Children with Special Health Care Needs and Atypical Development

1.4 Enrolling Children with Special Health Care Needs

A teacher sits with a family going over paperwork. When enrolling a child with special health care needs, begin by building a strong partnership with the family. This partnership includes sharing important medical information and coordinating with supporting services. You will need to work together with the family to have the most current information to help the child, including an up-to-date health assessment and an individualized care or treatment plan.

Review the initial paperwork together, especially the child’s Health Inventory form, and discuss how the program and family will coordinate the safe continuity of care in the child care environment.

The conversation with the family should focus on the following topics to gain more understanding for reasonable accommodations and the need for additional training.

Health Information

The child’s diagnosis/diagnoses
The health care provider and other specialists/therapists involved with the child

Medication and Procedures

Medications the child needs, including:
- Medications given on a regular schedule
- Medications used in emergencies, including when and why to give them (signs and symptoms)
Care procedures needed during child care hours, including:
- Special diets (e.g., gluten-free, formula, tube feeding, diabetic diet)
- Use of medical equipment (e.g., g-tube, oxygen, hearing devices)

Daily Activities

Activity guidelines according to the child's individualized plan, including:
- Modifications based on the child’s needs (e.g., asthma, diabetes, allergies)
- Any physical activity limits or restrictions
- Use of mobility equipment (e.g., wheelchair or other devices)
- Considerations for children connected to medical equipment (e.g., oxygen tubing, g-tube, monitors)
How the child should be monitored, based on their care/treatment or therapy plan
Supervision modifications if child tends to run off

Environment and Safety

Environmental needs, such as:
- Lighting, temperature, or weather sensitivity (heat index, air quality)
- Triggers to avoid (e.g., loud noises, gates, sensors, alarms, crowded spaces)
Emergency and evacuation plans, including any special supports (e.g., noise-canceling headphones, medications, devices, diabetic foods)

A program should include the special care plan and individualized care/treatment plan in the child’s onsite health records. Staff must be trained or oriented to the special tasks, monitoring needs, and emergency care required to support the child. A child's plan should be reviewed annually and updated as needed.

Office of Child Care forms* or documentation that may be helpful:

Health inventory (OCC 1215)
Emergency Form (OCC 1214)
All about me forms
Medication Administration Authorization forms as needed
Child’s individualized Medical/treatment/behavioral support plan
Special Health Condition Individualized Care Plan Checklist (OCC 1216 D) for additional training based on child’s individualized care/treatment/action plan, parent approval and documentation
Modified diet plan as indicated
Modified daily schedule of activities as indicated
Field Trip & Transportation Plan
Parent Communication plan
Inclusion in emergency preparedness plan

*Find the OCC forms at MSDE DEC’s Licensing Forms. OCC forms align with COMAR requirements. It is encouraged that the program staff provide updated forms from the OCC website or direct families to the website to access current forms.