Early Childhood Educ J (2009) 36:497–504
DOI 10.1007/s10643-009-0309-0
Parents’ Perceptions of Child Care for Children with Disabilities
Deborah Ann Ceglowski Æ Mary Ellin Logue Æ
Annette Ullrich Æ Jaesook Gilbert
Published online: 28 April 2009

Springer Science+Business Media, LLC 2009
Abstract Sixteen Minnesota families with children with
disabilities participated in a 2-year interview study of their
care experiences. Findings show that families developed a
network of care providers, struggled to pay additional costs
for care, were not informed of community services and
programs, and believed that their children received ade-
quate child care. This study highlights the need to provide
information to families and providers and to link services
in both rural and urban communities.
Keywords Child care
Parents
Qualitative research

Disabilities
Introduction
The number of young children in child care with and
without disabilities continues to rise. While the number of
children with disabilities participating in child care settings
is not known, we do know that mothers of children with
disabilities enter the labor force at the same rate as the
general population (Landis 1992). Availability, cost and
flexibility of care arrangements affect the choice of a
placement and sustainably of the arrangement for most
families but when a child has a disability, these challenges
can become more complex. Very few studies explore
parents’ perceptions of child care when children have
disabilities (Cryer et al. 2002; King Teleki and Buck-Go-
mez 2004; Knoche et al. 2006). Better understandings of
complexity of parents’ perceptions are needed in order to
best serve children with disabilities and their families.
D. A. Ceglowski (&)
M. E. Logue
A. Ullrich
J. Gilbert
Ball State University, Muncie, IN, USA
e-mail: daceglowski@bsu.edu
Literature Review
Families’ Child Care Usage
Booth et al. (2002), refer to child care usage instead of
parental choice. The reason for this distinction is that families
are limited in the child care arrangements available and
affordable to them. Parents do not choose from a wide range
of options but most often from a limited group of programs
that meet parental and children’s needs. Recent estimates
suggest that 60% of young children have working parents,
necessitating some type of child care (U.S. Census Bureau
2005). Families face difficult choices in selecting child care;
only 14% of preschool and 8% of infant/toddler classrooms
were rated ‘‘good’’ quality in a national study (Cost and
Quality and Child Outcomes Study Team 1995). Another
finding of the Cost and Quality Outcomes Study is that par-
ents want care that is of high quality, affordable and proxi-
mate to their work or homes. Once such child care is located,
parents of children with disabilities face other limitations. Not
all child care providers are comfortable accepting or working
with a child with disabilities, particularly when the child has
moderate-to-severe disabilities (Warfield and Hauser-Cram
1996). Additionally, logistical issues must be resolved
including arranging for transportation and time to get children
from child care to early intervention and special education
services (Booth and Kelly 1998).
Parents’ Child Care Usage for Children with
Disabilities
While typically developing children entered child care
early in the first year of life, children with disabilities
entered later and for fewer hours per week. By 14 months
of age, the children with disabilities were cared for more by
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mothers and relatives and less often in child care homes or
centers (Booth-LaForce and Kelly 2004). When choosing
child care, parents of children with disabilities felt more
comfortable considering and contracting a provider who
had been personally recommended (Devore and Bowers
2006). Parents of children with disabilities also rated a
provider’s willingness to accept subsidy and to enroll
children with disabilities as more important than did par-
ents of children without disabilities (Knoche et al. 2006).
Quality of Child Care
Examining quality of care, Booth-LaForce and Kelly
(2004) found that care by a relative care was the highest
quality. While most children with disabilities are in family
child care settings, higher quality of care is found in center-
based settings (Knoche et al. 2006). The existence and
severity of the child’s disability proved to be an important
factor in making work-related decisions for about one-third
of families (Booth-LaForce and Kelly 2004). Conse-
quences of these work and child care decisions affect
family income. Parents of children with disabilities have
more irregular employment and higher levels of stress
(Knoche et al. 2006). Todd and Jones (2003) reported that
mothers of children with disabilities, when working with
professionals providing services for their children, are
hesitant to bring up their own desires to work or their
feelings of isolation. Fearing professionals’ judgment on
their mothering or questioning their motivation for advo-
cating for their children, they remain quiet.
Family structure, more so than disability status, deter-
mined the type of child care parents’ use (Parish et al.
2005). Children with disabilities living in single parent
homes were in child care settings for considerably more
hours each week than were children with and without
disabilities in two-parent homes. Children living with sin-
gle parents had significantly more care arrangements than
children living with two parents, regardless of disability.
