Maternal and Child Health Training Program
Yesterday I was overwhelmed with joy as I heard three adults with autism speak of their successful college experiences and career aspirations (civil engineering, sports education, and childcare). They all shared how excluded they were in school and how few friends they had growing up. In college they found a niche and were all enjoying a more rich social life. One of the speakers spoke of how he was frequently bullied. I rarely hear the word “bully” without being flooded with numerous intense memories. One of the most poignant was when I was in the ninth grade. As I was gathering my books after school, a circular crowd formed around an escalating conflict, as furtive onlookers anticipated first blood. To my horror, an acquaintance, Jason (a fellow ninth-grader with cerebral palsy, intellectual disability, limited speech, restricted range of motion of both arms and legs, bilateral abductor lurch) was in the middle of the circle. What added to my shock was the starting fullback of our football team was pushing him, laughing and trying to get Jason to hit him so he would feel justified in pulverizing him. Impulsivity is often looked down upon, but as I left my brain at my locker with my books, my body and mouth was between Jason and our vigorous fullback. I told Jason to go home. I had to yell it over the din for him to hear me. After my third emphatic iteration he reluctantly walked away as I restrained his aggressor. My mouth then turned to Mr. Fullback and the crowd. Shame and ridicule were momentary companions and we thrashed until there was no more taste for Jason’s injury.
Why Developmental-Behavioral Pediatrics? Perhaps it is because my impulse has always been to come to the aid of those in need. Maybe I watched too much Spiderman as a child. Or perhaps being taught frequently that true greatness comes through service to my brothers and sisters, which is everyone.
Why Harvard and Boston Children’s Hospital? Research opportunity, diversity of mentors, diversity of served patient population, reputation, a positive interview experience, and local sports teams (GO RED SOX!) drew me to the program at Boston Children’s Hospital.
I am an active duty officer in the Unites States Air Force. When I am done with fellowship I will be assigned to work in a location based on the needs of the Air Force (most likely Germany, Alaska or England). My future job will be both clinical and administrative, with no protected time for research. My fellowship will have no direct impact on my immediate trajectory due to prior obligations with the Air Force, but will absolutely elevate my professional capacity to care for children. Due to the high quality of my training and my exceptional research opportunities, it will increase the likelihood of getting assigned at a residency program and training future residents for the Air Force. This training is clearly opening doors for opportunities in academic medicine after I conclude my full time service to our country.
I am tremendously enthusiastic about my research project, the part I fretted about most before I started fellowship. I’ve recently submitted my first abstract entitled, “Item-Level Analysis Demonstrates Significant Differences in Word Production and Understanding at 12 Months of Age in Children at Risk for Autism.” We’ve found that there are qualitative language differences measurable at 12 months of age when comparing typically developing and ASD children. We found that children with ASD have a significantly lower likelihood to produce “Hi” which may be early linguistic evidence of reduced social communication. We also found that children with ASD demonstrated a significantly higher likelihood of producing the word "block" as well as understanding words related to animals, toys and objects. This may be an early linguistic manifestation of restricted, repetitive interests or activities. We have recently formalized collaboration with the Infant Sibling Projects at the University of Calgary, University of Pittsburg, and the University of California San Diego. With this much larger pool of data will stabilize our initial 12-month estimates. Answering a novel research question and working with a lot of bright people is stimulating and FUN!
Biggest Lessons learned – Developmental-Behavioral Pediatrics is awesome! Research can be fun once you’ve found a direction and have a good mentor. The more I learn the more I realize how little I know, and how much more there is to discover and do.
I became involved with Illinois LEND in the fall of 2010 as the first Self-Advocate trainee at the LEND at Illinois. By being a part of LEND self-advocates have a chance to experience leadership in a new way. We learn about the medical part of disability, which you would not get a chance to learn from any other leadership training, and to see how other health professionals interact with people with disabilities. Self-advocates can learn a lot from the clinical experiences in the LEND program. While self-advocates may have significant knowledge of policy, leadership, and how to advocate for issues that may come up in legislation, we don't have as much experience in the clinical setting. LEND provides an opportunity to see this side of disability. This experience gives self-advocates a way to learn more about other disabilities than their own so when they work with other self-advocates they will know how to include and support them in other projects or groups they do.
