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Early Childhood Education Journal, Vol. 27, No.

3, 2000

Early Childhood Special Education

Inclusion of Children with Special Needs in School-Age Child

Care Programs
Alice Henderson HalP^ and Judith A. Niemeyer^

From an ecological perspective, the inclusion of children in school-age child care (SACC) requires
collaboration among policy makers, educators, parents, and child care providers. Both typically and
atypically developing children benefit from inclusive programs, yet they pose challenges for caregivers primarily due to lack of training, resources, and identification of successful inclusive program
components. The process of successful SACC inclusion should be at the forefront of human service
and research agendas.
KEY WORDS: school-age child care; inclusion; school-age children with special needs.

children will be served in the same programs they would

have attended if they did not have a disability emphasizing that all children belong together (Wolery & Wilbers,
Tbe philosophy of inclusion for the school-age child
with disabilities may not be supported in all the settings
in which they participate. For example, a child may be
included in the school-age child care program (i.e., participates in the regular classroom for all activities) but
may only be mainstreamed for part of their school day
(i.e., lunch, physical education, school assemblies).
Likewise, a child may be in a segregated elementary
school classroom (i.e., all children in the classroom have
disabilities) and included (i.e., program includes children
with and without disabilities) in the SACC program or
included in an elementary school classroom and segregated (i.e., only participates in planned activities for children 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 tbe
Most scbool-age child care practitioners agree with
the reasons for the passage of Public Law 101-336, but
are apprehensive about how to include children with special needs in their School-Age Child Care centers. The
approach many programs, consciously or unconsciously,
have adopted is what Bricker (1995) described as the
add-on method. The add-on approach requires only tbat
the child or children with disabilities be added to the pro-

The enactment of Public Law 101-336 (American
Disabilities Act [ADA]), in July of 1990, mandated the
full participation of individuals with disabilities into
American society (Shea & Bauer, 1994) therefore making it unlawful to discriminate against individuals with
disabilities in all arenas (e.g., employment, public transportation, public accommodations, and local and state
government services). This impacts the provision of services by child care centers, especially publicly funded
child care, who can no longer offer separate programs for
children with special needs, but must include these children in their regular programs. As with most changes in
educational curriculum and philosophy, the full integration of children with special needs into child care programs, specifically school-age child care (SACC), is easier said than done. For purposes of tbis article, schoolage child care is defined as child care for school-age children before and after school, and during full days when
school 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 of

North Carolina at Greensboro.
^School of Education, University of North Carolina at Greensboro.
'Correspondence should be directed to Alice Henderson Hall, Box
26170, Greensboro, North Carolina 27402-6170;

1082-3301/00/03O0-0185$18.0O/0 2000 Human Sciences Press, Inc.


Hall and Niemeyer

gram. Therefore, the children are not necessarily an

active member of the SACC program, but they are partially included and not totally involved. The following
describes a program using the add-on approach rather
than an inclusive one.
The fiisl child thai 1 included in my SACC program was
an eight year-old with multiple disabilities who could
not walk or speak. He knew some sign language, could
shake his head when asked questions, and appeared to
be somewhat equal to his chronological peers cognitively. 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 children with special needs and were very anxious about
working with him. Some staff were very reluctant to
help, arguing that they had not been hired to work with
children with special needs. The typically developing
children in the summer program were the most openminded. They eagerly tried to include him in all aspects
of their play and within days I could see the benefits of
having him in our program for the typically developing
children. I felt some successes with the inclusion of this
young man, but had some questions about whether we
were providing more than custodial care for him. I was
not convinced that he was fully participating in the
enrichmg dramatic, construction, crafts, and recreational activities that were part of our summer curriculum.
He tended to observe, rather than participate, in activities such as wood working or Lego construction. The
staff tended to work with him one-on-one rather than
encouraging and supporting his play with other children. The staff and I needed more training as to how to
communicate with him. to find out what activities he
was most interested in participating in. and help in
developing ways to adapt these activities for his successful participation. (Hall, 1997)