Issues involving employment, child care usage, and
stress are exacerbated by poverty. Many parents who have
children with disabilities are not successful in finding safe
and affordable child care programs that address their
children and the family’s needs (Dinnebeil et al. 1998;
Shearn and Todd (2000).
Child Care Providers Caring for Children with
Disabilities
Characteristics of Care Providers for Children
with Disabilities
Overall, better-educated providers provide higher quality
of care. They also earn higher wages and work in centers
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charging parents higher tuition (Phillips et al. 2000). Pro-
viders themselves report lack of knowledge as a barrier to
working with children who have disabilities (Dinnebeil
et al. 1998).
Family child care providers with positive experiences
are more likely than those without such experience to
report willingness to work with children who have dis-
abilities. In the Buell et al. (1999) study, more than half of
the providers surveyed had experience in caring for chil-
dren with disabilities and almost half of them (47%) were
willing to work with children with disabilities. The pro-
viders who refused to admit children with disabilities did
so for three reasons: a lack of knowledge, concern for the
welfare of typically developing children in the group and
the fear of expenses for special equipment.
Methods
This study is based on a series of five interviews with
parents and children over 2 years to ascertain families’
experiences with child care.1 The focus questions included:
How do parents recognize that their child has a disability?
How do parents locate out of home care for their children
with disabilities? What type of out of home child care
services did parents use? How do parents describe child
care rates and paying for child care?
Researchers worked in four counties to recruit fami-
lies for this study. Families lived in urban, rural and
suburban communities and on an Indian Reservation.
The diversity and availability of child care services
varied from county to county. For example, in one
county, there was only one child care center and that
center served only families enrolled in Head Start.
During the study there were no child care centers located
in another rural county.
The research team, in collaboration with county child
care assistance staff partners, developed interview ques-
tions and research scripts for the interviews and dis-
tributed these to the interviewers. The interviewers,
called community researchers, were members of the four
participating counties’ child care assistant staff. They
received an initial 2 days training and two full days of
follow up training.
1
This study is part of the Minnesota Child Care Policy Research
Partnership. Funding for the Partnership is made possible by a grant
from the U.S. Department of Health and Human Services, Child Care
Bureau (Project Number 90YE0010) with additional support from the
Minnesota Department of Human Services. This manuscript does not
necessarily reflect the views and opinions of the Child Care Bureau or
the Minnesota Department of Human Services.
Early Childhood Educ J (2009) 36:497–504
Types of Child Care
For the purpose of this study, four types of child care were
identified. In Minnesota, family, friends, and neighbor
(FFN) child care includes informal care and legally unli-
censed child care providers who are typically known by the
family and are eligible to receive child care assistance
funds, even though the providers’ homes are not inspected.
The second type of child care included in this study is
licensed family child care (FCC) homes. These homes are
inspected by the county and are eligible to participate in
several child care assistance programs, including the Uni-
ted States Department of Agriculture food program. Pro-
viders must participate in a specified number of hours of
training every year, and the county licenses them. The third
type of care is child care centers. Child care centers are
licensed by the state. Centers are inspected on a regular
basis, and all teachers must meet certain licensing stan-
dards and annual training requirements. The fourth type of
care included in this study is School-age Child Care
(SACC) programs. These programs are run in schools
before and after the regular school day, and they may
include children in half-day kindergarten. SACC programs
are also licensed by the state, and they must meet state
staffing and training requirements.
As described above, two of the four counties partici-
pating in this study did not have any operating child care
centers. Thus, families relied more heavily on family,
friend, and neighbor care and licensed family child care
providers.
Interview Questions
One hundred and eleven families participated in a series of
five interviews conducted over a period of 2 years. Of the
111 families participating in the larger study, 16 had
children with disabilities. The perceptions of these 16
families are the focus of this study. The first interview with
parents included basic questions about the household, the
current child care arrangements, and family income, how
parents paid for child care, and how families selected their
current child care arrangement.2 This interview focused on
parents’ perceptions of child care. Interview two focused
on the families’ child care history, beginning with the
oldest child and concluding with the youngest. This history
2 interviews, observations, and field notes. The portraiture is
The authors will refer to families’ child care usage versus child care
choice because in most cases the parents participating in this study
had few child care choices. As Wagner (2007) states, the child care
arrangements families use are often utilized because there are limited
options available. The different types of child care arrangements may
prompt some parents to think that there are many quality options
available to them when choosing care for their young children. This is
not necessarily the case.
