Special Needs Child Care Guide: Quality Care and Your Caregiver

The hard work is done: you narrowed down your options, crunched the numbers, interviewed your candidates, and settled on a child care provider. But it's important to continue to manage and evaluate your child care provider to ensure a good fit with your child's needs.

Don't forget that your child is an integral part of the equation-be sure to include them in a discussion if they're old enough and able to contribute their opinion. If it all seems to be going well from the point of view of a caregiver's skills and experience, but your child admits to disliking the caregiver, then something isn't right.  Making a great care match is always about creating a rewarding relationship for your caregiver and your child.

In addition to the basics of evaluating and managing your babysitter, nanny, or day care center, the following are important special needs related issues to keep an eye on:

• Center logistics. Have any structural accommodations discussed during the interview been made to accommodate your child's physical disability? If not, what is the timeline to implement the changes?

• Teacher interaction. Does your child care provider interact with your child in a positive and creative way? Do you feel that he/she is helping nurture your child's special needs and gifts through developmentally-appropriate activities? Are you happy with the way that they handle separation, power struggles, etc.?

• Individual needs. Has the child care provider undergone training for special skills to help them best care for your child with special needs, as discussed in the interview? Have they implemented specific learning plans that were discussed and agreed upon previously?

• External services. If external services such as speech or physical therapy have been required, has the child care provider helped integrate these services into your child's daily routine?

• Communication and follow through. Does your care provider recount how the day went when you arrive? Do they follow through on concerns you may have regarding care? If there are issues related to your child's special needs, do they communicate about them in a timely manner, and with sensitivity and compassion?

• Your child's response: Observing your child's response to the child care provider will provide important information, particularly at the pre-verbal stage. Does your child seem happy and excited to see your child care provider or have you noticed negative behavioral changes (e.g., withdrawn, more sensitive) since starting with the child care provider? Do you feel that your child is thriving and responding to the level of care, and attention to his or her special needs?

• Check in about other families. In addition to considering your child's needs, also ask whether there are concerns from other families about time and attention devoted to your child, and how that impacts the care provided to other children in the classroom. If there are issues or concerns, be open to meeting with other families to discuss.

Open communication is critical for your family to feel good about the child care provider(s) selected. Keep an eye on your child's development and satisfaction with your caregivers, and whether or not your child's needs are being met.

Christine Koh is a music and brain scientist turned parent and writer about parenting issues for Care.com. She is also the editor of BostonMamas.com.