This narrative illustrates some of the issues associated with implementing the ADA mandate in a schoolage child care program. An inclusive program approach
would assure that children with disabilities aie included
in all activities and actively involved based on their individual needs and interests (Bricker, 1995).
The purpose of this article is to discuss the inclusion
of children with special needs in school-age child care
programs. First, the need for SACC inclusion is discussed from an ecological perspective. Second, the benefits of inclusion for school-age children in regular education programs and early childhood preschool programs
are highlighted. Third, the challenges of SACC inclusion
are discussed.


According to the only national study that has

researched school-age child care programs. The National

Study of Before and After School Programs, about 1.7
million kindergarten through eighth graders were
enrolled in 49,500 before and after school programs in
1991 (Seppanen, e//., 1993). On the other hand, an estimated 17 million parents need care for their school-age
children during work hours (U.S. Bureau of the Census,
1991). Likewise, the Govemment Accounting Office
(GAO) estimated that in the year 2002, the current SACC
supply will meet as little as 25% of the demand in some
urban areas (GAO/HEHS-97-75, May 1997). Moreover,
an estimated (due to parent's reluctance to report leaving
children alone) 5 million school-age children spend time
without adult supervision during a typical week
(Hofferth, Brayfield, Diech, & Holcomb, 1991). These
data and statistics are disturbing when considering the
welfare of all school-age children. Unfortunately, this
research includes very little infonnation about schoolage children with disabilities. Moreover, leaving children
with special needs in self-care is often not an option. In
the study reported above, Seppenan et al. (1993) found
that only 7% of the programs primarily served children
with special needs. In fact, when considering services
currently not available, parents frequently (25%) requested SACC for their children with special needs. Clearly,
the child care needs of school-age children, particularly
those with disabilities, are not being met by school districts and community agencies.
From an ecological perspective (Bronfenbrenner,
1989), development occurs within a complex system of
relationships affected by multiple levels of the environment. Furthermore, children's relationships are all bidirectional and reciprocal. The environment is viewed as a
series of nested structures which includes, but is broader
than, the home, school, and neighborhoods where children spend their everyday lives. In other words, children
do not live in isolation but are part of a number of social
systems (micro-, meso-, exo-, and macro-) that influence
how they develop and leam.
For a child with special needs and his or her family,
child care, a microsystem, can be an important context in
the development of the child. Parents need child care in
order to be able to work {exosystem). Child care environments and schools are two microsystems where children
spend many of their waking hours. Moreover, for a child
with special needs, school, child care, family, and medical professionals constitute their mesosystem. Child outcomes are maximized when all of the microsystems and
the mesosytem, are working coUaboratively. Furthermore, SACC is needed by families who have a child with
disabilities because the child cannot be left alone. This is
often an option for families of typically developing chil-

School-Age Child Care Inclusion

dren when SACC is either unavailable or unaffordable.
Even if the parents of the school-age child with special
needs are not working, they may need respite from the
demands of parenting a child who is atypical. In addition,
children with special needs may need a setting where
they can interact with peers informally, just as typically
developing children benefit from extracurricular activities with their peers (another microsystem). Yet, societal
institutions {macrosystems) have not placed much
emphasis on SACC, especially school-age child care for
children with special needs. Raising a child with special
needs could be much more expensive than raising a typically developing child due to medical and therapeutic
expenses, as well as the cost of special equipment such
as wheelchairs or hearing aids (Fink, 1988).
Families of children with disabilities need
macrosystem support to raise and educate their child.
The ADA law is one extremely important macrosystem
support for children with disabilities. Yet, full implementation of it poses many challenges at the local, state, and
national level (e.g., quality, services, educated practitioners). As Peck (1993) pointed out, the implementation of
practices and policies supporting the inclusion of children with special needs in community programs involves
changes in federal and local education policy, human service policies, and community values. In particular, these
policy changes are needed to support SACC for the single parent or dual working parents of a child with special
Certainly, school-age child care for children with
special needs would benefit both the child and the family (Fink, 1988). However, minimal attention has been
given to this issue. One reason for this lack of consideration is ambiguity as to who is responsible for placing
this issue on political agendas. During the 1980s, schoolage child care for children with special needs was not a
priority issue for any national professional organizations
or networks (Fink, 1988). Instead, parents of children
with special needs spent a great deal of time and energy
seeking and, in some cases, fighting for proper medical
care, then the best educational setting, and finally child
care. The many challenges facing families of children
with special needs, one of which is child care, should be
at the forefront of human service agendas. Again, child
outcomes are maximized when all of the ecological systems influencing development are working together.


