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5 Steps to Hiring a Special Needs Child Care Provider

Julie Z. Rosenberg
March 15, 2017


Ask any parent and he or she will tell you that finding a great babysitter isn't easy, exacerbated only by the fact that there's no replacing Mom and Dad. And when you add the variable of a child with special needs, that task can become even more fraught.

According to a recent survey by the US Department of Health and Human Services, more than 20 percent of American households have at least one child with special needs, which means there are a lot of families out there in need of specialized care in all its various forms. Whether it's respite care, a long overdue date-night or a full-time special needs nanny, the trepidation remains the same: How can I find someone with the right skills to care for my child?

We spoke with several child development and special needs experts about key questions parents should ask when searching for a special-needs caregiver. Here are the five steps they suggest to help find the right family fit.

Step 1: Learn Your Options

"The three most common caregiving settings for young children include an in-home nanny; a small daycare at someone else's home; and a public or private daycare facility," says Rebecca Parlakian, senior writer at ZERO TO THREE, a national nonprofit that focuses on infants and toddlers. There are several factors that can influence which setting you might select for your child.

If choosing day care, it is always a good idea to visit the center or in-home care provider and watch them interact. Know that daycare centers vary in their structure, philosophy, and child to teacher ratio. How does your child react to the group and noise? And don't be afraid to ask about employee turnover. This is a good indicator of how staff members are treated and compensated.

In-home childcare is a more intimate option, as the facility is someone's home and the provider to child ratio is much smaller. Traditionally the caregiver is a mother caring for her own child and opts to care for several others as well. It's important that you talk about your child's needs upfront to ensure the provider is able to offer appropriate care for your child and has the necessary licenses. If not, pursue another source.

Lastly, the special needs nanny would work in your home, around your schedule. You would be in charge of hiring this person, checking certifications and running a background check. You will also need to seek opportunities to engage your child in social settings. "Children with disabilities often struggle with social skills and building relationships with other children," says Parlakian, who adds that many families hire a nanny they trust and then train them around their child's needs and provide access to a consistent peer group.

Step 2: Decide Your Criteria

Above all, a nanny or babysitter should exhibit certain qualities and characteristics including, "his or her willingness to learn the specifics of your child's medical or behavioral needs and be trained on them, while partnering with you in developing a care plan that reflects your needs," says Lynette Fraga, Ph.D Vice President of Early Care & Education and Special Populations at Care.com.

"The severity and characteristic of the special need will dictate what a parent will need," says Jodi Whiteman, senior project manager at ZERO TO THREE. "For children who are medically fragile - whether it be home-based or center-based care- parents will seek care providers who have the certifications or depth of experience in the care of your child."

Write a list of the most critical factors for you, including what you consider to be deal-breakers. Really get a sense of your stance on a center's approach to topics like toilet training, discipline, napping and snacks. If there's no outdoor space to play, do they at least take daily walks or visit the playground regularly? Know what your non-negotiables are at the outset so you don't waste your time or try to justify a person or facility that really isn't a good fit.

Talk to your child's specialists or other parents in the community who have children with special needs (you can often find them on listservs or Yahoo! groups) about how to prioritize your list and even to suggest criteria you may have overlooked.

You'll want a caregiver who is willing to be part of an early intervention team, says Parlakian, who notes that, "working with a child is one thing, but working with adults requires a whole other skill set." To that end, her ZERO TO THREE colleague Whiteman recommends families provide an opportunity for the caregiver to receive professional development in the child's area of concern.

Step 3: Reach out and Meet Candidates

Where are you going to find these wonderful providers to care for and love your child? There are many options and you should try several. A personal recommendation from someone you trust is golden, so ask friends, your pediatrician, or post a query to a local online community. Also, try care-matching websites like Care.com to post a job and meet candidates. Once you've compiled a respectable list of applicants you can begin the get-to-know-you process.

However you meet potential caregivers, start with phone interviews and proceed to in-person meetings (Care.com recommends doing these in public places such as a library or coffee shop). Arm yourself with a list of expedient questions such as, "How do you handle tantrums," "What experience do you have with children who share the same disability as my child," and "Are you Red Cross certified in child safety and CPR?".

Get nanny interview questions.

Once you've narrowed down your list, do your due diligence by calling numerous references and running background checks. If it's a daycare facility, ask for names of former or current families you can call as references. Also, make sure all caregiving licenses are up to date (licensing rules vary by state). Daycare complaints should be public record.

The final step is the trial run. Make a playdate with your child and your finalist(s) to see if the chemistry's right.

Step 4: Don't Forget About Your Needs

Whiteman can't overstate the importance of the parents' feelings too. "Do the caregivers ask you how you are?" she says. "How do you feel about the care environment? How do you feel about your relationship with the director and teacher? Parents have very good instincts about what's best for their child."

It's important to think of it as a relationship triangle, says Dr. Fraga, the triad being the parent, the caregiver, and the child. "All three need to be in sync in order for this to work. And the caregiver needs to be able to communicate hopes, fears, challenges and successes," she says.

Parlakian agrees adding that, "It's really important to give your caregiver respect as a professional. Understand that you are partners in supporting your child."

Step 5: Always Remember That Your Child Is More Than His or Her Disability

Pennsylvania mom Colleen Mook speaks from experience when she says, "I want (my daughter's caregivers) to help her become more independent, talking to her even though she can't talk back, and basically treating her like a typical little girl even though she is quite different." Mook's six-year-old daughter has a rare chromosome abnormality and receives homecare with an aide.

These are all critical steps in finding the right caregiver but don't discount your intuition. "At the end of the day, the person you really want is someone who loves your child," says Parlakian. "Someone who really appreciates and enjoys your child and someone you really like and trust. That's who you want to have with your child."

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