499
included the type of care used, reasons for changes in care,
current family income, and a description of the provider or
program. Children who were old enough were interviewed
as well but the results of the child interviews are not
included in this analysis. The second interview focused on
parents’ perceptions of child care. Interview three asked
parents to describe the aspects of care that their children
enjoyed or from. Interview four asked parents about pro-
gram quality. Parents described staff education levels, the
types of activities provided, the amount of outdoor play
space, and other pertinent details of their current child care
arrangements. Interview five asked parents to fill out forms
that included child care histories for each child, a diary of
their work schedule, and child care use for 1 week. This
interview focused on parents’ perceptions of child care.
Data Analysis
The principal investigator worked with four advanced
doctoral students who had extensive experience in quali-
tative research to code the transcripts. They developed and
tested a coding chart after reading and independently
coding three transcripts. Each interview required the team
to develop additional codes, using the same process
described above. Once the documents were coded, the team
grouped similar codes together into major themes. The
themes reflect the descriptions of family life and child care
provided by parents, children and providers.
Methodological Issues
Methodological Theories
Methodological theories used in this study are interpretive
interactionism (Denzin 2000) and portraiture (Lawerence-
Lightfoot and Davis 1997). Denzin explains that the current
practice of interpretive interactionism includes ‘‘in-depth,
intimate stories of problematic everyday life lived up
close’’ (p. 901).
Lawerence-Lightfoot and Davis (1997) created the art
and science of portraiture, a process that blends narrative
with quotations from research participants. In utilizing the
portraiture approach, the researcher develops a text that
includes both narrative description and quotations from
participants. The aim is to provide a portrait based upon
based upon the qualitative methods mentioned previously
but weaves them into a narrative that is more coherent and
story like than those found in most methodology sections
of qualitative research articles. The portraitures are based
upon 2 years of work with the families that included a
series of 5 interviews and accompanying field notes.
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According to Denzin (2000) and Lawerence-Lightfoot
and Davis (1997), the researcher strives to present cases in
which the reader ‘‘will discover resonant universal themes’
(Lawerence-Lightfoot and Davis 1997, p. 14). Thus each
qualitative study has unique features yet these are tied to
the local, national, and international contexts so that the
case speaks both of its uniqueness and tie to larger systems
and practices. The aim of this work is to develop theoret-
ical, not statistical generalizablity; that is, how do these
interviews with families help us to understand the experi-
ences of other families who seek child care for their chil-
dren with disabilities? It is not a predictive model but
rather a descriptive model (Hillebrand et al. 2001).This ‘‘is
a more complex process… concerned with developing
concepts, understanding phenomena and theoretical prop-
ositions that are relevant to other settings and other groups
of individuals’’ (Draper 2004). By providing the interview
results the authors provide a framework to understand some
of the processes used by other families.
Findings
Families of Children with Disabilities Used a Range
of Available Child Care Options
The term ‘‘child care’’ generally refers to care of children
under age 5 in formal or informal systems. In the case of
families whose children have disabilities, child care often
needs to extend beyond age 5. For purposes of this study,
child care includes after-school care. Children in this study
ranged in age from 19 months to 11 years. Of the 111
families participating in the five interviews for this study,
16 had children with disabilities. The children’s age, type
of disability, and type of child care are presented in
Table 1.
Child Care Staff Played a Role in Recognizing
the Child’s Disability
Children’s disabilities varied in severity. The age at which
the disability was identified also varied. Some parents
sought child care for a child with an identified disability
while others learned about the disability while the child
was already enrolled in a child care program. Child care
staff members were instrumental, in some cases, in
identifying disabilities. The parents who participated in
this study were sometimes unsure of what services were
available or whether they could or should access them.
School-age children were often identified in school but
this often happened after children had passed significant
stages in their development. Child care providers helped
parents recognize the child’s disability and encouraged
them to seek assessment. ‘‘Head Start actually had sug-
gested that [my son] had a developmental delay,’’ one
mother said. ‘‘They brought it to my attention at that
time. But there were a lot of problems with him there,
and R could just tell that they didn’t really want [him] to
be there at all.’’ Though she suspected Head Start staff
struggled to work with her son, she did admit that he
could not speak until he started going to Head Start and
receiving speech therapy.

