Pulling Them Out of the Cracks: Providing Consistent Care
Lesa Marie Storms
Instructional Application Project
Sometimes, we educators, we encounter students and situations that impact us on a deeply emotional level. We may come across a student that we just cannot seem to reach or perhaps we have a student with a terrible home life. Usually we stress ourselves out about these students and we remember them years after they leave our classrooms. How do we help these students who impact us so much? How do we leave a lasting impression, a positive one, with them, as they have with us?
The Problem: Reaching Molly
Molly is 4 years old and suffers from physical, mental and emotional disabilities. She was severely ill as an infant, which has caused permanent problems including slowed brain development and partial deafness. As a result – and for no explainable medical reason – Molly is mute. Due to the unusual and continuing nature of her upbringing, she has not had access to many of the services that she needs. When she was 2 years old, Molly and her three siblings were abandoned by their parents and they were taken in by their grandparents. Both parents abuse drugs and alcohol. As a result, Molly has not been able to form healthy relationships. “Young children experience their world as an environment of relationships, and these relationships affect virtually all aspects of their development (Harvard Working Paper 1, 2009.” Relationships help shape a child and their perception of the world around them, and how they fit into it. “Stated simply, relationships are the ‘active ingredients’ of the environment’s influence on healthy human development (Harvard Working Paper 1, 2009).” In the early, formative stages of Molly’s life, she did not receive one-on-one time with a loving, caring adult. While her grandparents tried to do their best, they are both aging and physically ill, and they found themselves stretched very thin between the four children. Molly continues to be reluctant to interact with adults and even children her age, because she has not been exposed to these types of situations.
In addition to not having “nurturing and stable relationships” at home, Molly also lacked (and continues) to lack these experiences with her caregivers. Three days a week, during the school year, Molly attends a preschool program through the public school system. The program is designed for special needs children and this is the only type of specialized care that Molly receives. She spends the rest of her days in a privately run day care facility. Unfortunately, this facility was chosen based on price and not on quality. Research has shown that positive relationships also need to be formed with caregivers in day care situations. “The warmth and support of the caregiver in a child care setting also influence the development of important capabilities in children, including greater social competences, fewer behavioral problems and enhanced thinking and reasoning skills at school age (Harvard Working Paper 1, 2009).” The workers in the facility that Molly attends are not trained to care for children with her needs. Also, they are usually at the maximum state allowed ratios of children to adults and they are stretched thin in the time that they are allowed to interact with the children. They do not work with the children, but mainly try to control the chaos that ensues from the children running around and tearing the building apart. My knowledge of this facility, the caregivers and how it is run comes from my briefly having been employed there. I terminated my employment and reported the facility to the state licensing agency because I was appalled by the conditions and the treatment of the children.
Lacking relationships is only one of many areas in which Molly is suffering. According to studies from Harvard University’s Center on the Developing Child, Molly could likely benefit from therapy in and outside of her home. “Therapeutic help for a young child with emotional or behavioral problems can be provided through a combination of home- and center-based services, involving parents, extended family members, home visitors, providers of early care and education, and/or mental health professionals (Harvard Working Paper 6, 2008).” Molly is not receiving any of these potential benefits. When she is not at school or day care, she is cared for by a state-funded home health nurse. While her father came back into her life a few months ago, he continues to be removed from Molly’s car and development. “When parents are inexperienced in child-rearing or overwhelmed by economic insecurity or threatening community conditions, effective parent education and family support programs can help them sustain the kinds of growth-promoting experiences that built child competence and shape healthy brain architecture (Closing the Gap, 2007, p. 67).” Even though programs such as these have been recommended to Molly’s father, he has shown no interest in pursuing them.
One of the biggest problems impacting Molly’s emotional, physical and social development is the lack of consistency in her care. “During early infancy, when parent-child bonding and emerging attachments are so important, there is a pressing need to strike a better balance between options that support parents to care for their babies at home and those that provide affordable, quality child care for parents who return to work or attend school (Closing the Gap, 2007, p. 7).” When children are put in child care programs, they should be placed in settings where the care givers are trained to deal with students who may need extra care. For example, Molly needs extra attention and does not even receive as much attention as the rest of the students. “With increasing numbers of children being expelled from preschool programs and/or treated with drugs greater investments are needed to confront this serious shortage of professionals who are qualified to address the behavioral and mental health needs of infants, toddlers and preschoolers (Closing the Gap, 2007, p. 9).” Molly receives quality care when she attends the special needs preschool. She is cared for and taught by trained special education teachers and she receives hands-on instruction in general education, social interaction and also in caring for herself.
