LSAFHS | Home Based Child Development

My name is Michelle Santoyo, and I began my volunteer adventures at the Little Sisters of the Assumption on January 10, 2003. My goal for the next six months was simply to have a positive impact upon the families of East Harlem and to gain further knowledge on the issues affecting underserved communities with the hope of applying that knowledge to my dream of becoming a physician. I was definitely excited, anxious, and eager, but I was a bit hesitant because I didn’t really know what I was getting myself into. Either way I was about to find out.

On my first day I was assigned to two different departments within the agency: the Nursing and Home Based Child Development programs. In the Nursing department I was given the job of organizing and leading the Children’s Asthma Group, which is an after school program that runs twice a week for children aged six through twelve. Its mission is to empower students to view their lives in a healthier context. There are segments on asthma education, living with asthma, environmental health education, homework exercises, writing and art activities, and positive mentoring. Meanwhile, in the Home Based Program, I became a home visitor. The main focus of my job was to enhance the parent-child relationship through parent guidance and child development information. My goals were to model stimulating adult-child interactions through developmentally appropriate play, identify developmentally delayed and at-risk children, provide corrective interventions, and monitor and assess mother-child responses. Both jobs were going to be a handful, but I looked forward to learning how to best serve the community.

I dived right in to the Home Based Program. I was anxious to have the opportunity to provide hands-on service to individual families. After accompanying several of my co-workers on home visits and receiving the proper training, I was assigned with my very own seven families. I must admit, even though I was excited, I was also very scared. I began wondering if the families were going to like me, if I would fail by not catching a “warning sign” in the family or in the child, and whether I would identify with the family. I had to move on, though, and just give it my best shot. One of my most memorable families, and a genuine story, taught me many beautiful life lessons.

The first mother I met was Jane Doe, who had a son named John. Jane was a Mexican immigrant who had ventured to New York with the great American dream for her unborn son. Unfortunately, the American dream turned into a typical nightmare as she became isolated and depressed. She lived in a shared apartment with two other families. Her husband began abusing her as he would come home late and drunk after work. She rarely stepped outside her home except once every two weeks to do grocery shopping and laundry, with her husband of course. Furthermore, Jane barely knew any English, which created additional barriers and added to her loneliness. Eventually her son was born, which eased some of the tension. Her husband’s spirit was temporarily lifted with the birth of his son. Unfortunately, the high didn’t last long. Within a matter of months, Jane was back into her domestic violence situation. As the great mother she was, all she could worry about was protecting her son, and she would only ask that before she was beaten, she could put John to sleep in the other room so that he wouldn’t see the violence. Luckily, her husband always respected her one request.

Jane heard about our services at the Little Sisters and became very interested in having a home visitor track her son, who at this time was 17 months old. An initial assessment was conducted, which demonstrated that John was delayed in his fine motor skills, communication skills, problem solving skills, and social/emotional development. He was expected to qualify for physical, occupational, and speech therapy. However, the hope was that in providing a home visitor to work on John’s skills, he would improve so that if, and, or when therapies were administered, he wouldn’t be so developmentally delayed. Hence, I came into the picture as the assigned home visitor to the family.

My first visit with Jane had me a bit nervous, but she was very welcoming. After introducing several activities with John, I realized his delays. For instance, he didn’t speak, he couldn’t coordinate his motor skills, and he would release his frustrations in bursts of aggressive behavior. Fortunately, even though I was concerned with John’s development, I was not concerned with the relationship between mother and son. Jane was very attentive, aware, and loving with John. My goal would be to assist in John’s development by modeling specific activities and engaging Jane to also model the same behavior. I remember feeling uncomfortable as I left her home because I was uncertain as to whether I could help this family, but I thought with faith, we might succeed.

