Supporting the Unique Needs of Children with Disabilities
More and more frequently, parents are seeking nannies who are adept in caring for and bonding with children who have special needs, ranging from conditions related to behavioral conditions like ODD or ADHD, Autism Spectrum Disorder, or Down syndrome. A special needs nanny is a professional whose strengths often lie in communication, adapting routines, and providing positive reinforcement with the overall goal of helping the nurturing and growth of the child. See below for some tips for caring for children with special needs – parents: use these tips as a basic guideline for communicating your expectations with your nanny, and then create an effective support plan together.
Caring for Children with Behavioral or Attention Disorders
Since the dawn of time, behavior has been a form of human communication for people, young and old. It is very common for behavioral issues to pop up alongside some of the diagnoses covered below; however, there are times when a disorder like Oppositional Defiant Disorder (ODD) or Attention Deficit Hyperactive Disorder (ADHD) shows up solo.
As much of the care involved will often require medical intervention in the form of direction and treatment from a healthcare provider, excellent teamwork between the home and the medical team is required. The ability to enforce stability and healthy boundaries with children who experience behavioral issues is key. Additionally, it is imperative to practice positive reinforcement. Encourage positive behaviors by recognizing and praising children when they demonstrate these good acts. It is also essential for parents and caregivers alike to model positive behaviors with others to improve a child’s social skills.
Should a child require treatment such as therapy or medication, anyone responsible for their care should be involved to ensure children receive uniform support and care. This is especially important for children with behavioral issues such as ODD, as symptoms can include combative tendencies. Remember that as a childcare provider, you may witness some behaviors that doctors, parents, or teachers do not, so communication is very important.
Engaging in various games and activities can help children with attention-specific needs expend mental and physical energy. Try outdoor activities when the children have excessive energy during the day. Avoid particularly competitive or contact-driven sports, as these can exacerbate behavioral issues. Instead, try activities such as swinging, jumping rope, or hopscotch. Remember that this can backfire if it’s too close to bedtime. In the late afternoon and evening, help the child wind down with low-key activities such as watching a movie, doing a puzzle, working on an artistic endeavor, or reading a book. Even gently rocking in a rocking chair can help children calm down when it’s time for bed.
Give specific directions. Kids with attention disorders often have difficulty following directions, and having specific guidelines to follow is essential. It is always asked that they repeat directions back to you so that expectations are understood.
Be flexible. It can help to provide the child with a daily schedule so they have an idea of what’s coming. If there are tasks they must complete (homework, etc.), you’ll want an hour-by-hour calendar—but be prepared for them to fall by the wayside. Children with ADHD often tire of activities more quickly than other children, so it’s essential to have plenty of ideas for additional things to do in case their attention wanes.
Be consistent. This is important for setting rules and moving through activities. Children with attention and/or behavioral disorders require a strict framework to keep them on track. When moving through the day’s activities, try to avoid switching gears too drastically. It’s much easier for a child with an attention disorder to move from a high-energy activity to a medium-energy activity than it is for them to go straight from soccer to naptime.
Caring for Children with Autism Spectrum Disorder (ASD)
Be a detective. When a child has difficulty communicating, as a caretaker, you need to be able to decipher what they’re trying to say without harming their self-esteem or causing frustration. This often requires a particular brand of detective work. For example, we spoke with a special education teacher who shared this anecdote: “I worked with a student who would say ‘Planet, planet, planet, planet, planet’ randomly throughout the day, and we had no idea why. Then, we watched an episode of VeggieTales. In the video, one veggie says he’s so hungry he could eat a whole planet. It turned out the student was using the word ‘planet’ to try to tell us he was hungry.”
Engage in their interests with them. It seems obvious, but having something to engage with the child about makes your interactions much more meaningful and shows them that you care. Even if the child is not traditionally affectionate, attempting to interact with them on their level makes a huge difference in the relationship. Many children with ASD become passionately focused on a particular area of interest; a good nanny will recognize this interest to form a connection with the child. For instance, if the child is particularly fascinated by maps, you could suggest exploring the house, neighborhood, or town and drawing a unique map using things you find as markers on the map’s legend. Every child has different interests, and showing you care about what they enjoy can build trust and help you bond with them.