LEND also gives the other trainees a chance to learn from the point of view of a person with a disability. A lot of what people know about disabilities comes from books, rather than first-hand experiences with people with disabilities. I think it is important for self-advocates to be involved in LEND to help provide the perspective of people with disabilities. This way self-advocates and students can learn together. Not only can self-advocates be teachers, but they can also learn from the other trainees and presenters.
I hope other LEND programs will give self-advocates an opportunity to be a LEND trainee. Both self-advocates and other trainees learn from each other and are able to share their experiences with each other. LEND trainees are able to take what we learned, work together, and use that knowledge in the community to be more influential in changing policy and legislation. This will help make a better world for people with disabilities.
I have had the privilege of completing an MCHB-funded Leadership Education in Developmental-Behavioral Pediatrics Fellowship Program at the Children’s Hospital of Philadelphia (CHOP). Before I left CHOP on my interview day I knew this was the right fit for me. Looking back there were really two reasons I felt this was the place to train, it was all about the people I met and the potential opportunities that were available for a trainee. The program provided me the opportunity to learn from a diverse and interdisciplinary group of faculty and other trainees and provided outstanding clinical and research training. Although I didn’t have a clear idea of what research or scholarly pursuits I wanted to pursue, the numerous doors for learning that were available along with experienced mentors to help guide my early career choices were all assets of the program that were unique and hard to miss.
During my three years of fellowship, I have worked with Drs. Thomas Power, Jennifer Mautone, and Nathan Blum on validating a new behavioral health-screening questionnaire to be used in primary care. I joined the cross-disciplinary study team and was able to learn about the inner workings of a research team and the integral role each member plays, organizing and running team meetings, as well as the nuts and bolts of data collection and management – most of which were fairly new concepts for me. As the initial phase of measure validation was concluding in the urban primary care offices, one of my mentors suggested applying for a Young Investigator Award through the Academic Pediatric Association (APA) and American Academy of Pediatrics (AAP) which could potentially fund a second phase of the study. Grant writing was not something I had any familiarity with, but with the collaborative effort and support of the study team it ended up an important turning point in my early research training. Fortunately our team was awarded the grant and suddenly I now had to use everything I learned with the initial validation and apply it in a more supervisory role. Writing an IRB application, submitting it for review to the scientific review committee, interviewing and hiring research assistants, creating meeting agendas, coordinating finances for the study itself and the research assistants involved, reporting to grant funders, amongst other tasks fell initially to me yet mentors and supervisors were always available for guidance and feedback throughout this process. I could not have planned it better myself – to first have the opportunity to join a fully functioning research team and then quickly apply what I had learned and establish a new research team was a truly invaluable experience.
In addition to the research training, MCHB funding provided me the freedom to pursue other areas of study. I have an interest in Bioethics and expressed to my mentors my interest in pursuing a Master’s degree in Bioethics at The University of Pennsylvania. Mentors in the program encouraged me to pursue this degree and helped me to jump the many hurdles necessary to successfully complete this Master’s Program during a busy fellowship.
My MCHB-funded training program emphasized the importance of remembering the perspective of the family in providing clinical care. This was one of the most important lessons for me personally. Families come to see a Developmental and Behavioral Pediatrician with a preface to their story and that story continues once they leave our office. A host of challenges have lead families to this point and numerous more await them once they leave our office. Navigating school districts or service providers and insurance coverage issues all while questions of their child’s prognosis and outcome persist are commonplace for our patients and their families. As much as I want to provide a parent or patient the tools to be well informed and a better advocate I have to remember where they are in the process of understanding those differences and the implications they hold for the family. As a trainee I worked with talented parent advisors and advocates who were a valuable resource and who are best equipped to remind clinicians of the importance of the perspective of the family in caring for children. Ultimately understanding the preface to a patient’s story may not make a clinician’s final report but there is a value in understanding the whole picture and this can serve as a catalyst to promote the right type of change to the next chapter of the child’s story.
