The Morning Report
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Friday, June 27, 2008 | Two-year-old Mia Zamora gripped a wooden puzzle piece in her tiny fingers as Elaine Lopez peppered the girl’s mother with questions: Can she kick a ball? Can she eat with a fork? Does she follow simple commands? Does she like being hugged? Can she focus on something for more than three minutes — other than a movie or the TV?
These simple questions have helped hundreds of Chula Vista mothers and fathers through a groundbreaking project, unique in San Diego County, which screens young children for disabilities, lags in development, and other problems. And the results have surprised even its creators.
Founders of the First 5 Kids on Track Project originally believed the 45-minute screenings would identify more children with disabilities and help link them with special education services long before kindergarten starts. For many Chula Vista families, it’s done exactly that, mobilizing teams of behavioral specialists, speech and language pathologists and other experts to attend to their children.
The screenings have also pinpointed problems that fall short of disabilities, but can be mistaken for them when students falter in the classroom — poor nutrition, depression, and even parental stress. The Chula Vista project isn’t necessarily finding more special needs students, but seems to be finding them more accurately.
That could have big implications for the larger world of special education, where over-identifying disabilities has been a persistent problem, particularly for Latino and black students, who are disproportionately represented in special education classes.
Educators face pressure to identify kids with special needs and their decisions can be subjective, said Arun Ramanathan, chief student services officer for the San Diego Unified School District, which isn’t involved in the project. Throw poverty and cultural misunderstanding into the mix, and over-identification can result. Well-meaning teachers sometimes mistakenly identify a child as disabled in their quest to help an underachiever, and unintentionally botch “a fairly high-stakes diagnosis.”
“You have to pull out all the stops before you can say, ‘OK, there’s clearly something going on with this student,’” Ramanathan said. “Screening is great because it forces people to really look at the student. How long have they been out of school? Have they had major family trauma? Did they just come from Mexico two years ago? All these things have to be factored in.”
Only ten sites statewide are piloting the program, and Chula Vista is the only site in San Diego County. Central to the Kids on Track Project are bilingual women from the community such as Lopez, who visits grocery stores, festivals and mobile home parks to find and screen families who are unaware or afraid of seeking help. Their clients include immigrants fearful of government services, many of them isolated in the absence of their extended families. Project manager Lisa Butler calls their work “taking it to the streets.”
Parents “feel a little afraid to knock the door to an office,” said Dolores Gahbler, another outreach worker. “We say, ‘We are mothers. We have little ones, just like you.’”
Gahbler and her coworkers reach out to families with children ages 4 months to 5 years and schedule screenings at home, in the library, or at a center operated by the Chula Vista Elementary School District. Chatting with the parent, they run through four questionnaires that cover the child’s health issues, physical skills such as using a fork or stacking blocks, social and emotional skills, and even the parent’s stress levels. If the child needs additional help, the workers help their parents get it.
Similar screenings are conducted by government-run preschool programs, but few actively reach into the community for kids who aren’t attending preschool. Minus that help, a child might not be evaluated until they go to school. And by that point, some have already fallen behind their peers in speaking, using their hands or other basic skills.
The Chula Vista data is limited but promising. Last year, every student referred to special education at Chula Vista Elementary School District by the screening project qualified, and none were turned away. Even doctors and preschools failed to match their accuracy. And by linking families with other services, such as counseling and workshops that build motor skills and help kids communicate, they hope to divert children who might otherwise lag behind and unnecessarily be labeled as disabled.
A surprising number of Chula Vista children fall into that category: Out of roughly 500 children screened yearly, fewer than a dozen are usually referred to special education, Butler said. Compare that with about 150 children linked with other resources after screeners identified “risk factors” in their lives: the depressed and inattentive boy whose sister died, the military kid who threw nonstop tantrums, and Lori Hurd’s 3-year-old son, who ignored other children on the playground and couldn’t be prodded to even say hello.
“I was afraid that he might be slow,” Hurd said. “I’m not worried about him at all now.”
Screeners recommended that Hurd and her son attend the free Kids on Track music and movement class where he socialized with other toddlers. No one can say whether the boy would otherwise have been diagnosed as disabled, Butler said. But the class helped him clear that developmental hurdle instead of delaying the problem until grade school or shunting it to special education experts.
“The systems are already overwhelmed, and we don’t want to set the family up to think they’ll get services they may not get,” Butler said. “And by supporting children, we’ve kept them from being referred” to special education.
The Kids on Track project costs $500,000 annually and ends in June 2009. Cigarette taxes pay indirectly for Kids on Track through First 5 California, a commission that spreads tax revenues for childcare, health and educational initiatives for young children to county commissions such as First 5 San Diego. The state and county commissions have split the expense over the past four years, hoping that the Chula Vista demo and its sister projects will reveal the value of childhood screening and build support for expanding the project statewide.
But in a grim budget year, extending or expanding the pilot across California could be tough. And First 5 has undergone heavy scrutiny this year after the San Francisco Chronicle reported that state funds paid for field trips and party supplies for middle-to-upper income kids, with one state senator now calling for its elimination. Those concerns could make an expanded Kids on Track program a tough sell.
“The Chula Vista program is wonderful, but it’s limited in scope,” said Catherine McDonald, a consultant with the Early Childhood Education division of the San Diego County Office of Education. “Resources are in short supply and everyone needs more. The issue facing our decision-makers is, what programs give us the best bang for our buck?”
Lopez chats easily with parents and asks question after question without embarrassment or unease, running the gamut from motor skills to problem solving to family stress. Toys lay scattered before her on a table: a foam ball, alphabet blocks, a thick bead to string along a cord. Lopez uses them to test children’s skills.
“Can she draw a straight line?” Lopez asked Claudia Ramos, who cuddled her daughter Mia Zamora on her lap. The toddler shied from the crayons, still grumpy from a fading bout of bronchitis. Ramos quickly sketched out the cartoon character SpongeBob SquarePants and coaxed Mia to add the arms and legs. Mia accepted the crayon and marked four stick legs on the cartoon.
“Oh my goodness, that’s great!” Lopez exclaimed, breaking temporarily from her Spanish. “I get so excited,” she added, laughing.
And if the Kids on Track project can accurately sort out kids with disabilities, it’s worth getting excited about — and investing in, Ramanathan said. Special education is massively expensive, with school districts shelling out millions for legally mandated services under disabled students’ individual learning plans. Funding for the programs has not kept pace with the costs.
“The places that have been able to do this make a tremendous investment in it,” Ramanathan said. “But it pays off in the long term because of the amount of money that’s saved from inappropriate identification.”