Early Childhood Education Journal, Vol. 27, No. 3, 2000

Early Childhood Special Education

Inclusion of Children with Special Needs in School-Age ChildCare Programs

Alice Henderson HalP^ and Judith A. Niemeyer^

From an ecological perspective, the inclusion of children in school-age child care (SACC) requirescollaboration among policy makers, educators, parents, and child care providers. Both typically andatypically developing children benefit from inclusive programs, yet they pose challenges for care-givers primarily due to lack of training, resources, and identification of successful inclusive programcomponents. The process of successful SACC inclusion should be at the forefront of human serviceand research agendas.

KEY WORDS: school-age child care; inclusion; school-age children with special needs.

INTRODUCTIONThe enactment of Public Law 101-336 (American

Disabilities Act [ADA]), in July of 1990, mandated thefull participation of individuals with disabilities intoAmerican society (Shea & Bauer, 1994) therefore mak-ing it unlawful to discriminate against individuals withdisabilities in all arenas (e.g., employment, public trans-portation, public accommodations, and local and stategovernment services). This impacts the provision of ser-vices by child care centers, especially publicly fundedchild care, who can no longer offer separate programs forchildren with special needs, but must include these chil-dren in their regular programs. As with most changes ineducational curriculum and philosophy, the full integra-tion of children with special needs into child care pro-grams, specifically school-age child care (SACC), is eas-ier said than done. For purposes of tbis article, school-age child care is defined as child care for school-age chil-dren before and after school, and during full days whenschool is not in session (e.g., teacher workdays, holidays,summer vacation). The term "full inclusion" implies tbat

'Department of Human Development and Family Studies, University ofNorth Carolina at Greensboro.

^School of Education, University of North Carolina at Greensboro.'Correspondence should be directed to Alice Henderson Hall, Box26170, Greensboro, North Carolina 27402-6170; e-mail:ahhall@ham-let.uncg.edu

children will be served in the same programs they wouldhave attended if they did not have a disability emphasiz-ing that all children belong together (Wolery & Wilbers,1994).

Tbe philosophy of inclusion for the school-age childwith disabilities may not be supported in all the settingsin which they participate. For example, a child may beincluded in the school-age child care program (i.e., par-ticipates in the regular classroom for all activities) butmay only be mainstreamed for part of their school day(i.e., lunch, physical education, school assemblies).Likewise, a child may be in a segregated elementaryschool classroom (i.e., all children in the classroom havedisabilities) and included (i.e., program includes childrenwith and without disabilities) in the SACC program orincluded in an elementary school classroom and segre-gated (i.e., only participates in planned activities for chil-dren with disabilities) in the SACC program. Indeed,participation in one type of program (i.e. segregated)does not make it the only appropriate placement for tbechild.

Most scbool-age child care practitioners agree withthe reasons for the passage of Public Law 101-336, butare apprehensive about how to include children with spe-cial needs in their School-Age Child Care centers. Theapproach many programs, consciously or unconsciously,have adopted is what Bricker (1995) described as theadd-on method. The add-on approach requires only tbatthe child or children with disabilities be added to the pro-

1851082-3301/00/03O0-0185$18.0O/0 2000 Human Sciences Press, Inc.

186 Hall and Niemeyer

gram. Therefore, the children are not necessarily anactive member of the SACC program, but they are par-tially included and not totally involved. The followingdescribes a program using the add-on approach ratherthan an inclusive one.

The fiisl child thai 1 included in my SACC program wasan eight year-old with multiple disabilities who couldnot walk or speak. He knew some sign language, couldshake his head when asked questions, and appeared tobe somewhat equal to his chronological peers cognitive-ly. He used a wheelchair, although not independently.He also needed to be fed and have his diapers changed.Many of my summer staff had no experience with chil-dren with special needs and were very anxious aboutworking with him. Some staff were very reluctant tohelp, arguing that they had not been hired to work withchildren with special needs. The typically developingchildren in the summer program were the most open-minded. They eagerly tried to include him in all aspectsof their play and within days I could see the benefits ofhaving him in our program for the typically developingchildren. I felt some successes with the inclusion of thisyoung man, but had some questions about whether wewere providing more than custodial care for him. I wasnot convinced that he was fully participating in theenrichmg dramatic, construction, crafts, and recreation-al activities that were part of our summer curriculum.He tended to observe, rather than participate, in activi-ties such as wood working or Lego construction. Thestaff tended to work with him one-on-one rather thanencouraging and supporting his play with other chil-dren. The staff and I needed more training as to how tocommunicate with him. to find out what activities hewas most interested in participating in. and help indeveloping ways to adapt these activities for his suc-cessful participation. (Hall, 1997)

This narrative illustrates some of the issues associ-ated with implementing the ADA mandate in a school-age child care program. An inclusive program approachwould assure that children with disabilities aie includedin all activities and actively involved based on their indi-vidual needs and interests (Bricker, 1995).

