18:50:09:15 - 18:51:20:06

Lisa: So Pat, tell me a little bit more about those first classrooms that you visited in your research in trying to sort of figure out what Tom Thumb was and how you would promote it in the community. You said classrooms had children with a variety of disabilities. What ages were they and what sort of interventions were the teachers using to support them?

Patricia: Well the children were mostly, certainly not younger than five, because it was at five where they were excluded from public school and we weren't doing anything with children much younger than that across the board. Early childhood education was certainly not even in the lexicon at that time but anyway so the teachers were mostly just trying to do basic kindergarten type work with them. The children were from five to 12 years of age. I think 12 was the oldest child we had and in any of the programs.

18:52:57:27 - 18:53:55:26

Lisa: So, Pat, the Tom Thumb program had received a grant that allowed you and Marion to be hired into work in support of the children and families in the program. How else did that federal grant, those federal monies, change the way the Tom Thumb program served children?

Patricia: It changed the program. It didn't really change the program. It opened up the program; a very good program to the best that they were able to do. They were working very hard, the teachers, to give the children some structure and some activities and to bring them along in development but what the federal grant allowed them, the staff, to do was to reach out to a broader community; to those people who did not have the money.

18:54:17:01 - 18:55:07:11

The federal grant allowed the program, the program staff, to reach out to the broader community so that this program was going to be available to people who did not have the money to pay for tuition or to provide transportation and that was extremely important. The federal grant gave transportation money also. I think maybe I hadn't mentioned that but I know it's a big county. People have to go on back country roads to get to places so it was necessary to have the federal monies for transportation as well as the staff and that allowed the association to reach out to a broader community and have more diversity in our population.

18:55:32:15 - 18:59:05:28

Lisa: So, Pat, visiting program to program, visiting the different Tom Thumb programs what did you observe as some of the most immediate needs the children had?

Patricia: Well, I noticed that many of them had not had any dental care and, this came about because I was trying to put together health records for each one of the children. That was something that was not available. There were no folders that had all this nice information. Now I was used to that, in a hospital, if you were going to talk about John Smith you went to his chart and you looked at John Smith and you found out all this nice information about him and they didn't have any of those records. So I thought it was important that we have a basic health record on each one of the children and I thought that would be helpful to the teachers to know something about the general health of the child. And so I visited the schools. I would.... I have to be very careful here because I was not a nurse practitioner or anything like that. I wasn't even a bona fide school nurse. I was just 'Pat', you know, 'nurse'. But I did know how to do certain routine physical things with children and didn't want to upset either the teacher or the child, but I did try to have a time with the child to make a cursory physical assessment and it was during that time that I noted that many of the children in the ages eight and nine, seven, eight, and nine had never had any dental care. And I was really amazed because, of course ,I knew it wasn't the fact that the parents didn't care so I wondered would they not have... I mean some of my concerns were very obvious where you could see that there were rotted teeth and I'm like hmm, got to do something. So as I talked to the teachers and also some of the parents as I would meet them when they would come to pick up the children I found out that parents had a great deal of difficulty getting a dentist to take care a child with a disability. Sometimes it was a child behavior problem in the dentist office but most often it was just that they were so far below in developmental milestones that the dentist didn't know how to deal with them so you know there's just no room in the practice that requires that much attention is what it was. And we were so fortunate in West Chester at that time that there was a young dentist who was just starting his practice and he was interested in our school for some reason interested in the children and he agreed to examine all of the children and recommend dental work as it was needed or even to do the dental work.

18:59:37:10 - 19:00:10:13

So his only stipulation was that I would have to be his assistant because he was doing it on his day off and you know would not be paying for his assistant to be there so, and he wasn't charging for this, and it was a wonderful thing that he was doing and I was so grateful but we did have to have permission slips signed so that was another thing that I had to get done.

19:00:23:00 - 19:04:26:04

Lisa: So, Pat, you were talking about the need for dental care that the children had and you found a dentist who was willing to treat the children. Did he come to the school to provide that treatment?

Patricia: No. No, his office was in West Chester and so I had to bring the children there but he did want permission slips signed so I decided that the best way to do that was to go to the home, meet the parents because I was going to be transporting their child to a dentist office, and of course I always encourage to come if they wanted to and some did. Some parents were brave enough to want to come. Others; it wasn't that they... there were all the other family obligations and I never really thought in looking back at that time why did I decide to go to the home? I don't know but it was a very important thing because when I went to the home I saw something totally different than what you would see in the school or when the parent comes to the school. I saw the stresses in the home that having this disabled child put upon the family. Sometimes there would be younger siblings that would be home. Sometimes I would be making my visit at home at a time that the other kids were out of school or home from school or maybe sick. So I saw that this wasn't easy to have... it wasn't easy on the siblings to have a brother or sister who was disabled but mostly I saw how hard it was for the mother; the prime caregiver and we're talking about the seven days mostly. We were talking about moms being at home, not in the workforce, and so this stress was on the mothers because they had to take care of a child that was maybe five, seven years old and couldn't feed themselves, couldn't go to the potty. Those were things that were extremely difficult; to fit into what we all consider normal family life. And I thought we've got to help...

I knew it was important that the children have some kind of, we move ahead in developmental with some of the skill levels, writing and things like that and some of the children would be able to accomplish that but more importantly they had to know how to feed themselves, how to brush their teeth, how to button their clothes; all those things that we did with our children when they were two years old. It's time to learn how to put your socks on and I just took for granted that my children would do that and that eventually... did you really teach your child to put on their own socks or did you children just put their socks on and when I look back at that I really don't remember. I don't remember that I had to teach these things but obviously it was a combination of the child being ready and wanting to and of course, you know, I now know that everything goes. You pull socks off before you pull your socks on so the children learn this way; so there's a real sequential system that goes on in this learning of things. And these children were not going through that and that was putting a tremendous burden on the family.