Childhood poverty, health and education are three complex issues facing Memphis and Shelby County today, and several local organizations are combining efforts to face the hydra's many facets.
Across Memphis, funders including Urban Child Institute, the Hyde Foundation, United Way and various levels of government are investing millions of dollars in a web of organizations and programs with one overarching goal — improve health, well-being, education and future economic outcomes by supporting Memphis’ most vulnerable youth.
Programs like UTHSC, Le Bonheur LEAD and ALLMemphis say they serve different needs for different populations but are all interconnected and working to lift the city’s most underserved children, their families and, ultimately, Memphis as a whole.
The Problem at Hand
Dr. Jason Yaun, assistant professor of pediatrics for University of Tennessee Health Sciences Center and president of the Memphis and Mid-South Pediatric Society, said children exposed to the chronic stress of poverty and adverse childhood experiences or ACEs, such as homelessness, domestic violence, food insecurity, incarceration of a parent, can experience lifelong impacts on their social, physical and mental health. These issues become more acute in Memphis, where 39 percent
of children in Memphis live in poverty.
In childhood, the ability of learning suffers
including retention, comprehension, attention, behavior
and school attendance. In adulthood,
rates of obesity, diabetes, cancer, depression, addiction and incarceration are increased when there is an early influence of ACEs.
A longitudinal study by the Annie E. Casey Foundation
found students who lacked reading proficiency by the time they entered fourth grade were four times more likely to drop out before graduating high school. In 2018, less than 16 percent
of Shelby County Schools high school students were considered proficient or with a mastery level in English language arts.
“With [poverty] comes the toxic stresses of poverty and lack of proper language foundations from birth to three,” said Dr. Krista Johnson, executive director and co-founder of ALLMemphis.
“When children don’t get proper exposure during that time, there are fundamental changes in their brains with the ways they learn and can access language.”
Outreach coordinators at the UT Le Bonheur Pediatric Specialists clinic work with clinic staff to assess patient and family needs beyond traditional medical interventions. (Submitted)
UTHSC Family Resilience Initiative
Yaun teaches and practices medicine at the UT Le Bonheur Pediatric Specialists. The clinic has 14,000 annual visits and is integrating health, early education and a family-centered approach.
The Reach Out and Read program provides free books to children six months to five years at each wellness exam.
Related: “Video: Memphis pediatricians prescribe books to young patients”
The Family Resiliency Initiative helps to identify traumas and barriers to care and wellness for patient ages nine months to five years and their families. It launched in May of 2018 and screened 203 families as of December.
An outreach coordinator at the UT Le Bonheur Pediatric Specialists clinic performs a needs assessment with a family at their child's checkup. (Submitted)
When children come for medical appointments, they meet with an outreach coordinator who assesses issues like food, housing or transportation instability or safety concerns.
They then act as case managers to help connect families with resources to address their needs. The clinic also provides some direct services, like free psychiatric services if a child or family member has experienced trauma and transportation assistance for those appointments.
“We’re looking at things that affect both the physical, mental, emotional wellbeing, providing wrap-around services to provide families with resiliency taking that two-generation approach,” said Yaun.
“We want children to graduate from our practice as happy, healthy young adults who are ready to continue in their education or employment and be successful."
Related: " New Memphis clinic considers the health effects of adverse childhood experiences"
Yaun said many programs targeting vulnerable children are using this whole-child, whole-family strategy because it acknowledges the complexity of childhood trauma and intergenerational poverty, rather than focusing on elements like education and healthcare as separate systems.
Le Bonheur inclusion facilitator Tereatha Hobbs supports a child during a group activity. (Submitted, Lisa Buser Photography)
LE BONHEUR LEAD INCLUSION AND SCHOOL-BASED THERAPY
"You can not separate the child's development from the family's development, the child's outcomes from the family's," said Danielle Keeton, director of outpatient rehab and developmental services at Le Bonheur Children's Hospital.
Le Bonheur Early Intervention and Development, or LEAD, has been in operation since the late 1990s and is an umbrella for a number of programs that work to support children with developmental and medical needs and their families. LEAD Inclusion and LEAD School-Based Therapy help ensure children with special needs can integrate into typical childhood settings for improved social engagement, cognitive and physical development and preparation for traditional school learning environments.
Le Bonheur's Inclusion Support Program Nurse Case Manager Carey Wright observes children during classroom activity. (Submitted, Lisa Buser Photography)
LEAD Inclusion helps children who have a developmental or medical need — like a catheter or feeding tube — attend early childhood education centers that might otherwise deny them.
Inclusion specialists assess and train staff then support them until they feel comfortable providing for the child. The program currently serves around 150 centers across Memphis.
LEAD School-Based Therapy launched in 2012 and provides speech, occupational and physical therapies from pre-K to 12th grade at 35 charter and Achievement School District locations across the city. The goal is to keep children in the learning environment so support is usually provided in the classroom.
"What I really hope to see is a world that is far more friendly for including differences," said Keeton.
ALLMemphis Tailored Phonics
ALLMemphis asks what happens in the gap between kindergarten and third grade. A recent Vanderbilt study
found that children who get receive pre-K and early intervention begin to fall behind again if they don’t recent ongoing support.
“We have a literacy crisis here in Memphis where over 80 percent of children are not reading appropriately by third grade,” said Johnson.
At KIPP Memphis Preparatory Elementary, ALLMemphis partner school specialist Clifford Stockton works one on one with students as an added layer of phonics support beyond the classroom. (Cole Bradley)
Johnson said one major problem is that most phonics programs are geared towards white, middle-class children who have never experienced trauma.
“These children will fail with those curriculums no matter how good the instruction is because it’s not catered to the way they learn,” she said, noting that failing to read then becomes another trauma they experience.
ALLMemphis, which launched in 2017, takes traditional phonics methods and provides a culturally relevant and trauma-informed program. It uses words and scenarios that are familiar to students to build comfort and confidence. Teachers don’t ask students to make guesses they might not know. The program is tactile and multi-sensory to give students many possible ways to absorb information. The speed of the lesson is tailored to the speed of the learner and celebrates small successes. Each of these small adjustments helps reduce the trauma associated with failing to learn traditional curriculums.
ALLMemphis works with three KIPP elementary schools and the Promise Academy Hollywood campus in grades K-2. They train teachers, provide continuing development and provide the phonics curriculum to pair with the schools’ existing reading comprehension focused programs. Their partner school specialists also work one-on-one with students who need extra help with a specific skill. So far, they have served over 500 students.
“Working with the kids is my favorite thing,” said partner school specialist Clifford Stockton with ALLMemphis. "You really miss the nuances of being able to work with kids and families and see and feel the impact you’re making on a daily basis.
“What I want to be known is that reading is directly related to opportunities,” said Johnson. “Being able to be a good reader and have opportunities in life should not be dictated by the ZIP code that we live in. With a mind towards equity, it’s important that all Memphis, that all students have the same access to success.”
Support for this story was provided in part by the Urban Child Institute; it is one article in a series highlighting the impact and importance of early childhood education. The Urban Child Institute focuses its grantmaking, advocacy and community support on kindergarten readiness and third-grade literacy in an effort to improve the education, health and well-being of children and families in Shelby County.