The purpose of this article is to discuss the inclusionof children with special needs in school-age child careprograms. First, the need for SACC inclusion is dis-cussed from an ecological perspective. Second, the ben-efits of inclusion for school-age children in regular edu-cation programs and early childhood preschool programsare highlighted. Third, the challenges of SACC inclusionare discussed.

THE NEED FOR INCLUSIVE SCHOOL-AGE CHILD CARE EROM ANECOLOGICAL PERSPECTIVE

According to the only national study that has

researched school-age child care programs. The NationalStudy of Before and After School Programs, about 1.7million kindergarten through eighth graders wereenrolled in 49,500 before and after school programs in1991 (Seppanen, e//., 1993). On the other hand, an esti-mated 17 million parents need care for their school-agechildren during work hours (U.S. Bureau of the Census,1991). Likewise, the Govemment Accounting Office(GAO) estimated that in the year 2002, the current SACCsupply will meet as little as 25% of the demand in someurban areas (GAO/HEHS-97-75, May 1997). Moreover,an estimated (due to parent's reluctance to report leavingchildren alone) 5 million school-age children spend timewithout adult supervision during a typical week(Hofferth, Brayfield, Diech, & Holcomb, 1991). Thesedata and statistics are disturbing when considering thewelfare of all school-age children. Unfortunately, thisresearch includes very little infonnation about school-age children with disabilities. Moreover, leaving childrenwith special needs in self-care is often not an option. Inthe study reported above, Seppenan et al. (1993) foundthat only 7% of the programs primarily served childrenwith special needs. In fact, when considering servicescurrently not available, parents frequently (25%) request-ed SACC for their children with special needs. Clearly,the child care needs of school-age children, particularlythose with disabilities, are not being met by school dis-tricts and community agencies.

From an ecological perspective (Bronfenbrenner,1989), development occurs within a complex system ofrelationships affected by multiple levels of the environ-ment. Furthermore, children's relationships are all bidi-rectional and reciprocal. The environment is viewed as aseries of nested structures which includes, but is broaderthan, the home, school, and neighborhoods where chil-dren spend their everyday lives. In other words, childrendo not live in isolation but are part of a number of socialsystems (micro-, meso-, exo-, and macro-) that influencehow they develop and leam.

For a child with special needs and his or her family,child care, a microsystem, can be an important context inthe development of the child. Parents need child care inorder to be able to work {exosystem). Child care environ-ments and schools are two microsystems where childrenspend many of their waking hours. Moreover, for a childwith special needs, school, child care, family, and med-ical professionals constitute their mesosystem. Child out-comes are maximized when all of the microsystems andthe mesosytem, are working coUaboratively. Further-more, SACC is needed by families who have a child withdisabilities because the child cannot be left alone. This isoften an option for families of typically developing chil-

School-Age Child Care Inclusion 187

dren when SACC is either unavailable or unaffordable.Even if the parents of the school-age child with specialneeds are not working, they may need respite from thedemands of parenting a child who is atypical. In addition,children with special needs may need a setting wherethey can interact with peers informally, just as typicallydeveloping children benefit from extracurricular activi-ties with their peers (another microsystem). Yet, societalinstitutions {macrosystems) have not placed muchemphasis on SACC, especially school-age child care forchildren with special needs. Raising a child with specialneeds could be much more expensive than raising a typ-ically developing child due to medical and therapeuticexpenses, as well as the cost of special equipment suchas wheelchairs or hearing aids (Fink, 1988).

