INTERVENTION INTERRUPTED

 

Author(s):    Andreae Downs, Globe Correspondent Date: February 9, 2003 Page: B7 Section: Education

 

In a big room full of play equipment, four toddlers are gathered around a water table filled with rice and beans. They fill and dump bottles, taste the beans, run them through funnels. Quietly.

"Don't you think it odd that in a room full of 2-year-olds, no one is talking?" said Candace Chang, director of the Bay Cove Early Intervention Program, which under a state contract serves roughly 400 families with young children from Dorchester, South Boston, and Roxbury. Many children in the room have struggled to develop normally. Some are just learning to walk. Others are still working on vocalizing - not yet using words. Medical conditions have hampered some of them; others have suffered abuse or neglect. In order to progress, specialists say, the children need to spend significant time climbing, exploring, and socializing.

 

Few, however, have access to safe neighborhood playgrounds, and some live in cramped quarters.

 

But now the state Department of Public Health has cut the time allotted for these highly-structured play groups from five hours to 2 1/2. Early intervention advocates say the move is shortsighted.

"This is when the children have an opportunity to practice social skills, and when they are most motivated to work on walking and talking - they see other kids doing it," said Chang, who said that about 90 children attend the group play. "But with just one session a week, we spend a lot of the time getting over their stranger anxiety. Their memories aren't developed enough that they remember week to week. Ideally, they should be here five days a week."

 

In the last five years, the state Legislature has passed a supplemental budget to cover the increasing number of families referred for early childhood intervention - up from 17,000 in 1997 to 26,000 today, said Sally Fogerty, assistant commissioner of the state Department of Public Health. But current fiscal constraints have made that scenario unlikely, she said, prompting the department in January to cut the time for the therapy play groups.

 

"We need to live within the allocation we have been awarded," Fogerty said. Federal guidelines directed the department to protect most home-based services, she said, but therapy groups usually meet in centers or playgrounds. She attributed the increasing demand for services to successful outreach by the department and a growing recognition that early intervention can make a significant difference.

 

Several studies show that early childhood therapies have long-term benefits, especially for disadvantaged children. For example, a 15-year study in Chicago found that urban, low-income children who participate in early intervention are more likely to complete high school, perform better in school, need fewer special education services, and are less likely to become involved with the law than their peers who do not.

 

The US Department of Education cites studies such as the Chicago one in its information on early intervention, noting a return of between $4 and $7 for every dollar spent.

 

"Before early intervention, she couldn't walk or talk, couldn't feed herself or play with her toys," Janet Clancy-Cadogan said of her 2-year-old daughter, Abby, who has Williams syndrome, a rare genetic disease that, among other things, makes it difficult for her to socialize with other children. "For her, communication with other children, developing social skills, is extremely important."

Marcus Chance, who is 2, waits for Tuesday play groups all week. His mother, Rochelle Chance, can occasionally drive him to a playground in another neighborhood, but the one near her Savin Hill apartment is dominated by teens who drink, swear, and smoke, she said. "I'm always calling the cops," she said. "They've got no respect for the little kids. Sometimes they are really hostile. So I have to drive for miles."

 

Chance's daughter, Kiki, spent four months in the newborn intensive care unit, and later struggled through developmental delays in speaking and motor control. But thanks to early intervention, Chance said, Kiki, now 14, is an honors student and has been accepted into the Boston Arts Academy in the fall.

 

Advocates said that cutting the play therapy in half will hurt the urban families who need it the most. "There are a lot of little kids trapped in tiny apartments," said Chang. "Proper brain development also requires gross motor activities."

 

The state, she said, pays about a quarter of the cost of early intervention. Medicaid or private insurance - in payments proportional to the state's - provides the rest of the funding. But under that arrangement, Chang said, "When DPH cuts, kids lose three times as much as the DPH will save."

 

Dr. Jack Shonkoff, dean of Brandeis University's Heller School for Social Policy and Management and an expert in early human brain development, said any cuts should be made on an individual basis, not across the board. "The most vulnerable are the children in the most impoverished and most disorganized families," he said. "A rational and equitable system gives services to people based on their need, not on their ability to advocate for themselves."

 

Representatives for the state Department of Public Health agreed, but said they were trying to save the most important features of early intervention without spending more than their budget. "It's always difficult when services are downsized or changed," said Barbara Prindle-Eaton, who directs a Cape Cod early intervention program and worked with the DPH in deciding where to cut. "But these were made in a thoughtful manner."