)
Childminding is often the childcare option of choice for families with disabled children. They value the flexibility, the greater degree of one-to-one care and the opportunity to build a trusting relationship with another carer and educator who values their child.
While studies show that caring for a disabled child has huge implications for the family budget, finding appropriate childcare when your child has additional needs can be a nightmare. Although some parents of disabled children make the choice to care for their child at home, for the majority work is a necessity often denied them because of the lack of appropriate childcare. In addition to the isolation that such parents may experience, there is poverty and deskilling through prolonged exclusion from the labour market.
Some childminders may feel anxious about caring for a disabled child and worry that they have no experience or might have to make unwanted adaptations to their home. In fact, most childminders who take the plunge find it immensely rewarding and say that although they may have to master new skills and overcome occasional challenges, it is not really different from caring for any other child. Although they felt at first that they might need a lot of expert knowledge about various impairments and conditions, they soon realised that this sort of knowledge wasn't as important as their knowledge of child development and existing expertise in offering quality provision for all children.
As a childminder, your house should be respected as a family home and you should not be expected to make a huge financial outlay on equipment or make unwanted major alterations. However, if you are choosing to care for a disabled child you might need to think about manageable and inexpensive adjustments that you could make to the home environment.
Childminders often worry about how caring for a child with additional needs will affect their ratio. Although this depends on the extent and nature of the disability it should also be a concern for your local authority.
If you are thinking about caring for a disabled child, gather information about what local support and advice, including financial help, might be on offer. Seek out sources of ideas and information that might help you care for a particular child and attend any training available. You could enhance your practice and provide a vital lifeline to a family with a disabled child.
FURTHER INFORMATION
National Childminding Association