Child Care Accessibility: Agencies Can Further Coordinate to Better Serve Families with Disabilities

What GAO Found

An estimated 2.2 million children aged 5 and under and 3 million parents of children in this age group have a reported disability, according to GAO's analysis of the 2019 Early Childhood Program Participation Survey and 2022 Survey of Income and Program Participation data.

Families of children with disabilities and parents with disabilities—including physical, intellectual, and developmental disabilities—reported various barriers to finding and using child care programs, which affected their family's well-being. For example, when searching for child care, parents could not easily find information about programs that could serve children with disabilities. Parents with disabilities reported difficulties communicating with their child care provider and instances in which they faced exclusion or disparaging comments from staff or other parents. Parents' difficulties finding and maintaining appropriate child care resulted in some reducing their work hours, leaving their jobs, or moving their families to new locations.

Barriers to Participating in Child Care Programs Described by Parents of Children with Disabilities

Selected federally funded child care providers made efforts to support children and parents with disabilities but faced challenges in meeting some families' needs. Some providers GAO visited made modifications to their facilities and their services, including installing playgrounds that can accommodate the use of wheelchairs and other mobility devices and using picture cue cards and assistive tablets to help nonverbal children communicate. Providers said staff shortages and funding constraints were among the challenges they faced serving children or parents with disabilities.

The Departments of Health and Human Services (HHS) and Education provide informational resources related to many of the difficulties identified by parents and child care providers, but GAO found that many parents we spoke with were unaware of relevant resources. While the agencies coordinate, they could more intentionally leverage HHS's network of state and local child care partners to disseminate information about Education's Parent Training and Information Centers. These centers are available to support parents of children with disabilities in every state. Increasing awareness of these centers can help ensure more families with disabilities have the tools they need to navigate their search for appropriate, high-quality child care.

Why GAO Did This Study

Families with disabilities may face challenges finding child care that meets their needs.

GAO was asked to examine the barriers children and parents with disabilities face in accessing child care. This report addresses (1) the prevalence of children and parents with disabilities, (2) what barriers children and parents with disabilities face to accessing and participating in child care facilities and services, (3) what selected federally funded child care providers report about their ability to serve children and parents with disabilities, and (4) the extent to which HHS and Education provide informational resources about child care to families with disabilities and to child care providers about serving these families.

GAO analyzed the most recent data (2019 and 2022) from two federal surveys; held discussion groups and interviews with 35 parents and analyzed 110 responses to an online questionnaire; conducted site visits to 12 federally funded child care providers in four states selected for geographic and demographic diversity and held discussion groups with nine additional providers; reviewed relevant federal laws and regulations and Education and HHS documents and interviewed agency officials; and interviewed child care and disability stakeholders from 15 organizations.