Outside Therapists And Educational Services

[nannyde]

A child's ability to walk, hold her head up, sit up, eat etc all definitely affect her at daycare. The therapists that come here are helping with those things...and helping the children interact and play with their friends. I just go on about my day...but it's written in their goals and special ed plans that they need to get their help at daycare to be most effective. It's about what helps the child, not what helps the parents. I have one that is 2 years old and can't hold her head up for more than 30 secs at a time, or sit up, let alone roll over or crawl or walk etc. And another with CP who is learning how to physically navigate around playing children without being knocked over etc.

I can see when you take medically fragile children you will need support. That's a different level of special needs care than I believe the OP is referring to.

It's a business decision to provide medical care to daycare kids.

I'm assuming these children also have daily intervention by specialist at home during evenings and weekends? If not, then why are the service professionals and parents choosing to have the therapy done at daycare instead of at home.

I'm not referring to adhering to the service plan but specifically the worker working with the child at daycare rather than at home.

[Georgiads]

My experience with an Autism Diagnosis

In my experience with Autism the therapist only work from 8 to 5 pm. If both parents work full time days there would be no way the sessions could take place in the home. In my area there are a couple of options for center based services but the children in those centers are closer to school age at the youngest.

It is really important to have as much therapy as early as possible for ASD. I respect any business owner who does not want to deal with it. If that is the case please tell the family they would be better served in a daycare center that could accommodate them, it could change the outcome of a child’s life.

[nannyde]

In my experience with Autism the therapist only work from 8 to 5 pm. If both parents work full time days there would be no way the sessions could take place in the home.

And that's what needs to change. How does a business that serves the children of working parents stay in business when the hours they work both the child and parent aren't at home or the parents can't bring the child to them?

That is the problem here.

The businesses that want to serve children of parents who are home with their children, work evenings and weekends or the children are at relative's houses during the week can have their business hours during the hours you stated.

If they want to serve children who are not on site at home or relative's then they need to adjust their model to accommodate.

Home child care does this. There are a certain number of providers who work evenings and weekends to accommodate parents who work odd hours. Why can't the specialist do the same?

This isn't a daycare issue. Whatever services are being done at daycare can be done at home before daycare, after daycare, evenings and weekends. The concept that the worker wants to view the children in the child care setting doesn't exist with children who are served at the family home. There's an understanding there are only siblings or no other children at all.

I just don't see this as having ANYTHING to do with child care.

I can see centers having the physical space to give a small area for therapy and the staff being thrilled to have one less kid during the time. I can also see therapist wanting to do the therapy with the other kids in the room and that would be something I would object to as a center owner. If they can serve a singleton child at home with their parents with the same treatment then they can serve the child without the age mates. I would never allow it in the classroom nor would I agree to a treatment plan that could be done exclusively at home. There would have to be very strong evidence that whatever therapy or plan that was supposed to be done at daycare would harm the child if it were done exclusively at home. That's a very high bar.

Providers who want to offer the hosting service are another option. The decision to do so shouldn't be defaulted onto the provider because the service providers refuse to adjust their business to meet the needs of their clients or because parents refuse to adjust their work place/schedule/work hours to meet their needs of their child.

Bottom line is that it's EASIER for the parents and the service providers to do it at daycare. Easier does not rise to the level of meeting ADA accommodations that force the provider to accommodate when the parents and providers won't.

[Blackcat31]

In my experience with Autism the therapist only work from 8 to 5 pm. If both parents work full time days there would be no way the sessions could take place in the home. In my area there are a couple of options for center based services but the children in those centers are closer to school age at the youngest.

It is really important to have as much therapy as early as possible for ASD. I respect any business owner who does not want to deal with it. If that is the case please tell the family they would be better served in a daycare center that could accommodate them, it could change the outcome of a child’s life.

While I understand fully where you are coming from, I don't think it's fair for to say the family would be better served in another program....

