The Other 60 Percent

Early education…in the doctor’s office

Stepheny Renteria, six months old, tentatively took the brand new board book from pediatrician Meghan Treitz just as the check-up began. It was called “Dulces Sueños,” or “Sleepy Heads.”

Sitting in her mother’s lap in a sunny exam room at the Child Health Clinic at Children’s Hospital in Aurora, she gazed wide-eyed at the book’s baby faces. She turned it upside down. She brought it to her mouth as if she might take a bite out of it. A few minutes later, she dropped it on the floor.

Stepheny Renteria, who is six months old, takes a new board book from Dr. Meghan Treitz at a Children's Hospital clinic in Aurora.
Stepheny Renteria, who is six months old, looks at a new board book held by Dr. Meghan Treitz at a Children’s Hospital clinic in Aurora.

While Stepheny played with her new book, Dr. Treitz spoke to Stepheny’s mother Maria Giron about the importance of reading, using a phone interpreter to translate her words into Spanish.

It only took a few minutes, but Dr. Treitz and others who hand out free children’s books and reading advice at routine doctor visits through the “Reach Out and Read” program believe it makes a difference for the low-income families it targets.

The same is true of another early childhood program called Colorado Bright Beginnings, which encourages all parents, regardless of income, to talk to, read to and play with their zero to three-year-old children, usually through doctor’s office visits or home visits by volunteers.

As advocates pay more attention to the power of early exposure to language, many of the most well-known programs are far from meeting demand. In Colorado, only a small fraction of young children are served by programs like Early Head Start, Head Start or intensive home-visiting programs.

Programs like Reach Out and Read and Bright Beginnings step into that void with a unique offer: to reduce early literacy deficits at a much lower cost and on a greater scale. Plus, by connecting with so many families at clinics or other medical establishments, both programs capitalize on the fact that during the early years of their children’s lives, many parents have their only contact with trusted professionals in health care settings.

The importance of starting early

It may seem strange that babies would be the focus of school readiness efforts when they are years away from entering a classroom, but there’s lots of evidence to support the idea that the first years of a child’s life are critical to future success.

One often-cited piece of evidence is a book published in 1995 called “Meaningful Differences in the Everyday Experience of Young American Children.” In it, two university professors, Betty Hart and Todd Risley, share findings from their painstaking study examining how and how much parents of difference socioeconomic statuses talk to their babies and toddlers.

A stack of Bright Beginning bags containing books, learning games and parent guides.
A stack of Bright Beginning bags containing books, learning games and parent guides.

“It was an amazing study,” said Treitz.

One of the most jarring results from the research, she said, demonstrated that babies of higher-income parents begin pulling away from the pack in terms of vocabulary size at just 14 months old. Children of working class families pulled away from their low-income peers when they were 22 to 23 months old.

In other words, massive differences in literacy can be traced back to the parent-child banter that takes place before most children celebrate their second birthdays. By four years old, Hart and Risley assert that children of professional parents hear nearly 45 million words compared to about 13 million words for children of low-income parents.

It’s statistics like this that drive programs like Reach Out and Read and Bright Beginnings, as well as others such as Parents as TeachersHIPPY and the Parent-Child Home Program.

Dr. Stephen Berman, chair of general pediatrics at Children’s Hospital and a founding member of the Bright Beginnings board, said the idea behind Bright Beginnings is to give parents and caregivers the tools they need “to lessen the socioeconomic influence on school readiness.”

And while intensive preschool programs such as Head Start attempt to compensate for deficits accumulated in early childhood, they are very expensive relative to programs like Bright Beginnings, he said.

In 2011, only about 16.5 percent of low-income Colorado children aged zero to five were served by Head Start or Early Head Start, according to data from Kids COUNT, an annual report on the well-being of children. In addition, 51 percent of the state’s three- to four-year old children didn’t attend any kind of preschool program between 2009 and 2011.

Low intensity and low cost

At baby Stepheny’s check-up, Treitz spent only a few minutes at the beginning of the appointment talking about the benefits of reading. She explained to Giron that reading to Stepheny would improve her vocabulary and make it easier for her to learn to read. She noted that babies Stepheny’s age are likely to put books in their mouth.

“That’s normal. That’s a six-month-old’s way of getting to know things” said Treitz,who is also an assistant professor of pediatrics at the University of Colorado.

While Treitz and others hope the impact of those bite-sized Reach Out and Read sessions will last a lifetime, their short-and-sweet nature is part of what makes the program inexpensive and scalable.