Jane and I agreed to meet every Wednesday morning to work on John’s skills, spending two to three hours on each visit. I brought particular toys and games that would stimulate John’s abilities. It was very frustrating in the beginning for all of us, but especially for John, as he would consistently attempt an activity, but fail. He couldn’t even stack two blocks one on top of another, place a chip in a “piggy bank,” or speak more than six words, or problem solve, which all added to his frustration expressed in aggressive outbursts. However, there was one activity that John loved and was successful in doing – playing ball. Therefore, I began to use a tennis ball as a means to practice his motor skills, coordination, and social skills (his ability to listen and follow directions). The activities with the tennis ball allowed him to build his self-confidence, which further encouraged him to continue to attempt the other activities. In focusing on the good, John was empowered to face the bad, in order to try and make it better. We would always begin each session playing ball. Soon enough, John was stacking towers of six to seven blocks and shaking his full piggy bank with pride. In addition, his aggressive outbursts slowly became fewer in number.

My next goal was to improve his communication skills. Jane and I began reading John stories, playing games to help him identify objects in the room, and singing him songs. He would clap and dance, savoring every bit of the fun. Then, one day as I was leaving, John waved and actually said bye! Jane and I couldn’t believe it! We were jumping with excitement as we all three repeatedly said byes. It was an amazing and inspiring moment that we all shared together. Before long, John was recognizing objects such as windows, doors, eyes, hair, shirt, etc. and talking endlessly. Even better was the fact that we could understand most of his conversations. He was able to articulate not just simple words, but his thoughts. He would tell us he was hungry and wanted chicken, or that he wanted to play a particular game, and would even instruct us on what to do. His aggressive outbursts disappeared, and instead his true loving self came through. John would sit on my lap and give me hugs and kisses. He had evolved into new person. The agency then decided to conduct evaluations to see if John would qualify for physical, occupational, or speech therapies. Keep in mind, he was expected to qualify for all. Jane was so emotional and proud when she finally informed me that the only therapy John would require was occupational therapy in order to improve his coordination with his fine motor skills. John was considered on age level in all other categories! In a matter of a couple of months, John had conquered the “impossible,” and had succeeded in developing his skills. I was so happy! To this day every time I arrive at John’s home, he quickly ushers me into his room and sits down on the floor, prepared to play ball, his face glowing with motivation and excitement. It is a pleasure looking forward to his zeal.

While playing with John, I also engaged Jane into thinking about her past, present, and future. We would discuss her achievements, failures, and regrets. As each week progressed, Jane continually opened up as I earned her trust. We would freely talk about any concerns, and especially about any accomplishments. A burden seemed to be lifted off of Jane, and she became more energetic and happy. In addition, Jane confirmed her dedication to her son by practicing the activities assigned every day. She too wouldn’t quit, even through the frustrations, and managed to maintain her focus. Her husband also began witnessing the sparkling improvements in John’s development, and in Jane’s commitment to her son and family. Jane’s husband stopped drinking, and instead would rush home after work to spend more time with his family. He stopped abusing Jane and wasn’t as controlling anymore, allowing Jane to take John to the park or to the agency. His life, and therefore Jane and John’s lives, took a new direction – a positive one. Currently, Jane’s husband has requested the “honor” of meeting me. He wants to watch me play with John, so that he can apply the same “techniques” in playing with his son. My mouth dropped in shock when I heard this news from Jane! She too was happily pleased. I couldn’t help but reflect on my feelings of three months ago, when I had first left their home. I had doubts about my ability to help this family, but we had faith, and I strongly feel now that it was this faith that prevailed.

It may be said that I did help advance John’s development and improve Jane’s home life, but I feel that both Jane and John helped me more than I helped them. From Jane I learned first-hand the true values of self-sacrifice, unconditional love, and an indestructible hope as she always maintained a positive attitude, even during grim times. From John I learned that through hard work and an unparalleled eagerness, a person can accomplish anything. Even with his vulnerability and frustrations as an innocent child, he was unwilling to quit and continued to persevere and to learn. The beauty in seeing all of these true values come together in perfect harmony, even in the midst of a dire environment, is an extraordinary experience that I couldn’t have learned elsewhere. And just imagine – all this I learned from just one family.

Entering a family’s home has been a remarkable and unique experience because it has given me the opportunity to taste their reality. I am confident that the lessons I have learned during my short time in East Harlem are lessons that will always live in me and will inspire me to become a better physician. I have come to realize and accept that I cannot save East Harlem, nor any other underserved community, but I can still place my best efforts in helping the individual families attain a higher level of awareness, just as the families help me reach a higher level of understanding.