Currently, as I am in the early months in my new position at The University of Texas Health Science Center at Houston and my experiences during fellowship have prepared me well to take advantages of opportunities in my new position. I have been recruited as a co-investigator and the prescribing physician for an NICHD funded study examining interventions for children with ADHD and Reading Disorders. Furthermore I am collaborating with the McGovern Center for Humanities and Ethics at The University of Texas Health Science Center at Houston and hope to build on my current work in bioethics.
I am the parent of a wonderful 7 year old boy with high functioning autism. He has changed my life for the better. I am now involved in an education program and work that is fulfilling. I am able to learn about developmental disabilities, affect family centered care, and from relationships with healthcare professionals. I have become an expert in my field, and been moved to further my education because of LEND.
I have been an advocate for my son since birth. At a young age he received early intervention for speech delay and some physical problems.
I noticed he developed some other behaviors that resembled autism. I was constantly told, “not to worry”, or that “he does not have autism.” When he was finally diagnosed with autism at 4 years old, I felt unequipped to help him. I remember asking myself “now what?” “What are the next steps after a diagnosis?”
I looked for resources and learning opportunities to help me learn how to strongly advocate for him, and get him the services and supports he needed. I found the LEND through one of the many emails I receive about resources. At that time I was a stay-at- home mom. I had to leave my career to manage my child’s care and also any school issues he was having. My husband works full time as a software engineer and supports us. I always wanted to go back to school on a graduate level. This program looked like it would help me to gain needed information on neurodevelopmental disabilities, and also influence providers on family centered care.
Through the LEND program I feel empowered. I never thought as a parent that I had a real voice. I am the expert on my child and I am valued. Parents should know that they are vital members of their child's health care team. I have gained valuable relationships with practitioners in this program and it has been a mutually beneficial experience.
How has your training program experience influenced your future career trajectory?
I have learned that I can be a leader, and affect change. I am a graduate student in a program at another university. I am studying Applied Behavior Analysis (ABA), and will complete my program and receive my Masters Degree in the summer. I am going to sit for my Board Certified Behavior Analyst (BCBA) exam in May. I am finishing up my 1500 hours of fieldwork under the supervision and guidance of a BCBA. I feel I would not have pursued this course without being involved in LEND. I feel I can help many more parents of children like my own son as an advocate and a provider.
Through LEND, I have been able to be involved in research. I have completed a research poster on barriers that minority face in getting an autism diagnosis and treatment. I have also been able to present my findings at conferences in different states. I would not have had these opportunities without the program. I now have a survey under IRB review. I would like to be able send this survey out to families of children on the spectrum to find out specific barriers to treatment they face. It is my hope that with the data I will be able to publish my findings.
My hope is to use further develop the skills I have acquired through this program so that I can continue to be involved in research, community outreach, as well as be a subject matter expert on Autism and cultural competency, and health disparities.
It is my hope to be accepted to a doctoral program so I can research behavioral health, and health disparities. My ultimate goal is to work for a University and work on increasing cultural competency and decreasing health disparities for minority populations. My specific area of expertise would be Autism.
What is one lesson learned from your time in the LEND Program?
Through LEND, I learned that anyone can be a leader! I am a servant leader. My leadership evolved from my desire to serve others parents and children with autism. I believe in being an expert in your field and empowering others to develop their gifts. I felt I was “just a parent” before LEND. I feel I am a parent with a purpose and I have much to give. My work has not only affected my family, but others as well. I have been able to provide resources for others and be an advocate. I plan on advocating for my son until he is able to do it himself. I am an accidental leader, but a leader nonetheless.