Also, most parents DO work the same hours as clinics (Drs), dentists and eye doctors etc but that doesn't stop them from taking time off to take care of their family's needs kwim?

A huge benefit of therapy for a child is parent involvement. Parents really should be an active and open participant in their child's therapy. Taking the time off work to do this is simply a parental responsibility in my eyes (not including special circumstances) and it's not something I am generally inclined to accept as my responsibility when I am caring for a GROUP of children.
One child's needs shouldn't outweigh the needs of others.

But that doesn't automatically mean a child that needs therapy is better off finding a different program. It just means the parent needs to find a better way of managing their child's needs.

fwiw~ I am not referring to situations where it's a known and expected thing for a child. ie programs that take medically fragile or special needs children.

[Georgiads]

Parental Involvement is Definitely Best if Possible

My son was diagnosed with ASD at 23 months. Luckily I have a homedaycare so I can have therapists visit on a rotating schedule. It’s really the only reason I have t gone back to working outside the home.

My son has 2 therapists doing ABA who come at least 4 times each every week for 2 hour sessions. He also has 3 therapists from Early Intervention who come 1 time per week for 1 hour.

Sometimes therapists have cancellations and call me to see if I want an extra session!

At a minimum my son has 20 hours per week of therapy. I definitely could not work around it and work a job outside of my home. The sessions are through out the week, some in the morning and some in the afternoon. The psychiatrists recommended 30 hours but I feel lucky that I was able to find a great provider who could give me close to 20 hrs of ABA.


I personally prefer home based child care for younger children but I think in the case of an Autism diagnosis the priority is to get the maximum amount of therapy at a young age.

I am constantly making accommodations for my son, I did not previously have experience with ASD. I would definitely do this for another child now that I know about it because I personally understand the needs of ASD kids and their families.

I’m sure other home providers are great at what they do but t is a big commitment and it can be disruptive, that is why I would say that the families might do better in a Center that has the space and staff to allow the therapists to come in through out the day.

[mommyneedsadayoff]

The only child I cared for who had therapies was when I was a nanny. He had autism and his behavioral and occupational therapist would come a few times a week. Mom scheduled this specifically so she could be there, because she wanted to be a part of it and because she wanted to know how she could help at home when the therapist were gone. It was much more one-on-one than a daycare setting and I think he got a lot out of it. In a daycare setting, I think he would have been too distracted to concentrate on what they were asking of him. Honestly, the therapist were really just role models for what Mom and Dad were supposed to be doing the majority of the time, since they are the ones spending the majority of the time with him. He got far more out of the continual therapy that is parents provided because they knew what to do by watching the actual therapists. I really think parent enrollment is important for therapy to actually work.

[Sunchimes]

One problem with doing therapy after hours is that the kids are tired by the end of the day. Most if my kids were in bed within 2 hours or less of leaving my house. Tired cranky kids don't handle therapy well

The kids I had all needed therapy throughout the day. One had a weighted vests that was on 2 hours, off 2 hours. One had special shoes to be worn in a schedule. One was a pediatric stroke survivor. He needed a constant eye to teach him how to move to get the most benefit from his muscles. Working parents can't meet these needs. I can. Since they spend most of their waking hours here, I have a responsibility to do this as part of quality care. It isn't for everyone, but it worked well for me.

[nannyde]

One problem with doing therapy after hours is that the kids are tired by the end of the day. Most if my kids were in bed within 2 hours or less of leaving my house. Tired cranky kids don't handle therapy well

The kids I had all needed therapy throughout the day. One had a weighted vests that was on 2 hours, off 2 hours. One had special shoes to be worn in a schedule. One was a pediatric stroke survivor. He needed a constant eye to teach him how to move to get the most benefit from his muscles. Working parents can't meet these needs. I can. Since they spend most of their waking hours here, I have a responsibility to do this as part of quality care. It isn't for everyone, but it worked well for me.

