Nursery World - A Unique Child: Inclusion

What approaches enable the inclusion and support of a child with high-level medical and physical needs in mainstream early years provision? Amanda King demonstrates with one successful case.

Grace is a very active, very determined two-year-old, who has CHARGE syndrome and has been integrated successfully into our Nurture Nursery.

Highly complex, CHARGE syndrome is characterised as a genetic cluster of birth defects and incorporates extensive physical and medical difficulties which present differently from child to child. It can be life-threatening. The syndrome occurs in about one in every 9,000 to 10,000 births worldwide, and usually, there is no history of the syndrome within the family.

In Grace's case, she has problems with swallowing and breathing and, in common with most children affected with CHARGE, she also has hearing loss, visual impairment arising from coloboma (a malformation of the eye), and balance problems, all of which have delayed her physical development and communication skills.

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