Each center at First Step, Inc. has the ability to screen or evaluate the hearing of individuals, whose ages are between birth and adulthood.  We have contracted with an audiologist for her services for the past 15 years.  Through the use of an audiometer and a tympanometer we are able to screen pure-tone air conduction hearing and determine the possibility of a referral to the primary care physician for middle ear problems.  Utilizing the audiometers during this time speech pathologists and our audiologist have screened our consumers and referred them for further evaluation by our audiologist, observation by their primary care physician (PCP) or ear, nose and throat physicians (ENT).  A part of that screening process is an observation of the middle ear and the movement of the eardrum (tympanic membrane).   Tympanometry is helpful in diagnosing otitis media (ear infections, middle ear fluid) and distinguishing a sensorineural and a conductive hearing loss.

Some years after our audiologist came to First Step we ordered a sound proof booth to be able to evaluate more thoroughly the hearing of our consumers.  We have VRA (visual reinforcement audiometry) capability which is used for screening the hearing of children who are 6 months through 2 years of age.  The children are trained to look at the sound source.  The children will receive a visual reinforcement for the correct acknowledgement of the sound source.

The most recent purchase for First Step has been an OAE (otoacoustic emissions) for each center which enables audiology assistants , audiologists, speech pathologists and nurses to screen every consumer who enrolls at First Step.  The audiologist trains each of these staff members on how to operate this equipment.  Otoacoustic  emissions screens the hearing to the cochlea hair cells and the consumer does not  have to make a physiological response.  This screener is able to determine outer ear canal blockage, and the presence of middle ear fluid and possible damage to the outer hair cells in the cochlea.  This equipment was utilized while First Step was working with two local hospitals, National Park Medical Hospital and Hot Spring County Medical Hospital, during the pilot project of the Newborn Hearing Screening in Arkansas.   Our speech pathologists , audiologist and audiology assistant provided round the clock hearing screens to all of the newborns in those hospitals giving us a wonderful rapport with the staffs of those facilities which ensured better services for their consumers.  When an infant failed the hearing screen at the hospital then they were usually referred through their pediatrician to First Step for further evaluation and treatment.

Through First Step’s commitment to providing quality care in the area of hearing and organizations such as the Hot Springs Community Foundation we have been able to purchase the equipment needed to provide such services.   First Step has taken the lead in providing superior care for hearing issues in the communities we serve.

70,277 full-time jobs in Arkansas are attributable to the Medicaid program, which is equal to 6% of all employment in the state.

Medicaid provides health insurance to 26 percent of Arkansans (750,000 people) with an annual budget of $3.14 billion.

Medicaid is a vital safety net for 120,200 children and adults with disabilities, such as Down syndrome, cerebral palsy, spina bifida, intellectual disabilities, and autism.

Medicaid is an important economic driver in Arkansas – approximately $5.9 billion is generated as a result of direct Medicaid (state and federal) spending of $3.7 billion in Arkansas.

Every federal Medicaid dollar that flows into a state stimulates business activity and generates jobs.  In Arkansas, every federal dollar spent on Medicaid has an economic impact of $6.31.

So, the loss of the “economic multiplier effect” that states would experience as a direct result of federal Medicaid cuts would be large and much greater than the amount of the dollar cuts themselves.

For every 5% (12% is being proposed) that is cut from the Medicaid budget, it means about $242 million in lost economic activity for Arkansas and a loss of 2,400 jobs.

Please send an email or make a call to the President (White House), our Senators, and our Congressmen. At this minute, negotiations in Washington are threatening 46 years of success and positive change in the lives of Individuals with Disabilities – and their families!  We have provided the contact information below for you convenience.  Tell your elected officials to lobby The White House and Congress for protection for our intellectually disabled!  Community Services for these individuals are the least expensive systems and morally the right thing to do.

Ask for their help in supporting the most vulnerable members in our society.  Explain that community funded Medicaid stops costly institutionalization, puts consumers with disabilities and their families into jobs, and protects community in each town in America.

We are counting on each of you.  Send a link to this page to your friends and family.  Put it on your Face Book page.  Washington MUST hear your voice!!!

Sincerely,

Pam Bland, Executive Director
First Step, Inc.

