Healthy Schools

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.

 

En pointe

How ballet is energizing one Memphis school — and helped save it from closing

PHOTO: Caroline Bauman
Briana Brown, an instructor with New Ballet Ensemble, prepares her first-grade dance students for a performance at Dunbar Elementary School in Memphis.

Instructor Briana Brown counts aloud as first-graders in pink leotards skip across a classroom floor to practice their leaps and twirls — a weekly highlight for students at Dunbar Elementary School.

In the South Memphis neighborhood, ballet lessons offered through the nonprofit New Ballet Ensemble introduce students to the art of dance at a school with few resources for extracurricular activities.

PHOTO: Caroline Bauman
Ten-year-old Briana Davis is among 40 students receiving dance instruction at Dunbar Elementary School.

Ten-year-old Briana Davis is among the beneficiaries.

Before joining New Ballet’s class, she danced throughout her mom’s house, just a short walk from Dunbar in the city’s historic African-American community of Orange Mound. Now, Briana is among about 40 Dunbar students who jeté and pirouette in a makeshift classroom studio at Dunbar, or after school in a studio at the group’s headquarters in midtown Memphis.

“I want to keep dancing and to be a dance teacher when I grow up,” Briana said. “I think this is really special. If I hadn’t done ballet at school, I don’t know if I ever would have danced for real and not just at home.”

For eight years, New Ballet Ensemble has been teaching classes at Dunbar and offering scholarships to a talented few to continue their dance education outside of school time. Here under the tutelage of teaching artists who are fluent in classical ballet and other styles of dance, they learn to follow instructions, practice new positions, strengthen young muscles and develop discipline, all while expressing themselves creatively and learning about a world beyond Orange Mound.

But the Memphis dance company’s work has gone far beyond teaching students how to plié and fondu. Thanks to grants that New Ballet helped secure, Dunbar now has a community garden and parent resource center.

And when Dunbar was on the chopping block to be closed this year by Shelby County Schools, New Ballet dancers, instructors and supporters showed up en force at school board meetings. The district later reversed its decision and opted to keep Dunbar open. Superintendent Dorsey Hopson cited community support as a reason for his change of heart.

Katie Smythe founded New Ballet Ensemble in 2001 to teach dance, but quickly discovered how her organization’s work was being limited by a dearth of community resources available to public schools in Memphis.

“We came here to find talented kids for dance, but we found that our access to community partnerships and the school board to be the real opportunity point for us,” said Smythe, who also serves as the group’s artistic director. “The school board and administration learned while trying to close this school how valuable community partnerships can be, I think.”

New Ballet became one of the first outside-of-school organizations to have a stake in the Dunbar school community, said Principal Anniece Gentry.

PHOTO: Caroline Bauman
Youngsters giggle as they watch their instructor demonstrate a dance move.

“When students see community partners are invested in their school, they want to achieve more,” Gentry said. “Our relationship with New Ballet is one I will always treasure. They work to do more than anyone else I’ve seen.”

The parent resource center is one of the most valuable additions. Stocked with computers, coffee and books, the room was created for parents with help from a $25,000 grant from ArtsMemphis, a local advocacy and funding group.

“There are computers for parents to use if they don’t have internet at home,” Smythe said. “I’ve seen parents drop their children off, walk to the room and apply for jobs while grabbing a cup of coffee. (For some parents), there was no positive reason for parents to come to school before this, only if their students were sick or in trouble.”

Building parent relationships have become key to New Ballet’s mission at Dunbar, and Smythe wants to take the group’s learnings to other Memphis schools. It’s already helping with arts education in classrooms at Bartlett and Sherwood elementary schools, and Smythe wants to bring Dunbar-style ballet programs to secondary schools that now teach former Dunbar students at Treadwell and Sherwood middle and Melrose and Douglass high.

But that takes money.

New Ballet is dependent on the National Endowment for the Arts, a federal agency that could experience huge cuts under President Donald Trump’s administration. In addition to $15,000 in NEA funding, the group gets money for its school programs through the Tennessee Arts Commission, which also comes from NEA.

PHOTO: Caroline Bauman
New Ballet founder Katie Smythe brought ballet to Dunbar Elementary in 2009.

To remind those who hold the pursestrings about educational ballet programs like Dunbar’s, Smythe recently joined other arts advocates to speak with lawmakers in Washington, D.C. Their message: The arts are more than just concert halls, expensive tickets and paintings that people don’t understand. It’s also about helping students to grow mentally, physically and academically.

For students like Briana, support for New Ballet would mean another year of free ballet lessons and after-school programming.

“I really look forward to performing,” Briana said. “Learning to dance is really fun. But being able to show off how much I’ve learned to my mom? That’s the best.”

Emerging partnership

Memphis schools have space. Boys & Girls Clubs have programming. Now they just need money to put clubs in three schools.

PHOTO: Boys & Girls Club
Memphis students show off "cancer awareness" posters they created as part of a Boys & Girls Club program at Promise Academy, a charter school in Raleigh. Three more clubs could open in Memphis schools by 2018.

Grappling with numerous under-enrolled schools and significant neighborhood needs, Memphis school leaders are seeking to fill some empty space by partnering with the Boys & Girls Club.

Shelby County Schools is working with the organization’s Memphis chapter to open clubs by 2018 inside three schools: Dunbar Elementary, Riverview School and Craigmont High.

But first they have to secure about $1 million to pay for the clubs’ first year of operations.

Both entities view the emerging partnership as a way to connect space and programming to strengthen schools and their neighborhoods. The Boys & Girls Club of Greater Memphis also wants to expand beyond its current seven sites.

“It doesn’t make sense to build a $4 or $5 million facility somewhere only to have the population shift due to school closure or neighborhood changes,” said executive director Keith Blanchard. “Suddenly, you have this super nice club and no kids. This way, we can go to where the kids are.”

The partnership would step up the effort of Shelby County Schools to join a national trend in developing community schools, which put facilities to use beyond the traditional school day and emphasize a holistic approach for addressing poverty, health and behavior. The arrangement also would tap into a growth and missional model for the Boys & Girls Club, which has been successful in working with schools in cities such as Orlando.

Blanchard hopes the new Memphis clubs would provide students with an after-school option in schools where extracurriculars are slim, as well as a place to go during summer breaks. Each site could serve up to 240 students.

While the district can provide space and utilities, each site would cost an estimated $330,000 to operate — an expense that district leaders plan to ask the County Commission to cover initially. The long-term goal is to get corporate and donor support.

“The last thing we want to do is open these clubs and have to close in two years,” Blanchard said.

PHOTO: Boys & Girls Club
The Boys & Girls Club operates seven clubs in Memphis.

Under-enrolled school buildings are plentiful in Shelby County Schools, where leaders have closed more than 20 schools since 2012, partially due to low enrollment. At the same time, Memphis school leaders are seeking more resources to serve a disproportionately high number of poor, black and disabled students.

“We are always looking for ways to expose our students to programs/activities that foster good citizenship, character building, and healthy lifestyles that contribute to student success,” a district spokeswoman said in an email this month.

The Boys & Girls Club of Greater Memphis already has one school-based club at Promise Academy, a state-run charter school in Raleigh, where about 60 students attend.

Blanchard said the three newest school sites were chosen because the organization doesn’t have a strong presence in those neighborhoods.

Dunbar Elementary Principal Anniece Gentry said the Orange Mound community would welcome the additional resource.

“There’s not a YMCA or Boys & Girls Club in this area,” Gentry said. “This would be a place not just for students, but for the entire neighborhood, as a way to bring families together. For the students, having structured resources in the afternoon is going to help them to grow even better during the academic school day.”