As an incoming Masters in Public Health (MPH) candidate at Boston University School of Public Health, I worked as a summer intern at the Department of Health and Human Services/HRSA in the Maternal and Child Bureau (MCHB) Division of MCH Workforce Development. As a maternal child health (MCH) concentrator I was excited that I would be able to acquire knowledge about the field before I started graduate school. My primary area of interest was research in the prenatal care in minority populations. While interning at MCHB, I gained invaluable knowledge about MCH policies, the life course approach, current MCH initiatives, and technological skills. During this time, I developed stronger leadership skills and enhanced both my communications skills along with my ability to multi-task. I attended conferences and seminars on child health including the Secretary’s Advisory Committee on Infant Mortality the First Focus Children’s Budget 2012 on Capitol Hill, and the Maryland Block Grant Review.
I worked on a variety of projects within Workforce Development. I collaborated with staff members in the redesign of the MCH Navigator website, which is a MCH professional supplementary learning website. I also added new learning opportunities to the website and cataloged existing trainings. In addition, I wrote the MCH Navigator monthly electronic newsletter. I worked with the Division of Research, Training and Education (DRTE) and wrote a literature review on autism spectrum disorder in underserved communities, which will be used in a paper for publishing. I updated the Microsoft Office Access database, of all currently funded MCH Training program, abstracts. On a daily basis I interacted with technical staff in transferring recent information to the MCH website. This experience was an excellent gateway to the MCH field. I was privileged to have the opportunity to learn about the MCH Navigator, which serves as a huge information resource for trainees and professional alike on targeted MCH information.
Soon after I graduated from Indiana University-Bloomington, with a Bachelors of Science in Public Health, I was given the opportunity to work as an intern at the Health Resources and Service Administration (HRSA) Maternal and Child Health Bureau (MCHB) in the Division of Research, Training and Education (DRTE). During my time at the MCHB I worked on a research project with the purpose to highlight the need to address disparities among Hispanics in the MCH workforce. Particularly, the research focuses on identifying MCH training programs and recruitment practices for potential MCH Hispanic trainees across disciplines to ensure a sustained commitment to the diversity of MCH faculty and trainees. I was also involved in other activities such as reading assignments, view various archived presentations and learn from distance MCH courses through which I gained a better understanding and appreciation of the field of public health at MCH generally and the Bureau specifically. As a part of the internship, I also had the opportunity to participate in networking activities with Hispanic Public Health leaders and Hispanic National Leaders in the Washington, DC area by attending luncheons, staff meetings, interviews and conferences.
Through these opportunities and my exposure on the different aspects of public health in the federal sector I discovered that my passion is in public health, specifically in improving the health and well being of women and children. I believe that my experience and the projects that I worked on during my internship at MCHB improved my knowledge, skills, and abilities so that I will become more competent in addressing health disparities among under-represented communities. Overall, my experience at MCHB was great, I had the opportunity to meet extraordinary people with a wonderful and positive attitude who worked with me and provided me with their guidance and support throughout my time at MCHB. I am very thankful for this learning experience and I am confident that my experiences at DRTE have prepared me to continue to pursue a graduate degree in public health with a concentration in Epidemiology.
This past year I had the honor of becoming the Rose F. Kennedy University Center for Excellence in Developmental Disabilities (UCEDD) first LEND Law Fellow. As a student at Cardozo School of Law in Manhattan, I heard of this great opportunity through a friend who knew I had my heart set on disability policy and advocacy. Looking back on my time with Children's Evaluation and Rehabilitation Center, (CERC) I can easily say that it was the most rewarding, and eye-opening professional experience of both my undergraduate and law school career. I was not only amazed by how much I learned about UCEDDs and the innovative research being done in the field developmental disabilities, but also by how many influential, and welcoming mentors I encountered – including attorneys, physicians, CERC directors (past and present), occupational therapists, physical therapists, psychologists, administrators, LEND fellows, and the most motivated and inspirational self-advocates I have ever known. Thanks to my attendance at LEND lectures, team meetings, and various conferences in DC, NYC, Albany, and Delaware, I was able to experience the value of interdisciplinary collaboration firsthand, as well as learn about an array of research topics from top-notch experts and academic scholars.
