If you haven’t already, you will eventually meet the high-need child at your childcare program. Parenting the high-need child is a challenging adventure, and likewise, so is providing professional caregiving services for a baby, toddler, or preschooler with high needs. In this article, we will take a look at several ways you can help the high-need child transition well and ultimately thrive at your early learning center. Read on to find out more.

What Is a High-Need Child?

The term, high-need baby, was coined by renowned pediatrician, Dr. William Sears, to describe babies otherwise called “fussy” or “colicky” babies. The term, high-need, is not exactly the same as “fussy” or “colicky”—it has to do more with the child’s inborn temperament. Here is how Dr. Sears describes high-need babies:

High-need babies is a kinder and more descriptive term than “fussy babies.” These babies crave physical contact. They like to be held constantly and will protest loudly when put down. They are supersensitive, intense, have difficulty self-soothing, and can be very demanding and draining on parents. High-need babies are, however, generally happy when their needs (as they perceive them) are met. These “Velcro babies,” as we dub them, are blessed with persistent personalities that encourage parents to keep working at a caregiving style until they find the one that works.

Let’s take a look at the features of high-need babies, according to Dr. Sears:

Supersensitive – These babies are acutely aware of their environment. They are easily bothered by changes in their secure and predictable environment and do not readily accept changes. They startle easily during the day and settle poorly at night. They have selective tastes and definite mind-sets. They do not take to new caregivers easily.

Demand to Be Held Constantly – Lying peacefully in a crib and needing to be picked up only for feeding and changing is not the profile of a high-need baby. These babies need motion, and lots of it. They want to be in-arms, at-breast, or otherwise attached to their caregivers pretty much all the time.

Difficulty with Self-Soothing – High-need babies are not known for their ability to self-soothe. They cannot seem to relax by themselves. Instead, they rely on their parents or caregivers to soothe them. They may even reject artificial soothers, like pacifiers.

Intense – The high-need baby doesn’t do anything by half measures. These babies cry loudly, laugh delightedly, and are very quick to protest if their perceived needs are not being met. These babies feel more deeply and interact more forcefully.

Demand to Nurse Constantly – High-need babies are “marathon breast feeders.” They want to nurse often and for long periods of time. They are known for being slow to wean.

Awaken Frequently – A hallmark trait of the high-need baby is frequent night-waking and minimal nap-taking during the day—definitely a recipe for exhaustion for his or her caregivers!

Unsatisfied, Unpredictable – High-need babies are known for their predictable unpredictability. Expect them to keep you guessing, just when you have found a routine or comfort measure that works. Every day is different.

Hyperactive, Hypertonic – Constant movement and squirming, including back-arching and muscle-tensing, are common.

Draining, Demanding – “He/she wears me out!” A high-need baby can be very draining for parents and caregivers.

Uncuddly – Some high-need babies don’t always accept the old standby of constant holding. They are slow to soften into a comfortable position in the parent’s or caregiver’s arms. Usually, most of these babies do settle into being held, but it takes a while.

For more information about the high-need baby, check out The Baby Book by William Sears, MD, Martha Sears, RN, Robert Sears, MD, and James Sears, MD, and The Fussy Baby Book by William Sears, MD, and Martha Sears, RN.

Many of the attributes of a high-need baby carry on into the toddler and preschool years too. High-need children can be just as lovable and agreeable as their less needy peers, but you can appreciate the difficulty of parenting a high-need child, especially when he or she comes to your early learning center.

So, what do you do to help a high-need baby, toddler, or preschooler transition and thrive at daycare? Let’s take a look at some practical ideas next.

6 Ways to Help the High-Need Child Thrive at Your Early Learning Center

Understand the challenge of caring for a high-need child. Learning about high-need children and understanding the challenge of raising and caring for them is the first step in being able to meet their needs as a childcare provider. A high-need child is not a “bad” child or a “misbehaving” child. Neither is he or she simply a “fussy” baby or “colicky” baby. High-need children are not brought up that way by a certain parenting style or lack thereof. These babies are born with high needs. It is a part of their personality and temperament. When you can see them this way, it will be easier for you to partner with the child’s parents to create a routine and environment where the high-need child can thrive.

Encourage a slow introduction. For parents who want to transition their high-need child into daycare, the anxiety of leaving a son or daughter who is often attached to them at the hip and only seems happy that way can be overwhelming. Encourage a slow introduction to you as a new caregiver. Give families plenty of opportunities to meet and interact with you and the staff members who will be caring for their child. If at all possible, set up a couple meet-and-greet days, where the child spends time with you in the presence of his parents and gets to know you and his new environment. When parents are ready to begin sending him to daycare, encourage a slow transition that involves a part-time schedule to begin with, half days or a couple days per week. Then work up from there.

Expect separation anxiety. Separation anxiety is a normal part of child development in the early years, but extreme separation anxiety can be typical of high-need children. Check out our article about how to help families navigate separation anxiety for tips on how to handle this obstacle. Be as patient and positive as possible during this difficult time for the parents and child.

Adopt attachment-promoting behaviors. It is very hard for a high-need child to form an attachment to a new caregiver because he or she will have such a strong bond to the primary caregivers, Mom and/or Dad. As such, it is important to adopt attachment-promoting behaviors as a caregiver that will help the high-need little one come to see you and your teachers as people he or she can trust. For example, try babywearing the baby who is used to being carried around a lot at home. Babywearing gives the baby a sense of security with you and also frees up your arms to care for other children as well. Learn from Mom and Dad what comfort measures are working at home, so you can try them at daycare.

Give it time. Most children can navigate a change in caregiver, environment, and routine with lots of reassurance, love, and patience. They eventually learn that daycare is a fun place where they are taken care of by adults they can trust, where they can make new friends, and where they reunite with Mommy and Daddy at the end of the day. High-need children need lots more reassurance, love, and patience. Change doesn’t come easily for them. The transition may take time and tears, but eventually you can help these children thrive at your early learning center.

Know when it isn’t working. We would be remiss to say that all high-need children will eventually transition into and thrive at a childcare center. Even Dr. Sears remarks that he has seen some children at his practice cry for months on end at daycare until their parents had to make a difficult decision regarding further childcare. These children did not adapt. While these are not the usual circumstances, even among children with high needs, it is best to know as a childcare provider when things simply aren’t working out. You may find yourself in a situation where you have done everything you can think of to help a high-need child adapt at your early learning program. You have given it time and patience. You have kept parents in the loop and have taken their suggestions, as well as tried your own. You and your teachers are getting burned out and simply cannot devote any more time and energy to the child than you already are. Consider letting the parents know gently that it isn’t working. You could recommend a different schedule or a different program, but at the end of the day, parents will need to make alternative arrangements for their unhappy little one. Try not to feel bad about it. You have done your best.

We hope this guide to the high-need child, the challenges they present, and ways you can help them transition and thrive at your early learning center is helpful!

Honest Buck Accounting offers a full range of professional accounting services for Early Childhood Education businesses. Schedule a call to speak with one of our experts and learn how we can help you grow a more profitable childcare business.