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Summer Experience Fuels Interest in Medicine

Sarah Rachal, W&L

Sarah Rachal, W&L

W&L student Sarah Rachal worked with children in PACT’s therapeutic nursery in Baltimore as part of the 2013 Shepherd Internship Program. Rachal is a member of the Class of 2016.

“My mommy comes back, she always comes back, she never will forget me!  Why?  Because she loves me!”

As we finish singing, the kids clap and cheer, while the parents smile appreciatively and hug their little ones closer. The older children wait in anticipation to hear one of the teachers read “Our Beautiful Children,” a book of photographs featuring them and their parents.  Looking around the room, I’m encouraged to see the mothers, fathers, and siblings of our kids choosing to be there with them, forming the cohesive family units which have such positive impacts on child outcomes.

At PACT’s Therapeutic Nursery, family comes first.  This daycare center, located in one of Baltimore’s poorest neighborhoods, serves homeless families with children between six weeks and three years old with the mission of promoting healthy development through strong parent-child attachment. Thursday mornings, when PACT hosts its Family Traditions Breakfasts, are weekly manifestations of this mission.  Parents are invited to join their children for a family meal, and they also get to participate in Circle Time, where they can sing and smile with their kids.  They then have the option of participating in a child-centered play therapy session mediated by one of PACT’s social workers.  Afterwards, the kids return to the nursery to play together while the parents are encouraged to attend a mindfulness group in which they can talk about their experiences and employ meditative practices to deal with their stressful lives.  When participating in this group, parents often share stories about how mindfulness has helped them to be more patient and loving toward their children.

When lots of parents come, which is what we hope for, Thursday mornings can become a little chaotic.  That’s why Rebecca Dean and I, as the Therapeutic Nursery’s summer interns, are tasked with making sure things run smoothly. We do everything from rearranging the nursery furniture to serving breakfast; more importantly, we try to facilitate conversations between parents and their children.  Many of the parents who come to PACT grew up in poverty themselves and had attachment problems in childhood, so some of them struggle to show affection toward their children.  Therefore, we encourage parents to speak to their children with loving words, to take delight in their children’s actions, and to reassure their children that they will always be there for them.  Research has shown that strong parent-child attachments lead to better social skills and even a higher IQ, increasing a child’s potential for future success and lessening the chance that he will become a statistic in our country’s serious intergenerational poverty problem.

When a child’s parents cannot come to breakfast, I try to give her extra attention to let her know she is cared for even though her family could not be there.  Parents are important at PACT, but it is also important for kids to know that they can trust the other adults and authority figures in their lives.  Although it can take a while for new kids to become comfortable around the PACT staff, I hope that we will help them to trust their future teachers, classmates and eventually employers by providing them with a nurturing environment at a young age.  So many kids from poor backgrounds struggle in school simply because they lack the skills that are necessary for functioning in a classroom; they may be unwilling to listen, act violently toward other kids, or face severe separation anxiety.  Telling a child not to hit or reassuring him that “Mommy always comes back” may seem like a simple intervention, but I hope that it will have positive consequences in the future.

At the end of the morning the parents go home, and we feed the kids lunch.  The kids then take naps from noon until 2 p.m., which provides the staff with planning time.  The whole Therapeutic Nursery staff meets for about half an hour to talk about how the morning went and to decide if we need to make any changes to our routine.  We also discuss and take notes on the parent-child interactions we observed so that we can save them with the children’s charts and track any progress that is made.  The programs at the Therapeutic Nursery are relatively unique because of their strong focus on attachment and mindfulness, so it is important that we collect data on their outcomes to determine their efficacy.  If they positively impact the development of these children as much as we expect, they could be employed in similar nurseries and have a significant impact on low-income children nationwide.

When I have free time in the afternoon, I work on a wide variety of projects related to PACT’s programs.  One day I might review the latest medical research on when to begin potty training, on another I might put together a handout for parents on crying and soothing methods.  A lot of my ongoing work involves evaluating the effectiveness of some of PACT’s programs through inputting and analyzing data from parent surveys about the mindfulness group.  Researchers have found that mindfulness practices such as meditation or even breathing exercises have a number of positive outcomes on health, from lowering stress levels to reducing pain.  At the Therapeutic Nursery, staff members hope that mindfulness practices will allow parents to be more calm and patient with their children, leading to better outcomes for both parent and child.  Crunching data can be tedious, but I am excited to be a small part of what could be the first published research on the impacts of mindfulness work on parent-child relationships for children under age three. I also help with less glamorous tasks like shredding paper and laminating photos, but I understand that everything I do supports PACT’s mission in some capacity.

My work at PACT has made me confident that I’d like to work with kids through my career.  All the kids I’ve met at PACT have great potential, and I wish I could be there for them to help them reach that potential.  As a potential future doctor, I noticed certain health problems like asthma and weak immune systems in these kids which could lead to bigger problems in the future.  I hope that I can go into pediatric medicine and treat at-risk children in a way that will help them to reach their full potential.  I noticed a lot of obstacles to good health this summer, ranging from poor nutrition to poor healthcare access to lack of a stable home; although poor health is often blamed on bad choices, this was definitely not the case for many of the children I worked with.  These are all factors that health care providers need to take into account when working to improve the health-related capabilities of impoverished Americans.  Following this internship, I know that I would like to spend more time helping low-income individuals both in Lexington and wherever I work in the future.  There are still a lot of poverty-related problems in the United States, but I think that widespread health and education interventions in early childhood, which PACT employs through its programs, would have a significant positive impact on poor kids and reduce the staggeringly high rate of intergenerational poverty.


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