In this program Molly is encouraged to do things such as put on her shoes and jacket, drink from an open cup and to make attempts at vocalization. Unfortunately, this interactive care is limited to a few hours a week. The day care facility she attends is an entirely different story. From the moment she gets there, she is treated like a baby. While state law prevents workers from keeping Molly in the nursery section of the building, it does not seem to prevent them from restricting her. For example, when the rest of the preschoolers sit in chairs at a small table to each lunch, Molly is placed in a high chair. If the rest of the group is fed something that requires utensils, Molly is fed finger foods, wearing a bib and she receives all of her beverages out of Sippy cups. When the rest of the group gets themselves ready to play outside – something that is encouraged in establishing skills and independence – Molly is told to sit and wait until one of the workers can get to her and get her ready. She is actually discouraged from doing things for herself. The reasoning behind this is that she “is too messy” or that she “takes too long. When Molly plays, she hums to herself. However, day care workers do not encourage her to vocalize or verbally express herself. Actually, she is told to hush and be quiet. Everything that Molly learns at special needs preschool – the life skills that help her become independent - are expected to be shut off when she leaves the school. How are these lessons supposed to take shape when there is no consistency of care? How is Molly supposed to learn anything when she is told different things by those who care for her?
Plan of Action
While the problems identified with Molly and her education are not unique, the plan presented for dealing with these issues will start specific to Molly and then broaden out to show how important these issues are to our overall educational system.
Step 1 – Educate and Communicate: Have a sit down
If we have any feasible expectation that Molly’s learning situation will improve, then we must indentify one person in her life that truly cares about her. This form of caring must go beyond an obligation as a relative. Thus far, “caring” has only provided Molly with food and shelter. Molly needs more than this. Another form of “caring” Molly has experienced has been affected by an hourly wage. In order to find someone in her life that cares about her, this person’s livelihood should not be based on the hours Molly spends in their care.
As an attempt to reach those in Molly’s life, we need to bring them all together. I recommend gathering everyone around the table – parent(s), grandparents, nurses, day care workers, medical professionals and special needs teachers. At least this should be the goal. More than likely, at least one part of this group will be resistant or simply not show up. For example, Molly’s father has not, as yet, demonstrated any ongoing interest in her care or treatment/education.
The hope for this meeting is to discuss the types of good and bad behaviors each group experiences with Molly. While unlikely, perhaps the lack of consistency in her care is simply a result of lack of communication. How do we expect the day care workers to know what Molly is capable of and how to work and encourage a special needs child, if they are not trained and educated in this area?
Step 2- Educate Day Care Workers
Having more educated child care workers will benefit everyone involved, not just Molly. While there has been an increase in those perusing further education, there are no consistent regulations. “Distance learning classes designed to upgrade the capabilities of child care workers and early childhood specialists are becoming increasingly evident (Clifford and Gallagher, 2000).” Unfortunately, not too many average day care workers will take the next step forward unless they are pushed to by law. This is the case in the facility that Molly attends. Annually, the workers are late in completed their needed state hours of instruction. It seems reasonable that child care givers can learn from each other as well. “In this era of advanced electronics, it is surprising not to find more programs for young children linked, through a dozen different networks, to the latest knowledge and practices in what we know about young children, their care and stimulation (Clifford and Gallagher, 2000).” While federal special education laws date back to 1968, there are many remaining gaps in the system. “As we move into the 21st century, young children under the age of 5 are still without comprehensive public policies to protect or enhance their status (Clifford and Gallagher, 2000).”
But, if we are going to expect day care workers to gain further education, it will be necessary to require more than a high school diploma to hold the job. We need to, as suggested in the article “The Missing Support Infrastructure in Early Childhood,” we need to realize that “the characteristics of high-quality child care programs do not really stir man debates within the professional community.” Whether the child requires special needs services or not, don’t our children deserve the best possible care and education? We need to recognize “that child care is a labor problem, a social problem, a regulatory problem and, of course, a familial problem (Gromley 1995, p. 32).” We need to show those with the ability to make changes how badly legislative changes are needed and how beneficial – both in the short and long terms – these changes can be.
Step 3 – New Legislation
We need to demonstrate to legislators that changes need to be made and long term benefit can be gained. According to information from Harvard University, law makers can get more bang for their educational buck by allocating more dollars to early learning for families living in poverty. “Research indicates that policy makers can achieve greater return on investments in early childhood education for children from families with low incomes and limited parent education than from remedial programs for adults with limited workforce skills (Closing the Gap¸2007, p. 12).” At the same time, these services need to be of quality. “The essence of quality in early childhood education services is embodied in the expertise, skills and relationship-building capabilities of their staff. The striking imbalance between the supply and demand for well-trained personnel in the field today indicates that substantial investments in training, recruiting, compensating and retaining a high quality workforce must be a top priory for society (Closing the Gap, 2007, p. 13.” But, in order to make high quality a priority, we must first educate the public.
