 |
5.16.2001
By
PETER B. LORD
Journal Environment Writer
WEST WARWICK -- What's that?
"Jet," says Ashley Matthews.
She tries to write the word, but instead of a "J" she writes a "C" with
a dot on top.
When her teacher points out that the letter isn't quite right, Ashley giggles,
scratches her head, and reaches for one of two big erasers.
She uses the erasers, baby talk, and her sweet disposition to apologize
for and correct a string of mistakes as she struggles through the second-grade
phonics workbook with her teacher, Lorie Levesque.
They are working in a closet-size room on the second floor of the Providence
Street School Annex. Ashley, wearing a gray T-shirt adorned with little
monkeys, faces Levesque. Both sit on the tiny chairs you only see in elementary
schools and patiently work on Ashley's words.
Ashley is almost 8 years old, but she has trouble saying certain sounds,
particularly "th" sounds. She struggles with sentences and with grammar.
And it's difficult for her to "retrieve" words, Levesque explains. Like
an older person losing her memory, Ashley looks at things and knows what
they are, but just can't think of the words for them.
Because of her learning difficulties Ashley gets more than five hours of
special-education help every week outside of her regular classroom. Some
sessions are one-on-one with Levesque, who uses much the same strategies
she learned working primarily with elderly people who have suffered brain
damage from strokes. Ashley also spends hours as just one of three students
with another teacher, Marie Strumolo.
Her mother, Brenda Matthews, likes Ashley's teachers but says Ashley is
learning very slowly and has a long way to go. "She's always taking her
books around. She looks at the pictures and makes up her own stories,
because she can't read."
Ashley is lead poisoned.
No one can say how much Ashley will learn, or how far she'll go in school.
But it's clear she faces huge obstacles.
| |
 |
| |
|
LEAD
(led) n. 1. Symbol Pb
A dense metallic element used in solder, radiation shields,
paints, and antiknock compounds.
|
|
| |
 |
And every year, hundreds more children in Rhode Island ingest lead-paint
chips and dust in and around their houses and suffer brain damage that
makes it difficult for them to learn.
NEXT FALL, 1,873 lead-poisoned children are expected to enter kindergartens
across Rhode Island.
In Providence, 770 kindergartners, or 25 percent of the class, will be
lead poisoned. In Central Falls, 109 kindergartners will have lead poisoning,
26 percent of the class.
Every town except New Shoreham is expected to enroll lead-poisoned kindergartners
-- 165 in Pawtucket, 29 in Burrillville, 60 in Warwick, and 35 in South
Kingstown.
The figures come from Kids Count Rhode Island, a nonprofit children's
policy group. The report shows that Rhode Island is making progress with
lead poisoning. In 1996, 35 percent of the children entering kindergarten
had blood-lead levels at or above 10 micrograms of lead per deciliter
of blood; next fall, it will be 13 percent.
But 13 percent still represents a lot of children with problems.
In Ashley, the tragic consequences of just one poisoning are clear. Judging
the statewide impact is more difficult.
Not all lead-poisoned children have characteristic symptoms. Many will
show no sign of trouble. Others will have learning difficulties, and it
won't be clear even to their teachers what's causing those problems.
But many will require special-education assistance similar to what Ashley
gets. By some estimates, the extra costs of such one-on-one schooling
average about $10,000 a year or more. Rhode Island already has the highest
per capita percentage of special-education students in the country.
No one knows how many of those special-education students need help because
of lead. But experts are certain that not all the children who need help
are getting it.
Dr. Peter Simon, a family-health expert with the Rhode Island Department
of Health, wrote a report for a medical journal in 1995 in an attempt
to alert educators to the high cost of educating lead-poisoned children.
By Dr. Simon's estimate, each year's group of lead-poisoned children in
Rhode Island requires extra special-education help that will cost $9 million
to $18 million during the course of their education. Half of that money
will be spent in Providence.
"With all the focus on educational reform, I was trying to help the educational
establishment," Dr. Simon said. He cited studies showing that even low
levels of lead poisoning contribute to a seven-fold increase in school
dropout rates. If poisonings could be reduced, there would be less pressure
on education budgets.