Thanks to my wonderful supervisors - Ms. Sheryl Dicker and Dr. Robert Marion - I learned so much about myself as a writer, researcher, and, most of all, an advocate. During my time as a LEND fellow, I completed several projects - which included writing a series of memos on the legal issues surrounding transition from special education to adulthood, and the challenges faced by individuals with developmental disabilities during the process, as well as a memo to the staff at CERC about the right of parents to obtain independent educational evaluations relating to special services for their children. I also co-authored several articles on "Autism Spectrum Disorder and the Law" for the publication Autism Spectrum News. Lastly, this past May, I presented my final project to CERC staff, focusing on the housing options available for adolescents and adults with disabilities and the fight to support community living.
Starting in January I will be relocating to Washington D.C. to complete a one-year Association of University Centers on Disabilities (AUCD) Disability Policy Fellowship. I could not be more thankful for the support of my mentors at CERC, nor more excited, to have this once in a lifetime opportunity. At AUCD I will be working alongside Kim Musheno, Director of Legislative Affairs, and Dawn Rudolph, the Director of Administration on Developmental Disabilities (ADD) Technical Assistance. In this role I hope to bring to light, and add to, the pool of knowledge I have gained from CERC. I realize that in the field of disability policy, I will never stop, or want to stop, learning, and will do everything in my power to advocate for positive change in disability legislation and policy.
Kristina Majewski was selected as the 2012 AUCD Disability Policy Leadership Fellow. In her LEND fellowship, she focused on research related to the transition of individuals with intellectual and other disabilities from special education to adulthood, as well as on the state of available housing options and deinstitutionalization efforts for this population. As the proud sibling of two adolescents with special needs, she has spent the past ten years working as an active member of various advocacy groups and volunteer agencies that specialize in developing community activities, administering legal aid, and providing various resources for individuals with disabilities.
My experience at the Maternal and Child Health Bureau Division of Research, Training and Education (DRTE) this summer was a period of valuable growth. As a Maternal and Child Health Masters in Public Health (MPH) trainee at the University of Minnesota, I am interested in policy and macro level work. I was eager to expand my knowledge in application of federal level policies and Title V programs -- programs that are funded and administrated through MCHB. Interning at DRTE expanded this understanding, allowing me the chance to work in a setting that aims to further professionals and trainees' careers.
My main project at the Bureau was working on an online learning portal for MCH professionals, called the MCH Navigator. Through screening and summary write-ups, I was able to contribute to the preliminary launch of the site. This continued editing as well as implementing a vetting project for the site helped me to fine-tune my organizational abilities. The vetting project also gave me the opportunity to implement my first evaluation process, a skill-set I learned as a student in Minnesota. I most enjoyed organizing the preliminary data and presentations, which allowed me to see my work and collaboration with others assembled into one final output.
The staff and my mentors at DRTE have helped push my pubic health knowledge into application. They supported me in visiting other division heads, and participating in outside meetings, one including a Congressional hearing with the Association of Maternal and Child Health Programs (AMCHP) on autism funding reauthorization. I also had the opportunity to participate in HRSA level meetings. These, in addition to my main activities, have helped further my training, career and MCH identity. I look forward to continuing my studies and collaborating with the professionals I made contact with over future years.
As I was preparing for my fulltime internship with the Division of Research, Training and Education (DRTE) at the Maternal and Child Health Bureau (MCHB) one year ago, I thought a lot about the organization of the federal executive branch, the relationship between states and federal policies, and the challenges of working in government. As a Masters of Science in Public Health (MSPH) candidate at the MCH Training Program at the Johns Hopkins School of Public Health, I knew that my time at DRTE would allow me to explore potential career paths and better prepare me for the impending job search process. What I did not realize was how much of an impact my internship would have on my professional identity and confidence as I began a career in maternal and child health (MCH).
