Early Childhood

With lead exposure rampant in NYC public housing, a new focus on lead’s impact on education

PHOTO: David Buffington | Getty Images

The recent revelation that New York City has allowed children living in public housing to be exposed to toxic lead could have pronounced consequences for the schools those children attend.

The dangers posed by lead poisoning, which include behavioral problems and impaired brain development, are grave and long-lasting. But studies show these effects can be mitigated with swift, early treatment. Here’s what we know about the impact of lead poisoning on student learning — and about what the city’s education department says it is doing in response to the current crisis.

‘No safe level’

Lead exposure at home can typically be traced to paint, which was manufactured with lead until the 1970s. Children are exposed to it if they eat paint chips or inhale dust from those chips.

It also exists in water that flows through lead pipes and in soil, which young children can unintentionally eat, according to the American Pediatric Association.

There is no “safe” level of lead — any exposure can have negative effects on the body.

“Once it’s in the body, it’s very hard to get rid of it,” said Morri E. Markowitz, director of the Lead Poisoning Treatment and Prevention Program at Children’s Hospital at Montefiore in the Bronx.

The effects are multipronged. Physically, anyone exposed to a high amount of lead may feel abdominal pain and constipation, according to the Centers for Disease Control and Prevention. Hyperactivity is another symptom, tough to immediately notice in young children since it’s common for them to run around, Markowitz said.

Those exposed to high levels of lead may also feel mental and psychological changes: depression, irritation and a sense of distractedness.

Depending on the severity and length of lead exposure in a child, it can result in “quite debilitating” neuropsychological effects, according to Mt. Washington Pediatric Hospital in Maryland. That includes poor performance in school and problems in developing social relationships.

Lead exposure has also been linked to misbehavior in school.

The effects of lead exposure can be minimized if a child has a nutritional diet because their bodies will absorb less lead if they’re eating other essential metals that humans need, like calcium and iron, Markowitz said.

That’s one reason why lead exposure is more likely to affect children in poorer families — lack of access to adequate or healthy food.

And poorer families can face greater obstacles avoiding led at the source, either because of a financial barrier or if the problem exists in subsidized housing.

Treatment is possible — if caught early

Lead poisoning was once thought entirely irreversible. But depending on the level of lead in a child’s blood, treatments do exist but vary, Markowitz said.

The first plan of attack is to get rid of the source so that the child is no longer ingesting lead. But this is a challenge for families who rely on public housing, where it’s beyond residents’ control to make such maintenance changes.

Another option is to reverse behavior -— stop the child from eating paint chips, for example, he said.

Children who test positive for a high amount of lead in their blood can also receive chelation therapy, Markowitz said. This medicine, taken orally, binds with the lead and leaves the body through urine.

But this medication is recommended for children who have blood-lead levels of 45 micrograms of lead per deciliter of blood or higher. A child’s blood-lead level is considered unsafe if it’s 5 mcg/dL or above, according to the Mayo Clinic.

Research has found that taking the extra step to curb children’s lead exposure even after it has happened — and monitoring their behavior and health — can actually help boost test scores.

A study published this year focused on a group of children with high lead exposure from Charlotte, North Carolina in the 1990s. They received coordinated interventions designed to reduce lead exposure, encourage  healthy habits, and provide information on nutrition, among other treatments.

For elementary and middle-school students, test scores went up moderately and they were suspended for fewer days when compared to children who didn’t get this help. The students who got treatment were also less likely to be cited for committing a crime in school. Such efforts are costly but they help avoid the need to address lead’s effects later on, which can be even more expensive.

More testing and education needed

Because of increasing evidence on lead’s negative impact on children’s development, many states have made it a priority to attempt catching lead exposure early — in part because blood tests, the easiest way to determine lead poisoning at present, typically only work for a few years after exposure.

“By the time you’re at school, the lead in the blood is gone — it’s gone elsewhere,” Markowitz said. Lead doesn’t sit “around in the blood for five years,” he said, but migrates to the bones or the brain, where lead can remain for two to three years, continuing to do damage.

That’s why — like many states — New York requires doctors to test young children for lead exposure, Markowitz said.

New York health care providers are required to test 1- and 2-year-olds for lead in their blood. They’re also supposed to assess children no less than annually for risk of lead exposure up to the age of 6 and to decide whether they need a lead blood test.

Despite these rules, reports have found that millions of children go without getting tested. In New York State, just 55 percent of children who were supposed to undergo testing actually got it, according to a Reuters investigation in 2016 — and those who are most at risk may be the least likely to get tested, owing to inadequate access to health care or lack of knowledge about lead dangers.

Other reasons might include children missing appointments, parents not following up on test referrals from doctors, or some doctors not ordering the tests — for instance if they’re unaware of the mandates.