Families of children with disabilities needmacrosystem support to raise and educate their child.The ADA law is one extremely important macrosystemsupport for children with disabilities. Yet, full implemen-tation of it poses many challenges at the local, state, andnational level (e.g., quality, services, educated practition-ers). As Peck (1993) pointed out, the implementation ofpractices and policies supporting the inclusion of chil-dren with special needs in community programs involveschanges in federal and local education policy, human ser-vice policies, and community values. In particular, thesepolicy changes are needed to support SACC for the sin-gle parent or dual working parents of a child with specialneeds.

Certainly, school-age child care for children withspecial needs would benefit both the child and the fami-ly (Fink, 1988). However, minimal attention has beengiven to this issue. One reason for this lack of consider-ation is ambiguity as to who is responsible for placingthis issue on political agendas. During the 1980s, school-age child care for children with special needs was not apriority issue for any national professional organizationsor networks (Fink, 1988). Instead, parents of childrenwith special needs spent a great deal of time and energyseeking and, in some cases, fighting for proper medicalcare, then the best educational setting, and finally childcare. The many challenges facing families of childrenwith special needs, one of which is child care, should beat the forefront of human service agendas. Again, childoutcomes are maximized when all of the ecological sys-tems influencing development are working together.

BENEFITS OF SCHOOL-AGE CHILDCARE INCLUSION

Over the past decade, the inclusion research hasfocused on demonstrating the blending of typically and

atypically developing children into the same programand the benefits of this approach to children and families.A review of the research on the outcomes and implica-tions of including children in general education pro-grams (Bradley, King-Sears, & Tessier-Switlick, 1997;Brinker & Thorpe, 1984; Brown et al., 1987; Lipsky &Gamer, 1989; Madden & Slavin, 1983) and preschoolchild care (DeKlyen & Odom, 1989; Guralnick &Groom, 1988; Honig & McCarron, 1988; Jenkins,Odom, & Speltz, 1989; Lefebvre & Strain, 1989;McEvoy etal., 1988; Peck, Palyo, Bettencourt, Cooke, &Apolloni, 1988) has demonstrated that the blending oftypically and atypically developing children into thesame program can be beneficial to all children.Unfortunately, research on the inclusion of children withspecial needs in general education programs is not com-pletely generalizeable to SACC because it focuses on thelearning of academic skills rather than the enrichingextracurricular skills that are emphasized in SACC. Forexample, general education programs focus on skillssuch as reading and writing, whereas SACC programsmight emphasize creative (e.g., art, music, dance, woodworking) activities and peer interactions. Although learn-ing Cakes place in SACC programs, the program goals areconsiderably different. Therefore, a review of theresearch related to the inclusion of preschool children inearly childhood settings is also relevant when examdningbenefits in SACC programs. Preschool classrooms areoften extended day programs that focus on child-initiat-ed, child-directed, and teacher-supported environmentsthat are individually appropriate, age appropriate, andculturally appropriate (Bredekamp & Copple, 1997).These classrooms support the creative expressions ofchildren and emphasize interactions with peers.

Specifically, program structure and social interac-tion studies in preschool child care settings (DeKlyen &Odom, 1989; Guralnick & Groom, 1988; Honig &McCarron, 1988; Lefebvre & Strain, 1989; McEvoy etal., 1988; Peck et ai, 1988) between typical and atypi-cally developing children consistently suggest that orga-nized and stnictured interventions can increase positivechild outcomes. Likewise, follow-up studies of studentswith special needs in general education settings havefound that students placed in segregated programs aremore often unemployed and often have lower self-esteemthan those who were mainstreamed in school (Brown etal., 1987; Lipsky & Gamer, 1989). Moreover, when ser-vices and programs are provided in inclusive settings,children tend to develop into more independent adultswith less financial assistance from public institutions(Brinker & Thorpe, 1984; Madden & Slavin, 1983).Social development in an inclusive setting is enhanced

188 Hall and Niemeyer

because it is "normal or real world" and provides oppor-tunities for social skill improvement and practice.Inclusive settings provide students with and without spe-cial needs opportunities to interact, communicate, devel-op friendships, assist one another, and work together(Bradley et ai, 1997). Furthermore, Willis (1994) foundthat typically developing students in inclusive settingsgain skills and insights related to tolerance and the appre-ciation of human differences. Overall, most of the childoutcomes in the studies reviewed report positive resultsin inclusive programs. The most reoccurring finding inthe preschool literature has been that child interactions ininclusive settings do not happen without consistent,planned, and structured efforts (Lamorey & Bricker,1993).

