This article first appeared in the St. Louis Beacon, April 14, 2010 - At home, Liam Longsworth is a pretty good kid. He has a village of adults to see to that, too. Sure, he may get a little whiny now and then, but he's a 2 year old.
At school, though, things weren't so good. When Liam moved into a new class, where the ratio of teachers to students went down, he started having problems.
He hit, wouldn't listen to the teachers and said no a lot.
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"And so the end result was, he was expelled a week ago," says Liam's mom, Mary Lynn Longsworth.
Longsworth was given a number to call and told to have her son tested for psychological problems.
"I came out feeling like, oh my God, I'm a bad parent, my son is nuts, and oh my God, he will never be in school again," she says.
When she called the number the school had given her, it was the Missouri Department of Mental Health. Longsworth spoke with someone there, who told her her son sounded like a normal 2-year-old.
That night, her parent educator with Parents as Teachers came by. She suggested the family start instituting "time outs" and some discipline around the house, even though they weren't seeing that behavior at home.
"She calmed me down a lot," Longsworth says.
Longsworth, who lives in Overland, started with Parents as Teachers before her son was born. Her parent educator visits about once a month.
"I am 39 years old, so I'm a late bloomer when it comes to parenthood," she says.
The benefit of having PAT is that when she has a question she can't answer, they can.
At least they can for now.
Drastic budget cuts are currently proposed for the parent education program in Missouri, which could reduce the program's budget by 59 percent and result in the loss of 1,300 parent educators. Current amendments also call for means testing -- charging middle-income families for PAT services -- and curtailing services if a child is screened up to six times with no problems.
But Longsworth, and many others who support PAT, don't think education and money guarantee the ability to parent successfully.
"I got my bachelor's degree in anthropology, but all the education doesn't mean diddly when you're facing a little baby."
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Cuts looming in state budget
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Right now, no one can say exactly what PAT will look like next fall. That depends on the final shape of the Missouri budget, how the Missouri Department of Education chooses to allocate funds and what individual school districts do with those funds.
Now, state Sen. Rob Mayer, R-Dexter, has proposed cutting PAT's budget to $13 million from $31 million, according to the Associated Press. Mayer did not return calls or e-mails for comment.
U.S. Sen. Kit Bond, R-Mo., who ushered in PAT during his time as governor, did.
"As a former governor, I know how hard it is to balance a budget, but investing in early education is just good sense," he said in an e-mail. "It's one of the best investments we can make, which pays education and economic dividends."
With upcoming legislation, some fear for the program's ability to do what it was created to do: serve Missouri's families and children.
Tina Watson of Webster Groves has been a parent educator for 23 years and used PAT as a new mom.
Recently, she visited a family with a new baby who was between the birth and 2-month check-up with the doctor. She immediately saw that the child had vision problems, recommended testing, and now the baby is getting the services needed.
"That would have been missed," she says. "You have all kinds of things that are going to be missed."
If fewer families are served, she fears the real repercussions will be come once children enter kindergarten and more need special services.
Tresa McCallie, who was the director of Kirkwood's PAT program for 25 years, also fears what an abbreviated program will mean when kids start school.
"I hope I am wrong, but I cannot help but believe this is going to have a huge impact on school readiness."
One of the crucial aspects of the program to date has been the screening services, says Kathy Thornburg, assistant commissioner for early and extended learning with the Missouri Department of Elementary and Secondary Education. "Often the screening can find a child that needs further assessment, which can then get some services perhaps needed before elementary school. And so, of course, in the long run it not only helps the child, but it saves potential dollars in other ways."
According to PAT, if a child can avoid one year of special education, the state saves $3,700 in education costs.
"I think it's fair to say that we would like to retain as much of the funding as possible to help support families, not only in the onsite visits, but the screening is crucial," Thornburg says. "We think screening done today will save for tomorrow."
But with such huge cuts, all kinds of families won't get services, she says.
"If there's a bill signed into law that requires the districts to provide services to low-income families, then that will make it look different than it has in the past because low-income is only one part of a definition of high-needs."
Right now, Thornburg says, DESE is looking at the variety of home-visiting services in Missouri to see where there are overlaps and gaps and find the best way for the money available to be spent.
If low-income families are the new target, programs will be directed to find them through recruitment at WIC offices and through a variety of referrals from human services agencies, Thornburg says. (WIC is a federal nutritional supplement program for poor "women, infants and children.")
Last year, PAT served 154,000 children in Missouri.
"More than half of the families that they served fell into one or more categories that we call vulernability," says Pat Simpson, marketing communications director with PAT's national center in St. Louis. "That's a lot of people. That's a lot of teen parents. That's a lot of low-income people, that's a lot of people right now who are already unemployed and are already under stress from other situations and this is just adding to it."
Stuck in the middle
Longsworth, the mom of 2-year-old Liam, isn't the only one who's benefited from PAT in her family. PAT detected a hearing problem in her younger sister's son when he was an infant.
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"Because of this, because of Parents As Teachers being there and saying here's some resources, you're not the only one feeling this way, my nephew now has a cochlear implant, he is 8 years old, he speaks relatively well and nothing slows him down."
They also caught autism in her sister's 5-year-old daughter.
So would Longsworth pay for PAT? "Yes, without hesitation. Yes," she says.
Longsworth, who works part time, says her husband was just laid off from his job so $100 a month would be too much, but she could pay $20.
But not everyone's sure if middle-class families would pay for the services.
"I can see where middle-class families who have already been in the program and know the value of the program being willing to pay to continue in the program," McCallie says. "I suspect that as each year goes along there will be fewer and fewer families paying for the program because they don't understand the value of what they would get."
Right now, a lot of options are on the table, Simpson says, and DESE will have to weigh in on what ultimately happens.
"It's something that we haven't even gotten that deep into, but just the logistics of how something like that would work are kind of mind boggling," she says.
However, John Schlitt, director of the Pew Home Visiting Campaign, says that when resources are scarce, people with higher needs should get first priority.
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Up for vote
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The state budget is in crisis, and cuts have to be made, Thornburg says. But that doesn't mean that only certain families, like poor families, would benefit from resources that PAT provide.
"The majority of people do not know and understand child development very well, so it really is a good program for everyone," she says. "But I know in the legislature right now, the amendment I am aware of would in fact prioritize families with lower income and at least one or two of the amendments would allow others to get the service but in some way pay for it."
Like Thornburg, Watson thinks a parent's level of education doesn't determine their parenting skills.
"I see lawyers and doctors and CEOs and some very highly qualified and educated people, professional people, that really don't know much about how to take care of a baby, how to raise a child to adulthood," she says. "And some of those families need me more than families of lesser means."
While the looming cuts and changes are still unknown, another factor could come into play, too. In the recently passed federal health-care law, $1.5 billion is made available over five years to states for evidence-based home-visiting programs.
Simpson with PAT says the cuts could jeopardize PAT's ability to access that money in Missouri, but Thornburg and Schlitt both say the rules are still being written and they very well may not.
Parents As Teachers is also looking at other programs around the country, where PAT isn't state-funded but run through agencies like United Way.
"In other states across the country, it just varies," Simpson says. "Parents as Teachers is part of other organizations; it is kind of like the 'Intel inside,' for example."
But in Missouri, she says, they're still fighting.
And Longsworth is confident that whatever happens, PAT will find a way to continue the work they do.
"They will find a way to regroup because the families will not let it go, the school districts, the families and the educators won't let it go," she says. "It's a kick to the throat, but it doesn't mean we can't get back up."