by Barbara Kaiser & Judy Sklar Rasminsky

When it comes to detecting significant physical, cognitive, social, and emotional problems in young children, caregivers are on the front line.

With their training in early childhood education and their experience with many children, they are well prepared to notice when a child in their care is having difficulty -- if, for example, the child does not hear well or shows unusually aggressive behaviour.

Educators handle small problems every day, but dealing with severe problems requires a different approach. Without extra help, caregivers may quickly burn out.

When children have special needs, the parents must be informed. They have the ultimate responsibility for their child, and any decisions are theirs to make. Early diagnosis and treatment are often crucial. Their involvement and support are vitally important.

But telling parents that their child is not perfect is the hardest thing in the world to do. They do not welcome this news. They may suspect that their child is different, but hope that it is because he is developing at his own pace and will catch up eventually. They may have avoided discussing the issue with their pediatrician, and they certainly do not want another professional to confirm their worst fears.

How can a director or supervisor in a day care centre or family day care home help in this situation? How can you and the caregiver work together to best tell the parents the truth and enlist their full cooperation in assisting the child?

When an educator encounters a serious problem in a child, her first step is to talk to the supervisor. Some caregivers may be reluctant to ask for help for fear that the supervisor will think they are not doing their job properly. One way to head off this apprehension is to make reporting a matter of routine -- standard written policy -- so that no one's competence is on the line. Another method is to set aside a regular time at staff meetings to discuss the children - some teachers feel more at ease knowing their colleagues will support them.

Teachers need to remember that children do not all develop at the same pace, especially in a multicultural environment where values and lifestyles vary enormously, so it is helpful to get input from everyone who is in contact with the child.

The supervisor must also observe the child over a period of time and under a variety of circumstances in order to help identify the problem and sort out whether it is a response to the day care or a problem within the child himself. Since these observations by the supervisor and the educators will form the basis for future action, they must be detailed, concrete, specific -- and recorded.

When you have completed your observations, sit down together to look for patterns. Does Adam attack during transitions or when there are too many children in the room? Does he have trouble putting his wishes into words? Is his behaviour totally unpredictable? Is it consistent in the sense that you are not talking about one isolated incident?

Now you can formulate a plan. If the child's behaviour seems to occur at the day care during particular times of the day, try to develop an arrangement that can eliminate or reduce the problem. But in the meantime, the director should find out where the family can go for a formal assessment and what resources are available in the community. How long will they have to wait for an appointment? Will they have to pay for testing? Giving the parents a name and phone number makes it easier for them to act.

It is important to be clear, unified, and organized when you talk to the parents, so go over every detail together ahead of time. Who will speak? If the child's own teacher is mature and experienced, she is probably the best person to present the problem. (The director or supervisor may intimidate parents.) But an educator who is not comfortable with so important and threatening a task may want you there to back her up.

Before either of you approaches the parents, be sure your caregiver will be available. Most parents will want to meet the next day, if not sooner. In fact, this meeting is so important that you should hire a substitute if necessary. Even if the caregiver plans to meet with the parents alone, you should be available, too.

If she feels capable, the teacher should make the initial contact with the parents. She must not phone the parents at work -- nothing will create more panic. Instead, she should write a note asking them to come see her, and when they appear she should say something like, "I have some concerns about Lauren's language (or behaviour or hearing), and I'd like to talk with you about them. Can we make an appointment?" She must be prepared to resist the parents' attempts to talk then and there and instead arrange for a quiet, private place -- the director's office or an empty classroom -- free from interruptions. To avoid misunderstandings within the family, ask both parents to be present.

Above all, whoever talks to the parents must be warm, kind, and sympathetic. To relax them and make them more receptive to what follows, begin with something positive: "Anna is a very friendly and gentle child, and she has many friends at the day care." Have they noticed she does not always seem to hear what they are saying or that her speech is not always clear? How do they handle the problem at home? Have they talked to anyone about this?

Without labelling the behaviour or the child, describe what you have seen at the centre. Try not to minimize or exaggerate -- honesty and clarity are the best tools you can use to get the parents to hear you. Indicate that, by itself, the day care cannot provide all the services that Anna needs to thrive, and that if she is going to stay, you will need their help. Explain that they should have her assessed by a professional who may recommend additional support services for Anna at home and when she is at the day care.

Some parents prefer to consult their own pediatrician. This is a reasonable route to follow and you should support their decision. To be sure that the child's doctor is fully aware of all you have observed in the child, you might want to write the doctor a referral letter to send along with the parents. (Be sure to give parents a copy).