Specific to SACC settings. The School-Age/SpecialNeeds Study (Fink, 1988) was conducted by the School-Age Child Care Project of the Wellesley College Centerfor Research on Women. The goals of the School-Age/Special Needs study were to develop a comprehen-sive knowledge base, to develop criteria for quality inclu-sive school-age child care programs, and to identify pro-gram models that offer high-quality experiences toschool-age children with special needs which can beemulated. Data in the study were collected by gatheringinformation from parents, from child care providers,resource and referral centers, and special educators.Indeed, this study clearly identified the need and desirefor children with special needs to be included in SACCinitiatives. The study uncovered a variety of approachesto staffing, funding, administration, and training in pro-grams serving atypically developing children, indicatingnot just one successful approach for inclusion. Althoughthe Wellesley study was an excellent beginning, provid-ing the field with valuable information about school-agechild care, little information has been collected on thesubject in the last 10 years.

A more recent study completed in collaborationwith Wellesley, The National Study of Before and AfterSchool Programs (Seppanen, et al., 1993), provided thefirst nationwide picture of the prevalence, structure, andcharacteristics of SACC programs for children ages 5-13by examining 1,300 SACC programs from a sample of144 counties in the United States. The three most com-mon locations for SACC programs were child care cen-ters (35%), public schools (28%), and religious institu-tions (14%), with approximately one half of the pro-grams using space shared with another program. Theaverage hourly staff-child ratio for all programs is 8.9:1.Furthermore, a number of important concerns were iden-tified in the study: (a) SACC programs were serving asmall number of minority and low-income children, and

(b) many programs have a high staff turnover rate, lowpay, and offer minimal staff benefits. Another finding,reported by this study, was that only 7% of the programsreported serving children with special needs.

While providing important information aboutschool-age child care and children with special needs,these two national studies were broad in scope.Moreover, they provided very little specific informationon the availability and characteristics of school-age childcare for children with special needs. Furthermore, anextensive review of the research uncovered no empiricalinformation on the outcomes and implications of includ-ing children with special needs in SACC programs.

THE CHALLENGES OE INCLUSIONSchool-age child care practitioners are concerned

with the program variables that create an effective, highquality, successful inclusive programs. Fortunately, sev-eral early childhood special educators offer insightfulcomments related to inclusion. Guralnick (1990) dis-cussed the major accomplishments and future directionsin early childhood inclusion. He stated that there isgreater agreement and compatibility in regard to inclu-sion public policies, educational practices, developmen-tal principles, and research. Yet, the challenge for thenext decade is to ensure that the unique needs of a largernumber of children with special needs and their familiesare served within the general early childhood system.Bricker (1995) stated that extensive thinking and plan-ning are required to ensure successful integration effortsfor children, teachers, parents, and the larger community.Unfortunately, the preschool child care inclusionresearch and general education inclusion research dis-cussed previously has focused primarily on child out-comes which limits the understanding of the programvariables necessary for the successful inclusion of chil-dren with special needs.

Bricker (1995) believes successful inclusion of chil-dren with special needs is influenced by three factors thatare interrelated: attitude, resources, and curricula. Thus,teachers with a positive attitude also need resources toimplement an inclusive, rather than add-on, program.Strategies that foster positive and constructive attitudesin children and adults include careful placement selec-tion, increased training, and strategies to assure the main-tenance of positive attitudes. The second element,resources, includes access to specialists; collaborativeplanning and decision-making; and appropriate environ-ment and equipment. Finally, the program content or cur-riculum refers to the treatments and interventions usedby teachers in inclusive classrooms. An inclusive cur-riculum would include activities that promote interaction

School-Age Child Care Inclusion 189

between children and naturalistic approaches thatencourage participation in activities in which the chil-dren are interested.

General education professionals have identifiedsimilar elements necessary for successful inclusive pro-granis. Bradley et al. (1997) stated that with an increas-ing number of schools and classrooms striving to beinclusive, services and supports for students with disabil-ities need to be reconstructed and new skills for teachersacquired. Likewise, to accomplish the goals of inclusionthe educational system must make notable changes inphilosophy, funding and personnel allocations, teachingmethods, and distribution of resources. In other words, asuccessful teacher and curriculum for an inclusive pro-gram is a complex and multidimensional process.