He got some reaction from special-education teachers. The Kids Count survey
now focuses on lead in its annual reports on the well-being of Rhode Island
children.
But ultimately, Dr. Simon said, his report failed to bring about the change
he sought. School budgets around the state continue to be limited. School
administrators are loath to add more students to their special-education
rolls, which are already high. So many lead-poisoned children aren't getting
extra help. And too many children continue to be poisoned.
Dr. Michael Msall, chief of the Child Development Center at Hasbro Children's
Hospital, estimates that only 1 in 4 children with elevated blood-lead
levels is getting the extra education needed.
"I would anticipate there is at least a kid a day discovered who's got
lead over 20 (ug/dl -- indicating significant poisoning)," said Dr. Msall.
He said the consequences can only be estimated, and poverty and other
deprivations worsen the effects of lead . But the damage
is not irreversible, he added.
"Having one child with a degree of mental retardation is a tragic loss
for anyone," Dr. Msall said. "But I don't want people to be so afraid
after lead exposure that they don't think a child can learn."
No one knows the actual costs of educating lead-poisoned children, in
part, because schools don't gather that kind of information, says Tom
DiPaolo, chief of special-needs programs for the state Department of Education.
If a lead-poisoned child comes into a school system from an early intervention
program, there is probably information about the child's medical and educational
problems, DiPaolo said.
But some children are never tested for lead if they don't have a doctor
or don't get taken to a clinic. Even if a child is found to be lead poisoned,
his medical records may be kept separate from his educational records.
"The problem is schools don't know who the lead kids are," DiPaola said.
"Clearly the knowledge that a kid has a high lead-level exposure could
be useful, but others argue it might influence a teacher's perception
of a kid, or lower the expectations for a kid.
"So if a third-grade kid was having behavioral problems, you'd look at
the record and there might not be any information to explain it," he said.
DiPaola wouldn't speculate on how many of the students in special programs
are there because of lead. But he said there is no question that lead-poisoned
children are a "staple of the special-education world."
"The research is pretty clear that there's a relationship between kids
who have high lead levels and learning difficulties, particularly learning
disabilities and retardation. But as far as an actual study based on screenings
or Health Department reports or lead clinics," DiPaola said, "we don't
have data."
THE TURNING point in Ashley's life came after she moved with her
family to an apartment on Providence Street, in 1995, after her parents
broke up.
Until then, Ashley was her mother's shining star. Brenda Matthews's two
older children had many problems; neither completed high school. But Ashley
was different, bright and engaging. She was the one who would go on to
college.
One recent morning at her home, Ashley played on a rug as Matthews talked
about what she was like before the move. On that day, Ashley stared at
a book, and appeared to be daydreaming. She didn't say a word.
"She was learning faster than the other two ," Matthews
said. " She could count to five. She knew most of her primary
colors and part of the alphabet."
Matthews told a psychologist who evaluated Ashley that she was walking
at 12 months and speaking early.
But she stopped reciting the alphabet, "or doing her colors. I figured
it was the move," Matthews said.
In early 1998, Ashley had a routine physical exam. Then came the bad news.
"I got a call from Midland Medical saying I had to rush her to the hospital.
They were in a panic. They scared the hell out of me."
Matthews took Ashley to Hasbro Children's Hospital. Her lead level was
found to be 61, about three times the level considered significantly poisoned.
Hospital workers x-rayed Ashley's stomach, gave her medication to draw
the lead out of her system, and kept her overnight.
Matthews recalls someone at the hospital warning that Ashley could become
mentally retarded, and she thought, "Oh, my God."
Matthews said she thinks she knows where Ashley was poisoned . There
was a low window in a hallway. Ashley and her friends would sit on each
side and pretend it was a McDonald's drive-through.
"There were paint chips everywhere," Matthews recalls. "You could see
the layers of paint. And she put a lot of things in her mouth."
While Ashley was being treated, inspectors for the state Health Department
examined the apartment. They found lead paint on the ceilings, walls,
windows, doors, woodwork, cabinets, closets, stairways, on the building's
exterior and a fence out back.
