Excluding Children From Early Childhood Learning Programs

1. Excluding Children from Early Childhood Learning Programs

If you asked an ECE to list the issues they find most challenging one of them would be ill children. Most
employers still do not entitle parents to have paid leave to attend to a child who is ill or for other family
emergencies. This is coming along but still needs to be addressed more. This can be why many times
parents feel pressured to send their child to child care, even when the child is not feeling well!
This is why it is so important for child care programs to develop policies that clearly provide the program’s
exclusion policies so parents are well informed and are thoroughly discussed at the time of enrollment.

2. Who are the child care staff concerned about in managing illness?

• The ill child: The director and staff want to ensure that the child is
comfortable while in their care.
• Other children and staff: Educators are concerned that the child’s
illness is contagious. Also, another concern may be the extent of one
to one care that the ill child needs and how this affects the quality of
care for other children.
• The ill child’s parents: The director and staff consider the effects of
the child’s illness on the family as well.

3. What are the basic exclusion policies the child care program should implement?

1) The illness prevents the child from participating comfortably in all program activities, including going
outside.
2) The illness results in a greater need for care than the staff can provide without compromising the health,
safety and care for others. (Have to provide one-on- one care for the ill child)
3) The illness poses a serious health risk if it spreads to other children or staff

4. Medical Officer of Health in Canada

Each Medical Officer of Health in Canada is responsible for the health of children in centres within their geographic area.
For example, the Medical Office in Manitoba is different from the one in Ontario.
One of their responsibilities is to establish the exclusion criteria for the centres. With each province working independently
of one another, child care programs in different regions may be provided with different exclusion criteria.
Programs are required to have space available to isolate the ill child temporarily as a strategy to try to prevent or limit the
spread of infection. Usually this is the director’s office or a separate part of the play area that allows educators to supervise
the resting child as well as others. Along side this the staff should ensure all handwashing/diapering procedures are
followed. Another issue is to sanitize all the toys the child came into contact with and tables etc.

5. What issues will the child care program take into consideration when making a decision to exclude a child?

The decision to exclude a child depends largely on issues such as:
-
What the educators think is wrong with the child
-
The time of day
-
Whether you feel you can care for the child or not

6. Community Action to Illness

Supporting families as a child care program can include:
The director developing a list of substitutes that they can call on when a child is ill, or a staff person is away. The
substitute can care for the child in a separate area of the program if mildly ill. Sometimes, if the substitute is
comfortable to go to the family’s home or the substitutes own home this can be arranged as well. This is usually not
a general practice but the textbook does suggest this as a community action.
Some programs have identified the need for this community service that provides for mildly ill children. With this in
mind, a local agency can be developed to provide this service to the parents.

7. Societal Change

As an Early Childhood Educator or CCA one should belong to an association like the Manitoba Child Care
Association.
This way you can be a part of the association that can lobby the government to legislate employers to provide family
responsibility leave. These associations can make a difference in developing higher quality care.
Also, as an individual ECE or CCA you can exercise your democratic right to vote for political candidates who are
committed to child care and families.

8. Daily Observations

The first step in managing illnesses is welcoming the family every morning and asking how the day is going. Parents
may discuss with how the child ate breakfast, how well the child slept or whether the parent has any concerns
about their child such as woke up with a sore throat, sore tummy etc.
Daily observation of a child takes time and beginning with a quick conversation with the parent when they drop off
the child can give you a good start for information on the child.
Usually there is a daily log book where staff place important information about children which allows each staff to
review and add comments as the day goes along.

9. Fevers

A parent quite often will ask when you call them---does the child have a fever?
Some important things to note about fevers are:
-
Fever is just one sign of an illness
-
Fever, by itself, is not dangerous.
-
Fever is one of your body’s defense mechanisms that helps us fight infection.
-
Fever is unreliable to determine how sick a child is
-
There are a number of factors that can cause the child’s body to rise such as overdressing, strenuous exercise/play, time of day, a vaccination or an infection.

10. Fevers Continued

Many people believe that children with a fever are sicker than a child without a fever but that isn’t
necessarily true! For instance, a child with meningitis can have a fever of only 38.5 but the infection is
serious.
Observing a child behavior is most important when a child is ill! If the child is lethargic, not participating in
activities, irritable, crying, has poor skin color and doesn’t eat, these are just a few indicators that the child is
not well. When you come to know each child individually you will find it easier to determine when a child is
ill by their physical/behavioural indicators.

11. Documenting Health Observations

It is important that any change in a child’s behavior or physical well-being be documented. Some programs
have a daily log book that they place important information about children or the daily concerns in the log
book. Others have individual child’s logging information so the parent can view it at the end of the day. This
is very helpful in an infant program. The parent can easily glance at this and check how the day went,
diapering, food eaten, naps taken, activities participated in and whether the child indicated any symptoms
that the parent should be aware of etc.

12. Documentation Continued

Accurate documentation is important so when you call a parent you have the documentation of what happened,
when it started etc. Other questions that can be addressed in the documentation are:
How has the child’s behavior changed to lead you to believe that the child may be ill?
What are the signs and symptoms that the child is experiencing? Describe the symptoms as clear as possible
What have you done for the child so far?
What time was the parent called should be logged as well.

13. Documenting illnesses if more than one child has had the infection

When a child is ill, educators take into account what has happened in the program over the past few days to
consider factors that might be relevant to this child.
-Are any other children ill in the program? What are their signs and symptoms? What was the diagnosis if the
child/ren were taken to a doctor?
At times, like when E-coli has spread through a child care program, many times public health is notified and brought
in to connect with the staff on what to do and how to proceed so children are not easily infected!
Communication is the key with director, staff and parents!

14. Alternative Care Arrangements

• There are times when a child must be excluded from the program.
• This can cause chaos for families especially if they don’t have any other family member or friend
available to pick up child.
• At times, the job is not flexible and that causes financial hardship due to not being paid for the
time away.
• If at school, this may mean failing grade if a big project is due or exams.
• For parents who have neither job flexibility nor relatives or friends available as backup,
alternative care can be makeshift, unreliable or inconsistent. This places the director in an
awkward position and must balance the needs of other children and staff. The director decides
whether to keep the child or exclude the child and the parents must deal with the decision made.
• Depending on the mode of transportation can be a problem as well.

15. References

Kernested, D., & Pimento, B. (2019). Healthy foundations in early
childhood settings. (6th ed). Toronto: Nelson.