While Bricker (1995) and Bradley et al. (1997)identified several factors that facilitate inclusion, otherresearchers outlined specific program variables affectingchild outcomes in inclusive settings. Guralnick (1981)outlined 13 programmatic variables that should be takeninto consideration when evaluating child outcomes ininclusive settings. The most important include teacher-child ratio, ratio of children with special needs to non-special-needs children, types of disabilities, level ofteacher training, and quality of program. Other factorsthat facilitate inclusion are elements outside of the class-room such as parental attitudes as well as exosystemvariables (i.e., parental employment) and macrosystemvariables (i.e., reorganization of the county school sys-tem). Until recently, general educators and special edu-cators have typically worked with separate budgets, inseparate classrooms, and not in collaboration. However,states, school districts, and individual schools are reorga-nizing to provide successful educational programs fortypically and atypically developing children in theirneighborhood schools and are examining unique waysfor creating these programs. Therefore, SACC programs,especially those in public schools, should be part of thisreorganization plan.

Research agendas on the outcomes and implicationsof including children with special needs in SACC pro-grams must extend from previous research agendas inrelated fields. Initial child care studies examined the ben-efits or harm to children's development, while initialinclusion studies sought to determine that integratingtypically and atypically developing children would beadvantageous to all children and families. This researchhas demonstrated that inclusive programs can be imple-mented effectively (Bradley et al, 1997; Gurlanick &Groom, 1988; Jenkins et al., 1989) and child care can becommensurate with mother care for children (Clarke-Stewart & Fein, 1983; Rutter, 1981: Zigler & Gordon,

1982). Recent child care findings (Helburn, 1995;Whitebook, Howes, & Phillips, 1990) are focused on keyindicators of high quality care, program improvements,and the relationship between child care and the familyenvironment. Similarly, recent inclusion research isfocused on designing high-quality inclusive programs. ASACC research agenda should begin by examining themany variables (i.e., staff-child ratios, level of teachertraining, ratios of typically developing children to atypi-cally developing children) external to inclusion that canaccount for a SACC program's success rather than limit-ing studies to child outcomes.

The National School-Age/Special Needs Study(Fink, 1988) outlined implications and study findings forparents, educators, and child care providers. This studypointed out that in 1988 there were few places in theUnited States where more than one out of four parentscould find high quality school-age child care for theirchild with special needs. Fortunately, there are profes-sionals in the United States that know how to designappropriate and enriching SACC for children with spe-cial needs if parents, educators, and child care providersvoice their opinions and knowledge to the community.Fink outlined several important directions for parents,educators, and child care providers to take before highquality inclusive SACC will be a reality. Fink (1988) rec-ommended that parents make their need for child careknown to public school personnel and resource and refer-ral programs, as well as within advocacy and serviceorganizations. Likewise, public school districts need toallocate resources to school-age child care for childrenwith special needs or develop partnerships with agenciesto run inclusive programs in schools.

Identification of important program elements isonly the initial phase in facilitating successful inclusion.Lamorey and Bricker (1993) pointed out that communi-ty-based programs currently do not have the necessaryresources or personnel to implement effective programsand that future program development will be limited.However, Peck (1995) suggested that difficulties arisewhen inclusion is postponed until the system is ready.For instance, changes in resources, professional roles,and classroom practices are more likely to occur whenthe program is pressured to be inclusive. The establish-ment of effective inclusive school-age child care pro-grams can occur on a program by program basis, whereparents are in need of a service and SACC providers arecommitted to being inclusive.

CONCLUSIONThe inclusion of children with special needs is a

complex interactive relationship between the many eco-

190 Hall and Niemeyer

logical systems that intluence a child's developmenl.Thus the implementation, as well as the challenge ofinclusion, is more complex than the passage of ADA in1990. Clearly, typically developing as well as atypicallydeveloping children benefit from inclusive school-agechild care. However, implementing an inclusive programmust be more purposeful and thoughtful than the add-onmethod recognizing that the optimal amount of resourcesor trained staff may not available initially. The success ofschool-age child care inclusion depends on program vari-ables such as teacher-child ratios, the level of providertraining and experience, ratio of typically developing toatypically developing children, and type and severity ofthe child's disability. Optimally, staff can serve the childwith special needs when they are working coUaborative-ly with parents, general education teachers, and SACCstaff to meet the needs of each individual child.

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