Childcare for children with additional needs

When it was announced that there was going to be a Parliamentary inquiry into childcare for disabled children, we asked Mumsnetters to respond to the consultation questions. Based on the responses we received, we sent the following response to the Inquiry.

Q1: Why is childcare for a disabled child often more expensive and what can be done to reduce the costs of providing childcare for this group of children?

a) Higher adult-to-child ratio necessary. (And sometimes insisted on by childcarers even when it’s not necessary - lack of confidence).

b) Extra training requirements.

c) Need for specialist equipment.

d) Children with additional needs often cannot be cared for under informal ‘childcare swap’ arrangements with other parents.

What can be done?

a) Capping charges or clearly defining where this is appropriate. The government could undertake a review of ‘the disability tax’.

b) Allow Direct Payments and childcare tax credits to be used for informal care by non-Ofsted childcare providers. Family members are often able to provide appropriate care, but are rarely registered. Allow informal childcare costs to form part of means-test calculations for housing and council tax benefits.

c) Greater recognition that group care settings should not be the only model for state-funded childcare.

d) Greater recognition that childcare must be more flexible, to cope with day-to-day fluctuations in health and wellbeing, and to allow for hospital appointments, assessments and so on.

e) An increased childcare allowance for siblings, to cover times when the parent needs to focus on the child with additional needs, or attend appointments.

f) Individualised childcare funding for children with additional needs.

g) Appropriate school-based wraparound care, including supervised transport home.

Comments from our users

  • This should not be happening: the Equality Act requires all providers, both public and private, to make reasonable adjustments, without additional charge above that of able service users.
  • It's like what happens with weddings...tack 'special needs' onto anything at all and the cost rockets.


Q2: To what extent does the current system of support with childcare costs help parents with disabled children to meet the additional costs of childcare?

  • It is very hard for people to commit to the few hours of work for the childcare funding that is available.
  • Life for children with additional needs is unpredictable - different health and social needs, and plenty of appointments for health and social care assessments, make a regular childcare timetable impossible.
  • The free childcare offer for pre-schoolers often cannot be taken up by children with additional needs because the providers cannot provide safe or appropriate environments.
  • Childcare tax credits are not allowable for informal childcare providers such as family members.
  • The system is rigid and inflexible, and was not designed with disabled children’s needs in mind.
  • The current default model of group care is often inappropriate for children with additional needs, and childcare workers do not have adequate training.
  • Childcare necessitated by illegal exclusions from schools cannot be catered for by paid-for childcare.

Comments from our users

  • My preschooler cannot even access the 15 hours a week he's eligible for since the local authority will only fund 6 hours a week of one-to-one support, with no option to pro rata this throughout the year or for us to self-fund outside of term times.
  • We get Direct Payments for a few hours only. We have asked for more and they have continued to refuse, even after he was found a on the street in winter barefoot and in his pjs and taken to the police station. We chased them for 3 months to do an assessment and assign more hours of DP; still nothing. There's a centre of sorts for the whole local authority and the different age groups get a saturday per month plus one evening every 3 weeks and you have to book 3-4 weeks in advance because it gets full quite quickly. We always miss out.
  • We could not access the 15 free hours for our daughter as she has seizures, is unpredictable and needs to be medicated. She did on average one hour per week; I was constantly called in by anxious staff.


Q3: If there was to be financial support to meet the additional costs of providing childcare for disabled children, how could this be most effectively delivered? What do you think are the pros and cons of offering extra support either directly to parents or the providers, or via local authorities?

Comments from our users

  • I would be happy for the funding to be paid directly to the childcare provider but the system must allow for flexibility to chose other than those listed on the LA website.
  • The LA could be a service provider carefully targeted to meet need, either directly or by commissioning, and parents could choose their service or another to spend their child's funding on.
  • Ringfenced funding from national government direct to childcare providers to allow them to hire one-to-one staff for disabled children. Direct payments to parents will bring more admin headaches we don't need and can't cope with. Direct Payments has shown that the direct to parent route just doesn't work for many.
  • Extend the use of Direct Budgets or Personal Budgets to allow use for childcare. Additional funding might also be paid directly to the child rather than the parent, making it non-taxable, possibly via DLA payments and regardless of whether or not the parent works outside of the home in addition to caring. A realistic number of hours funded at rates according to Care and Mobility components might be a starting point.
  • Let the parents have the option to receive the money unless there are good reasons why they cannot manage it themselves.


Q4: What are the barriers to extending access to suitable childcare for disabled children and what can be done to address them?


Need for one-to-one care; inappropriateness of group care; poor training of childcare workers; flexibility and irregular timetables necessary when providing care to this group of children.

What can be done?

Greater funding for childcare providers to address need for much lower ratios and more training.
Extend statement of SEN or its successor in title to include childcare settings and specify resources for the after-school care.

Comments from our users

  • Training, awareness and inclusion driven approaches are needed nationally and should be free to access for all providers who should then be recognised for its efforts by OFSTED or similar.

Are they the same/different for disabled children from BME communities?
First-generation migrants often have limited support networks or family funds, so it's harder to get support.

There are superstitions in some communities surrounding how a child got the disability in the first place; ‘it's a hidden otherworld no one wants to talk about but the pressure can be immense. For some people the consequences of disobedience is steep and they may face ostracism from the communities.’

Q5: What are the different challenges in extending access for disabled children for?

