Care giving policies and educational practices within early childhood education
Practitioner Researcher: Vol 3, Num 2 - March 2013
Recently, a young preschool child came into the spotlight, due to his parents disclosing to the early childcare centre that he was HIV positive (Fuatai, 2012). Subsequently the family were asked to withhold the child from the centre while decisions were made regarding his future attendance. As with any subject like this, things became highly emotionally charged. Most people would openly decry such treatment of a fellow human being, least of all a child. Yet if your child attended this centre what would you do? Nobody is blaming the child for his condition but parents need to know what safeguards are in place. If we follow the fundamentals of Te Whāriki there are the principles of empowerment, holistic relationships, family and community that should guide us (Ministry of Education, 1996). However these principles apply to both sides of this discussion. The child with a non infectious illness and the healthy child each has the right to learn and grow through holistic empowerment in all areas of human development. Through the building of relationships they learn and grow by developing responsible and reciprocal interactions with people, places and things (MoE, 1996). In this way the families and community can embrace and nurture this family within the community.
What many people fail to realise is the full impact of HIV on a parent and whānau within the community (Murphy, Roberts & Herbeck, 2011). It is only when an incident like that reported in Whangarei occurs, that society wakes up to the stigma regarding this illness. Childcare centres have the guidance of Te Whāriki and The Treaty of Waitangi to develop partnership with whānau, to protect them from harm, and encourage all to participate in support and care. It is an obligation of the childcare centre whānau and staff to support all families in an inclusive manner through communication and emotional support leading to a sense of belonging within the environment. This sense of belonging cements a child’s desire to attend a particular early child centre, resulting in longevity of attendance, which is good for the parent, child and financial viability of the centre.
The confusion over exclusion
Many mothers with HIV miss out on their child’s younger years due to their own health restricting their ability to care for their child or participate in activities at their childcare centre or school (Murphy et al., 2011). While there is a curriculum that addresses all children and their inclusion, within the regulations there are licensing criteria (Ministry of Education, 2008) which address infectious disease control. The criteria specifies that children with infectious diseases stay away from the centre, since these are spread through close contact and children of this age are only starting to be able to self monitor. An example of this exclusion is seen in relation to Hepatitis B where children are to be excluded until they are well again. In some cases this can take years, not forgetting they can be contagious after contact and prior to showing symptoms for up to six months (MoE, 2008). However Hepatitis B is a notifiable disease, HIV carries no mandates.
The Australian National Health and Research Council (2005) believes that there is very little risk that either of these viruses are communicable. In Nga Kupa Oranga Healthy Messages (1997) HIV was documented for New Zealand childcare centres as being a safe illness when symptoms have been treated and any open sores are covered. It has taken a further step in recommending that if there is any risk of infection present at the centre then the person with HIV should stay home for their own health as they are more susceptible to illness. So although this is an older reference, it is interesting to note that within the medical definitions, HIV was considered a “safe” illness 15 years ago. Unfortunately it would appear that society as a whole has not embraced this information. It is only when there is a controversial matter as has occurred with the child in Whangarei that it is brought to society’s attention, and the missing link in people’s knowledge results in unjustified actions.
How do we halt this prejudice?
Early childcare centres are an ideal place to help prevent such prejudice through professional development courses and information nights for parents and informative pamphlets (Murphy et al., 2010). Childcare centres should, as of right have policies that specify and cover HIV so that there is no room for argument. As these policies are developed and processed in consultation with the whānau of the early childcare centre, their contents should reflect the needs and attitudes of the centre whānau and management. Unfortunately in many centres there is no clear policy framework or guidelines to guide staff when confronted with objections or concerns from parents regarding an HIV child within their centre (Aggleton, Yankah & Crewe, 2011). This is made worse by many centres ignoring the issue in their professional development, and training relating to all areas of early childhood education. Some centres appear to conveniently forget that it is a requirement of teacher registration to continually up skill their teachers and that they should be supporting their staff in achieving this requirement (New Zealand Teachers Council, 2012).
