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The Special Needs Child Care Guide: The Cost of Care

The next step in finding the right special needs caregiver for your child is figuring out how much it is going to cost. 

Images courtesy of Getty Images/asiseeit

As parents of children with special needs work to find with the best way to provide the care required, many struggle with the reality that taking care of them comes with some hefty costs. It’s important to study your health insurance policy to determine what is covered. Talk with your care provider. Many are willing to write letters for needed items, and be ready to dispute insurance denials if they go against what you’ve found in your policy.

The average annual fees for full-time center care for an infant range from $4,822 to $14,366, and the cost for a 4-year-old child ranges from $3,997 to $11,700, according to a report from the National Association of Child Care Resource & Referral Agencies (NACCRRA). The variability is attributed to geographic location. In considering the cost of care for your child with special needs, the cost issues become more complex.


Where you live

No matter what type of child care you opt for, where you live will impact the price. Child care providers in big cities will get paid more than providers in small towns. For example, a New York Special Needs Caregiver may have a different pay rate than a Cincinnati Special Needs Caregiver.  Similarly, if you live in Florida, you should compare the rates of Orlando, Tampa, and Miami Special Needs Caregivers. Parents of children with special needs have additional costs to consider which may in some cases be reimbursed by the state. However, the rate of coverage and reimbursement varies widely by state, especially when it comes to Medicaid. This can really be an issue when it comes to out-of-pocket expenses for special needs care.


Child's age

As seen from the above statistics, child care gradually becomes less expensive as your child gets older. Infant care is more demanding, and day-care scenarios require a smaller child/teacher ratio than preschool care.


Hours attending

Most care centers are also flexible in the number of days that your child attends each week.  Costs will vary depending on the number of hours of attendance. The amount of time you spend at work and whether the hours are flexible could allow a scenario of part-time work and part-time child care, which may bring the beneficial situation of personal work fulfillment, socialization for your child, and time spent at home together.


Type of care

Beyond the above factors, different child care scenarios have variables that will result in different wages. Babysitter fees will vary depending on amount of experience, number of children, special training (e.g., CPR), and how much is required of the sitter in the way of housekeeping and transporting kids to activities.  Care.com data from 2016 found the average hourly rate of a caregiver who is trained in CPR is $18.96.  Nanny costs take into account factors similar to those listed for babysitters, as well as different types of living arrangements (such as live-in vs. live-out) and benefits payments. Child care center costs also vary depending on number of kids you have in the program (in general, with multiple children, it's more expensive to have them at a child care center vs. at home with a nanny), whether it's a private vs. public facility, and whether other add-ons such as meals or language lessons are included. Also, large child care centers tend to be more expensive than in-home family run child care centers.


Special needs training

If you are seeking a babysitter or nanny with experience or training in caring for children with special needs, their fees may be higher. Overnight care or help with more than one child, may also have higher fees. Care.com data from 2016 found the hourly rate for a caregiver with training to care for cerebral palsy patients is $14.80. For muscular dystrophy, the rate is $15.25.


External special needs services

If your child requires speech, occupational or other types of therapeutic intervention in addition to day care, you may need to prepare for additional costs for various specialists. However, finding a nanny or babysitter with experience or training involving special needs could allow some assistance with certain tasks, such as at-home therapy or exercises.

The cost of child care will vary considerably depending on a number of factors, but generally, the factors that impact cost apply to all children. Requirements that involve extra therapy or tutoring at day care or babysitters or nannies with special experience involving children with special needs will be more expensive.


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 .

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