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

atypically developing children into the same program
and the benefits of this approach to children and families.
A review of the research on the outcomes and implications of including children in general education programs (Bradley, King-Sears, & Tessier-Switlick, 1997;
Brinker & Thorpe, 1984; Brown et al., 1987; Lipsky &
Gamer, 1989; Madden & Slavin, 1983) and preschool
child 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 of
typically and atypically developing children into the
same program can be beneficial to all children.
Unfortunately, research on the inclusion of children with
special needs in general education programs is not completely generalizeable to SACC because it focuses on the
learning of academic skills rather than the enriching
extracurricular skills that are emphasized in SACC. For
example, general education programs focus on skills
such as reading and writing, whereas SACC programs
might emphasize creative (e.g., art, music, dance, wood
working) activities and peer interactions. Although learning Cakes place in SACC programs, the program goals are
considerably different. Therefore, a review of the
research related to the inclusion of preschool children in
early childhood settings is also relevant when examdning
benefits in SACC programs. Preschool classrooms are
often extended day programs that focus on child-initiated, child-directed, and teacher-supported environments
that are individually appropriate, age appropriate, and
culturally appropriate (Bredekamp & Copple, 1997).
These classrooms support the creative expressions of
children and emphasize interactions with peers.
Specifically, program structure and social interaction studies in preschool child care settings (DeKlyen &
Odom, 1989; Guralnick & Groom, 1988; Honig &
McCarron, 1988; Lefebvre & Strain, 1989; McEvoy et
al., 1988; Peck et ai, 1988) between typical and atypically developing children consistently suggest that organized and stnictured interventions can increase positive
child outcomes. Likewise, follow-up studies of students
with special needs in general education settings have
found that students placed in segregated programs are
more often unemployed and often have lower self-esteem
than those who were mainstreamed in school (Brown et
al., 1987; Lipsky & Gamer, 1989). Moreover, when services and programs are provided in inclusive settings,
children tend to develop into more independent adults
with less financial assistance from public institutions
(Brinker & Thorpe, 1984; Madden & Slavin, 1983).
Social development in an inclusive setting is enhanced

