A Chance To Grow is a special place for many reasons, not the least of which is our Turnquist Child Enrichment Center, that primarily serves young families that require county assistance to receive childcare services.
Turnquist consists of age-specific rooms for infants, toddlers and on up to preschool age. In addition to implementing a developmentally appropriate curriculum, Turnquist teachers are responsible for completing developmental assessments for each child every two months.
“Most times, we [the teachers] are the first to notice any social, verbal or motor skill issues,” says Sami, an infant room teacher of three years. “If a child isn’t meeting certain developmental milestones, we notify the parents that we’ve identified an issue and recommend they be referred to our Clinics team. Parents are almost always OK with an observation, and quite often say that they’ve seen the same issues at home, but didn’t know how to address them.”
Depending on the nature of the referral, an Occupational Therapist (OT) or Speech-Language Pathologist (SLP) will observe the child in their classroom, alongside the Turnquist teacher. This provides a safe, familiar space for the child, and allows our therapists and teachers the opportunity to discuss whether evaluation and treatment would best address the child’s needs. Once an evaluation is complete and a care plan is established, a child will receive 1-3 therapy sessions per week, with the teacher available to receive additional instructions from the therapist about ways to continue the treatment. The teacher also serves as the intermediary between therapist and parent, providing progress reports and suggestions for therapy at home.
“Working with the therapists is really nice,” says Sami, “especially when they show us how to do certain techniques. It makes a big difference that the teachers know how to help them, not just the therapists, because that means the child is getting the therapies they need all day, not just during one or two sessions. Parents really appreciate the convenience, they don’t have to take time out of their work days and it makes their lives a lot easier.”
Michelle Koyama, MA OTR/L, ACTG’s Assistant Director of Clinical Services, knows that this process is only possible with great communication from everyone involved. “Normally, these families wouldn’t have access to additional therapies, but we’re able to take that barrier away because we are able to fluidly communicate with the teachers in Turnquist,” she says. “We have a shared philosophy and see things through a developmental and trauma-informed model. We’re on the same page so it makes our communication very easy.”
Presently, 20 out of 32 children at Turnquist are receiving OT or SLP services. The need for these services has grown substantially in the wake of the COVID pandemic, and has often led to other areas of concern, including vision and auditory issues. Luckily, we offer vision and hearing screenings as well, and give parents the option to allow their child’s Turnquist teacher to represent their child in the exam room. Not only does this allow for the most optimal treatment schedule for the child (and parent), it provides our doctors with additional insight into their development, because they’re hearing it directly from the person that interacts with them in the early learning setting.
“During the pandemic, seeing became flat,” says ACTG’s Optometrist, Dr. Shelby May, OD. “The world got small and children of all ages stayed in the same loop. They didn’t go to the grocery store, take vacations or have other novel experiences. The world wasn’t big enough for these children to grow properly, and we’ve seen milestone delay amplify.”
From infants unable to hold their heads up (motor skills), to toddlers throwing tantrums (self-regulation), and preschoolers unwilling to give up screen time (attention), the effects of COVID are everywhere. The therapists and teachers at ACTG, however, are uniquely prepared to help these children. “Early intervention is so important,” says Sophie Reynolds, MS, OTR/L. “It’s really cool that our clinic is able to intervene at such early ages, where change can be made quickly because we can get to them so soon.”
Dr. May sees several Turnquist children in her clinic, and despite the difficult environmental factors, she says that she’s now starting to see a rebound effect. “Kids are picking back up really fast. If we give them the right tools, all those skills come back. Their brains didn’t change, they always had the capability, they were just missing the experience - we have to give them the right stimulus to grow.”
Shania said that Larico had been to other daycares, but they didn’t provide the type of communication, support or sense of community that she wanted. “Now when they wake up, they’re both excited to go to school and to see their teachers and therapists. They really love it here, and I do too.”
The Turnquist Child Enrichment Center and Clinical Services are amazing resources for young parents striving to provide the best foundation for their children. But more importantly, the community that our teachers and therapists cultivate is what sets A Chance To Grow apart from any other daycare, school or clinic in the Twin Cities.
“My kids wouldn’t be where they are today without the Turnquist teachers and the other services. It’s great that everything and everyone is in one building,” says Shania. “You can’t find a place like this anywhere else.”
