Every year, 1,500 babies in the UK are affected by cerebral palsy, a condition caused by an injury to the brain before or soon after birth. This figure equates to one in every 400 births, and the children will all have varying degrees of difficulty with movement, posture and co-ordination.
For parents with a child affected by the condition, the task of finding a suitable childminder, or integrating their child into a nursery, might seem daunting. However, this situation could be about to improve with the help of an initiative launched jointly by the charities Scope and HemiHelp, which respectively deal with cerebral palsy and hemiplegia (in which one side of the body is affected).
With National Lottery funding, the two charities have launched an early years inclusion pack - a comprehensive and easy to understand resource aimed at nursery and early years professionals. The pack is the culmination of a three-year project and includes a leaflet containing information for childminders about communication for children with complex needs. This leaflet is also appropriate for all early years professionals.
The aim is to provide practical guidance on how to better support the inclusion of disabled children. It is useful for children with a range of needs, but clearly has an emphasis on cerebral palsy and hemiplegia.
The information includes an overview of the two conditions; a guide to physical practicalities such as handling a child with cerebral palsy and managing eating and mealtimes; communication; playing and learning and therapeutic roles, treatments and learning systems.
The emphasis throughout is on treating each child as an individual and doing activities with a child, not to a child, so that they are encouraged to become as independent as possible through motivation and interaction with staff and other children.
Lindsay Brewis, an early years co-ordinator for Scope who was responsible for much of the pack's content, says, 'The thinking behind this came from our own research and from parents of children with these conditions. When parents dealt with early years professionals they were often asked the same questions, but there was no single source of information that would point people towards the answers. With this pack we have brought together a range of sensible and practical advice to help early years professionals feel able to welcome and include all children.
'This is backed by lots of useful contacts such as website addresses and details of where to get hold of factsheets on specific issues so that professionals have all the information they need at their fingertips.'
According to Claire Hewitt, Scope early years co-ordinator for inclusion and a member of the team that is spearheading this project, the key attribute of a successful inclusive nursery is a positive attitude towards disabled children.
'Early years workers may think they need to know about a wide range of conditions, and this may hold them back in feeling able to include all children,' she says. 'But in fact including disabled children is more a case of extending ordinary good practice and recognising that all children have interests, ideas and aptitudes.
'Obviously training is important but having the right ethos and attitude is even more vital. In a successful inclusive nursery there is a positive attitude towards disabled children where staff support and encourage children to reach their potential. In order to do this, staff must understand the additional needs of the child and how this might affect the child's learning and development.'
Ms Hewitt adds that practitioners also need to ensure their environment and activities are accessible for disabled children and to foster a proactive, planned approach to inclusion rather than simply reacting to individual referrals. 'A successful inclusive nursery will take into account the needs of disabled children when making changes to the environment and will know where to go for further information and advice,' she says.
A total of 3,000 packs have been printed and distributed to early years professionals through nursery and childminding organisations. Ms Hewitt reports that reaction has so far been very positive with one Sure Start area alone ordering 800 more packs. In September, Scope will launch a CD version, which will contain the same information, an inclusion checklist and additional useful information.
'There are many nurseries that have been successful with disabled children, mainly because they have committed staff who are prepared to go the extra mile and get extra help, support and training,' she says. 'The best nurseries are those where staff are not afraid to let disabled children try activities for themselves. Children with cerebral palsy and hemiplegia don't need continuous one-to-one support - that's a fallacy and actually not even helpful because they need interaction with lots of different people to make them more independent and stop them from becoming bored.'
Communication with parents is also vital and as Ms Hewitt explains it's not just about spending money on special resources or additional staff. 'There are many easy things early years professionals can do to make their nurseries more inclusive. For example, getting parents to bring in the equipment and toys that the child has at home or focusing on low-tech aids that all children can use that don't highlight the differences - things like Velcro and rubber suction mats, for instance, to stabilise toys.'
Scope and HemiHelp have been keen to ensure that childminders are not overlooked by this initiative. Along with a separate leaflet developed specifically for childminders, the charities also organised two childminder development days, which took place in Rochdale and Norwich.
Karen Booth, a childminder from Rochdale who attended her local development day, says, 'I don't look after a child with a disability, but I was keen to attend this course because I wanted to be better prepared should the need arise.
'The information pack is very useful and I'm glad Scope and HemiHelp have included childminders in this initiative. The big problem for childminders is that we are generally on our own with more than one child to look after, so although I now feel more confident about looking after a child with cerebral palsy I would still want to feel that I could cope alone.
'It's different for nurseries where staff can support each other, but not so easy for childminders because you only have one pair of hands.'
Further information
Scope www.scope. org.uk/earlyyears/prof/resources.shtml
HemiHelp www. hemihelp.org.uk
Liverpool Early Years Centre
In an ideal world, all nurseries would be inclusive, helping to remove barriers and encourage mutual understanding between disabled and non-disabled children.
At the Scope Liverpool Early Years Centre (LEYC), this has become reality with the help of funding from Liverpool City Council and support from the local social services department.
The centre, which has been operating for more than 10 years, looks after 40 children a day, of whom half are disabled. The children range in age from nought to five and most attend for three days a week. Specialist help, such as physiotherapy, speech and language therapy and occupational therapy, is on hand, along with a specialist Scope social work team and family link service.
Jean Brown, deputy manager of LEYC, says, 'Caring for a disabled child isn't automatically complicated. It's more a question of treating all children as children and looking at each child individually to see how you can accommodate their needs.'
The child:staff ratio at LEYC is four to one (two to one in the baby room).
For some nurseries, especially those in the private sector, there is concern that a policy of inclusion might mean having to recruit more staff or invest in additional resources, but in reality a four to one ratio is not uncommon and many nurseries are already sufficiently well equipped to accommodate disabled children - they just don't realise it.
'You don't necessarily need specialist toys and equipment because a lot of what you have can be adapted to suit,' Ms Brown explains. 'I think the Scope inclusion pack is great because it will give other nursery managers the confidence to open their doors to disabled children. Having all the information in one place is a good start. People need to know where to go for advice. And they need to see that, with the right support and advice, inclusion is a real possibility.'
The pack clearly points out that nurseries and childminders don't have to spend money or make complex plans to provide a place for a disabled child.
Specialist equipment usually comes with the child via the parents and specialist toys are not necessary. The most important thing an early years professional can do to include a disabled child is give more of their time so that the nursery experience for all children remains fun-filled and relaxed.
