RE: Question 1: Pre-school support

As a childcare center director for a private non-profit program, I am in a unique position to "screen" preschool children for health and physical development concerns.  Part of our enrollment packet includes a Needs Assessment for the parents to complete, but concerns often crop up after the child has been enrolled in programming for 6 - 9 weeks and can be observed within a peer group.  Our teachers are required to assess children (a formal written observation) quarterly and conference with parents twice a year, which also helps inform our response.  If we red flag a child, our next action is to immediately conference with parents and contact the families' school district, as well as encourage the families to contact their school district (the only way to receive permission for school district assessment). However, we cannot force parents to respond to our concerns in a timely manner.

The problem for private (non and for-profit) childcare is that clients are very often not ready to discuss their children's flaws and may hop from preschool to preschool(rather than address the underlying condition) when the children's behavior becomes so problematic as to force their withdrawal from the program. The reality of this practice is that many preschool directors overlook behavior concerns to keep a high enrollment (rather than alienate clients). If these children could be reported to the school district (with parental knowledge, but not necessarily with parental consent) and tracked accordingly, the program hopping could not continue to undermine the child's well being.
  
Also, not every school district has an impressive Preschool Assessment Team - often members of this team are unfamiliar with developmental milestones (having never taught with children under the age of 6) and strictly screen for speech and language in an unfamiliar office with a 1:1 staff-child ratio.  
However, I have had the priviledge of working with some excellent elementary school team members who consider their first responsibility to be that of observing the child in his/her regular preschool environment (four year olds that cannot consistently handle the 1:10 teacher-child ratio are red flagged) and this gives the assessor a much better sense of the preschool teachers' concerns.  

Over the past four years, I have seen more than 2 dozen children who were written off as "challenging" or "naughty" by their families have their needs met once conditions were accurately determined; diagnosis included: Autism, PDD, severe hearing loss,severe loss of sight,ADHD (the real kind),and severe food allergies. These parents were very grateful that their children's needs could continue being met in the childcare where their siblings attended.  

Advocating for children in the private sector would be easier if our concerns were met sooner and with a more serious consideration by the public school preschool assessment team.