One clear solution could be spreading more education and awareness to parents about the importance of catching lead exposure early. To date, the Department of Education has largely focused on the risk of lead in schools, sending letters to families about detailed lead test results within its buildings.

But students are most likely to be exposed to lead outside of school — even as children are bringing the impact of that exposure to classrooms, where it has the potential to undo schools’ best efforts to boost academic success. Schools thus have an invested interest in battling the perils of lead.

The city’s education department shared with Chalkbeat a letter parents have access to, with subsections that tell parents about lead’s health effects, where it can be found, and whether a child should be tested.

But given recent revelations about widespread exposure to lead in public housing, affecting some of the city’s most vulnerable populations of students, schools may need to join the battle to combat the severe danger that lead poses to students’ social and emotional health and academic prospects.

Department officials did not respond to a follow-up question: whether students are explicitly taught in class about the dangers of lead exposure outside of school.

But similar to other research, Markowitz and his colleagues conducted their own study and found that regular intervention, including improving nutrition and reversing behaviors that reduce lead exposure, can over time reverse lead’s effects on children’s cognitive functions.

“There is the possibility that the brain can get better,” Markowitz said.


Head of Denver Preschool Program resigning after more than five years

PHOTO: Eric Lutzens/Denver Post
Jennifer Landrum, president and CEO of the Denver Preschool Program

Jennifer Landrum, who oversaw the Denver Preschool Program for the last five and a half years, announced Friday that she’s leaving for personal reasons.

During Landrum’s tenure, Denver voters increased the sales tax that supports the program, allowing it to cover summer tuition costs and serve more children, and extended it through 2026. Landrum also oversaw the redesign of the tuition credit scale, expanded scholarships and awards for teachers and directors to better support quality improvement efforts, and developed a new strategic plan.

Landrum said she was leaving not for a new job but to take care of herself and her family after experiencing “extreme loss.”

“I need time to pause, reflect and recharge,” she wrote in an email to supporters of the program.

The Denver Preschool Program provides tuition subsidies that scale according to family income and preschool quality for students in the year before they enter kindergarten. The largest subsidies go to the poorest families enrolled in the best preschools. The program also supports quality improvement efforts, including for younger students, part of a broader shift in focus in the early childhood sector. It is funded by a voter-approved 0.15 percent sales tax and has become a model for communities around the state.

“Jennifer has served with vision, boldness, and a constant and deep commitment to improving the lives of Denver’s young children and supporting Denver families,” preschool program board chair Chris Watney wrote in an email. “The board, staff, and community are going to miss her in this role. The board of directors firmly supports Jennifer’s decision and wishes her all the best.”

Deputy Director Ellen Braun will serve as the interim director while the board conducts a search process for a new leader this spring.

Meet Reggio Emilia

Power to the kids: A preschool approach imported from Italy comes to public schools in Denver

PHOTO: Courtesy of Boulder Journey School

Boulder Journey School feels different from most other child care centers almost as soon as you walk through the door. In the hallways, there’s a kid-sized mail-sorting station, a giant metal spaceship trimmed with white and green lights, and a child-designed memorial for the school’s chickens, who were killed by raccoons a few years ago.

Preschoolers there help decide what and how they learn, drawing on their interests, imagination, and environment. Which means trying out adult-style jobs, building 10-foot-tall contraptions, and even talking about death are all par for the course.

“Rather than covering the curriculum, we’re uncovering the curriculum with the children in the classroom,” said Alison Maher, Boulder Journey’s executive director.

It’s all part of the school’s Reggio Emilia-inspired approach to early education — one that prizes play-based and project-based learning, grounded in the local community. At least two public preschools in Denver will soon begin using the approach.

Early childhood leaders in Denver see the adoption of Reggio in district classrooms as a milestone that brings a celebrated approach typically found in private preschool programs to a diverse group of children in the public sphere.

PHOTO: Ann Schimke
A spaceship designed by preschoolers at the Boulder Journey School.

Next fall, with help from Maher and other partners, a new Reggio Emilia-inspired child care center and preschool will open in a facility called Z Place in the Green Valley Ranch neighborhood. A new preschool program planned for Inspire Elementary School in the Stapleton neighborhood will also use the Reggio approach, which school leaders said ties in well with the expeditionary learning focus in other grades.

“Denver has been a bold city around early childhood,” said Rebecca Kantor, dean of the school of education and human development at the University of Colorado Denver, a partner in the work at Z Place. And adopting the Reggio approach is a “continuation of that bold theme.”

Denver isn’t the first community to incorporate Reggio principles into public classrooms. Early education programs in Boston, Indianapolis, and Tucson, among other cities, have implemented them, but the approach is hardly widespread.