I don't provide service to children who only spend two waking hours in the evening with their parents. I also base my rates on when the child is picked up. The earlier the pick up after nap the way cheaper the daycare. This draws early departure kids who have four to five hours of awake time with their parents at night. They don't go to bed early because they have had a long and deep sleep afternoon nap. When their parents pick up they are well rested and ready for action.

The kids I care for have a pretty even amount of awake time with their parents as they do in care so there isn't any reason why the therapist can't come to their home before daycare, after daycare, and on weekends.

We are talking about therapist coming to the home not the therapy that needs to be done. If a child has an every two hour order then they would have about two or three occurrences in a day when I would assist. If they arrived at eight then I would do the vest at ten and two.

Children need AWAKE time every day with their parents. A significant amount every day. Children who spend a significant amount of awake time with their parents daily are, ime, much easier to care for than children who have two hours plus the morning rush. I target the families who get up and spend time in the morning with their kids by having a family breakfast, and pick up early or stay up later if they pick up later. Being tired isn't an issue at all. After daycare is their time to cut loose, run house, run the town, and spend time doing things with their parents.

[Josiegirl]

I agree with both sides here. It's definitely up to an individual provider. I also think parents should be heavily involved to promote learning and support. I've had a couple dcks in recent years that needed an hr. weekly but nothing like what some of you describe. It's disruptive to the dc but beneficial to the dck. And I'd accept outside support on a case by case basis. As part of our care for these children, at the very least, I believe we need to know how to support any particular individual needs. And it's about supporting the families too; if it creates an extreme hardship for them to constantly miss work then I'd be very apt to help. Or the possibility of working with the dck at dc AND at home, if a lot is required.JMO

[Blackcat31]

I am sad that so many providers accept that working parents can't fit parenting into their day as a reason.

As a parent, I'd do whatever I have to do for my child.

I quit my job (w/awesome benefits and excellent $) and dropped out of college (2.5 yrs in) to take care of my child.

He needed me.

I just couldn't imaging making my job (or anything) more important than my child.

[nannyde]

I am sad that so many providers accept that working parents can't fit parenting into their day as a reason.

As a parent, I'd do whatever I have to do for my child.

I quit my job (w/awesome benefits and excellent $) and dropped out of college (2.5 yrs in) to take care of my child.

He needed me.

I just couldn't imaging making my job (or anything) more important than my child.

I think the idea that working parents can't fit parenting into their day is the genesis of the turning child CARE into early childhood education instead of care.

Once that became a foundation of "quality" then other parental responsibilities started showing up on the shoulders of child care.

This is just another avenue to remove parents from having to do the HARD parenting work and make the HARD choices like you made.

I gave up a very successful 21 year business in a fantastic set up I built from the floors up and moved to a little town with a kick high school for my teenager who could have never made it in the huge high school he was slated to attend after Jr High.

I gave him four years of really low child to adult ratios in class and a school where more than half of his teachers are male. I gave him a chance to play sports where he wouldn't have made first cut in the huge schools much less play.

I gave him a home four blocks from the school so he didn't have to be at a bus stop at 530 am to bus downtown and transfer to take another bus to school.

It changed my life dramatically. It changed it in a way that I don't know with certainty that I will be able to replicate my past success once his high school is over and I return to my home city.

I had to do it. I knew when he was born that I would have to move when he became a high school student.

Sometimes you have to sacrifice your whole way of life to do what your kids need. Sometimes you have to give up a high paying job. Sometimes you have to risk that you won't recover once your sacrifices are no longer necessary. Sometimes you have to live a life that doesn't suit you an iota or makes you terribly unhappy because it's perfect for your kid.

I'm over hearing how hard it is for working parents. If your kid needs something that changes your work and lifestyle you just do and figure out the rest as you move on.

[amberrose3dg]

I think the idea that working parents can't fit parenting into their day is the Genesis of the turning child CARE into early childhood education instead of care.