All told, Reach Out and Read includes eight to 10 doctor visits in which children get free books and parents get free advice on reading to their children. The cost, which is covered through private grants and donations, is $5 per visit or up to $50 per child over five years. About 86,000 children in 48 of 64 Colorado counties receive new books through the program annually. 

Bright Beginnings, which  can include up to three annual sessions in which parents receive advice and age-appropriate kits containing children’s books, learning games and parent guides, has a similarly modest price tag. It costs about $55 per visit or $165 per child over three years.

Last year, just over half of Bright Beginning sessions took place at medical clinics. About one-third took the form of home visits led by volunteers and the rest occurred in group settings at libraries, museums or other locations.

Christopher Price, chief operating officer at Colorado Bright Beginnings, said the program reached around 19,000 parents and caregivers last year.

Like Reach Out and Read, Bright Beginnings relies on private grants and donations to cover costs. Leaders of both organizations say they don’t anticipate receiving funding from President Obama’s early learning initiative, which proposes a variety of investments in early education efforts.

While the low-intensity aspect of the two interventions are part of what makes them easy to disseminate, there is sometimes skepticism about the impact of  programs that take only about 15 to 45 minutes a year to administer to a family.

Price said his organization must constantly overcome the question: “How much difference can you really make with a single visit?”

New research

Guidelines on Reach Out and Read posted  at the Child Health Clinic at Children's Hospital.
Guidelines on Reach Out and Read posted at the Child Health Clinic at Children’s Hospital.

More than a dozen studies have been done on Reach Our and Read since its creation 24 years ago. They have found that parents served by the program are four times more likely to read aloud to their children and that preschool children served by Reach Out and Read score three to six months ahead of peers who have not participated.

While there have been a few studies on Bright Beginnings and several surveys that generally show positive feedback from participants, the organization continues to seek evidence supporting its model.

“We have validity to what we’re doing,” said Price. “What we need is credibility.”

New studies underway on both Bright Beginnings and Reach Out and Read in collaboration with Children’s Hospital  may strengthen those findings and explore new ways of reinforcing the early intervention message with parents.

Dr. Treitz is just beginning a $15,000 study that will determine whether a video tutorial demonstrating a technique called “dialogic reading” will help parents engage their children in conversations about books.

“You don’t necessarily read every word that’s on the page. It’s kind of a dialogue between the parent and child,” said Treitz. “The more we can get parents to talk to their kids the better.”

The study will examine whether the video is effective in teaching parents of two- to three-year-olds dialogic readings skills.

The goal, Treitz said, is to “take Reach Out and Read to the next level.”

“[Treitz’s] research, I know for a fact, it will impact our clinics across Colorado, but we’ll share that nationally as well,” said Megan Wilson, executive director of Reach Out and Read Colorado.

Osvaldo Narvaez-Huerta, two, looks at his new book while Dr. Meghan Treitz looks on.
Osvaldo Narvaez-Huerta, two, looks at his new book while Dr. Meghan Treitz looks on.

Wilson noted that because Reach Out and Read occurs in a health care setting, “we have unprecedented access to children…and also the parents themselves.”

She cited a Colorado Trust brief stating that while 90 percent of children ages five and under go to the doctor for preventive care, less than 30 percent are in a child care setting, the next most common contact with a “formal service system.”

Dr. Maureen Cunningham, co-investigator on a planned study of 2,000 Aurora and Denver children in Bright Beginnings, agreed that doctors’ offices are an ideal vehicle for disseminating early learning materials.

“Everybody brings their child to the doctor,” said Cunningham, a primary care research fellow at Children’s Hospital.

Dr. Cunningham and Dr. Berman are collaborating on the Bright Beginnings study, which will pilot an effort to reinforce the program’s face-to-face parent interactions with text messaging and social networking.

For example, researchers may include daily text messages reminding parents to read with their children or suggesting learning games from the Bright Beginnings kits, which come in brightly colored cloth bags. They may also organize “virtual playgroups” of six to eight moms with babies the same age who will share their experiences with Bright Beginnings games and books through online posts or photos.

The additions “will speak the language of young moms,” said Dr. Berman.

The study will initially target families with children in the 12-24 month age range, with follow ups into their school-age years.

Dr. Berman said the study will help answer the question, “Can we strengthen the ability to change parent behavior?”

Price said if the study by Dr. Berman and Dr. Cunningham goes as planned, it will provide indisputable evidence that the effects of early disadvantages can be eliminated with a program that costs around $150 per child

“Where else are you going to get that impact with so little cost?” he asked. “We can change the world with that.”