Let the parents know that you are available at any time if they are having problems, but set a deadline for taking the first steps toward professional intervention. Schedule a follow-up meeting to keep track of appointments and developments, good as well as bad. You will want to get together later, but do not overload them. They will have plenty to deal with -- feelings of sadness and anger, possible marital problems, and extra hours spent working with their child and sitting in doctor's offices. If they have to wait three months to see a specialist, you will need to work out an interim survival plan together.

Sometimes parents cannot face the possibility that their child has a severe problem. They find it easier to turn away than to abandon all their dreams for their child. Even with very sensitive handling, they may withdraw him from the centre or just plain refuse to cooperate. If they are not willing to seek the support necessary to keep the child in the day care, his presence may make the educator's job too stressful and compromise the quality of care for the other children. The same may be true if the process of assessment and referral does not get you the help you need or if the problem is very severe and the parents cannot get help within a manageable time. In these situations, a responsible director has to put the needs of the other children and the staff first. Though it is a hard decision to make, your only option is the ask the parents to withdraw the child.

However, once a family has sought help and is on a waiting list, they are ready to work with you, and the dynamics of the situation often change. Their support does not automatically lighten the caregivers' load, but everyone feels a stronger commitment to making the situation work. The caregivers may need extra support from you, especially if it takes a while to put a new system into place. If possible, offer them a day off, take the child into your office, or hire additional staff for a few hours to give them a break.

(Barbara Kaiser, who teaches early childhood education at College Marie-Victorin in Montréal, is the founder and director of Garderie Narnia, a non-profit day care centre in Westmount, Québec. She and writer Judy Sklar Rasminsky are co-authors of "The Daycare Handbook: A Parents' Guide to Finding and Keeping Quality Daycare in Canada.")

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Have you ever seen a child cling to a caregiver when his parents arrive to pick him up at a child care center? How about a child who greets her parents happily then returns to her activity, in no rush to go home? While such close attachments to caregivers and child care settings may make some parents initially uneasy, these bonds are an important part of children's development and learning. Working together, parents and caregivers can ensure that children see their educational settings as safe places where adults other than their parents support and care for them.

Caregivers with a strong knowledge of child development recognize how important it is for children to have a sense of belonging, being loved, and trust in their environments. Warm and caring relationships with adults provide children with the basis for all types of learning. For instance, studies show the presence of attentive caregivers encourages children to explore their worlds. Responsive adults help children extend their learning and reach out to other children and adults.

Specific training in early childhood education is critical because even the most supportive caregivers may not fully understand children's needs at different stages of their development. Also, working with groups of young children is very different from relating to one's own child or neighbor's child. Caregivers who attend workshops, courses, and staff development programs are better able to create strong bonds with children. In addition, these caregivers are more sensitive and responsive to all children in their care.

Because very young children have limited ability to communicate their wants and needs, it takes a skilled adult who knows the child well to recognize different signals and respond appropriately. Caregivers should be sensitive to each child's learning needs, a unique combination of individual, developmental, and cultural characteristics. Such attention helps children develop self-confidence and self-worth.

Good caregivers know that children's learning occurs in informal activities as much as in formal instruction. Children's language development, for example, begins with their earliest human interactions. Attentive caregivers help children learn the words to communicate their needs effectively. They see everyday caring routines as opportunities for expanding children's language skills.

Parents can help strengthen the bond between children and caregivers by helping to communicate an attitude of trust. Mention the caregiver's name in conversations at home, and show interest in your child's interactions with her/him. Say goodbye confidently to children to make their transition more comfortable.

Parents will find the best caregivers by recognizing signs of early childhood expertise. As communications between parents and caregivers develop, the bonds between children and caregivers will grow. A caregiver who understands the educational needs of each individual child can help parents make early years the best learning years possible.

What helps strengthen the ties...
Small groups of children. For babies, NAEYC recommends no more than 6 to 8; for toddlers, 6 to 10; for pre-schoolers, 16 to 20 - and always with at least 2 adults.
A primary caregiver assigned to infants and toddlers to promote consistency and responsiveness. Scheduling that keeps groups of children with the same caregivers for extended periods of time, rather than changing with the traditional school year, or even more frequently. Low staff turnover to reduce any anxiety caused by changing faces and styles of handling. Ask programs about rate of turnover and steps taken to recruit and retain qualified staff. Active parent participation. Close communication with caregivers may ease parents' initial concerns and help children benefit most from their experience.