Handicapped Desegregated : Day Care: Center promotes socialization of children with special medical needs by mixing them with healthy peers.

In November, when Steve and Rebecca Havland were scouting day-care centers for their son, Erik, they knew that they would have more than the usual problems finding quality child care.

Erik, almost 3, would need constant medical supervision. Born prematurely with a kidney disease that required 13 operations before his second birthday, he lives today with a tube implanted in his stomach.

But the Havlands didn’t want Erik to feel isolated from other children because of his illness.

The couple found SpecialCare, a Kearny Mesa child-care center and preschool that integrates healthy children with those who need constant medical supervision.

“We wanted Erik to feel comfortable socializing with kids whether or not they had a medical problem, and we feel good about this place because he is not segregated from other children,� Steve Havland said. “He used to be afraid of other kids, but now he is learning how to learn. I guess we were just in luck because this place opened at the right time.�

Opened last October, the center is said to be the first of its kind in the United States, with a full-time staff of nurses to handle children like Erik who have debilitating conditions that require constant medical attention. The program works in conjunction with the San Diego school district, which supplies teachers for the project.

The goal of SpecialCare is to integrate both kinds of children in classrooms, and help disabled children who sometimes have spent their entire lives in hospitals feel no different from their healthier peers, the president said.

“The problem with medically fragile kids is that, sometimes, developmentally, they are much younger than their chronological age because of their medical problems,� said SpecialCare president Terry Racciato.

“We mix the groups because we want to get them moving along and not just

concentrating on their medical problems but on just being kids,� she said.

The day-care center grew out of Racciato’s 12-year-old SpecialCare Organization, which did home health care and hospice work. She said she got the idea about seven years ago while taking care of children who were isolated from their peers because of their illnesses.

Twenty children are enrolled in the center’s preschool and day-care program, seven with muscle disorders, respiratory illnesses or digestive problems that require feeding or breathing through tubes and constant supervision.

A staff of 60 nurses is on hand at the SpecialCare organization next door to monitor IVs, administer medicines and handle medical emergencies.

Parents of healthy children must pay about $2 an hour for SpecialCare services while those with children who require more attention pay about $25 an hour. Only children with non-contagious diseases are admitted.

Healthy children are admitted only if they have sick siblings who attend SpecialCare, or if their parents work for the organization. Racciatio says this measure is necessary because these children already have been exposed to sicker kids, and are more accepting of them.

The large, sunny classrooms, cluttered with bright toys and noisy preschoolers, resemble a kindergarten more than a hospital.

SpecialCare is split into five colorful rooms, each named after the pastel animal pictures that line the walls.

In a “lamb� classroom, Nicholas, nearly 2, runs pell-mell among the toys, playing airplane and eagerly awaiting a lunch of cheese enchiladas as Hillary scurries in from the back-yard playground with a snail she squashed in her hand.

Erik sits in a highchair nearby, watching his healthy playmates, the gastrostomy tube through which he takes his food poking out of his Pampers. Because of his illness, Erik has not learned to walk or talk, and is taking lessons on muscle coordination skills, but his chubby legs pump excitedly watching Nicholas and Hillary.

Raccatio feels that the experience of being together and learning from each other’s differences is good for all the children.

The students are all taught sign language so that even those with tubes in their throats can join in lively discussions. The children also are given multiracial dolls with feeding and breathing tubes to show that, although not everyone is the same, everyone has value as a person.

At the end of the term, there is a graduation to the next level, complete with mortarboards and tassels, to show achievement, Racciato said.

“SpecialCare is far different than anything we had previously existing here because it fosters independence,� said Deborah Ferrin, child-care coordinator for San Diego. “It is an extremely high-quality child-care program for our population, and we are glad it finally happened here.