Autism is a huge issue that may affect many daycare providers or those that own childcare centers.  Diane Van Driesen, Director of Autism Services for the Wawa Eden House, clarifies autism spectrum disorder and describes special services for autistic children. Van Driesen also provides advice for parents of autistic children who are searching for child care and for daycare providers who care for autistic children.

OwnADaycare: What is autism? How and when is it diagnosed?

Van Driesen: Autism is a complex, lifelong developmental disability that affects a child’s ability to communicate, understand language, play, and relate to others.  Autism is considered a “spectrum disorder” meaning that its symptoms and behaviors can present itself in a variety of combinations from mild to severe.  Children with autism process and respond to information in unique ways.

Among the early signs and symptoms that parents and Pediatricians look for to alert them that a child needs further evaluation for autism include: (more…)

Attention Deficit and Hyperactivity Disorder (ADHD) is a group of disorders that include inattentiveness, over-activity, and/or impulsivity. Daycare providers must recognize the signs of symptoms of ADHD as well as how to manage children diagnosed with the disorder.

Part 3 of our interview with child neurologist Dr. Sara J. Dorison provides tips for child care center educators dealing with ADHD behaviors.

OwnADaycare: Could you give a few tips to help preschool teachers or daycare providers help manage ADHD behaviors?

Dr. Dorison: It is often difficult for a preschool teacher to know how to manage an ADHD child.  This is especially true of the teacher has a large class, an assistant who is not highly trained or if there are several ADHD children together in one class.

1.  Set expectations that the child can meet.  For example, insisting that a child sit for extended periods of time is likely to be unattainable and for this reason a teacher would be wise to allow ADHD children a bit more leeway in terms of physical activity.  If the child is not able to meet expectations, then the expectations need to be changed or accommodations can be made such as allowing a child to run class errands or hand out snacks (instead of trying to wait quietly).

2.  Identify one or two “problem behaviors” to target.  For example, if an ADHD child is physically aggressive, then the teacher and child can sit down and talk about “angry hands don’t touch.”  If all behaviors are targeted at once, the child will be confused and unable to meet the demands.  This will result in frustration and poor cooperation.  Other behaviors such as not cleaning, fidgeting, etc. should be dealt with after the aggression has resolved. (more…)

Attention Deficit and Hyperactivity Disorder (ADHD) is a group of disorders that include inattentiveness, over-activity, and/or impulsivity. Daycare providers must recognize the signs of symptoms of ADHD as well as how to manage children diagnosed with the disorder.

Part 2 of our interview with child neurologist Dr. Sara J. Dorison details the important aspects of managing ADHD in the preschool setting.

OwnADaycare: What are the symptoms of ADHD in preschool children?

Dr. Dorison: Preschool children with ADHD often have difficulty sitting still during story reading (“happy circle”), finishing little projects and waiting their turns.  Often they have low frustration tolerance which can lead to impulsive aggression.  For example, an ADHD child is more likely to push another child when that child grabs for a toy.   Due to impulsivity, many children with ADHD have a hard time following the rules.   Often it is hard for the ADHD child to “keep his hands to himself” since impulsivity is such a prominent feature.   Transitions such as going from the playground to the classroom can be difficult for them and they have a great deal of difficulty waiting quietly.   They might have difficulty learning their letters since paying attention in class is hard for them.   Low frustration tolerance can lead to tantrums.

OwnADaycare: What can parents or early childhood educators do if they suspect children are exhibiting ADHD behaviors?
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Attention Deficit and Hyperactivity Disorder (ADHD) is a group of disorders that include inattentiveness, over-activity, and/or impulsivity. Daycare providers must recognize the signs of symptoms of ADHD as well as how to manage children diagnosed with the disorder.

Our interview with child neurologist Dr. Sara J. Dorison details the important aspects of ADHD in the preschool setting.

OwnADaycare: What is ADHD?

Dr. Dorison: Attention Deficit Hyperactivity Disorder is a syndrome characterized by the presence of clinically significant levels of hyperactivity, impulsivity, disorganization, difficulty staying on task, short attention span, and difficulty waiting on line, interrupting, and low frustration tolerance. The diagnosis is based on the DSM-IV criteria which outline the criteria necessary to make the diagnosis.  It is felt to be present in about 5% of children.

OwnADaycare: How is ADHD diagnosed?

Dr. Dorison: ADHD is a clinical diagnosis and is made by taking an appropriate history and physical examination of the child and their behavior.  Unfortunately, there is no blood test, genetic testing, brain wave test or brain imaging test that can currently make the diagnosis.  The diagnosis is often made with the assistance of psychoeducational testing, or with a clinical interview, generally with a child psychiatrist or child neurologist.  The clinical features must be present in at least two settings and over a period of time.   Often doctors or psychologists use the Connor Rating Scales which ask parents and teachers to fill out forms regarding behaviors.   It is important to rule out other disorders that can present similarly in a young child.  These include Asperger Syndrome, Developmental Delay, Pervasive Developmental Disorder, Autism, deafness, lead poisoning and severe anxiety. (more…)

Developmental screening is a procedure designed to identify children who should receive more intensive assessment or diagnosis for potential developmental delays. Developmental screening allows daycare providers and parents the ability to receive a snapshot of a child’s development.