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A Chance To Grow is committed to providing services to those who need them the most. Sometimes, that means partnering with an agency that focuses on meeting the needs of a specific population. For example, we knew from the research and from our own experience that the Somali community has higher rates of Autism Spectrum Disorder (ASD) than other groups, but that there were barriers – language, culture, or transportation – that prevented parents of these children from getting services. So in 2019, we began a partnership with ISKA, Inc., a Somali-owned community service organization. It was founded by Ifrah Hudle, a human service professional who recognized that Somalis not only have a very high prevalence of ASD, they also have to deal with barriers to getting help.
ISKA Inc., located in St. Louis Park, has a staff of 25 that works with children from birth to age 21. They currently see about 30 children a year, but hope to expand that to 50 to 60 in the future. When it opened in 2016, ISKA offered an adult waiver program where they could help disabled individuals in their homes. However, says Ifrah, “After a year or so, we saw that a lot of clients, especially younger ones, were getting diagnosed with autism and other developmental delays. We knew that our community was not getting the services they needed due to lack of communication and transportation, so we wanted to make it a one-stop shop for our clients.” Ifrah heard about A Chance To Grow at one of the Charter schools to whom we provide services and reached out to us.
Working together, the two organizations developed a program for Somali children that combines behavioral and developmental approaches. The young clients receive EIDBI services from ISKA staff that include targeted interventions designed to improve behavioral challenges and self-regulation, cognition, functional communication, learning and play, safety, self-care and social/interpersonal interactions. This helps the children regulate behavior and reach developmental milestones. They also receive Speech/Language and Occupational therapy from ACTG staff. The occupational therapy helps them work on their cognitive, physical, social and motor skills, with the goal of fostering independence. The Speech/Language therapy addresses challenges with communication by improving their verbal, nonverbal and social communication.
This more intensive approach is necessary. According to Ifrah, “There are high numbers of Somali children with autism here and most of them are further along the spectrum. In Somalia, there isn’t a medical word for autism. So when they come here, most of our clients have some idea that there might be something wrong with their child. A mother would call and say ‘my son is not talking, I think my son may have these signs, can you help me?’ But most of them don’t know how to read or write, some of them have very large families, so it’s hard for them to search for what they need, to understand what they are missing, what they are entitled to in terms of services, and how to get to them. So we partner with the mother or father or caregiver to understand the family needs, we help them set up schedules and routines, make appointments, help them with insurance and so on.”
“Our main goal is to help families bridge the gap to services they deserve in a way that respects and upholds Somali culture and Islamic practices,” says Ifrah. This involves, in part, helping families navigate barriers to receiving care. “Children usually have the initial diagnosis from their doctor, but this often presents problems. Office visits are too short for doctors to really get to know the child, particularly if language is an issue. Many parents say that at the first visit, doctors don’t take their child’s symptoms seriously, or they misdiagnose them, or prescribe the wrong medication. The mothers get discouraged and don’t go back. I tell them, stay with one doctor, give them a couple of sessions with that individual before they label or diagnose. I want medical professionals to really listen to our clients. I tell all the doctors that visit, this mother has a Ph.D. in her child, nobody knows this child more than the mother.”
Another barrier is access to transportation. Many families have difficulty finding transportation that meets their needs, particularly when their children have a hard time adjusting to strangers. Ultimately, says Ifrah, “We partnered with a couple of Somali transportation companies so that children will become familiar with one person. They call the driver Abti (Somali for Uncle), they know he will wait for their mother and will not call the police on her just because she’s late.”
It was also vital to establish an environment that honored cultural and religious practices. “For Somali clients, it’s mostly based on religion,” says Ifrah. “We follow Islamic beliefs and customs, we follow dietary rules, so they come to us knowing that we guarantee our space will not have anything that they are against.”
This creates an environment of safety and trust. Says Ifrah, “We have a client who’s about 7, she used to go to a mainstream agency, but now she comes to us. Her mom told us that every time she knows she’s coming here, she puts on the headscarf. When she’s gone to mainstream schools, she takes it off. Her grandma says I know that this is the right place because every time she’s coming to you guys, she puts on the headscarf. The kids feel like they could assimilate with us. They look like us, we look like them, they feel much closer to us.” Says Michelle Koyama, the Assistant Director of ACTG’s Clinical Services who coordinates all care at our partner sites. “We talk a lot in the field about how best practice is to give client-centered care. ISKA giving the children a space that they feel is theirs helps us reach that goal.”