Doctors advised Matthews not to bring her back to that house. So Matthews
moved Ashley in with her grandfather while Matthews and her older daughter
worked to try to make the apartment safe.
They put duct tape on all the window molding and put plastic over the
windows and washed all the painted surfaces.
A month or so later, her landlord sent a crew in to replace the windows.
The intention was good, but the method was all wrong, she said.
"Paint chips were everywhere," she said. The crew used a regular vacuum
that spewed dust throughout the apartment, instead of a high-efficiency
vacuum that captures minute dust particles.
Matthews said she cleaned the best she could, and brought her daughter
back home. Ashley's lead level shot up again.
"I called the landlord's office and I asked him to come and do something.
But he never got in touch with me again," Matthews said.
The family moved out for good.
Later, Matthews sued the landlord.
Since then, there have been depositions and discovery. Dollar figures
have been exchanged, but there has been no settlment.
Matthews was closely questioned by a defense attorney for her landlord's
insurance company.
She said it was clear from the questions that the lawyer wanted to show
Ashley's problems were not caused by lead but were inherited, similar
to her siblings and Matthews herself, all of whom were in special-education
programs.
"But my kids could read, write, and do the alphabet," Matthews said.
She points to an evaluation of Ashley and says, "Parts of that report
. . . I just wanted to cry."
A psychologist who evaluated Ashley last year found her speech "to be
baby-like with multiple mispronunciations, jumbled speech, reversed (letters
in words) and over-rapidity."
Asked to complete a series of tests, Ashley became confused. She got upset
and refused to draw a figure or do several other exercises.
"She tends to put her hands to her mouth when she is distressed and to
tap herself on the head when she does not know the answer," the psychologist
noted.
"Speaking, reading, writing, verbal reasoning and spelling are all quite
difficult for Ashley," the psychologist concluded. Using various methods
of evaluating Ashley's intelligence, the psychologist found she is average
in many activities, but her verbal skills placed her in the mentally retarded
range. If the verbal skills could be improved, she may be able to function
normally in the future.
"If they cannot be remediated, and there is some evidence that this has
not occurred so far," the psychologist said, "then she will have a very
difficult time in our left-hemisphere, speech-language dominant culture."
The psychologist said Ashley's "symptoms are a direct result of the lead
poisoning that she sustained."
As part of her treatment, Matthews gives Ashley vitamins and feeds her
food high in iron, because iron displaces the lead.
"I get Stop & Shop [Crispy Rice] because it has higher iron, 60 percent,"
of a child's daily requirement, Matthews says. "I try to give her nutritious
food, but I can't force-feed her."
Ashley is cared for primarily by her older sister because her mother works
the second shift in a factory. Brenda Matthews is sleeping when Ashley
gets up in the morning, and she leaves for work before Ashley gets home
from school.
ASHLEY'S SPEECH teacher, Lorie Levesque, said she thinks Ashley
understands what she sees in books, but has trouble expressing it.
"It's similar to brain damage," she said. "It's similar to adults who
have things in their heads, but can't get them out. But the kids don't
get as frustrated. We have to give them lots of stimulation so they are
using their brains.
"Kids with word-retrieval problems talk around a point. They have trouble
being concise."
Ashley is far from alone in West Warwick, Levesque said. She says the
more she looks at health records, the more she finds students who are
lead poisoned.
"We're seeing it pop up more and more," she says. "And I ask parents,
especially if a child is having trouble with memory."
Later in the morning, Ashley joins two other students and they work with
teacher Marie Strumolo on their words.
Strumolo hands the children cardboard letters and they rearrange them
into words. TUB . . . BUT . . . SHUT . . . SUB . . . STUB.
Then they play a simplified version of bingo. Strumolo gives each student
a card with eight short words and a pile of big red dots. She reads off
words and the children mark their cards if they have them.
NO . . . OFF . . . AND . . . ASK . . . NOW . . . TAKE . . . SAW . . .
WHEN . . . DID.
Ashley wins.
But when Strumolo asks her to read back the words, she stumbles. They
are right in front of her, Strumolo has just said them, but Ashley can't
read them.
CLICK
HERE FOR PRINTER FRIENDLY VERSION
|
|
