There are nursery schools, and then there is the Warbasse Nursery School in Brooklyn, NY. While most schools follow the rules and regulations set down for them, and many of them make their educational presentations and relationships with their young pupils innovative and creative, Warbasse does this - and so much more, according to Lisbeth Utz-Angeli, OTR/L.

"To my knowledge, there is no other nursery quite like Warbasse," says the therapist who became the school's first OT in 1980. The nursery school, she informs, has been in existence since the 1960s as a not-for-profit parent cooperative nursery run by a board of directors. In its earlier years, it was much like all the other nursery schools - a nice place for little ones to go to gain a head start in learning and socialization.

But in 1979, Warbasse crossed over into another realm by developing a program for children with special needs. And today, the school has an enrollment of about 90 children, with one - third of the youngsters having physical handicapping conditions.

The children are referred to the school by social services, neurologists and pediatricians, and word of mouth. Its program for all children is multidisciplinary with two components -clinical and educational.

"We have a regular nursery school program," explains Mrs. Utz-Angeli, "But every group, every level, every class has one-third with special needs. It is the most normalizing environment for e children from ages 0 to five years old. It is the only mainstreaming setting that I know of where the special needs children are in the classroom with other children"

Mrs. Utz-Angeli explains that the special needs children have a primary diagnosis of spina bifida, but children with other handicapping conditions are eligible as long as it is decided they can profit from the program.

The present one-third have diagnoses ranging from spina bifida, cerebral palsy and arthrogryposis to speech and language impaired and children at risk because they were preemies or had low birth rate. "We have had amputees as a result of accident or cancer, also," the OT adds.

"We take children at two weeks of age and work with them in the early intervention program," she continues. "If we have them that early and if they are ready to move on to the toddler group, they do so.

"Once they are put into the mainstream setting, they are working at a ratio population of one-third. As early intervention, they are children who are challenged. They move on to the toddlers where there are children from the regular population."

Mrs. Utz-Angeli says that at the point of mainstreaming, the OTs are very much involved in helping parents place their children in public schools. "We have done our best to get the children mainstreamable, to have them ready for public school kindergarten when they are five years old," she states.

The therapy team members run parent groups at the early intervention level for parents of the special needs children, but the group meetings are open to everybody. They are well attended by parents of the children without special needs. Guest speakers have been nutritionists, neurologists, genetic counselors and social workers.

Warbasse Nursery School's treatment team includes special education teachers, the PTs who started the therapy program in 1979, OTs, speech and language therapists, adaptive physical education specialists, and art and music therapists. The school provides transportation for the children who come from a large catchment area, but primarily from Brooklyn.

Another project involves making buildings of foam blocks on the vestibular platform while seeking to facilitate different positions with the child. Once the youngster is stabilized, the therapist then challenges him further by introducing gradual movement on a swing.

And sometimes, the therapists use a big puzzle on the swing. "While engaging the child in placement of the puzzle pieces, you would be involved in building the child’s coordination, " Mrs. Utz-Angeli explains. "It makes adjustments more spontaneous and a little bit more fluid."

It is obvious that the OT enjoys her work with the children – all the children – at Warbasse. Proof is the fact that her own three young sons have been students there. And it is most likely that the twins she is expecting early this next year will also become students.

"It is a great environment for all children," she states. "We have no problems with the blending of the two populations. All children are taught that ‘Friends are not for hurting.’"

Although a child may occasionally be pulled from class for therapy, most of the treatment sessions are conducted in the classroom. "We prefer to work in the classroom setting so that the children are not isolated," explains Mrs. Utz-Angeli.

"For example, I will sit with a child for fine motor coordination, and the activity is with, maybe, two or three other children. It has been my experience that it is a more effective use of therapy.

"Sometimes we have the non-handicapped children imitating the special needs children. They want to use their wheelchairs or walkers. It is really nice to work with children who are not all handicapped. The special needs child has his own role model right there, and it is beautiful for the children - for both children. It is nice to learn that one is not always like everybody else and that each can function in his own way.

"This interaction is carried over also in our gym and our wonderful outdoor setting. All children interact beautifully with or without personal equipment".

The OT adds that all children benefit, also, from the special equipment provided for the special needs group in the gymnasium. These include climbers, swings, mats, ladders and other devices for gross and fine motor skills and vestibular stimulation.

Outdoors, the children enjoy more special equipment - wooden structures with swinging bridges, a special slide that accommodates children with the most limiting skills, and more.

The classrooms also are specially equipped, and there, the therapists work closely with the teacher who is responsible for follow-through of much of the directives, Mrs. Utz-Angeli states. And all of the staff persons interface very closely with the special needs children’s medical facility.

The presence of the therapist often has proven very beneficial to the regular population children, the OT says. "While they are children who have no diagnoses, there is disparity," she explains. "Some are light years away from others – that happens in any setting where you have children. Here, they really help each other more. They promote problem-solving, and we are able to evaluate and guide them."

Last year the children were involved in a special project. Mrs. Utz-Angeli says the school had access to fabric paints and decided it would be nice for each child to take a part of his or her body, hand or foot, and a paint brush and make a personal statement.

"We encouraged the little ones to crawl on the big sheets of fabric," she says. "And they saw that it was their hands and feet that could make the prints, so we used it in therapy. We made a mural, blankets and pot holders that the older children then were able to staple together and stuff. So in essence, any project that we do, we look to involve every child at every level he or she is able to attain."