Once that became a foundation of "quality" then other parental responsibilities started showing up on the shoulders of child care.

This is just another avenue to remove parents from having to do the HARD parenting work and make the HARD choices like you made.

I gave up a very successful 21 year business in a fantastic set up I built from the floors up and moved to a little town with a kick high school for my teenager who could have never made it in the huge high school he was slated to attend after Jr High.

I gave him four years of really low child to adult ratios in class and a school where more than half of his teachers are male. I gave him a chance to play sports where he wouldn't have made first cut in the huge schools much less play.

I gave him a home four blocks from the school so he didn't have to be at a bus stop at 530 am to bus downtown and transfer to take another bus to school.

It changed my life dramatically. It changed it in a way that I don't know with certainty that I will be able to replicate my past success once his high school is over and I return to my home city.

I had to do it. I knew when he was born that I would have to move when he became a high school student.

Sometimes you have to sacrifice your whole way of life to do what your kids need. Sometimes you have to give up a high paying job. Sometimes you have to risk that you won't recover once your sacrifices are no longer necessary. Sometimes you have to live a life that doesn't suit you an iota or makes you terribly unhappy because it's perfect for your kid.

I'm over hearing how hard it is for working parents. If your kid needs something that changes your work and lifestyle you just do and figure out the rest as you move on.

This!
I have done the same. I now run this business because it is what was best for my children. I have had lots of people refer to me as the babysitter when I am much more than that. One of the parents referred to me as the stranger when I have been with her son 3 days a week for the last 1.5 years! I realize I provide a service and do that to what is best for my family and not everyone else. At the end of the day your family and children are the parent's responsibility. The daycare provider just needs to do what they agreed to when the parents sign up. One of my family's just asked if their kids can stay late on wednesday's(pick up is at 230 usually and wanted to stay until 4.) I told them no. Sorry but it doesn't work for me. (i have older kids coming in and hectic pick ups at that time do not want to add one more to the list)They will have to figure something else out or take turns keeping their kids so the other one can do it. I only have one assistant. This is why I will not take special needs children. I cannot accommodate them and would feel awful. There simply isn't enough of me to go around.Now if you take special needs children and offer that option to the parents then it is a different story.

[Second Home]

Can I ask how is that worded in your regulations?

Looking for it .

[Sunchimes]

"Children need AWAKE time every day with their parents. A significant amount every day. Children who spend a significant amount of awake time with their parents daily are, ime, much easier to care for than children who have two hours plus the morning rush. I target the families who get up and spend time in the morning with their kids by..."

In a perfect world, I totally agree, but in this tiny town, it is 1)hard to fill spaces, and 2) hard to get good jobs. My last 2 families worked an hour away. They pick up at 6 because they are doing the best they can. There are older kids who need attention for schoolwork, dinner, baths, etc. It is hard, but I believe it takes a village, and it is my responsibility as a provider and a "villager" to do what I can.

[Leigh]

I am sad that so many providers accept that working parents can't fit parenting into their day as a reason.

As a parent, I'd do whatever I have to do for my child.

I quit my job (w/awesome benefits and excellent $) and dropped out of college (2.5 yrs in) to take care of my child.

He needed me.

I just couldn't imaging making my job (or anything) more important than my child.

I quit for my child, as well. His medical appointments weren't working with my job schedule, and I just wanted to be with him, anyway, as well as to focus on being a foster parent.

One of my DCM's attends therapy at my house (just feeding therapy regularly, but will make other appointments when she can). Therapists want to see kids in their natural environment, which is daycare for many kids (they spend more time with me than their parents). I especially can see the speech therapy at daycare, since communicating with other kids is a motivation for lots of kids.

It is unfortunate that more parents won't participate. When my foster kids get therapy, it is sometimes in the evenings, where we take them to the therapist. Several therapists do work evenings, but none of the FREE ones do (birth to three or school district).