because it is "normal or real world" and provides opportunities for social skill improvement and practice.
Inclusive settings provide students with and without special needs opportunities to interact, communicate, develop friendships, assist one another, and work together
(Bradley et ai, 1997). Furthermore, Willis (1994) found
that typically developing students in inclusive settings
gain skills and insights related to tolerance and the appreciation of human differences. Overall, most of the child
outcomes in the studies reviewed report positive results
in inclusive programs. The most reoccurring finding in
the preschool literature has been that child interactions in
inclusive settings do not happen without consistent,
planned, and structured efforts (Lamorey & Bricker,
Specific to SACC settings. The School-Age/Special
Needs Study (Fink, 1988) was conducted by the SchoolAge Child Care Project of the Wellesley College Center
for Research on Women. The goals of the SchoolAge/Special Needs study were to develop a comprehensive knowledge base, to develop criteria for quality inclusive school-age child care programs, and to identify program models that offer high-quality experiences to
school-age children with special needs which can be
emulated. Data in the study were collected by gathering
information from parents, from child care providers,
resource and referral centers, and special educators.
Indeed, this study clearly identified the need and desire
for children with special needs to be included in SACC
initiatives. The study uncovered a variety of approaches
to staffing, funding, administration, and training in programs serving atypically developing children, indicating
not just one successful approach for inclusion. Although
the Wellesley study was an excellent beginning, providing the field with valuable information about school-age
child care, little information has been collected on the
subject in the last 10 years.
A more recent study completed in collaboration
with Wellesley, The National Study of Before and After
School Programs (Seppanen, et al., 1993), provided the
first nationwide picture of the prevalence, structure, and
characteristics of SACC programs for children ages 5-13
by examining 1,300 SACC programs from a sample of
144 counties in the United States. The three most common locations for SACC programs were child care centers (35%), public schools (28%), and religious institutions (14%), with approximately one half of the programs using space shared with another program. The
average hourly staff-child ratio for all programs is 8.9:1.
Furthermore, a number of important concerns were identified in the study: (a) SACC programs were serving a
small number of minority and low-income children, and

Hall and Niemeyer

(b) many programs have a high staff turnover rate, low
pay, and offer minimal staff benefits. Another finding,
reported by this study, was that only 7% of the programs
reported serving children with special needs.
While providing important information about
school-age child care and children with special needs,
these two national studies were broad in scope.
Moreover, they provided very little specific information
on the availability and characteristics of school-age child
care for children with special needs. Furthermore, an
extensive review of the research uncovered no empirical
information on the outcomes and implications of including children with special needs in SACC programs.


School-age child care practitioners are concerned
with the program variables that create an effective, high
quality, successful inclusive programs. Fortunately, several early childhood special educators offer insightful
comments related to inclusion. Guralnick (1990) discussed the major accomplishments and future directions
in early childhood inclusion. He stated that there is
greater agreement and compatibility in regard to inclusion public policies, educational practices, developmental principles, and research. Yet, the challenge for the
next decade is to ensure that the unique needs of a larger
number of children with special needs and their families
are served within the general early childhood system.
Bricker (1995) stated that extensive thinking and planning are required to ensure successful integration efforts
for children, teachers, parents, and the larger community.
Unfortunately, the preschool child care inclusion
research and general education inclusion research discussed previously has focused primarily on child outcomes which limits the understanding of the program
variables necessary for the successful inclusion of children with special needs.
Bricker (1995) believes successful inclusion of children with special needs is influenced by three factors that
are interrelated: attitude, resources, and curricula. Thus,
teachers with a positive attitude also need resources to
implement an inclusive, rather than add-on, program.
Strategies that foster positive and constructive attitudes
in children and adults include careful placement selection, increased training, and strategies to assure the maintenance of positive attitudes. The second element,
resources, includes access to specialists; collaborative
planning and decision-making; and appropriate environment and equipment. Finally, the program content or curriculum refers to the treatments and interventions used
by teachers in inclusive classrooms. An inclusive curriculum would include activities that promote interaction