My primary responsibilities at DRTE centered on the MCH Navigator—a new web-based learning portal for MCH professionals. During my twelve months with the Division (six months full-time, the rest part-time), I contributed to a variety of aspects of this project, including searching for and screening online learning resources, coordinating workgroup meetings, developing and revising draft documents, and making suggestions about the structure and substance of the MCH Navigator system. I also participated in strategic planning activities for the MCH Training Program; a task which required me to draw both on my time at DRTE and my experiences as an MCH Trainee at the Johns School of Public Health. I was also involved in a number of smaller projects, including the drafting of materials for the MCH Training website and helping to brainstorm better ways of that DRTE could communicate directly with MCH Trainees. These experiences built not only upon the knowledge and skills that I gained in my academic program, but also allowed me to further develop my "soft" skills, including interpersonal communication, organization, and critical thinking. The individuals with whom I worked—both DRTE staff and professionals from partner organizations and institutions—were extremely warm and welcoming, making this past year both an enjoyable and rewarding experience.
As I leave DRTE, I recognize that the increased knowledge and appreciation that I gained for the field of MCH and the intricacies of the federal government. I know that the relationships I have developed—whether they be personal or professional (or sometimes both)—will stay with me as I continue to explore the field of maternal and child health.
As a graduate student in the Tulane School of Public Health, I was given the opportunity to work as an intern at the Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau (MCHB), in the Division of Research, Training and Education (DRTE). All of the DRTE staff were extremely welcoming and gave me many options for projects I could help with over the summer.
One of my main tasks was to formulate a draft of a HRSA Healthy Weight Strategic Plan. Working with two other interns in different Bureaus, we developed a background section about current obesity trends and initiatives. We also included information about HRSA's mission and goals, the functions of the many HRSA bureaus, and a chart based on the Recommendations in the White House Task Force on Childhood Obesity Report laying out actions HRSA could possibly take.
I also compiled Performance Measure data from10 different grantee programs managed by DRTE. I edited and updated charts to display this information, to be used in presentations to the grantees as a record of their achievements over the past few years.
Additionally, I helped edit the Background section for the LEND guidance, helped prepare presentations for HRSA staff to present at national conferences, participated in many planning conference calls about the 75th Anniversary of Title V, Bright Futures publications, a grant proposal review, and upcoming meetings. I was able to attend many different conferences throughout the year, including the ASTPHND Annual Meeting, the Diversity Peer Collaborative Conference, and a Kaiser Family Foundation presentation about Global Health.
Through my work on various projects this summer, I learned that a huge number of meetings, conference calls, emails, and other communications are necessary to accomplish any task. I was impressed by the frequent cross-bureau communication and joint efforts undertaken by HRSA staff from different offices and divisions. Even though this wide range of contributors often slowed the process of accomplishing projects, the many viewpoints they all bring to the table seems to be a great asset to the work being done.
Overall, I had a wonderful experience as an intern at DRTE, MCHB. The DRTE staff allowed me to participate in a variety of different activities and always explained to me the often complicated governmental public health processes. I met many unique people who all helped me grow and learn over the duration of my internship. I am very grateful for this experience and am confident that it has prepared me well for a future career in the public health field.
The MCH Pipeline Training program has been a major help to me. All throughout my undergraduate career I was not sure of what my career choice was in healthcare. After becoming a part of the MCH program, I developed an interest for maternal and child health and nursing. Within the program, Mrs. Catrina Waters prepared me for moving into the direction to pursue a degree in nursing and work in underserved communities. The program offered a lot of career networking opportunities and ways to excel professionally. I had the opportunity to meet Dr. Glenda Smith, a nurse practitioner from UAB. I was able to have mock interviews and resume and personal statement preparation. The MCH Pipeline Training program has been a major help in assisting me in finding my passion in healthcare. I would strongly recommend it to anyone.
Ms. Caroline Stewart has been accepted into the University of Alabama at Birmingham Accelerated Masters Program in Nursing. Caroline is a very dedicated and academically successful young lady. She has participated in the ASU Pipeline Training Program for 3 ½ years. She is a native of Racine, WI. Caroline currently lives in Birmingham, AL. She is a biology pre-health major. She has maintained 3.0 or above G.P.A. in her years at Alabama State University. She is a member of Beta Kappa Chi National Honor Society and Zeta Phi Beta Sorority, Incorporated.