Monday, December 28, 2015

A Response to Amber Scorah: Learning from Parents and Child Care Providers to Create Better Policies

Professor Elizabeth Palley co-wrote a piece with Corey Shdaimah in response to a New York Times story about U.S. child care policy. They discuss the individual and societal causes that lead to parents making the decisions they make, and question whether or not regulation in response to tragedies are beneficial.  

Originally published on From The Square

A Response to Amber Scorah: Learning from Parents and Child Care Providers to Create Better Policies

Posted on December 1, 2015
Amber Scorah’s loss of her son Karl is tragic. Leaving a young child in daycare can be hard for any parent. Scorah’s story illustrates why this decision is so much harder in the United States for two reasons. First, unlike in most other countries, many US parents who prefer to care for their own infants do not have the financial and societal support to do so. Second, we do not treat early child care and education or the people who provide it as the valuable service that it is.

Despite hardships, most parents and providers work hard to find and deliver the best care for young children. What happened to Karl is rare. Most children survive and those in high quality care thrive. That does not make the decisions that parents of young children face any easier.

Some criticized Scorah for returning to work and questioned how she could blame larger societal pressures on her own “poor” choice. The factors that shaped Scorah’s decision, however, were not only individual but also societal. The very real pressures that she and her family experienced, including a need for health insurance and salary, compelled her to leave Karl in care. As Scorah noted, we live in a society that values paid employment over caring responsibilities and often leaves little space for parents to stay with their children when they are the most vulnerable. Though parents should have choices to stay with their children until they are less vulnerable, our workplaces and our government have not provided such choices for most Americans. We are anomalous in the economically developed world, where most countries have some policy that protect parents’ employment and even provide some form of salary or insurance that allows parents to care for their own children or assists them in securing affordable, quality care.

While Scorah indicated that she does not necessarily hold the provider responsible, she does implicate child care providers as overburdened, insufficiently trained, and callous to the needs of their charges. In our discussions with child care providers across New York State, we have met many center based directors and family providers who view the children in their care (often for the majority of their waking hours) as a sacred charge. Their interests mirror those of the parents whose children they care for. They want more training, better pay to allow them to hire and retain a stable and sufficient workforce, and the best equipment and curriculums. Karl seemed to be in distress and though a child care worker noticed and expressed concern, no one followed up. Karl was also left on his stomach. These are both issues where better training might have prevented Karl’s death, and they raise the possibility of regulatory policy responses. In our research, however, we have found that regulation in response to rare tragedies often makes for bad policy that burdens providers without always resulting in substantive improvements. In any contemplated policy change, policymakers and advocates must consider the voices of parents and providers, whose input will lead to better policy.

This blog post was contributed by Elizabeth Palley and Corey Shdaimah, the authors of In Our Hands: The Struggle for U.S. Child Care Policy (NYU Press, 2014).


Monday, December 21, 2015

Know Your Family History

Professor Benjamin Weeks recently appeared on Your Health Matters to discuss the importance of knowing your family health history. You can view the full video here:

Monday, December 14, 2015

More On The Spectrum Training For Tech Jobs

In this article originally published on Disability Scoop, Clinical Assistant Professor Stephen Shore discusses the job outlook of individuals with Autism Spectrum Disorder. He covered the challenges faced by many individuals and his personal experiences with the condition.

