- The Washington Times - Monday, November 13, 2006

Baltimore resident Tara Doaty knows the consequences could be severe if her 22-month-old son, Donald, so much as sits near a child snacking on peanuts.

Ms. Doaty has stopped worrying about that during weekday hours. She recently enrolled her son, who has severe food allergies, with the Kennedy Krieger Institute’s PACT: Helping Children With Special Needs program in Baltimore.

The program, in its 10th year, offers day care services for children who, in the words of PACT Executive Director Audrey Leviton, are “medically fragile.”

That means children who require feeding tubes, heart monitors, individualized physical therapy and any number of other considerations.

The children in question, who range in age from 6 weeks to 4 years, receive a tag-team approach to their needs. Everyone from social workers to speech pathologists and occupational therapists is on hand to entertain, enlighten and help children grow beyond typical expectations. PACT workers expose children to a number of functional lessons to let them maximize whatever abilities they have with the goal of preparing them to enter the educational system.

The program is one of two in Maryland — the other is in Rockville — and one of just a few in the nation to offer special-needs children the kind of day care that will put their parents at ease.

Ms. Leviton says while a typical day care center might have one professional for every 12 children, PACT, which stands for Parents and Children Together, offers roughly one staffer for every three to four children.

A PACT child starts his or her day with a physical checkup to make sure no new complications need immediate attention. Then the youngsters go through a series of lessons meant to challenge and entertain. Those with severe medical issues play side by side with others who may have less challenging complications.

The children draw, bang on musical instruments and climb just like their peers.

The rooms in PACT look like those one might find in any child care center. Brightly colored walls, inviting toys and tiny chairs await the children. A few of the rooms aren’t so ordinary.

The multisensory room helps children who are visually or hearing impaired. Among several innovations, the room features a bubble column with lights that change when a child touches it. One couch is connected to a stereo system so that hearing-impaired children can lie on it and feel the musical vibrations.

The sensory-integration room is primarily for autistic children, who are overly reactive to certain senses. The room offers swinging devices that children can use while experiencing different sights and sounds. The undulating motion has a calming effect, Ms. Leviton says.

Toddlers with vocal difficulties work with speech pathologists who help them not only with pronunciation skills, but also with eating habits. The same muscles activated during speech are used while eating, so a child used to intravenous feeding may begin behind his or her peers with vocal patterns.

Money prevents more states from establishing PACT-like centers, Ms. Leviton says.

PACT gets by with help from friends far and wide. The state is the program’s principal funder. Grants and medical assistance play a role, as does money from United Way and other sources. One of the two sensory rooms came courtesy of a grant from the Garth Brooks Teammates for Kids Foundation.

PACT is trying to increase the funding flow coming from Maryland.

“It’s hard to make ends meet,” Ms. Leviton says.

Because hiring a nurse to care for a child can cost up to $30 an hour, she insists that programs like PACT save money over existing services. Most parents without Medical Assistance pay between $25 and $35 a day to keep their children at PACT. Medical Assistance is funding provided by the state to low-income persons or those whose medical expenses warrant such aid.

For Ms. Doaty, traditional day care centers “overlook the severity” of her son’s food allergy, she says.

“That was a big concern for me,” Ms. Doaty says. “Peanut butter is a common good in day care centers. Even a small amount can be disastrous for him.”

Her initial experience at PACT sold her, and her son, on the program.

“It was the first place he visited where he didn’t want to leave,” she says of her son, who also suffers from eczema and psoriasis.

Children with food allergies at PACT typically eat meals made by their parents and sit in chairs designed to keep their feeding area isolated from other children.

Severna Park, Md., resident Victoria Sulerzyski’s 7-year-old daughter, Abby, suffers from a number of debilitating conditions, including autism, cerebral palsy and blindness.

Mrs. Sulerzyski had to wait six months before her daughter became eligible for PACT. The day care program is licensed to house up to 63 children at any given time, and parents often have to wait before a space opens for their children.

By that time, Mrs. Sulerzyski and her husband were exhausted from juggling their schedules to care for Abby.

“We were pretty much toast by the time we got into PACT,” she says. “We drove 40 miles each way to get to the day care center, but it was our only option.”

Mrs. Sulerzyski, who joined the PACT board after her daughter left the program to attend the Maryland School for the Blind, says Abby made strong progress during her day care period. She can communicate through some basic signs and has increased mobility.

“You have a window of opportunity if you can maximize their capabilities. The chances of them picking up abilities is so much greater” with programs that allow children to improve their motor skills and socialization, she says.

Ms. Leviton says part of the work PACT does has less to do with children’s disabilities than with the consequences of their difficulties.

“There’s a lot of guilt and anger in having a child with a disability,” she says.

PACT social worker Sharon Holloway says she tries to help guide parents through “all the emotional ups and downs they’ve been through.”

The parents of disabled children suffer more divorces than the national average and are more likely to have attendance problems at work.

“Some people say they’re relieved to have us, but some would rather not know who we are,” Ms. Holloway says. Visit www.medicalhomeinfo.org/model/bulletinchildcare.html for a listing of medical day care centers across the country.

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