Coverage of early literacy is supported in part by a grant from Mile High United Way. EdNews Colorado retains sole editorial control over the content of this coverage.

 

Unmet needs

A social worker in every grade? Perhaps for 10 Colorado elementary schools

PHOTO: Ann Schimke/Chalkbeat
Fifth-graders practice mindfulness at Munroe Elementary School in Denver.

Educators, parents, and social workers told of students struggling with depression, younger and younger children attempting suicide, and youths ending up in prison. A bill approved Thursday by a Colorado House committee would pay for a three-year trial to provide social and emotional help for elementary students in the hopes of addressing some of these challenges.

If approved by the full legislature and signed into law, the measure would create a three-year pilot program at 10 high-needs schools. It is estimated to cost about $5 million a year. House Bill 1017 would place social workers, counselors or psychologists in every elementary grade at the test schools starting next year.

In an impassioned presentation, bill sponsor state Rep. Dafna Michaelson Jenet, a Commerce City Democrat, said schools need more social workers “to stop our children from dying by suicide, from ending up incarcerated, from being failed by our system.”

Suicide is a leading cause of death among youth ages 10 to 24 in Colorado, and advocates of the bill said schools are often ill-equipped to deal with children suffering from trauma, bullying and behavioral challenges.

The bill was scaled back from an original version that would have cost $16 million a year. Michaelson Jenet said the nearly $5 million annual cost would be funded in part by $2.5 million from the state’s marijuana cash fund, with the rest from private foundations.

The National Association of Social Workers recommends one social worker for every 250 students, and one for every 50 students at high-needs schools.

Colorado schools don’t come close to those numbers.

About one-third of the state’s 178 school districts employed social workers during the 2016-17 school year, the most recent for which data was available from the Colorado Department of Education. Those districts represented about 89 percent of that year’s 905,000 pre-K through 12th grade students.

The nearly 590 social workers employed worked out to less than one full-time employee per 1,000 students.

Englewood’s Sheridan School District had three social workers for 1,511 students, while Yuma County had 1½ social workers for 807 students.

The two largest districts, Denver and Jefferson County, employed more than one-third of school social workers that year, with more than one social worker for every 1,000 students. Denver voters approved a 2016 tax to help pay for more social workers.

But many districts have no social workers. And most school social workers are stretched thin.

Jessie Caggiano is a social worker who serves more than 3,000 students at four high schools in Weld County.

“I’m not able to meet with students effectively on a one-on-one basis, because I’m trying to implement other services schoolwide,” she said. “I’m only at each of my schools one day a week, so I’m not able to meet their needs by any means.”

Darlene Sampson, president of the Colorado chapter of the Association of Black Social Workers, recalled working at a Denver school when a student was killed in the cafeteria.

“Many kids are carrying their trauma in their backpacks into the school,” Sampson said.

And Cam Short-Camilli, representing the Colorado School Social Work Association, said students are facing increased emotional problems at most schools. The increase in youth suicide and suicide attempts is especially difficult, she said. One Denver incident last fall attracted national attention.

“Every school district, every student is impacted, that’s rural, urban, suburban schools,” Short-Camilli said. “In the past five years, I’ve been at elementary schools, and it’s been extremely shocking. Kids at those schools, there’s an immense ripple effect.”

But state Rep. James Wilson, a Salida Republican, questioned whether the pilot program would be possible to replicate because of the high number of professionals needed.

“I’m sitting here feeling like the Grinch,” Wilson said. “I cannot bring myself to put together an unrealistic pilot. Will it really work in the real world?”

State Rep. Janet Buckner, an Aurora Democrat, also expressed concerns, but voted for the bill.

“I’m concerned how we’re going to fund it,” she sad. “The suicide rate is off the chart and our kids need so much help. I don’t think we can wait. I have a lot of phone calls and emails about this bill, people who really need the help.”

HB-1017 next goes to the Appropriations Committee before being considered by the full House, then the Senate. It is one of several measures aimed at offering help for students and their families beyond academics at public schools.

Story time

This Memphis teacher’s favorite student didn’t stand for the Pledge of Allegiance. She taught him a powerful lesson.

PHOTO: Xzavier Bonds
Daniel Warner teaches at East High School in Memphis.

When one of Daniel Warner’s favorite students refused to stand for the Pledge of Allegiance, he could feel the tension in himself rising.

It was August 2017, the first week of classes, and Warner said he knew how important setting a tone was during the first few days of school.

