Saturday, December 18, 2010

wrap around services

One of my former co-teachers from when I was a classroom teacher sent me a clip of Arne Duncan. (A minute on this awesome-former-co-teacher- she's who I try to be as a sped teacher, and I keep trying to get her to come back to the think-tank... )
Back to the clip...  I have my own issues with Arne and am frequently frustrated by him and the way the Department of Ed is going, but occasionally I hear him say something that is dead right. He manages to do that a few times in this clip. 
One of the issues he talks about is the need for wrap-around services for our kids. He acknowledges that what our children from poverty need isn't just fabulous schools but also quality health care and good early intervention. Can I get an Amen?

This week I've found myself thinking over and over again about how much our children need access to good quality health care. In the craze of the health care debate last year I realized that nothing that was being debated was going to make any difference to the kids I teach. No matter how much we pay to give people health care and insurance it doesn't magically make it easier for our families to go to the doctor. It doesn't magically mean the doctors will listen careful to the parents' concerns and give a thoughtful diagnosis. It doesn't mean that our parents will suddenly learn how to read the directions for giving their children medication, or will easily be able to get off work when their children are sick. It does not free up a doctor's schedule so our children can quickly get the care they need when they need it.

Over the years I've run into so many children whose pediatricians have utterly ignored parents' very valid concerns. Children who should have been referred to Child-Find and yet were not because the doctor overlooked many of their developmental delays and told the parents that the child was "normally developing" when in fact they were not. I don't know how many kindergarten children have come through our doors with severe delays and every time the parents told us that the doctors said they were fine, despite the fact that the parents themselves were gravely concerned. In many of these cases if the children would have received early intervention they could have caught up with their peers by kindergarten, or at least greatly increased their verbal abilities.

This week one of my co-teachers and I sat down with a family to share our concerns for their little five year old (not Magical, this is another child all together) and learned that the family shared the same concerns. The parents had taken him to the doctor twice because he's stopped eating, only to have the doctor say he was fine and refuse to run any tests. The five year old has lost significant amounts of weight and yet the doctor would not give the parents the time of day to run the tests. We had to write a letter from the school stating our concerns in order to back the parents up. This happens time and time again. I cannot tell you how many of these letters I have written begging doctors to simply listen to the parents. It's not an overly-worried mother, there are true concerns.

Do the pediatricians see our parents as immigrants with no common sense or second class citizens?  Do they look at our parents come through the doors and make broad assumptions that keep them from truly diagnosing our children? If we are held to standards to meet every one's needs in the school system why are the doctors not held do the same standard?

Don't even get me started on how difficult it is to get our children in to see a neurologist. We basically have to sign them up for clinical trials so that they have access to brain scans and the doctors.

And it's not just the doctors' fault. Many of our parents do not have cars and have to rely on the bus to get them to and from the doctor- something you do not want to do in the winter with a sick child. Many of them do not get paid if they take the day off to work and many work 7 days a week just to pay the rent. They want to make sure their child is really sick before they sacrifice a day's pay to go to the doctor (who may or may not listen to their concerns). Many are fearful of questioning anyone in authority and so do not ask the doctor any questions when they are concerned.

The combination of all these factors leads our children to suffer through something as simple as chronic ear infections to something as grave as cancer. Would wrap-around-services change that?

I'd love to have medical clinics walking distance from the subsidized housing most our children live in. I'd love to have medical clinics that have a partnership with the schools, so that we are all working together to support these families. We know these children- we see them daily and develop relationships with their parents- wouldn't it make sense for us to work together with the doctors in some fashion?  To be honest I'm not sure what that would look like, and right now I can hear Mr. Lipstick shuttering at my socialist ideas- but there must be a way to provide wrap-around services that will protect the privacy of our families while also giving them easier access to medical care, allow all the children's care takers to communicate concerns, and allow doctors to see the whole picture behind each of their patients.


Unlimited said...

Said by a parent during a meeting this year: "I told our child's doctor about our concerns (inability to focus and hyperactive behaviors) - and the doctor said 'It's just a phase, he'll grow out of it.'"

Cue list of alternative doctors.

Snippety Gibbet said...

A couple of years ago someone told me a local doctor was ignoring notes from our school because the principal wrote too many. It sounded as though he thought we just wanted to medicate them all.