Professional Development for Teachers and Children
With the increase of paediatric HIV/AIDS over the last three decades, early childhood caregivers and educators require to be educated themselves regarding this field. Care giving policies and educational practices need to be developed to ensure confidence within the early childhood education sector (Coleman & Toledo, 2002). Generally in the United States of America (U.S.) early childhood teachers receive extensive training for children with HIV. In New Zealand as there is so little attention paid to the issue it would appear there is very little active support and advice on offer.
In the U.S. there has been consistent information provided to teachers in helping children with regard to care, empowering them and providing confidence to the industry. In South Africa where HIV is in some areas at a pandemic level (Bhana, 2007) effecting over 20% of the population, there is still resistance with regard in early childhood to educate children in the safe practice of relationship building and safe play. This is because it was felt that the children were too young to understand and it was inappropriate to put adult matters on small children. That said if we can educate children from a young age about the facts and fallacies of HIV, the misrepresentation and prejudice might be avoided (Miller, Lin, Poulson, Fasula, Wyckoff, Forehand, Long & Armistead, 2011). Looking further into the future, statistics show that the earlier young people are educated in the facts and precautions related to HIV, the better able they are to relate to the condition and children who suffer from the disease (Miller et al., 2011).
With honest and accurate information children learn they can play with those who have contracted HIV through being born to HIV positive mothers. At this young age, education is not required to go into the depths of sexual contact, however this should be disclosed as the children get older prior to entering an age of sexual activity as this has also shown that they are more likely to take the appropriate precautions by practicing safe sex. As with education in general, it is all a building practice, adding more appropriate information as the children get older. As parents are considered to be the first teachers, it is appropriate to expect parents to be the primary source of information, as this enables them to instil their values and disclose as much information as they feel comfortable with. Sadly this ‘falls down’ when the parents have prejudices and arguments over the problem.
In the past most of the infants with HIV/AIDS have died prior to five years of age having contracted the disease from their mothers (Coleman & Toledo, 2002). With improved medical treatments they now have a much better life prognosis. However they are still prey to health issues like diahorea, weight loss and bacterial infections, and many suffer neurological damage (Coleman et al., 2002) resulting in cognitive, sensory and gross motor problems. Society needs to look at children with HIV in the same way we address people with diverse needs. Many require additional help and can obtain this through Special Education Services. However it is imperative that the mothers and children with HIV feel confident to disclose the condition and access help.
Patients with HIV find it particularly stressful when informing their whānau of their illness (Maiorana, Koester, Myers, Lloyd, Shade, Dawson-Rose & Morin, 2012) due to the related prejudices of homophobia and drug use. Consequently it takes a very confident mother to share this information of HIV. However if the mother does disclose this information it may help to break down barriers (Maiorana et al., 2012) and encourage them to fully partake in the learning environment. If they feel that society is not accepting of them and their child, they are likely to go into seclusion. Doctors have discovered that when patients with HIV feel accepted within their environment, their symptoms lessen and they can live far happier lives with greater longevity (Bhana, 2010). Equally when young children understand about an illness there is less personal and social stigma towards the child with HIV (Zhao, Li, Zhao, Fang, Lin & Stanton, 2011). Consequently it is unfortunate that authorities choose to miss the opportunity to foster a supportive environment within the community (Aggleton et al., 2011).
Conclusion
New Zealand Early Childcare Centres need to address the situation of disclosure of and policy for HIV/AIDS within their centres. With very little academic research in this area of preschool, children and their whānau appear to be an area that requires support. In this country an inclusive education for all children is seen as a right as in the Treaty of Waitangi, Te Whāriki Curriculum and Licensing Regulations, yet within early childhood centres there is diffidence in adopting the recommendations of the Ministry of Health regarding infectious diseases. There is no reason why a centre cannot admit a child with HIV, as long as a care programme is put in place. With HIV in the public arena for over 30 years, it would be expected that HIV was an accepted illness, but with the recent Whangarei Early Childhood Centre HIV incident, it has brought to the attention of all, how unprepared many people are in relation to the low risk connected with the illness. An education programme is required to be put in place between the Ministry of Health and AIDS Foundation targeting the entire population, particularly parents and teachers to quell the unease that HIV stirs up. With this put in order, and put to the side, teachers can return to what they do best, caring and teaching all children in a stimulating inclusive environment, providing children a sense of belonging allowing the learning process to return to producing competent confident lifelong learners.
References
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