Visi­ta­tion

The Commercial Appeal - - Front Page - BRAN­DON DAHLBERG

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 jen­nifer.pig­no­let@com­mer­cialap­peal.com or on Twit­ter @JenPig­no­let.

Ja-Mykal Den­nard, 3, plays with toys dur­ing a home visit.

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