More On The Spectrum Training For Tech Jobs
by Arianna Skibell, The Hechinger Report | December 1, 2015
NEW YORK – When Joseph Leogrande, 18, rides the subway, his caretaker reminds him to be aware of his body and space, not to stand too close to people. Sometimes it’s hard for Leogrande to concentrate on these directives – his mind is elsewhere. He likes to move to the front of the train and peer into the cab, where the driver sits. “I want to see how everything works,” he said.
Since Leogrande was a kid, he’s collected extension cords and traffic signals from the MTA. He likes to take old things and make them work again, like a broken old-fashioned touch-tone phone he recently fixed.
“It had no phone cord,” said the curious young man, who is on the autism spectrum. “I had to wire one, and I had to program it. It took a little time to figure out the contacts, but in the end I figured out the proper screws and I got it working.”
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Leogrande said he isn’t sure what he’ll do professionally, but he wants to work with technology: computer programming or maybe electrical wiring. He knows he’s capable, but those around him worry it might be hard for him to find a good job. Their fear is not unfounded. Advocates for those with autism estimate that up to nine out of 10 adults with autism are unemployed or underemployed.
But a growing group of educators see technology work as an ideal field for some adults with autism and hope that tech can provide a career path and a means to financial security. At the same time, employers are beginning to see advantages to hiring people with autism, many of whom have strengths that lend themselves to working well with technology, such as being able to stay focused for long periods of time and to perform repetitive tasks with accuracy. Some critics, however, say this push could pigeonhole people with autism, focusing them too much on one interest while ignoring other potential career fields.
“It’s not a pretty picture at the moment,” said David Kearon, director of adult services at Autism Speaks. “People with autism are quite capable of lots of different types of work, but they’re not given the opportunities.”
Over the last 40 years, the decline in manufacturing jobs and increase in service jobs, which usually require social interactions, has made employment more challenging for a population that tends to struggle with social etiquette and has had few options outside of low-wage labor jobs.
But things are starting to change. This year Microsoft launched a pilot program to hire adults with autism. SAP Software & Solutions announced that by 2020 it plans to hire 650 employees with autism, 1 percent of its workforce – nearly the same proportion of people with autism in the general U.S. population. And others are following suit, seeing this community as an untapped, and potentially industrious, labor force.
To prepare students with autism for these and other tech jobs, education programs nationwide are stepping in to introduce technology training at an early age. In California, STEM3 (cubed) Academy, which teaches science, technology, engineering and mathematics skills for high school students with special needs related to autism spectrum disorder, announced last month that it’s expanding to serve middle school students.
In New York, Leogrande developed the skills he needed to fix that old-fashioned phone at a tech education nonprofit called Tech Kids Unlimited (TKU). Beth Rosenberg, a mother and educator, founded the organization after she realized there was nowhere that would teach her son Jack, who has special needs, how to turn his passion for technology into marketable skills.
For the last few years, TKU has offered in-school and after-school workshops as well as weekend and summer programs in which students learn everything tech, from computer programming and animation to 3D printing and website development. Each TKU classroom has a three-to-one ratio of students to teachers and social workers. And the students have many opportunities to practice so-called “soft skills,” like ordering lunch or negotiating whose turn it is to play Nintendo Wii.
“Our students, if exposed, really can keep up and can be really great technological producers,” Rosenberg said.
At a recent workshop, students learned how to use audio software to create podcasts focused on their areas of interest.
“Paris Metro Broadcast,” one student’s podcast began. “Hi, my name is Bennet Cook and I will talk about the Paris Metro system and its history.”
In his podcast, Cook, 16, laid out plans for expanding and streamlining the Paris Metro so that it can grow efficiently as the population grows.
“I first noticed it when I was reading a book called ‘Paris Underground,'” he said. “And then it really got me thinking, what if I could extend the system itself?”
In creating transit maps, Cook said his brain takes a picture of the current map and revises it for the future.
Advocates believe this kind of passion should be valued and celebrated.
“Society is made stronger with all kinds of minds,” Rosenberg said. “And we know that kids at Tech Kids Unlimited are kids whose brains are just like mini computers, they’re just like mini databases, and shouldn’t those kids be the ones who are working in society in wonderful jobs where they can use their talents?”
Kearon of Autism Speaks said it makes sense that some people with autism thrive in tech environments, which tend to be predictable, systematic and rule-based. But he also stressed that everyone on the spectrum is an individual, with individual interests and skills.
“The autism spectrum is so wide. We know people with PhDs who are mechanical engineers and doctors and professors,” he said. “We also know that there are a lot of people with autism who struggle with daily activities, getting themselves up and out of the house and living in a safe way.”
And not everyone on the spectrum likes technology. One young girl at the podcast workshop said she was only there because her parents had signed her up.
“I just like to shop online,” she said.
Stephen Shore, a professor at Adelphi University in New York who studies autism, said encouraging children on the spectrum to follow their own passions can have a positive impact – as it did for him.
“After 18 months of typical development, I was hit with what I call the autism bomb,” he said. “Which happens to about half of us on the autism spectrum.”
Shore lost the ability to communicate, had repeated meltdowns and withdrew from his environment. His parents refused to institutionalize him, and instead enrolled him in an intensive early intervention program. When he was four, his speech returned.
In school, he said, he didn’t know how to get along with his classmates, bullying was pretty bad and his teachers didn’t know how to teach him. But he had his special interests.
“I would go into the library and pull out all the books in my favorite subject, whatever it was at the time – maybe electricity, aviation, space exploration, earthquakes, whatever it was,” he said. “And I remember in third grade, I had a stack of astronomy books on my desk and the teacher told me that I’d never learn how to do math. But fortunately, I’ve learned just enough math to teach statistics at the university level.”
Shore now divides his time between researching and teaching courses about autism, traveling around the world consulting, writing books on the subject and giving music lessons to children on the spectrum.
He said that, regardless of profession, the most heavily weighted variable in career success is social interaction – often a challenge for people on the autism spectrum. Shore leads workshops for people on the spectrum to teach them how to interact more successfully with others in the workplace. But, he said, it ought to go both ways.
“It’s also a matter of educating employers and society in general for interacting with people on the spectrum,” he said.
And this is starting to happen. Kearon said lately he’s seen a lot more interest from businesses that want to learn.
“They want to talk to us, they want to meet people with autism and they want to train their staff,” he said. “People are recognizing their strengths and so we’re seeing more and more programs developed that are designed to get people with autism to get jobs, which is awesome.”
The nonPareil Institute in Texas provides technical training, employment and housing for people on the spectrum. Specialisterne, a nonprofit founded in Denmark, assesses the strengths of people with autism and then trains them as IT consultants and for other technology jobs around the globe. In San Francisco, The Specialists Guild trains adults with autism for tech jobs in Silicon Valley. And Autism Speaks offers a “tool kit” for businesses that want to learn more.
“I cannot give you numbers, but there is for sure a rising awareness among employers of the quality of services provided by autistic persons,” said Thorkil Sonne, a team member at Specialisterne.
As for Leogrande, he’s not too worried at the moment. First, he has to finish high school. And right now, he’s more focused on fixing the antique, albeit broken, television set he finally convinced his grandmother to give him.

