CHILD CARE AND CHILDREN WITH SPECIAL NEEDS: ALMOST EVERYTHING YOU WANTED TO KNOW BUT WERE AFRAID TO ASK!
Are child care centers covered by the Americans with Disabilities Act
all privately-run child care centers (including small, home-based centers, even
those that are not licensed by the state) and all child care services provided
by government agencies (like Head Start, summer programs, and extended school
day programs) must comply with the ADA. Even
private child care centers that are operating on
the premises of a religious organization are covered by ADA.
Only centers that are controlled or operated by a religious organization
do not have to comply with ADA. Even those centers may have to comply if they
have agreed to comply through contract with a federal, state, regional, or local
What are the basic requirements of the ADA for child care centers?
Child care providers may not discriminate
against persons with disabilities. They must provide children and parents with disabilities with
an equal opportunity to participate in
their programs and services.
Centers and providers cannot exclude
children with disabilities from their programs unless their presence would pose
a direct threat to the health or
safety of others or require a fundamental
alteration of their program.
Centers and providers must make reasonable
modifications to their policies and practices to include children, parents,
and guardians with disabilities in their programs unless doing so would be a fundamental alteration of their program.
Centers and providers must provide
appropriate auxiliary aids and services needed for effective communication with children or adults with
disabilities, unless doing so would be an
undue burden (significant difficulty or expense, relative to the childcare
provider’s resources or the resources of the “parent” company.)
Centers and providers must make their
facilities accessible to people with
disabilities. Existing facilities
must remove any readily achievable
barriers, while newly constructed facilities and any altered portions of
existing facilities must be fully
accessible. If existing
barriers can be easily removed without much difficulty or expense, childcare
providers must remove those barriers now even if there are no children or adults
with disabilities using the program. Installing
offset hinges to widen a door opening, installing grab bars in toilet stalls, or
rearranging tables, chairs or other furniture are all examples of readily
achievable barrier removal. Centers run by government agencies must insure that their
programs are accessible unless making changes would impose an undue burden; this
will sometimes include changes to facilities.
In order to demonstrate “reasonable
efforts,” childcare providers must attempt to access available resources
outside of their programs. For
example, resources to support the inclusion of a child with a disability may be
provided by the New Jersey Early Intervention System-New Jersey Department of
Health and Senior Services, or by a local school district through its special
education program. Other resources
may be available through the Special Needs Child Care project of the New Jersey
State Department of Human Services and the local county Unified Child Care
Resource and Referral agency. These
agencies offer free information and assistance to childcare providers.
How do I decide whether my center can meet the needs of a child with a
Child care providers must make individualized
assessments about whether they can meet the particular needs of each child
with a disability who seeks services from their program, without fundamentally
altering their program. In each
case, the provider must talk with the parents or guardians and other
professionals who work with the child. Providers
are often surprised at how simple it is to include children with special needs
in their programs. Child care
providers are not required to accept children who would pose a direct threat or whose presence or necessary care would fundamentally
alter the nature of their program.
What are some reasons that are not
acceptable for rejecting children with disabilities?
insurance rates are not a valid reason for excluding
children with disabilities. If any
extra cost is incurred, it should be treated as overhead and divided equally
among all paying families.
The need of a child with a disability for individualized
attention is not a valid reason for excluding that child, unless the extent
of the child’s need for individualized attention would fundamentally alter the child care program or the cost of providing
the individualized attention would be an undue
burden on the program.
The need for a child with a disability to
bring a service animal, such as a
seeing eye dog, to the center, is not a valid reason for excluding that child,
even if the center has a “no pets” policy.
Service animals are not “pets.”
The need for a child with a disability to receive
medication while at the childcare program is not a valid reason for
excluding that child. As long as
reasonable care is used in following the written instructions about
administering medication, centers are generally not liable for any resulting
The fact that a child has allergies,
even severe, life-threatening allergies to bee stings or certain foods, is not a
valid reason for excluding that child. Childcare
providers need to be prepared to take appropriate steps in the event of an
allergic reaction, such as administering a medicine called “epinephrine”
that will be provided in advance by the child’s parents or guardians.
New Jersey state law has recently changed to allow non-medical personnel
to administer these “epi-pens.”
speech or developmental delays are not valid reasons
for rejecting children with disabilities. Under
most circumstances, children with disabilities must be placed in age-appropriate
impairments are not valid reasons for rejecting
children with disabilities. Some
children with mobility impairments may need assistance in taking off and putting
on leg or foot braces during the day. As
long as doing so would not be so time-consuming that other children would have
to be left unattended, or so complicated that it can only be done by licensed
health care professionals, it would be a reasonable modification to provide such
need for toileting is not a valid reason for rejecting
children with disabilities, even if the provider has a general rule about
excluding children over a certain age unless they are toilet-trained. Under state regulations, the childcare provider must have an
approved toileting area if toileting services are provided for any child,
regardless of age. This is not
grounds for refusing to accept a child who requires these services.
Of course, universal precautions, such as wearing latex gloves, should be
used whenever caregivers come into contact with children’s blood or bodily
fluids, such as when they are providing toileting services.
What are some reasons that are
acceptable for not accepting children with disabilities?
Children who pose a direct
threat - a substantial risk of serious harm to the health and safety of
others - do not have to be admitted into a program.
This determination may not be made on generalizations or stereotypes; it
must be based on an individualized
assessment that considers the particular activity and the actual abilities
and disabilities of the child.
Child care providers may ask all applicants
whether a child has any diseases that are communicable through the types of
incidental contact expected to occur in child care settings or specific
conditions, like active infections tuberculosis, that in fact pose a direct
threat. Providers may not inquire
about conditions such as AIDS or HIV infection that have not been demonstrated
to pose a direct threat.
What are some reasons that are
acceptable for removing a child with disabilities from a child care program
after he or she has been admitted?
If a childcare provider has made reasonable
efforts to meet the needs of a child with disabilities already in their
program, but the child’s needs cannot be met, or the child continues to pose a
direct threat to the health or safety of others, the child may be
removed from the program. However,
this decision must be made on an individual
How does a childcare provider cover the costs of providing special
services to a child with a disability?
Childcare providers may NOT charge parents
of children with special needs additional fees to provide services required by
the ADA. For example, if a center
is asked to do simple procedures that are required by the ADA, like finger-prick
blood glucose tests for children with diabetes, it cannot charge the child’s
parents extra. (Of course, the
parents must provide all appropriate testing equipment, training and special
food necessary for the child). Instead, the provider must spread the cost across all
families participating in the program. If
the childcare provider is providing services beyond those required by ADA, like
hiring licensed medical personnel to conduct complicated medical procedures, it
may charge the child’s family.
help offset the cost of actions or services that are required by the ADA, such
as architectural barrier removal, providing sign language interpreters, or
purchasing adaptive equipment, some tax credits and deductions may be available.
Contact the ADA Information Line, 800-514-0301, for more details.
Contact the Special Needs Child Care project at 609-984-5321 for more
information or for the Resource and Referral agency nearest you.