Dennard family since before Ja’Mykal was born.
The family is part of a bi-weekly home visitation program called Parents As Teachers that provides social services and support to about 300 clients with young children, all done out of the client’s home. Many families, but not all in the program, live below the poverty line.
Home visits have been part of the child wellness landscape in Tennessee since the late 1970s. Some have the goal of decreasing infant mortality rates, with others, like Parents As Educators, focusing on a child’s development and readiness for school.
Significant local collaboration and increased funding over the last 10 years, including nearly $10 million to Tennessee each year for the last six years, has boosted the profile of home visits and providers’ abilities to reach more families.
Additional state funding this year and a plan to improve outcomes for the most vulnerable children in Shelby County seeks to increase the reach of home visits even further.
About 1,000 children currently receive home visits in Shelby County, although the number who benefit increases when there are other children in the home. Additional programs in the county, including some schools, have a home visitation component, but not as the main focus of their efforts.
Under a Shelby County Early Childhood Plan to improve the quality of life for children, the county has a goal to double the number of children and families participating in home visit programs over the next three years.
Seeding Success, an early childhood coalition in the county headed by Executive Director Mark Sturgis, is the organizing force behind the plan and the efforts to grow home visits.
“This is the front door to what hopefully will be a robust and national-leading early childhood program in Shelby County,” Sturgis said.
‘It’s a relief’
Shante Dennard enrolled in Parents as Educators about two weeks before Ja’Mykal was born.
At first, she wasn’t sure she trusted having another person in her home so frequently. But she soon found Ruffin to be supportive, and free of judgment.
“It’s a relief,” Dennard said. “It’s assuring to know I have someone that won’t judge or give me negative feedback.”
Instead, Ruffin points Dennard and her 24 other full-time clients in the right direction, whether that’s education about the risks of smoking during pregnancy, or making sure every electrical outlet within reach of a child is covered.
Her goal with every client is to empower the caregivers with the skills and resources to provide a nurturing environment for their children and to reduce their exposure to adverse childhood experiences, or ACES. A 2014 survey by the ACE Awareness Foundation showed 52 percent of adults in the county reported experiencing trauma as children.
The ripple effect of those experiences can be children with developmental delays, behavioral issues or falling behind in school. Research has shown that children who don’t read proficiently by the third grade are four times more likely to drop out of school before graduation.
In a city where 39 percent of children live in poverty, just 24 percent of students in grades three through five in Shelby County Schools read at grade level.
A child’s first teacher
With her first two children, Dennard said she wasn’t sure where to go if she needed help buying them clothes or finding them the right medical care. She didn’t always know how to talk to her children or how to discipline them in a way that corrected their behavior.
Ruffin provides access to those resources, and works with Dennard to be her children’s first teacher and advocate.
She helped Dennard find the best school for her oldest son, who has a speech problem. She taught Dennard how to work one-on-one with each of her children on their homework, and to make reading a priority.
Now, Dennard said, her children won’t go to sleep until she reads to them.
“I know that each one of their goals and needs is being met,” she said.
Ja’Mykal just started preschool this fall, and it’s been a challenging transition. Ruffin’s visit last week was to check in on his progress settling into his new routine.
“He’s still learning the rules,” Dennard said, describing her youngest as a “busy body” who is constantly on the move.
In the evenings, she’s practicing his colors, numbers and simple word recognition with him, helping him learn to write with chalk on a blackboard attached to a child-sized easel with broken legs.
Those are exercises Ruffin is pleased to see mother and son working on together.
With all her families, Ruffin also makes sure children are hitting their developmental milestones, updated on vaccinations and developing appropriate social skills. She works with families on interactions as simple as sitting together at the dinner table. Families can stay in the program until their youngest child is 5.
Ruffin visits every other week, but families have her cell number.
“I call her all the time,” Dennard said. “She gets tired of me.”
State funding increased this year
Each year in Tennessee, between 2,700 and 3,000 children participate in a home visit program supported by the Tennessee Department of Health at an average cost of about $3,800 per child, according to a 2017 report.
Programs that involve health care professionals cost more than ones like Parents as Educators, which averages about $2,000 per child, according to PorterLeath.
The department receives about $9.8 million each year from a federal program designed to reduce infant mortality. That money is allocated across 50 counties
Coalition creates a central home visiting system
Ten years ago, Sandra Allen was coordinating home visits through LeBonheur Healthcare when she realized some of their clients were in more than one such program. She also had open slots in her program, which was small at the time, and she knew she wasn’t tapping into the need that existed.
She formed the Early Success Coalition, at the time still under LeBonheur, to coordinate a comprehensive home visit operation throughout the county.
Now under Porter-Leath, the coalition fields referrals and directs clients to the home visit program that best fits their needs.
Home visits see results in both the health and wellbeing of the child as well as academic milestones, she said, because of the relationships built between the client and the visitor.
In 2017, Shelby County home visit programs under the coalition had just one infant death in 801 births — a far better record than the county’s overall infant mortality rate of 9.3 percent.
“When you actually go into the home and you’re able to help demonstrate for the parents some of it in their own environment, it begins to click,” Allen said.
That relationship also works to provide mothers, who are often teenagers or not much older, enough of a support system to set goals for themselves to move forward in their lives, and in many cases, out of poverty.
“One of the things we’re doing is to help people see that they can have hope, they can have dreams, they can work toward it,” she said.
Dennard’s dream is to go to nursing school. She’s an obsessive researcher, constantly looking up medicalrelated concepts or terminology.
Having help from Ruffin to create a household budget or a meal plan keeps her on track for that goal.
“The smallest of things help,” she said. Reach Jennifer Pignolet at email@example.com or on Twitter @JenPignolet.
Ja-Mykal Dennard, 3, plays with toys during a home visit.