Table 1 Children’s age, type of

disability, and type of child care
used by the family
Child’s age Disability Primary type of care
11 Physical and mental School aged child care program
11 Learning disability and attention deficit disorder School aged child care program
4 Speech Family child care home
5 Fetal alcohol syndrome, attention deficit disorder Family child care home
5 Speech Kindergarten
7 Attention deficit disorder Family child care home
7 Physical disability and speech disorder Family child care home
10 Speech disorder and learning disability YMCA after school program
3 Hearing impaired School district learning center and
family child care home
4.5 Visual impairment and cerebral palsy Family child care home
19 months Hearing impaired Family child care home
7 Bi-polar depression Foster care
5 Speech Family child care home
3 Speech Family child care home
1 Physical and mental disabilities Family child care home
4 Physical disabilities Family child care home

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Other parents reported that hearing and speech problems
and other delays were first noticed during routine preschool
screenings. One mother said, ‘‘[the screening] really
showed the areas that he was lacking in…you could defi-
nitely see it, and we went in for a second [test].’’ Her son’s
screenings revealed an assortment of learning disabilities.
‘‘He can count, but he can’t associate that there are, you
know, for example, that there are three objects.’’ The
mother was referred to a special education program in her
school district. She reported that the school also contacted
her.
Parents Face Challenges Accessing Child Care
Parents of children with disabilities had to be more selec-
tive than other parents when choosing a child care pro-
vider. When they did find an optimal care situation, it was
often by chance—they could just as easily have placed
their child with a provider who could not have met their
child’s needs. In many cases, parents were simply happy
that a provider found their child manageable, even if the
situation was not optimal. As one father explained, ‘‘[this
child care situation] was our only option basically. It’s hard
to find someone that will take a special needs child and you
can’t pay them enough to make it worth their while.’’
Native American participants generally received assis-
tance much faster through tribal organizations than they did
through county social services. For example, a woman who
was the guardian of a young cousin applied to receive
special education services for the child through the county
social services program. However, the length of the county
waiting list made her decide to apply for assistance through
her tribal organization. She received services immediately
because her child was diagnosed with a disability.
Parents were often unaware that Head Start programs
would give priority to children with disabilities. For exam-
ple, one mother mentioned to the interviewer that her son had
been unable to get into the local Head Start program. The
interviewer told her that children with disabilities are given
priority when applying. Because the boy had a noticeable
speech impediment and a documented hearing loss, the
mother tried again, and the child was admitted to Head Start.
One mother reported that said she thought young mothers
were unaware of the help available to them, and that
assistance programs needed to advertise more. ‘‘I see a lot
of people who are looking but they never know where the
child’s going for the next day, because for one thing, they
can’t afford to pay for it… It just makes me heart sick,’’ she
said. ‘‘I think it would be nice if brochures were sent home,’’
she said, describing one idea. ‘‘If you’re pregnant and you
go to the clinic you could get a packet of all this informa-
tion. That might be a nice spot to put something, [during]
the baby’s first 2-week check up.’’
501
Challenges Continue for Families Once Their Children
are Enrolled in Programs
Children with developmental delays were best cared for in
Head Start, school-based Early Childhood Special Educa-
tion programs, and other county or government programs
that provided therapeutic care. Children with severe
physical limitations were best cared for in environments
with fewer children that featured professional supervision
by nurses or similarly trained caregivers. But programs
such as Head Start could not always cope with children
with significant disabilities. For example, a woman from a
rural area explained that her stepson had attended Head
Start as a 3-years-old, and she felt that Head Start was
‘‘probably the best they have around here for special needs
and delayed children.’’ But the teachers were unsure what
was wrong with him. She reported that since her son had
been diagnosed as bipolar, she and her husband have
‘‘struggled and voluntarily placed him in a therapeutic
foster home hoping that they could help him, and even
these therapeutically trained foster parents started coming
to the county begging for respite care for help because they
couldn’t do it anymore.’’
Once a child with a disability is enrolled in a program,
parents cannot necessarily assume the caregiver would be
willing to provide child care. One parent reported that a
child care provider refused to continue caring for her child
because her child proved too difficult to care for. Staff
members’ confidence in caring for children with disabili-
ties and the increased cost for doing so affect the security
of the placements.
Parents whose children have disabilities often need to
coordinate multiple care arrangements and therapies for
their children. For example, one mother of a child with
fragile health and multiple disabilities, arranged a multi-
faceted network of relatives to attend to her daughter’s
child care needs. This mother was able to arrange optimal
child care for her child because she was knowledgeable
about her daughter’s condition and the extent of her needs.
