Coordinating services can seem like an overwhelming task for the early care and education providers, specialists, and families who support children with special needs. To learn more about how those who care for children with special needs in many capacities can collaborate to support their early development, PDI interviewed two experts in the field, Nina Lublin, an early childhood specialist for Resources for Children with Special Needs since 1993 and Barbara Schwartz, director of the Early Childhood and Early Childhood Special Education graduate program at the Steinhardt School of Culture, Education and Human Development at New York University. Both women have served on the Local Early Intervention Coordinating Council.

How can child care and education providers best support the work of paraprofessionals and specialists working with children who have special needs in their programs? Are there any techniques or strategies you find particularly effective?

Now imagine what education would look like if we all had a mentor, a trusted counselor, a trusted guide. What would this picture look like?

Nina Lublin

I believe that everyone must have the child and the child's family as their first focus. While it is critical that the child care and education providers first be comfortable with each other, their own environments, materials, and children before they welcome in specialists, interventionists and/or paraprofessionals, making sure that the providers have all the pertinent information necessary comes first. Confidentiality issues versus sharing of information with others should be addressed clearly and any consents for sharing IFSPs, IEPs and other relevant information should be taken care of so that everyone is ready to work with that child and his or her family. All parties should also establish a mechanism for early problem identification as well as early success acknowledgement.

There is also a need for all adults involved with the child to 'do their homework' and ask about or learn about specific disabilities or special health care conditions so that there is less 'mystery' or fear about working with a particular child and their family.

What are some of the ways paraprofessionals or specialists can support child care and education providers that providers might not be aware of?

Barbara Schwartz

One thing paraprofessionals can do is avoid becoming a type of "helicopter parent." Some research has found that when you have paraprofessionals, children can actually become more isolated than part of the group. So they have to find a way to support the child's engagement with other children, without being a barrier. Sometimes this role can be giving the words to the child to help them enter play with the other children, rather than just telling the child to "go ask if you can play." Another option is for them to give the child props to offer other children to facilitate his or her entry into play.

Paraprofessionals and specialists can also assist providers by sharing their goals, with the parents' permission. Goals should also be explained clearly so that both the specialists and providers understand what they are working toward with the child. For instance, if the goal is for the child to "use action words 80% of the time," that needs to be translated into common activities and words that make sense within the educational setting.

What are some of the common challenges for child care and education providers in collaborating with paraprofessionals and specialists to provide care and education for children with special needs?

Nina

One challenge may still be how the interventionists, therapists, specialists and others integrate their services for children with special needs into the daily routines, specific environments, and adult/child interactions without disrupting the 'order' of the day. Current research and best practice emphasize providing services in natural environments or least restrictive environments, embedding interventions and methodologies into the actual activities the child is engaged in. All the adults involved with the child must 'be on the same page' so that there is consistency in helping the child achieve their goals and outcomes.

How does the program setting affect coordination of care? Are there some techniques or strategies that work better for home-based settings but not centers, or vice versa?

Nina

I think it is critical for the providers, regardless of their setting, parents, interventionists or therapists, and anyone connected with the child who has special needs to be completely familiar with the early care and education setting the child is in, its environmental and staffing strengths (and limitations - if there are any), and communicate effectively with the parent what the child's abilities and needs are in the particular setting.

While the setting may affect the types of services and the coordination of care, it is effective communication among all the folks involved with a particular child that will make things work to the child's benefit. Consideration of a child's special health care needs and medications versus the need for a specific type of behavioral intervention versus the need for a barrier-free setting, etc may impact how services are provided via an IFSP or IEP.

Barbara

For both settings, but especially home-based, the goal is for the specialist to use the equipment and materials in that site, and not bring things that are unique to their work. If a specialist brings in his or her "bag of tricks" and then walks out with them, the provider no longer has the tools to build on the specialist's work. The specialist must explain what to do, or recommend equipment necessary because the child is going to be in the provider's care the rest of the time. For instance, if the child works better on the floor, he or she can suggest equipment the provider can use to facilitate that. Or else, they need to be able to find a way to get low-cost equipment into the home.

5. Keeping families informed and involved in the care and education of their children is crucial. Are there any effective strategies or practices for communicating with families and encouraging their participation? What challenges does this pose to providers, paraprofessionals and specialists?

Barbara

This is a big challenge. One frustrated parent put it best: "I don't want to be Samuel's therapist; I want to be his mom." Specialists and providers can help by assisting families to engage in natural activities and not take an extra half hour to do something else. For instance, if you want the child to begin to sort things out, make a suggestion like: "why don't you have Alexander to help sort the socks?" Or instead of asking families to "work on fine motor control," give them a concrete example of an activity, such as: "let them practice eating by themselves. It might take longer and be messy, but it will help." This gets back to the idea of making suggestions for families to do things that would fit in with their daily routines. You want to support the parent in doing what they do normally. Help parents think about the schedule, think about where things fit in, and then translate this into activities that make sense for their family.