Monday, December 7, 2015

New York State needs $17.8B more in Sandy aid

In 2012, Long Island was hit hard by Hurricane Sandy. Now, three years later, New York is still feeling the economic effects of the superstorm. Meghan McPherson, assistant director of the Center for Health Innovation and adjunct faculty member for the Emergency Management Graduate Programs, was featured in Newsday this week and covered how the storm is still affecting us today.
Originally printed in Newsday.

New York State needs $17.8B more in Sandy aid
Officials said those costs from the 2011 and 2012 storms are expected to rise as the state continues to evaluate recovery and mitigation needs, with infrastructure projects such as sewer systems, rail lines, park amenities and wastewater facilities accounting for most of the costs.
The projections -- which do not include New York City -- are detailed in a funding plan amendment the Governor's Office of Storm Recovery filed with U.S. Housing and Urban Development updating how the state has spent or plans to spend the about $4.4 billion in federal disaster recovery grants that Congress appropriated in January 2013. HUD approved the plan in April 2015.
"The damage is much larger than the allocation we received," said Simon McDonnell, director of Research and Strategic Analysis for the Governor's Office of Storm Recovery.
What's more, there is likely no more federal funding coming down the road, given that Congress authorized $60 billion in recovery dollars after Sandy. About $17 billion was allocated to New York through several federal agencies including HUD, Federal Emergency Management Agency and the Army Corps of Engineers.
"There's not going to be any changes in the allocation," HUD spokesman Brian Sullivan said. "What New York got, New York got."
He later added, "Even with the substantial federal investment . . . we recognize there may be lingering, unmet needs. For its part, HUD allocated all the recovery funds Congress appropriated for this purpose."
States are asked to tell the federal government of their needs -- even though there may be no additional funding -- because existing money can be refocused as circumstances change.
New York says it filed the projection to keep a tally of need in case other sources of funding may happen. "It's not an inflated number," storm recovery spokeswoman Barbara Brancaccio said. "It's just everything is included there. You have to be strategic. You're constantly playing a matchmaking game between [funding] source and project."
Disaster recovery money never truly fulfills the need, Sullivan said. "I haven't heard of a single disaster when the need hasn't exceeded the funds allocated for disaster recovery," he added.
That need can be acute when it comes to costly infrastructure projects that are long term and highly expensive but not necessarily considered a funding priority, said Andy Herrmann, past president of the American Society of Civil Engineers.
Public spending on transportation and water infrastructure dropped 23 percent between 2003 and 2014, according to a March report issued by the Congressional Budget Office.
Costly delays
"We're not spending enough money on our roads and bridges and when they get hit with something like superstorm Sandy it takes a long time to recover," Herrmann said. "By not investing, it is going to cost us more money in the long run."
In its 2015 infrastructure report card for New York, the society rated the state with a C- after examining bridges, dams, roads, transit, wastewater and drinking water and other systems. The report card said it would cost New York $36.2 billion to repair, replace or update wastewater infrastructures over 20 years, and another $40 billion would have to be spent on roadways by 2030 to keep up with road conditions.
Those findings mean the state's infrastructure needs since the disaster are not surprising, Herrmann said.
On a national level, the need is more severe. In a 2013 nationwide report card, the society gave the United States a D+ and said $3.6 trillion would be needed by 2020 for projects ranging from aviation to wastewater.
"It's no secret that New York -- and the entire country -- is sorely lacking the infrastructure funds needed to repair our crumbling roads, bridges and water-sewer systems," Sen. Chuck Schumer (D-N.Y.) said in a statement. "In addition to an increase in federal grant dollars, one effective way to tackle the laundry list of projects is to establish a federal 'infrastructure bank' that states can access to put people to work building what they need."
Efforts to create such a bank have repeatedly failed.
In its filings to HUD, New Jersey said it needs another $29.6 billion to completely recover from the three storms.