She also had the advantage of having relatives around her
who knew what to do for the daughter because they were
nurses. Other parents needed to coordinate services and
transportation to and from Early Childhood Special Edu-
cation programs and informal child care settings, increas-
ing the levels of stress for parents.
Many Child Care Staff Lack Sufficient Preparation
to Care for Children with Disabilities
Most staff in both family child care homes and center-
based care environments were not trained to deal with
specific disabilities. Parents reported that their child care
providers did enroll children with disabilities and a few
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families did find specially trained care providers. One
mother, for example, found a provider whose husband was
fluent in sign language. ‘‘Without her hearing aids you need
to speak loudly to [my daughter],’’ the mother said. ‘‘It’s
hard to tell if she can pay attention to what’s being said or
done.’’ It was very helpful that the husband knew American
Sign Language. In another family, the mother, whose child
had multiple disabilities and fragile health, had developed a
multi-faceted network of child care options to cover her
needs, including several relatives who were nurses. ‘‘I’ve
got such a wonderful extended family that it works,’’ she
said. These experiences, however, were the exception.
Financial Considerations
Financial considerations affect both the families and the
child care providers. Some providers accepted children
with disabilities because they could charge a higher rate for
children who required more care. The rate was similar to
the higher rate charged for infants even though the child
with the disability might be well past infancy. But many
parents with child care assistance subsidies did not know
that providers could request a special-needs rate.
In one case, the provider charged more for an infant with
acid reflux problems. The mother reported, ‘‘He was the
only infant there and she had him for 2 weeks and said that
either I needed to pay her more, or else find new care
because he was so demanding a baby. And so I ended up
paying way more. She charged me special needs prices to
keep him.’’
All families with children with disabilities face addi-
tional costs, but low-income families like those who par-
ticipated in this study are particularly burdened. Some of
the parents we interviewed worked only because their job
provided health insurance. They would have preferred to be
home. One woman, for example, called herself ‘‘a slave to
[my] health insurance.’’
A father explained that he and his wife both worked to
pay for their child’s needs: ‘‘We discussed it, my wife and
I, what we should do, if one of us should stay home, but
because of her [child’s] special needs, we just don’t have
enough resources that we can stay home, so we decided to
try and find help outside of the home.’’
Parents Are Satisfied with Their Child Care
Arrangements
Despite the challenges families face in securing child care,
parents were generally pleased with child care and social
service providers. One mother from a rural area, for
example, praised the care and services her son received
through the school district’s Early Childhood Special
Education Program: ‘‘I think it’s good, very good.’’
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Another mother said she, too, was pleased with the services
her child received through the local school district: ‘‘… it’s
kind of a long journey, but it shows that the system’s
working.’’
Discussion
Parents of children with disabilities rely on personal rec-
ommendations in choosing child care for their children and
prefer informal child care arrangement such as relative-
care or family-child care Booth-LaForce and Kelly 2004;
Devore and Bowers 2006). Parents in this study also relied
heavily on these informal networks. This finding was par-
ticularly true for parents who were cognizant of their
children’s disabilities and the extent of their disabilities.
These parents preferred home- and relative-care for their
children with disabilities. The limited or lack of center-
based options in some of the rural communities may have
affected this finding. It is impossible to know if these
families might have selected other options had they been
available or would have continued to choose home and
relative care.
Child care providers, Head Start staff, and preschool
screening services were essential in helping families
identify their children’s disabilities and find appropriate
services for them. Yet even when parents worked with
these providers, teachers, and agencies, many did not know
about the regulations regarding Head Start services for
young children with disabilities. Some of the participating
parents learned about Head Start services to children with
disabilities from the community researcher. None of the
parents were familiar with the statewide support and
training center for child care providers who care for chil-
dren with disabilities.
There were no child care centers in two of the counties
participating in this study so that parents in these counties
relied on licensed family child care providers, relatives,
and friends to provide child care services. Given the lim-
ited number of child care programs available in some areas
of the country, particularly rural areas of the country, this is
an important factor to consider when investigating child
care for children with disabilities. Research suggests that
the highest quality services for young children with dis-
abilities are available in centers and yet most young chil-
dren with disabilities are cared for in home-based settings
(Knoche et al. 2006).
