Welcoming Patricia Marianne, a director of a neighborhood child care center, was excited to meet her potential new student, Patricia. When Patricia and her mother, Joyce, walked into the classroom, Marianne was a bit surprised to learn that Patricia was a little girl with Down syndrome. Marianne was concerned because, as a new director, she had never been responsible for a child with Down syndrome before. Nonetheless, she quickly tried to cover her surprise and bent down to introduce herself to Patricia. The child smiled at her and waved hello. They entered the four-year-old classroom where Patricia immediately went over to the dramatic play area and picked up a baby doll. Once Patricia was comfortable and playing, Marianne and Joyce sat at a table in the back of the classroom to talk. Joyce explained that she was looking for a part-time child care program as Patricia goes to a special education program in the afternoon. Marianne asked Joyce some questions about the special education program and then she asked what Patricia likes to do when in the special education program. Then, she asked Joyce to describe her daughter's needs and if there were any special considerations that should be kept in mind. Joyce thoughtfully provided the following description. Patricia just turned four years old and learned to walk one year ago. She needs a little bit of help navigating play structures as sometimes she walks up the steps holding the rail and sometimes she crawls. At that point, Marianne decided that it would be a good idea to have Joyce and Patricia stay while the classroom went outside so she could observe Patricia's motor skills to determine how much support she would need and if she had enough staff. Joyce expressed concern that her daughter wears diapers and was wondering if that was okay. Marianne thought about that and explained that the four-year-old classroom does not have a diaper-changing table, but that it is right next to the three-year-old classroom that does have one. Marianne would have to talk to the staff to discuss creative ways to supervise the classroom while Patricia gets her diaper changed. They discussed actually placing Patricia in the younger classroom, but decided that she should stay with her same-age peers. Joyce also explained that Patricia has a few single words and uses several different signs and gestures. Joyce handed Marianne a three-page worksheet with pictures describing the signs that Patricia knows. Though the staff does not know sign language, the signs, thought Marianne, seemed pretty easy to learn. In the meantime, Patricia seemed very comfortable in the room exploring many toys and even went and sat down for some of the circle time. When the classroom went outside, Marianne was pleased to discover that the other children were very accommodating. They made sure not to bump into Patricia as she slowly climbed the structure. Also, two students waited at the top and encouraged Patricia to keep going. A staff person stayed fairly close to the structure as Patricia needed help sitting on her bottom to go down the slide. Marianne saw that even when Patricia was not on the climbing structure, the staff stayed fairly close to make sure all children were safe. Upon reflection, Marianne's general feeling was that the special needs of Patricia were relatively easily accommodated with some creative thinking and help from the mother, such as the sign language handout. She explained to the mom that the staff has not been trained to work with a child who has Down syndrome, but that she was sure that they would be willing to learn. Joyce said, "that's okay, when I had Patricia, I wasn't trained either." Read-Reflect-Discuss Questions 1. Identify the factors in Appendix A that Marianne took into consideration to ensure that she was complying with the Americans with Disability Act. 2. Based on Appendix A, what other questions would be helpful to ask to understand Patricia's needs? 3. Thinking ahead, what are some of the benefits and challenges that might arise from including Patricia?