Wraparound school or holiday childcare providers

  • The reduced level of supervision at childcare for older children is often inadequate for children with disabilities.
  • Need for specialist transport to be provided to bring children home again.
  • Specialist, non-mainstream schools often do not provide wraparound care because of low numbers.
  • User comment: ‘We had a particularly successful stint at a mainstream after-school club. As my son attends a special school, he got the chance to integrate after-school and the space was adequate. The special school were kind enough to invite the after-school club in for a day of training, they agreed some social targets and there were frequent visits from the school teacher to the after-school club to see how he was getting on and to address any concerns. It was an amazing experience but it has became too expensive to sustain.’

Providers of childcare for older children

  • The reduced level of supervision at childcare for older children is often inadequate for children with disabilities.

For all

  • Adequate staff training to understand disabilities, medical needs, manual handling, alternative communication. Accessible premises. Accessible curriculum and transport. One to one support. Funding. Special school transport is currently only allowed to deliver child to home, not to a childcare setting.
  • Inappropriate emphasis on group care.
  • A clear lack of adequate compliance with Equality Act and a lack of robust complaints procedure which represents the interests of the child.


Q6: What is the role the following bodies or organisations should play in improving the availability of childcare for disabled children and what is needed to enable them to fulfil this role?

National and devolved government

  • Adhere to the provisions of the Equalities Act.
  • Provide national leadership for all service providers.
  • Robust policies, monitoring, reporting to parents, ombudsman that is actually effective and unbiased, and access to free legal representation for the child regardless of household income.
  • Allocate enough money, including a contingency fund if a business case can be made by an LA or parents.
  • Increase in the minimum number of hours allocated for short breaks nationally. These should be free and inline with the minimum number of nursery hours currently available to many mainstream pre-school children, regardless of age of disabled child.
  • Recognition that the current legislation, though admirable, isn't easily enforceable in reality. Families need more robust and dependable recourse nationally, and they should not have to pay out of family income (incurring further levels of financial deprivation) to take action to ensure fair access to services, support and social inclusion. Legal support should be free and seen as available to the child, to ensure their legal rights.

Local authorities and their health partners

  • Adhere to the provisions of the Equalities Act.
  • Ensure that all LA services are accessible and inclusive with appropriately trained staff.
  • Regulation, monitoring and robust complaints procedures without fear of being labelled a problem family for raising concerns.
  • Appointments out of hours, visits to the childcare setting, adequate staffing.
  • Better assessment of real levels of demand.
  • Position themselves as training providers, or brokers of training services, for childcare workers.

Early years providers, including childminders

  • Adhere to the provisions of the Equalities Act.

Schools (mainstream and special)

  • Adhere to the provisions of the Equalities Act.
  • Enforceable right to access to and be supported in all extra curricular activities and all school trips, including residentials.
  • Address the staffing and training needs that underlie illegal school exclusions.

Comments from our users

  • Don't try and make a one size fits all system. When a child has complex needs, it may be that the provision needs to be tailored. Work with the family, they usually know what would work!


Q7: What can be done to ensure that inclusive childcare becomes the norm for disabled children going into the future?

  • OFSTED should include this as part of its statutory assessments.
  • The child needs to be seen as an individual and not a list of diagnosis and disabilities.
  • All too often, budget and profit stands in the way of a truly inclusive environment.
  • Training and awareness are needed. No matter how much money you invest, unless people are educated and believe they can provide the best environment its not going to happen.
  • Childcare settings must assume they will be catering for disabled children and undertake this as part of their design, setting planning, staff training and business plan.
  • Paying for additional staff is a cost childcare settings cannot carry, and nor can parents or local authorities. National government must make this a priority.


Q8: What are the reasons childcare offered for disabled children can be lacking in quality and what do you think needs to be done to improve this?

What can be done?

  • Training (leading to greater confidence) and ongoing support; closer working with non-mainstream specialist schools
  • Flexibility
  • Better facilities
  • More money


Q9: Are there particular groups of disabled children who are better or less well served by current childcare provision? 

  • Children in mainstream educational settings - because they cannot use their own after-school/wraparound provision, and are not eligible for specialist schools’ provision.
  • Children with complex disorders (eg sensory disorders) that are poorly understood by mainstream providers - especially those whose behaviour is interpreted as ‘disruptive’ or ‘naughty’ (leading to illegal exclusions).
  • Those whose medical needs necessitate skilled childcare workers or lots of hospital appointments.
  • Those with extreme mobility issues; lack of specialist transport services and equipment.
  • Any child whose needs make group childcare impractical.


Q10: To what extent is the childcare workforce equipped to provide high quality care for disabled children?

It is not. Please see previous responses, especially Question 6.


Q11: What more do you think needs to be done to improve the information provision to ensure that families are aware of the provision available in their area?

  • The assumption must be made that families with disabled children want and need to work. Often the assumption is the opposite, so local authorities are not providing families with information about potential childcare settings and seem to think it is an oddity and an inconvenience when both parents want and need to work.
  • All Local Authorities currently have a legal duty to publish their Local Offer; this should include details of childcare and short breaks for disabled children of all ages. CAF Assessments (Common Assessment Framework) ought to be an opportunity to ensure that families are given full information. CAF is however, not always effective or even available. Neither is the obligation for LAs to provide a carers assessment. Local Authorities used to also have a legal duty to maintain a full register of all children with disabilities living within their area but this was lost in subsequent legislation rather than enforced.


Last updated: about 3 years ago