As was found in other studies (Knoche et al. 2006)
parents of children with disabilities perceived child care for
their children with disabilities as ‘‘good’’ because they
were grateful for providers who would take care of their
children with disabilities, even if they had to pay higher
tuition rates or extra fees. This does not mean, however,
Early Childhood Educ J (2009) 36:497–504
that children received high quality child care. Rather,
parents were appreciative when they found child care
providers who were comfortable caring for their children’s
disabilities.
Sometimes child care programs refused to serve children
with disabilities. Buell et al. (1999) report that providers
who were not willing to work with children with disabili-
ties felt that they did not have the knowledge-base or
expertise to work with children with disabilities, were
concerned about meeting the needs of typically developing
children, or felt they would incur additional expenses if
they cared for children with disabilities. Thus, families
with children with moderate to severe disabilities found it
difficult to acquire and maintain child care services.
Child care was essential if families needed to maintain
insurance coverage for their children. This lack of choice
was more evident for single parent families who have
children with disabilities. For single parent families, ful-
filling their obligation to work is impossible without child
care and more specifically, child care assistance. In other
instances, such as Head Start, transportation was not
available to families. This required the families to provide
transportation to and from the program or to seek alterna-
tive programs for their children.
In many families, parents developed a network of child
care providers that might include Head Start, a licensed
family child care home, and relative care. This care com-
bination was often essential to meet the parents’ child care
needs and to provide quality care for children with dis-
abilities. This often necessitated moving a child from one
program to another during the day. This was particularly
true for preschool children enrolled in either Head Start or
Early Childhood Special Education programs because of
the part-time nature of these programs. Future studies
should explore the impact of transitions within a day for
children and parents.
Parents shared their concern and frustration of paying
extra tuition to meet their children’s needs. Parents felt that
they had no choice but to pay the extra fee because finding
care for their children with disabilities was difficult and
child care was a necessity for single parents in order to be
able to work. Although child care assistance programs
provide additional funding to income eligible families with
children with disabilities, none of the families in this study
were aware of this program. A coordinated effort to edu-
cate parents and child care staff about all assistance pro-
grams could assist many of the families in paying the
additional costs charged by some child care providers.
While programs and services exist to support parents
and caregivers in securing and providing quality care for
young children with disabilities, awareness about these
resources is inconsistent. Many parents learn about services
by chance. Caregivers continue to refuse children with
503
disabilities because of a lack of training and financial
hardship. A more coordinated system of dissemination
information to parents and caregivers is necessary.
Families in rural communities with limited child are
options face different challenges than families in more
populated areas. Children with mild disabilities who are
cared for by family networks may be getting identified later
and missing valuable early intervention services. It appears
from this sample that routine screening is working to
identify children but not all children participate in the
screening. The unique need of service delivery for children
with disabilities in rural areas deserves more attention.
Limitations of the Study
This study was not designed specifically to study families
of children with disabilities. Families were recruited as part
of a larger study of child care use. Data from the sixteen
families whose children have disabilities raises awareness
of the challenges families face. These families are not
representative of all families with children having dis-
abilities and the findings from this study are not general-
izable. However, the issues the families share illuminate
questions that need to be asked by researchers. Findings
point to the serious challenges parents face in locating,
accessing and affording child care for their young children
with disabilities. They also highlight the unique challenges
of securing high quality services in rural areas as well as
the challenge of disseminating important information to
caregivers working in informal child care networks.
Conclusion
The sixteen families of children with disabilities inter-
viewed in this study have a more difficult time locating
child care providers willing to care for their children. This
is particularly true for children with moderate and severe
disabilities. In rural areas, parents had no center based child
care choices. These parents relied on family, friends,
neighbors, and licensed family child care providers for
care. Parents and program staff were often unaware of
service that would assist them financially or in providing
high quality services to children with disabilities. Generally
speaking, families rather the child care their children were
receiving positively—perhaps because parents appreciated
any effort expended by providers, program staff and social
service staff on behalf of their children. This finding points
to the importance of separating parents’ satisfaction with
child care from discussions of quality.
The perceptions of parents reported in this study suggest
a need for increasing awareness among parents and care-
givers about available services. Additionally, coordination
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of outreach efforts across child care agencies, schools and
medical facilities could increase awareness and access.
Parents of children with disabilities need to frequently
piece together multiple programs and services if they want
quality child care for their children that meets parents’
work obligations and financial needs. Collaboration with
families and service providers is important for the devel-
opment of all children, but it is especially critical for
families of children with disabilities due to the complexity
of resources and services available.
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