Our interview with Dr. Pio Andreotti, NYS Licensed Psychologist, discusses the importance of developmental screening in the daycare centers and preschools:

OwnADaycare: Why do preschoolers undergo developmental screening? Are all children screened? At what age are they screened?

Dr. Andreotti: A preschooler will undergo a screening when there is some concern regarding their development.  Typically, parents notice that their child is not walking by a certain age or that their language is not developing appropriately.  Also, many times, schools and daycares will recommend to a parent that their child be screened due to concerns about language, behavior, or socialization.  Not all children are evaluated.  A child is referred for a developmental screening only when there is a concern regarding a delay in development.  Preschool evaluations typically occur when a child is between 3 and 5 years of age. (more…)

Separation anxiety is a stage of development in which children become anxious, nervous, or scared upon separation from a parent and is normal in preschool and daycare.

Children may cry and cling to parents at daycare center drop-off time, need a carry a security item throughout the day, and/or cry at pick up time. Separation anxiety typically peaks between the ages of 12 months and two years.

Our interview with Dr. Shannon Ayers, assistant research professor at the National Institute for Early Education Research, discusses the issue of separation anxiety in the daycare and preschool setting.

OwnADaycare: Can you define separation anxiety in preschool aged children and some of its characteristics? At what age range is separation anxiety most common?

Dr. Ayers: Separation anxiety is at its highest intensity between 6 months and 3 years.  It is when the child’s relationship with their caregiver has become more intense and exclusive.   Resistance to separation occurs, but the child should exhibit happiness upon reunion.  With preschool children, they are beginning to understand other persons’ intentions and can often cognitively understand that a parent will return.  It is reassurance that this will occur that is important as the child struggles and that this plan is followed through consistently to build trust.  For example, a parent should not suggest that she will pick the child up after snack and then get held up and not come until after rest time.   A child may feel anxious, nervous, and/or scared about the new environment and fear being alone.  Over time, with appropriate interventions and environment, this fear should become less intense.  However the child may have some relapses such as when he or she is sick, tired, after a vacation, or if there is a big change in the family like a new sibling or a move.

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Thumb sucking: Is it a true issue for young children? An interview with Dr. Michele Saysan, a Riley Hospital for Children pediatrician, answers questions about thumb sucking that are common among parents and licensed daycare providers.

Q: Is thumb sucking harmful for children?

A: Thumb sucking can be bad for children. Children who continue to suck their thumb may have dental problems.  Their teeth may be pushed outward or be poorly aligned which is called malocclusion.  The longer thumb sucking persists, the greater likelihood the child will need orthodontic treatment to fix the teeth.  Some children may have difficulty talking who have prolonged thumb sucking.  Some children may get skin infections of their thumb from thumb sucking.
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As children develop, they learn the skills to be polite, cooperative and helpful. Along the way, it is the duty of parents and daycare providers to encourage and support appropriate behaviors. Two childcare experts give excellent tips for reinforcing good behavior in toddlers.

Suzy Martyn, Parenting Consultant, Speaker, and author of Enjoy the Ride: Tools, Tips, and Inspiration for the Most Common Parenting Challenges provides the following suggestions:

1. Model the desired behavior. If a toddler sees the behavior naturally in a parent or teacher, they are much more apt to do it when directed so.
2. Encourage and affirm. It takes 7 positive statements to make up for a negative one so our children need to hear much more praise in order to accept any direction.

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Does your daycare center participate in developmental screening? Screening is the process by which a brief, well-validated, standardized tool is administered among young children to aid in the identification of children who may be at risk of a delay or disorder. Most screening tools take only 10-20 minutes to administer per child.

A child in your daycare center will undergo screening if there is some concern about their development. Typically, parents notice developmental problems. For example, they may notice their child is not walking by a certain age or that there are language development issues. Preschools and daycare centers may also recommend to a parent that their child be screened due to concerns about behavior, language or socialization.

Not all children are evaluated. A child is referred for a developmental screening only when there is a concern regarding a delay in development. Preschool evaluations typically occur when a child is between 3 and 5 years of age.

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Sending your child to a day care is not only hard for your child but also for you. There are so many things which you have to consider as you pick a day care for your child. But no matter which day care you choose, you need to make sure that you hire a childcare center that will provide your child with what he need and not what he wants. Each and every day care has its own policies and regulations, so it is best that you look into each to determine which will work best for your child’ development.
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