Step 4 – Educate the Public
In order to educate the public and law makers in hopes of getting the needed attention and funding to quality early childhood special education, we must first evaluate where we are now and where we need to be.
One of the key elements in an effective early childhood infrastructure for a state would be the design of a data system for the systematic collection of information related to early childhood programs. It is often taken for granted by policy makers that information about various programs should be available automatically. So, when policy makers ask for the number of children cared for at home, or in family day care, or by relatives, they react with great surprise when they are told that no one knows the answer to those questions or where to go to find the answers (Clifford and Gallagher, 2000).
Once we have some consistency in reporting and we can look at the services that are lacking, then we can work to determine which areas we need to push for changes in first. “Although the large number of children and families who could benefit from additional assistance will require significant increases in funding, extensive research indicates that investment in high quality interventions will generate substantial future returns through increased taxes paid by more productive adults and significant reductions in public expenditure for special education, grade retention, welfare assistance and incarceration (Closing the Gap, 2007, p. 12).” Basically, what this means is that we can all benefit from identifying and providing needed services.
Step 5 – Turning this Education into Consistency of Care: Bringing Together all the People Money
With more than $7 billion of state and federal funds spent on early childhood education and childhood services, and going up every year, shouldn’t we take this time to make sure that we are spending this money on the best possible care for or children (Mitchell, Stoney & Dichter, 1997)? In Molly’s case, state dollars are spent on every hour of her care including preschool, day care and the in home nurse. In the latter two areas, that money is not being well spent. Because of that, Molly is slipping through the cracks, as are the children in similar situations. We need to work together as a collaborative team- learning from our mistakes – in order to reach all of our children.
With the proper interactions with adults, Molly could learn to better care for herself. As she learns, she will also be gaining independence. As stated earlier, increased independence can lessen the dependence on the need for special services. According to information from the United States Department of Education, of children ages birth to age 2 who receive special services, one-third do not continue will special services when they reach the aged 3 to 5 years preschool age (2005). Keep in mind that these numbers may be subjective and some may argue that they are skewed by a lack of consistency in reevaluation standards. At the same time, the number of children receiving early childhood special education services has increased by 38 percent over a 10-year period, with an estimated 680,000 American children ages 3 to 5 receiving services in 2003 (Socol, 2010). The federal basis that determines who qualifies for programs, falling under the Individuals with Disabilities Education Act, is subjective and primarily labels children as having a “developmental delay.” In the U.S., 44 states have tests to determine if a child qualifies for services.
So, what it all comes down to is that there is no consistency in the types of care given, who receives it, who provides it and how long children are eligible for services. As a result, we are failing our children when they need us the most. Molly is the perfect example of this, unfortunately. The only consistency in her life is that she is either ignored, or treated like a baby. The few hours a week that she spends receiving special education services are not nearly enough to provide any help to Molly because the rest of her time is spent stamping out those ever-so important lessons. Because of this, the hours spent in special services are both a waste of time and money. And this waste will continue as long as there is no positive consistency in the care that Molly receives. But, who makes the determination of what services will be provided, to whole and for how long? Unfortunately, this will likely fall into the political arena, where blame and responsibility are routinely passed. “There is no linear, straight-line path from where we are now to where we want to go in terms of building a viable support system or infrastructure for early childhood (Clifford and Gallagher).” What it comes down to is if we want to help our children, if we want them to be productive and successful, that we have to provide them with the services that they need. “We need to identify and cultivate various powerful sources in the states that could be supporters of the infrastructure concept. Such a power source could be a governor, or a key state legislator, but it could also include professional organizations and business leaders who are convinced of the importance of high-quality early care and education (Clifford and Gallagher).” We have to be willing to make changes, or we will continue to set our children up for failure. We need to do this for all of our children, you would not let the system continue to fail Molly if she were your child would you?
Is this an easy problem to fix? No. Is this going to be an easy problem to address? No. Should this slow us down? No. Obviously, it is going to take a lot of hard work to make Molly’s educational situation more productive. It is going to take even more work – probably over the course of years – to change the overall situation for all of the students impacted. But, we should not be deterred by the amount of work required to make progress in establishing a consistency in child care and early childhood education. As educators, it should be our goal to help all of our children. If we can change the system so that all children are experiencing the relationships they need and get the attention they yearn for, then we are closer to giving them the education they all deserve.
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