To avoid behavioral outbursts, make transitions between activities smooth and precise. It’s essential to try to maintain a calm environment. To do this, you could use a visual timer so they can see how much time they have left. You could also give them 10-minute, 5-minute, or 2-minute warnings so they know what’s about to happen. If you’re transitioning away from a preferred activity (for example, playing with toys), make sure the next activity is at least somewhat preferred as well (such as a snack) to avoid non-compliance behaviors.
Be a support system. Talk to them, and help them talk to others. Research shows that students with disabilities hear fewer words than their non-disabled peers and experience fewer activities outside of school. Things that come quickly to you may require more teaching for the child, but that doesn’t mean they’re incapable of doing them! Let them be as independent as possible while letting them know you’re there for support if they need it.
Go slowly. When it comes to physical contact, it’s better to start small. Ask the parents how the child reacts to physical touch and go from there. If the child doesn’t respond well, don’t push it. To promote trust, try sitting near the child as they play and mimicking their actions. This can get their attention and lead to more interactive play.
Caring for Children with Down Syndrome
Learn how the child communicates. When you begin working with a family, always ask the parents how the child prefers to express themselves, especially if they are nonverbal. As you spend more time with the child, their communication style will reveal itself to you. Don’t be afraid to observe as the child interacts with others to see if there are different modes of communication triggered by various activities or people.
Keep rules simple. It can be difficult for kids with Down syndrome to follow directions, so ask the parents about any family rules and stick to them. Be sure any new regulations or guidelines you set for the child are as simple as possible. It can also help to get the child used to a routine so they know what to expect at a given time. If necessary, you can enforce rules and routines with visual, auditory, or tactile cues.
Be patient! When helping them perform tasks such as showering, getting dressed, or brushing their teeth, give them cues if they need help, but make sure you don’t do the activity for them. Repetition is the key to learning. If they don’t understand immediately, it’s okay. As mentioned above, consistency is essential when working with a child who has behavioral issues and experiences outbursts. Always be aware that stubborn or oppositional behavior may communicate frustration or a lack of understanding.
Safety first! There are many different levels of functioning within the Down syndrome community, so get to know the child’s specific medical history. Typically, children with Down syndrome have lower muscle tone and difficulty with coordination. It may be difficult for them to move quickly, but this does not mean they dislike playing outside! It’s important to help them exercise their muscles safely.
How you do this depends, of course, on the individual child’s level of musculoskeletal impairment. Still, guidelines recommend that children with Down syndrome engage in 60 minutes of moderate to vigorous physical activity daily. If the child knows how to swim and enjoys it, taking them to the pool is a great low-impact, high-reward option. Playground activities such as swings and slides are also a good way to make physical activity fun. Always keep a close eye on the child; wandering or running off is a typical behavior for children with Down syndrome. As a caregiver, you must ensure they do not inadvertently find themselves in dangerous situations.
Create social situations. Find something the child enjoys, and do it with them. Children with disabilities are often less exposed to social situations and activities than other children. To help a child with Down syndrome learn developmentally appropriate social skills, make sure they have one-on-one time with a variety of classmates outside of the classroom, in addition to time with you.
Have a plan—and a backup plan. Oftentimes, things don’t go as we’d like. Knowing how to deal with difficulties as they arise is important, but sometimes, the best option is to regroup and do something entirely different. Whenever you plan an outing, make sure you have a mental list of modifications to the plan should something go awry, and another plan entirely on the back burner. For example, you might hope to take the child to a parade but find on that morning that they are irritable or having difficulty processing sensory information. You do not want to bring a child who is already on edge to a large social gathering, so you should be prepared to propose alternative activities: watch the parade on TV, for instance, or play quietly in the backyard.
Every Child Deserves Compassion and Care
Lastly, and most importantly, a child with functional needs is like any other kid. Their brains and/or bodies may work differently from other children’s, but their difficulties do not define them. A positive attitude is key to initiating a relationship with any child, and that’s the same for children with disabilities. A good nanny focuses on the child’s strengths, not their challenges, and does their best to nurture those innate strengths while helping the child reach their full potential. If you are a nanny with experience working with children with disabilities, send us your resume!
Is your family seeking high-quality, experienced nannies? The Nanny Authority works with many caregivers who specialize in children with special needs and with families whose children need special care. Please email us at info@nannyauthority.com or call us at (973)-466-2669 to get started.