Intervention Visits, What Would You Do?

Child Care Provider Keeps the Baby in the Playpen All Day…What Do You Do?

You’re nervous as you walk into the child care provider’s home this week. On the last two visits, you noticed that the baby you are seeing was lying in a playpen in the dining room away from the other children. He was awake, lying on his back, which you noticed he kept arching due to his cerebral palsy (CP). There were no toys in the playpen and you had the sense that he was being kept out of the way. You know he’s a quiet baby and you are concerned that he could be spending all day there.  When you ask the child care provider about it, she shrugs and says that she doesn’t want him to get hurt with the other children running around. She also says that she finds it hard to hold him or put him anywhere else because of his CP. While you’re in the home, you keep him out of the playpen and work with the child care provider, trying out ways to position him and get him engaged but she seems distracted by the other children. When you leave, you see the child care provider put him back in the playpen.

Situations like this can haunt an early interventionist long after he/she drives away from the home. It’s important to keep in mind that most child care providers have good intentions and most probably have not cared for a child with a significant disability before. Supporting a child care provider can be complicated by many factors, such as a lack of understanding about the child’s abilities and challenges, the need to attend to other children in their care, differences in child-rearing practices between the parents and child care provider, etc. As the early interventionist, you have to find ways to build a supportive relationship with the care provider that is both sensitive to the complex environment and effective in addressing the child’s needs through appropriate and engaging care.

With that in mind, how would you handle this situation? What would you do?

How would you share your concerns with the child care provider? With the parent?

What would you do to support this child care provider so that she is more comfortable caring for this child?

What questions would you ask to find out how to help her?

Share your thoughts and ideas!

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8 Comments to “Child Care Provider Keeps the Baby in the Playpen All Day…What Do You Do?”

  1. Woooo….this one gave me the “willies” and all my red flags were raised with hackles! I’m looking forward to reading the posts!

  2. I had the same reaction, Cori! I thought of how to share this information with the child’s family, how often this happens, during visits, and how to build a collaborative relationship with the caregiver. How have you guys handled this kind of situation?

  3. SUCH a difficult topic and so important to discuss!

    I find that complimenting the daycare provider consistently on what they are doing RIGHT sets me up for better reactions if I need to address difficult topics. For example, if the daycare provider gets the baby OUT of the crib, immediately saying for (baby’s name) “THANK YOU (daycare provier) for helping me out, I feel so good when I stretch!”. I’ve also talked about previous children that I’ve seen (or made up situations -shh!!) of Another child that had Such positive improvements when this and this were done. For example, saying “You know, (name of child) reminds of a little one that I used to see in early intervention. They also had (difficulties) and they had a great daycare provider just like you that made such an impact on their life by doing (strategies, exercises) every day.” Sadly, sometimes I feel like some daycare providers think some cases are “hopeless” and don’t realize what a difference they can make with consistent work.
    I also agree with sympathizing with their busy day. Maybe you can find a “gentle” child in the room that always plays nicely or enjoys babies and say “If you’re ever on the floor playing with (gentle child), get (EI child) on the floor with you to practice interactions with other children!”

    When talking about this with the parent I would say “I think (daycare provider) is hesitant to get (child) out to play when other children are running around.. Maybe before you leave the daycare you can get down on the floor and show her how to (play, exercise) with (child) when other children are around. If (provider) sees YOU doing it, maybe she will be more comfortable doing it herself.”

    Just some ideas.. and hoping to hear more from others 😉

    • Thanks Sara for such great suggestions! I love your positive approach to this issue. Encouraging the child care provider by pointing out what she does well is a really nice, subtle way to make a big difference. I think you could easily pair your compliment with asking the care provider what she thinks the child is learning, why she has a hard time holding him, etc. to help her think about what she’s doing. Complimenting the good things and helping her think about why they are good can really help the caregiver improve how she interacts with the child!

  4. I have had lots of experiences being a good liason between parents and also a daycare or childcare provider. Sometimes, we find “creative” ways of finding times where we can all sit down to talk. I acutally just had the chance to sit down with a family and a daycare this morning to complete an annual IFSP. It is often a great way to bridge the gap, explain some things that may be unclear to the provider, and allow a parent to “air out” any concerns with someone else present. Of course, the meeting always ends up being more positive than negative. It can be very exciting to collaborate!

    • This is a great example of collaboration, Lauren! It makes so much sense for all of the child’s caregivers to get together to develop/review the IFSP or just to talk about intervention issues. The daycare provider really is such an important part of the child’s team and often has great insights to share. I think the service coordinator or early intervention service provider can do much to support this partnership!

  5. This post gave me a case of deja-vue. We are seeing a family with a similar situation! Sara (posted above) gave such great ideas on how to handle situations like this! Since I’m still seeing a family with similar circumstances, I will try to incorporate those techniques.

    I think its also important to remember that we are there to serve as models, too. I would jump on opportunities to show the care provider how many different things I can get accomplished while still easily including the child. She may be more willing to get the child out if she has seen your success in including the child in her daily activities.

    • I like how you are seeing this situation as a positive opportunity to support the child care provider. This situation might also be a good one for asking the provider about what she would be doing if you weren’t coming and asking if you can just join that activity (like on your comment on the playful blog post). Finding ways for HER to see the collaboration as a positive opportunity could go a long way too!

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