August 23, 2026Puffin Services

Care for Children With Additional Needs: What Families Should Know

Finding childcare for a child with additional needs usually means explaining your child to strangers, repeatedly. What to ask, what a caregiver can and cannot do, and where therapy support is different from childcare.

Finding childcare for a child with additional needs usually involves explaining your child to a stranger, and doing it again the next time, and the time after that. Most families have had at least one experience of an arrangement that did not work and were never quite told why.

This post is about what to ask for and what to expect. **It is not clinical guidance.** Nothing here can tell you what your child needs; that comes from people who have assessed them.

A note on scope: much of what is written about additional needs — on this site included — is about autism specifically. This one is broader. Down syndrome, ADHD, cerebral palsy, a genetic condition, medical complexity, sensory differences, a developmental delay with no name attached yet: the practical childcare questions overlap a great deal even when the conditions do not.

Childcare and therapy are different things

Worth separating early, because providers often blur them.

**Childcare** is supervision, safety, routine and company. A caregiver keeps your child safe and occupied and follows the routines you set. They are not delivering a programme.

**Therapy support** works to a plan written by a registered clinician — speech, occupational therapy, behaviour intervention — with goals and data.

pediatric services

What a caregiver can do

**Follow your child's routine precisely**, rather than negotiating it. For many children this is the entire job.

**Arrive briefed.** Medical needs and care instructions are collected per child on every booking, so the person who arrives already knows about the seizure protocol, the feeding plan, or the thing that reliably helps.

**Administer medication** on the schedule you set, when that is arranged in advance.

**Provide transport** to appointments or activities when it is arranged beforehand.

**Support communication** in whatever way your child already uses — a device, signs, cards, gestures. Hand over how it works.

What a caregiver is not

**Not medical staff.** Puffin caregivers do not provide nursing care. A child who needs clinical attention during care needs a health service, not a childcare booking.

**Not a therapist**, and not there to work on goals.

**Not an assessor.** Nobody at Puffin decides what your child needs.

Being clear about the boundary is fairer than a vague promise, and it is how you avoid an arrangement that quietly fails.

Questions worth asking any provider

**What happens when my child is dysregulated?** The useful answer describes following your child's plan, not managing behaviour generically.

**Will it be the same person each time?** Continuity is worth more here than almost anywhere. Rotating strangers means starting over weekly.

**How is information handed over between shifts?**

**Are caregivers employed and insured, or introduced to me?** If the answer is introduced, the vetting and the liability are yours.

**What training does the specific person have** — not the organisation, the person.

Continuity, and why it is the one to insist on

A child who takes three sessions to settle with a new adult is not being difficult; they are doing something that costs them. Every rotation spends that cost again.

Puffin matches caregivers to bookings rather than assigning whoever is free, and requests for the same caregiver are ordinary. Say so when you book.

Respite is a different, legitimate request

If what you need is a break rather than childcare while you work, that is respite, and it is worth naming plainly rather than dressing up as something else.

in-home respite for autistic children

Funding

how BC autism funding works

For other diagnoses, funding routes differ and depend on your child's circumstances. Your paediatrician, your child development centre, or the Ministry contact on your file will know what applies; a website cannot.

Who turns up

Every Puffin caregiver is an employee rather than a contractor, insured through Puffin, and cleared through the provincial CRRP vulnerable-sector check before any placement. Pediatric specialists additionally work under supervision by a therapist registered on BC's Registry of Autism Service Providers.

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