At Z Place, the student body will include some children in the federally funded Head Start preschool program. School leaders say that there are special challenges when adapting Reggio for taxpayer-funded classrooms because of additional state and federal regulations governing everything from technology use to how children are assessed. Still, they believe it’s doable since Reggio is a philosophy of teaching and learning, rather than a prescriptive program.

In addition to Z Place and Inspire, Denver district officials may also bring Reggio to two programs in South Denver in 2020: The Stephen Knight Center for Early Education, which includes preschool and kindergarten, and Place Bridge Academy, a school for immigrant and refugee students that will soon be getting new preschool space.

Lisa Roy, executive director of the Denver Public Schools’ early education department, said incorporating Reggio principles into preschools in different neighborhoods advances the district’s plan to offer high-quality school choice options throughout the city.

Currently, most district-affiliated preschools use what’s called the Creative Curriculum, a research-based curriculum popular nationwide. About 15 use a curriculum called Tools of the Mind, which emphasizes social-emotional skills. Another handful uses the Montessori method, in which students in multiage classrooms learn at their own pace with the help of special educational materials. In addition to using the Reggio philosophy, the Z Place program will incorporate Montessori principles and emphasize the inclusion of students with disabilities alongside typically developing children.

Unlike Montessori, which is named for its founder, Italian educator Maria Montessori, Reggio Emilia is named for a place — that is, the northern Italian city where the educational philosophy first emerged after World War II. That’s because learning about and through the local community figures prominently into the approach, even for the smallest children.

For example, in Molly Lyne’s toddler classroom at Boulder Journey School, “bus” is the name of the game these days. That’s because city buses and school buses often pass by the playground just outside her room — regularly piquing the interest of her 1-year-old charges who watch the vehicles through holes in the fence and often blurt out the word “bus.”

To capitalize on their interest, Lyne and her two assistant teachers sometimes project a video on the wall showing what it’s like to be on a moving bus, from showing the traffic passing by to a simulation of the loud, creaky lurch passengers hear when the bus stops. Like all the technology used at the school, the video isn’t meant for the kids to sit and watch quietly. It’s intended as a backdrop and inspiration for their play.

Older students at Boulder Journey get even more opportunity to interact with the community. When a new pizza restaurant opened near the school several years ago, preschoolers got to visit — taking photos and interviewing restaurant patrons. They also offered up a critique: The restaurant didn’t quite work for little kids — the stools didn’t spin, for example, and the toilets in the bathroom were too high. Back at school, the children fashioned their own ideal restaurant furnishings out of clay, a collection featured at the pizzeria for a time and now displayed in the school hallway.

“It’s not only getting kids ready to read at third grade proficiently, but it’s for them to become citizens, owners of their community … and understand how their neighborhoods are different from other neighborhoods in the city,” said Roy, who last year visited Reggio Emilia schools in Italy with a delegation from Boulder Journey School and the University of Colorado Denver.

Maher said there’s a common misconception that Reggio-inspired schools are unstructured.

“People think because children have a voice in their education, in the way the day’s organized, in the projects that are developed, that the teachers are invisible and hands-off, and that’s not the case,” she said. “It’s a highly structured dance between children and adults to make sure all voices are represented.”

PHOTO: Ann Schimke
The “materials room” Boulder Journey School.

At Reggio schools, you won’t likely see any commercially produced alphabet charts, daily schedules, or cartoony posters. Many Boulder Journey classrooms have attractive blond wood furniture, colorful light tables and aquariums full of fish. The “materials room,” where kids can craft and create, is a feast for the eyes — with wood, colorful fabric, tubes, lids and other supplies arranged neatly on white shelves that line bright orange walls.

Maher said people who tour her school tend to think she has a big budget because the school is beautifully appointed. But many of the school’s decorations and supplies are inexpensive, everyday items that can be found around town, she said.

Maher acknowledges that being in Boulder, an affluent community northwest of Denver, means a wealthier pool of families. About 20 percent of her students receive some kind of help paying tuition, which is about $1,300 a month for a preschooler who attends four hours a day, five days a week.

The percentage of students who need financial assistance will be higher at the Denver programs’ adopting the approach next year. A little over one-third of Inspire’s student body come from low-income families, and the new Z Place program will likely serve a high proportion of such students.

At Inspire, there are already two teachers with training in Reggio, both graduates of a special masters degree program run by the University of Colorado Denver and Boulder Journey School.

One of them is Sarah McCarty, a kindergarten teacher who had never heard of Reggio before she entered the program. She believes the approach, in addition to helping kids build creativity, work collaboratively and develop problem-solving skills, instills a love of learning.

“I’ve never seen a kid who, when they got to do what they wanted, wasn’t happy about it,” she said.