Going Forward

The demand for OT student fieldwork placement grew tremendously. According to Suzanne Makielski, "I've done some marketing, but the creation of our web-site (www.qualityoflife.org/ich/peds/peds5.htm) was instrumental in getting information out about the program. This included information about the program, student objectives, reading requirements and the philosophy of the model. It's been mostly by word of mouth that we've ended up with so many interns interested in this program." With the increase in interns and the number of CFH guests interested in the program, the need for a larger and more functional space grew as well. During this period of time, CFH was undertaking a major bricks and mortar campaign to raise funds to expand their existing space. It was a perfect time for the PEDS program space to expand. A larger facility, planned to the requirements of childcare licensing, was designed with opportunities for Suzanne to add her input. The new space would accommodate more children and provide the proper layout and equipment. "The Center was very accommodating to our program. They obviously wanted to continue the partnership. There was a lot of positive learning and involvement from our mutual goal and this led to the development of this state-of-the-art facility," recalls Suzanne.

Guests at the Center for the Homeless had the advantage of easy access to the facility. Many would drop their children off in the morning on their way to Center programming or work. According to Tasha Bricker, a former Center guest and PEDS parent, "The student interns were so nice to the children. And there were enough of them that all the children seemed to get enough attention. The whole program is so helpful to both parents and children." She goes on to explain, "My son, Junior, was the first one here at the PEDS program; Brenda, my daughter, came later. Junior was not used to interacting with other children but at PEDS he learned to interact. He used to be shy and not speak much but after a few weeks in the program he was singing and clapping. They taught him sign language and he used it to communicate with me. They also taught me how to work with my children to stimulate them and teach them to do things."

In 2001, the Center began to use cutting-edge brain research, in particular for people living in poverty and those who had experienced trauma, as a way of understanding the cycle of homelessness and working to break that cycle. According to Drew Buscarano, current CFH Executive Director, "We had begun to bring this brain research material to bear on adults; then we more fully appreciated just what the PEDS program was offering to the 0-3 population." Drew goes on to explain that, "The vision for the Center is - only the best for the most in need. So bringing the best resources to those most in need is what the PEDS program is all about - bringing Memorial's own expertise to the development of these children who are most in need." The Center has integrated Dr. Becky Bailey's Brain Smart Discipline and Ruby Payne's A Framework for Understanding Poverty in helping them understand the impact of poverty on a person's development. They have focused on how to work with children who are at-risk by creating an environment to grow smart brains. According to Drew, "These ideas have shaped how we have worked with Memorial to develop our continuum of care." These core principles and mutually shared goals helped to evolve a natural and innovative role for the PEDS program within the Center for the Homeless, playing a vitally important, high leverage role in breaking the generational cycle of homelessness.

As PEDS began to grow, Memorial had moved Suzanne to full-time oversight of PEDS. A testament to PEDS' success, this commitment served in many ways to formalize Memorial's investment and acknowledge the work that implementing the program required. Nevertheless, in other ways the new structure marked the end of the natural growth of the partnerships acquired at the beginning of the program. Madison Center no longer places interns at PEDS, and the role of the Regional Center for Children's Developmental Progress, without the need for staff training, was diminished. A future challenge to the program may be to look at how partnerships might be reinvented as PEDS continues to evolve.

After the PEDS program moved into its beautiful, new space and enlarged its numbers served, the need for additional financial support became evident. In 2001, a grant from the Bureau of Family Protection/Preservation, Division of Family and Children for Children's Trust Fund was awarded. In the pursuit of this funding the PEDS program more clearly defined outcomes and objectives:

Outcome #1: Ninety percent (90%) of all referred mothers with children between the ages of 0-3 will choose to participate in PEDS parent education and will demonstrate increased parental involvement.	Mothers are informed about the developmental status of their child and are apprized of early intervention services available through First Steps of St. Joseph County. Mothers will demonstrate an increase in their ability to successfully engage their child in feeding and play activities (NCAST Scales). Parent satisfaction surveys will be implemented at four weeks and at discharge. Mothers will follow through with recommended early intervention services to meet the needs of their child. Ninety percent of all mothers will demonstrate increased awareness of early intervention services available in the community. Seventy-five percent of the population will demonstrate an increase in NCAST teaching and feeding scores.
Outcome #2: Fifty percent (50%) of all children referred will be deferred from First Steps as a result of participation in the PEDS program	Each child will receive developmental screening or assessment with follow-up assessment every six (6) weeks for monitoring. Upon completion of initial assessment, mothers are informed about developmentally appropriate play activities that will enhance their ability to nurture and promote their child's growth and development. This is carried out continuously and as long as the child participates in the program. Pre- and post-testing will document and substantiate the fifty percent of all referred children who participate in the PEDS program who will be deferred from First Steps referral as a result of program participation.
Outcome #3: Fifty percent (50%) of all PEDS families will be re-contacted at three and six month intervals after discharge.	Increased communication with Center for the Homeless counselors and case managers regarding families who have completed Center programming. Administer follow-up developmental teaching. Administer follow-up assessments at three and six months via outreach.

With the increase in funding and expansion of the program came the need for evaluation and self-assessment. The Children's Trust Fund grant not only spelled out the program's objectives in a clear and concise way, but it required specific evaluation and reporting on the progress being made to meet those objectives. This process helped the PEDS program obtain both quantitative and qualitative evidence of program success. In its first biannual report to the Division of Family and Children, the PEDS program reported to be well on the way to meeting the goals set out in the grant application. Percentage levels were on track for reaching the quantitative goals established by the contract.