State regulations require documentation that the child has received vaccines and screening tests according to the recommendations of the American Academy of Pediatrics and the Advisory Committee on Immunization Practices. Any document (including an electronic printout from the child's medical record) that provides this information is acceptable. The Office of Child Development and Early Learning (OCDEL) offers a form that allows health care providers to say whether the child is up to date, the CD 51. This Child Health Report form was last revised in 2008. It does not require the dates and results of the recommended screening tests. It has a check box to indicate "yes" or "no" that the child has received all the recommended screenings. The only screening information it requests is the results of any abnormal vision, hearing or lead screening. These are important, but not all the screenings that assess whether a child is healthy and ready to learn.
The majority of early learning programs serve some children with special health needs. These are children with a special medical, behavioral, or developmental condition. They are children who require care that differs in some way from that of typically developing children. For example, children need individual care plans if they have asthma, a severe allergic reaction to a food, seizures or diabetes. Children who have challenging behavior require care plans too.
ECELS has developed many tools to help programs set up a care plan for a child with any type of special need. The ECELS website has forms, a checklist and a process guide to download and use to make effective care plans.
Since 1986, conference workshops, professional journal articles, manuals, national standards, and sample forms have described the risk to an unborn child if a pregnant mother is exposed to certain infections that commonly spread in groups of young children. Employers of female early education staff of child-bearing age should educate their staff members about this risk. They should urge them to discuss with their health care providers how to reduce their risk.
Cytomegalovirus (CMV) is one of the infections that pose a risk to an unborn child. CMV is a common infection among young children, usually without symptoms. Between 30% and 70% of children less than 3 years of age in child care excrete the virus in their urine, saliva and blood at any one time. Excretion of the virus may occur intermittently for years after the first infection. Women who work in child care may or may not be immune to the strains of CMV infecting children in their care. If a woman has her first CMV infection while pregnant, or has a CMV infection with a different strain than the one she had previously, her unborn child is more likely to be infected.
In utero (congenital) CMV infection occurs in only 1% of live births. However, CMV is the most common viral infection of babies before they are born and the most common cause of sensorineural hearing loss. About 10% of the CMV-infected babies have some symptoms or signs at birth. Those who do may have devastating multi-organ damage. These include poor growth, liver damage, brain damage, hearing loss, blindness, underdeveloped brains and developmental delay. About half of infants who have some symptoms of CMV at birth develop hearing loss from damaged nerves that are needed to carry sound sensations to the brain from the ear. About 15% of those who are infected but have no symptoms of CMV infection at birth develop this type of hearing loss as they grow older. In many children, the degree of hearing loss is progressive.
Nurses who conscientiously practice recommended hand hygiene don't get CMV infections from their CMV infected patients at a higher rate than other women. Teachers/caregivers of groups of young children could similarly reduce their risk by practicing hand hygiene after every contact with urine, saliva or blood. However, achieving this level of hand hygiene is challenging in group care. Teachers/caregivers have contact with more than one drooling child at a time, and frequently touch saliva coated toys or other surfaces. They change diapers or soiled underwear for children in their group multiple times a day.
At the least, women who teach groups of young children need to know how to reduce the risk if they might become or are pregnant. When properly informed, they can consider three options: 1) be very careful about practicing hand hygiene, 2) decide to provide care for preschool or older children instead of infants and toddlers when pregnancy is possible, or 3) choose to work in settings where they have less risk of contact with body secretions of young children.
Employers should explain CMV and other common occupational health risks verbally pre-employment. The information should be in an employee handbook given to each staff member, and discussed at a staff meeting at least once a year. It is best practice to use a Staff Health Assessment form that lists the common occupational risks. The list may prompt the health care provider who completes the form to assess and discuss these risks. Many health care professionals are unaware of the tasks performed by women whose work involves close contact with groups of young children. A list of these occupational risks is in Caring for Our Children, Managing Infectious Diseases in Child Care and Schools, and in Model Child Care Health Policies. Each of these publications has a sample Staff Health Assessment Form too.
Teach early education staff members about each of their occupational risks. Then have them sign a statement acknowledging the teaching received, that they understand and know how to reduce each risk, and that with this knowledge, they accept the risks.
Early educators have a vital role in the lives of children. What teachers/caregivers do can directly impact each child’s health and wellbeing. Teachers need the knowledge, skills and tools to meet this awesome responsibility! ECELS recently revised three self-learning modules so they are now updated and easy-to-use in online or print formats:
Each module meets STAR Level 2 Performance Standards for Health and Safety and provides 2 hours of professional development credit. See the brief overview of each module below, click on the active link above or go to the ECELS website at www.ecels-healthychildcarepa.org Select the Professional Development/Training tab at the top of the page, then Self-Learning Modules. Find the one you want to use in the alphabetical listing of the more than 30 Self-Learning Modules that ECELS offers.