New York City estimated it had $17 billion in unmet needs after its initial aid application but has not updated that number to HUD since it initially filed after Sandy. City officials said they never expected to recoup the full $17 billion in damages.
Instead, in 2013 the city issued a 10-year $20 billion recovery and resiliency plan that outlined 257 initiatives throughout the boroughs to harden the city and upgrade infrastructure.
Mayor Bill de Blasio's spokeswoman Amy Spitalnick said that more than $20 billion has been secured "but we continue to seek new funds to address additional long-term climate adaptation needs."
The money is coming from a number of sources, including Con Edison, the city, New York Rising and federal agencies such as FEMA, HUD and Army Corps of Engineers, she said.
The city is still seeking money -- public and private -- for remaining projects that need funding, such as retrofitting private buildings for resiliency. Both the city and the state have applied for additional money as part of a national resilience competition. The winners, expected to be announced in January, will receive awards between $1 million and $500 million, according to HUD.
Gov. Andrew M. Cuomo's office did not respond to requests for comment about whether the state has pushed for more money elsewhere or cobbled together funding from other sources.
"Essentially there is no source of funding for these additional unmet needs," McDonnell of the governor's office said.
Aides with Assemb. Robert Rodriguez (D-Manhattan), who chairs the subcommittee on infrastructure, and state Sen. Andrew Lanza (R-Staten Island), who chairs the committee on infrastructure and capital investment, did not respond to requests for comment.
"There are substantial needs," said state Sen. Thomas Croci (R-Sayville), who serves on the infrastructure and capital investment committee. "Part of the issue has been not a sustained level of commitment in investing in infrastructure. You have to invest infrastructure money in places with the highest maximum benefit. These are not endless funds."
The projects that the state counts in its unfunded need tally include $546 million for an outflow pipe at the Bay Park sewage treatment plant in East Rockaway and $52.4 million for a project called Living with the Bay, focusing on an area stretching from Hempstead Lake Park to East Rockaway.
"The number of infrastructure projects will continually increase as more physical needs assessments are completed," the amendment said.
To help communities rebuild, the state formed community reconstruction groups in 124 communities stretching from Long Island to Niagara County and allocated $700 million for projects proposed by these grassroots groups. Dozens have been approved. But an estimated 275 projects -- from microgrids and storm water retention to community assistance centers and solar panels at schools -- are unfunded and total an estimated $1.6 billion. They are included in the state's tally of unmet needs.
Unfunded economic development costs total $898 million. Housing costs without sources of funding are more than $2.9 billion.
A local connection
Most federal aid programs require some local entity to provide money to cover a portion of the costs. It's called a local match and the state has pledged more than $580 million to help municipalities cover that requirement. The stateincludes that in the unmet need tally.
"These are projects that still remain unconstructed and they won't go ahead until we pay the local match," McDonnell said.
Some say that's not necessarily an unmet need.
"Your cost share is not an unmet need," said Meghan McPherson, an adjunct faculty member for Adelphi University's emergency management graduate program. "Repairing the bridge is an unmet need. The local match is a barrier for the project but not an unmet need to the feds. Your need is to fix the bridge."
"You're never going to be made whole by disaster recovery funds," said McPherson, who is also assistant director of Adelphi's Center for Health Innovation. "That's an unfortunate expectation in disaster recovery. You're not going to have one to one. You can't expect the feds to account for every dollar."
State officials say they are simply being judicious.
"For now it's a list to stay out there," McDonnell said. "We constantly change our budget and priorities."
Also, while HUD provides guidance on calculating unmet need, there are no specific statutory requirements.
"There is no standard," said Laurel Matula, a program manager for ER Assist in Bentonville, Arkansas, which does disaster recovery consulting. "The difference of what a need is varies from area to area, state to state, disaster to disaster.
"The real questions is, 'Is there pork in there . . . or pet projects in there,' " she added. "The answer is 'Of course there is.' "