According to Michelle, this actually strengthens the bond between ISKA and ACTG, whose on-site clinicians are not Somali. “What I appreciate about ISKA is that the staff makes it feel more like a community than a program. There was a child, 4 years old when we started, who didn’t have a means for expressing herself to strangers. At ISKA, she could see how other people she trusted, trusted us. For example, there was a day when her mom came in to see the session and the girl witnessed the three-way conversation between the ISKA staff, her mom and I, in both English and Somali. It was really evident to her that we were a team that all cared for her. We were able to go much deeper in conversation than what is typical with an interpreter, and that allowed our relationship to be more therapeutic faster. After that day she would often pause for a moment in therapy and say "you know my mom.”
In Somali, the word “iska” means “to belong,” to “have a sense of self.” Between the combined therapeutic approaches and the nurturing environment, this program has a tremendous impact on its young clients and their families. Michelle describes the impact on one young girl: “She first came to us at age 4. She had very little awareness of her environment or how she interacted with it. She could not even hold a crayon, let alone draw a picture, she was unable to see detail, draw recognizable shapes and so on. She’s 6 now, and she’s able to hold a crayon or marker in a functional way. She recently gave me a picture of herself. It has details, like her arms and legs and eyes, it has butterflies and flowers, it has dimension. The picture shows an awareness of self and she’s even created a safe space for herself in it.” In a sense, the drawing demonstrates how, through her progress there, the child embodies the spirit of ISKA: She has found a place where she belongs and there, she has begun to have a sense of self.
“As a kid, I had a harder time reading,” says Leah, a veteran educator currently with the Eau Claire, WI school district and a long-time S.M.A.R.T. advocate, whose passion for teaching and love for her students are palpable. “And I want to do everything in my power to prevent others from struggling.”
After several years in the classroom, Leah found herself in a position to support other teachers – as an educational consultant, instructional coach, literacy coach, Title I teacher, among other roles. While teachers were telling her that student behavior was their biggest problem, as a literacy coach and Title I teacher, she noticed that many children were having reading issues. “I had several kids, I could actually see their eyes doing different things on the pages, or they’d look at me and their eye would bounce, and I thought ‘something is going on there.’” Then she attended a training for a movement-based program that dealt with dyslexia. Her original teacher training had included very little about brain-related issues or the importance of movement to development. This new perspective changed her. “I started telling parents, ‘you might want to get their eyes checked, I’ve been noticing some things’ and parents wrote to me to say, ‘There was an issue, thanks for telling us!’ I thought, this is knowledge that everybody needs to have. It’s great and more students could be helped.”
Several years later, when she attended a three-day S.M.A.R.T. training, it was revelatory: “Every time I heard a story I thought ‘oh, that was that kid.’ I remember having an a-ha moment: They showed us how the alligator crawl is really good for reading comprehension, and I thought, ‘why have I not been doing this the whole time with the struggling readers?’”
Movement Anchors Learning!
Movement influences the ability to concentrate in a classroom and to learn to read and write. The body is designed to move. Research shows purposeful, specific, and systematic physical movement can affect the brain in a very positive and dramatic way. Physical activity helps create an optimal learning condition for the brain by:
Leah began to advocate for all teachers in the district to incorporate S.M.A.R.T. into their classrooms. Last year, district administrators went all in, arranging for all teachers and assistants to get trained. “The first time through the training, some of [the teachers] said, ‘oh my gosh, I thought this kid was doing this because they were misbehaving but really, they had this sensory or auditory processing or vision issue.’ They started to see behaviors differently, which I think is amazing.”
Her S.M.A.R.T. training continues to inform her practice. When her colleagues say, “This child has ADHD” she asks, “’Have you tried spinning? Or balancing? Or pencil rolls? Let’s start with some of those.’ I say to parents, do you ever notice them spinning? And they say ‘yeah.’ And I say, ‘let them, they need it, their bodies are telling them they still need to move.’”
“I have probably three or four kids with high behavioral needs. One of my little guys used to have really large emotions and now you wouldn’t really recognize him. Does he still have moments? Absolutely, we still have to work on it. However, he’s really calmed down quite a bit. His mom said, ‘oh my gosh, he has improved by leaps and bounds.’”
“We are a container society, we are putting our kids in car seats to highchairs to bouncy seats and they are never getting those experiences on the ground, and those experiences are the ones that lead to academic success. We should tell parents ‘Don’t rush them, there are a lot of stages we try to rush through, and quite honestly they need to be on the ground moving.’"
For parents of older children that are having problems academically or behaviorally, Leah says, “There’s a lot of brain-based activities that we can be doing, even at upper levels. My favorite video to show people is The Brain Highway, because there’s always someone who says ‘oh, yeah, I get it!’ when they see it.”