Children with Delays and their Parents Find Help in Play

The cheerful sound of kids and their parents signing “head, shoulders, knees and toes!” filled a classroom in San Pablo on Monday morning. Despite the smiles and laughter, the play was purposeful, part of a playgroup for children with developmental delays.

If it weren’t for the playgroup, offered at the First 5 Center in San Pablo, the mostly low-income, Spanish-speaking parents may have been hard-pressed to find help for their children.

Despite documented delays in language, cognitive, social or behavioral ability, the children in the playgroups didn’t qualify for services at state-funded regional centers for the disabled.

Children who are 2 to 5 years old have to have a delay in at least 50 percent of the developmental categories to be eligible, explained Graciella Pagano, who teaches the playgroup in several First 5 Contra Costa locations. These strict guidelines were adopted during the Great Recession, when painful funding cuts hit social services across the state.

As the new requirement squeezed available services, First 5 Contra Costa was training about 300 children’s services providers to identify kids who weren’t meeting developmental milestones. A common concern emerged during the trainings: once those children were identified, were services available to help them?

Often, the answer to that question was no. “Even before the cuts, the regional centers weren’t adequately funded,” Cally Martin, deputy director of First 5 Contra Costa, explained. “It’s a terrible thing to screen a child and identify a need and then tell parents there are no services to provide.” The regional centers will adopt less stringent criteria for eligibility next year, she noted, but still won’t serve clients with milder developmental delays.

The playgroups started in 2013 as a pilot program for children who didn’t meet the high bar of eligibility for state services and became a full-fledged program earlier this year. The evaluation of the program is not yet ready for release, but several children from the first year of the program improved to the point where they no longer required services, according to Martin.

Intervention is most effective in the early years of life, when the brain is developing quickly and has the most plasticity. “Those years are the foundation for everything in life, including acquisition of the skills needed for school,” Martin said. “It’s the use it or lose it period.” Interventions later in life are possible too, she added, but they typically require more work and expense than early interventions.

In Monday’s class, Pagano was nudging kids toward one specific developmental milestone – learning the names of body parts, a lesson she calls “All About Me.” The rounds of signing “head shoulders knees and toes” were meant to teach by repetition, which is how younger children learn, Pagano explained.

The need for repetition is one reason why parents also attend the classes. They learn the games and activities and can practice them at home with their children. Parents and children also work one-on-one for the last part of the class, called table time. To learn about body parts, parents and their kids played with Mr. Potato heads and dolls with removable limbs. “There is a lot that parents can do at home,” Martin said.

During table time, Pagano gently coaches parents on how to instruct the children. “The instinct is to correct,” she explains patiently. “But we want to redirect. So when they touch the nose instead of the head, say, yes, that’s the nose. Where is the head?”

Janice Grant of Richmond says she’s seen a noticeable difference in her great grandson since they started attending the playgroup together three weeks ago. She began worrying about Brandon’s speech when he was one. “At a year, most babies say hello and goodbye,” Grant said. Brandon didn’t speak or mimic the sounds he heard.

Grant was also concerned because Brandon, now two, is an only child and does not have many opportunities to interact with children his age. Since he started at the playgroup he’s been mimicking a bit more, Grant said.

When Pagano brought the playgroup together to say goodbye for the week, Grant’s face lit up with pride. “Did you hear that?” she asked Pagano as the families started to trickle out after class. “He said bye. He said bye back.”

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