“Didn’t my teacher prep program teach me that I have to set high expectations in that first week or the year is lost?” asked Warner, a U.S. history teacher at East High School in Memphis. “If I don’t set those, we’re done for.”

But before Warner reacted, he said he took a few moments to reflect on what could be going through her head.

Chalkbeat TN Storytelling Event
PHOTO: Xzavier Bonds
Daniel Warner tells his story to a crowded room.

It was the Monday after a violent white supremacists rally in Charlottesville, Virginia. Stories of former NFL quarterback Colin Kaepernick were again dominating the news, as he remained ostracized for kneeling during the national anthem to protest police brutality.

Instead of punishing her, Warner said, he refocused on what she might be thinking through as a black American high schooler.

“The lesson she taught me that day was that some of the most harmful instances of school discipline happen when we are too focused on ourselves as teachers,” Warner said.

Warner was one of seven educators and students who participated in a February story storytelling night hosted by Chalkbeat Tennessee, Spillit, and The Knowledge Tree. The stories told centered around school discipline practices, a topic Chalkbeat recently dove into in this special report.

Video Credit: Gillian Wenhold, The Social Exchange. The Social Exchange is a pay-as-you can PR & content creation firm for nonprofits and responsible, women/minority owned businesses.

Here’s an edited transcript of Warner’s story. It has been lightly edited for length and clarity:

It’s a week into school in early August. And kids are just trickling into my senior homeroom mostly asleep, sitting quietly in their desk as 18-year-olds do at 7:15 in the morning…And then morning announcements come on. “Please stand for the Pledge of Allegiance.”

So I stand up, and I say, “Alright y’all, go ahead and stand up with me.” I see these seniors throwing their bodies out of their seats, trying to stand up while they are still asleep. And almost everyone stands up but one girl doesn’t…  

So, my eyes meet this girls eyes as she stays in her seat during the pledge. And I can feel the tension in me of my authority being challenged in the room. And I wonder if everyone else is looking at me, my other students. So I give her a teacher look meant to communicate, “Are you going to stand up?” And she looks at me from across the room and shakes her head and mouths, “I can’t.”

So this student was one of my best students the year before in honors U.S. History. She engaged deeply with the material and personally. She asked questions of herself, of her country, of democracy, what this whole thing is about. She processed the double consciousness she feels of being both black and American. And she did so while being kind, thoughtful hardworking. The student you think of that makes you want to cry, you love that kid so much. I wonder what’s going on, what is she thinking about…

This is a Monday and the weekend before had been the white supremacists march in Charlottesville… When she told me, that she couldn’t stand, I went and sat in the desk next to her…I asked, “What’s keeping you from standing up?”

She started by saying, “I hate,” and she stopped herself. She took a breath, calmed herself down and said, “I just can’t.” And so we just sat there for a second. I could see as I got closer to her that she was flooded with emotion and feeling something deeply. And so we let the announcements end and I tell her, “When I say the pledge I say it more as a hope and a prayer…that there would be liberty and justice for all.” She said, “Yeah, I was thinking about that,” like a good U.S. History student, but she said “things don’t’ seem to be headed that way right now…

The lesson she taught me that day was that some of the most harmful instances of school discipline happen when we are too focused on ourselves as teachers. She showed me that I was a little too focused on how I was being perceived by other students in the classroom. And that I wasn’t focused enough on her and what she might be processing. As teachers, we have all of this opportunity to escalate conflict, I’ve done it plenty of times. But we also have an opportunity to be gracious to students who are working out who they are in public…

This girl wasn’t being disengaged by saying no to me, she was being especially engaged with who she is… When we talk about restorative justice, the first step we have to take is for us as educators and adults, and it’s doing your own emotional work. And we have to ask ourselves questions about our identities. You can only lead someone somewhere if you’ve gone there yourself…

What is it about us when it sets us off when a kid says no to us? Why are we that insecure? … When we pay attention to ourselves, our emotional status, the hurt we’ve felt, the pain we’ve lived through, that is when we can begin paying attention to how formative schools are. They are spaces where folks are working out their identities in public, and that’s when you feel the most self conscious and vulnerable and in need of grace offered by someone else.

So, I hope as we talk about this, we think of ways where we can make school a space for people to be figuring out who they are and not just punished into compliance. In high poverty schools, you talk about compliance like it’s the ultimate behavior. I hope we can make schools where students can learn what it is to seek justice, even when and especially when, things just don’t seem to be headed that way right now.