School-Age Child Care Inclusion

between children and naturalistic approaches that
encourage participation in activities in which the children are interested.
General education professionals have identified
similar elements necessary for successful inclusive progranis. Bradley et al. (1997) stated that with an increasing number of schools and classrooms striving to be
inclusive, services and supports for students with disabilities need to be reconstructed and new skills for teachers
acquired. Likewise, to accomplish the goals of inclusion
the educational system must make notable changes in
philosophy, funding and personnel allocations, teaching
methods, and distribution of resources. In other words, a
successful teacher and curriculum for an inclusive program is a complex and multidimensional process.
While Bricker (1995) and Bradley et al. (1997)
identified several factors that facilitate inclusion, other
researchers outlined specific program variables affecting
child outcomes in inclusive settings. Guralnick (1981)
outlined 13 programmatic variables that should be taken
into consideration when evaluating child outcomes in
inclusive settings. The most important include teacherchild ratio, ratio of children with special needs to nonspecial-needs children, types of disabilities, level of
teacher training, and quality of program. Other factors
that facilitate inclusion are elements outside of the classroom such as parental attitudes as well as exosystem
variables (i.e., parental employment) and macrosystem
variables (i.e., reorganization of the county school system). Until recently, general educators and special educators have typically worked with separate budgets, in
separate classrooms, and not in collaboration. However,
states, school districts, and individual schools are reorganizing to provide successful educational programs for
typically and atypically developing children in their
neighborhood schools and are examining unique ways
for creating these programs. Therefore, SACC programs,
especially those in public schools, should be part of this
reorganization plan.
Research agendas on the outcomes and implications
of including children with special needs in SACC programs must extend from previous research agendas in
related fields. Initial child care studies examined the benefits or harm to children's development, while initial
inclusion studies sought to determine that integrating
typically and atypically developing children would be
advantageous to all children and families. This research
has demonstrated that inclusive programs can be implemented effectively (Bradley et al, 1997; Gurlanick &
Groom, 1988; Jenkins et al., 1989) and child care can be
commensurate with mother care for children (ClarkeStewart & Fein, 1983; Rutter, 1981: Zigler & Gordon,

1982). Recent child care findings (Helburn, 1995;
Whitebook, Howes, & Phillips, 1990) are focused on key
indicators of high quality care, program improvements,
and the relationship between child care and the family
environment. Similarly, recent inclusion research is
focused on designing high-quality inclusive programs. A
SACC research agenda should begin by examining the
many variables (i.e., staff-child ratios, level of teacher
training, ratios of typically developing children to atypically developing children) external to inclusion that can
account for a SACC program's success rather than limiting studies to child outcomes.
The National School-Age/Special Needs Study
(Fink, 1988) outlined implications and study findings for
parents, educators, and child care providers. This study
pointed out that in 1988 there were few places in the
United States where more than one out of four parents
could find high quality school-age child care for their
child with special needs. Fortunately, there are professionals in the United States that know how to design
appropriate and enriching SACC for children with special needs if parents, educators, and child care providers
voice their opinions and knowledge to the community.
Fink outlined several important directions for parents,
educators, and child care providers to take before high
quality inclusive SACC will be a reality. Fink (1988) recommended that parents make their need for child care
known to public school personnel and resource and referral programs, as well as within advocacy and service
organizations. Likewise, public school districts need to
allocate resources to school-age child care for children
with special needs or develop partnerships with agencies
to run inclusive programs in schools.
Identification of important program elements is
only the initial phase in facilitating successful inclusion.
Lamorey and Bricker (1993) pointed out that community-based programs currently do not have the necessary
resources or personnel to implement effective programs
and that future program development will be limited.
However, Peck (1995) suggested that difficulties arise
when inclusion is postponed until the system is ready.
For instance, changes in resources, professional roles,
and classroom practices are more likely to occur when
the program is pressured to be inclusive. The establishment of effective inclusive school-age child care programs can occur on a program by program basis, where
parents are in need of a service and SACC providers are
committed to being inclusive.

The inclusion of children with special needs is a
complex interactive relationship between the many eco-

logical systems that intluence a child's developmenl.
Thus the implementation, as well as the challenge of
inclusion, is more complex than the passage of ADA in
1990. Clearly, typically developing as well as atypically
developing children benefit from inclusive school-age
child care. However, implementing an inclusive program
must be more purposeful and thoughtful than the add-on
method recognizing that the optimal amount of resources
or trained staff may not available initially. The success of
school-age child care inclusion depends on program variables such as teacher-child ratios, the level of provider
training and experience, ratio of typically developing to
atypically developing children, and type and severity of
the child's disability. Optimally, staff can serve the child
with special needs when they are working coUaboratively with parents, general education teachers, and SACC
staff to meet the needs of each individual child.

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