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CONTACT THESE ELECTED OFFICIALS

President Barack Obama
1600 Pennsylvania Avenue, N.W.
Washington, DC 20500
E-Mail:  http://www.whitehouse.gov/contact

_______________________

U.S. Senator John Boozman
320 Hart Senate Office Building
Washington, DC 20510
Phone:  (202) 224-4843
E-Mail:  http://boozman.senate.gov

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U.S. Senator Mark Pryor
255 Dirksen Senate Office Building
Washington, DC  20510
Phone: (202) 224-2353
E-Mail:  http://pryor.senate.gov

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U.S. Representative Rick Crawford – 1^st District, North Central & Northeast Arkansas
1408 Longworth HOB
Washington, DC  20515
Phone:  (202) 225-4076 Fax:  (202) 225-5602
E-Mail:  http://crawford.house.gov/
(Counties:  Baxter, Fulton, Sharp, Randolph, Clay, Izard, Lawrence, Greene, Searcy, Stone, Francis, Lee, Phillips, Monroe, Arkansas, Prairie, Crittenden, and Lonoke)

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U.S. Representative Tim Griffin – 2^nd District, Central Arkanas
1232 Longworh HOB
Washington DC  20515
Phone:  (202) 225-2506 Fax: (202) 225-5903
E-Mail:  http://griffin.house.gov/
(Counties:  Conway, Faulkner, Perry, Pulaski, Saline, Van Buren, White, and Yell)

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U.S. Representative Steve Womack – 3^rd District, NW Arkansas
1508 Longworth HOB
Washington, DC 20515
Phone:  (202) 225-4301 Fax:  (202) 225-5713
E-Mail:  https://womack.house.gov/Contact/
(Counties:  Benton, Boone, Carroll, Crawford, Franklin, Johnson, Madison, Marion, Pope, Sebastian, Washington, and Newton)

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U.S. Representative Mike Ross – 4^th District, South Arkansas
2436 Rayburn House Office Bldg
Washington, DC  20515
Phone:  (800) 223-2220 Fax:  (202) 225-1314
E-Mail:  http://mike.ross@mail.house.gov
(Counties:  Ashley, Bradley, Calhoun, Clark, Cleveland, Chicot, Columbia, Dallas, Desha, Drew, Garland, Grant, Hempstead, Hot Spring, Howard, Jefferson, Lafayette, Lincoln, Little River, Logan, Miller, Montgomery, Nevada, Ouachita, Pike, Polk, Scott, Sevier, Union)

From a Parent

Olivia Pilgrim will graduate First Step’s Preschool program and enter public kindergarten in the fall of this year. She is active and happy and is anxious to start school. However, the first five years of her life have been a real challenge.

Olivia was born with a heart defect and had her first open-heart surgery when she was one week old. She was also born with DiGeorge Syndrome, a rare congenital disease that affects an infant’s immune system. She has no thyroid or parathyroid glands. In addition, she has scoliosis.

At 18 months, Olivia was still not walking. We took an aggressive approach to her treatment and upon our pediatrician’s referral placed her in the First Step program. In addition to being a part of First Step’s Preschool program, Olivia has received physical therapy, occupational therapy, and speech therapy at First Step. Olivia underwent her second open-heart surgery at three years of age and because of the scoliosis has to have a surgical procedure on her back every six months.

Olivia was a full-term baby and weighed 7lbs-11 oz. at birth. We did not expect any problems, and it was a shock when, just after birth, she had to be put on oxygen. Within hours she was med-flighted to Arkansas Children’s Hospital. We didn’t know what to do.

Medicaid has seen us through the last five years. We don’t know what we would have done without it. Today, Olivia still has some delays, but she is so much farther along than we ever thought she would be. Please contact our President, Senators, and Representatives and ask them not to make cuts in the Medicaid program. There are other children out there just like Olivia, and I hate to think where they would be without the help of Medicaid.

— Amber Pilgrim, Olivia’s mother

David, now 35, has a form of autism spectrum disorder, a term used to describe one of many different sensory disorders.  When an individual has trouble processing information received from one or more of his/her senses (sight, hearing, smell, taste, touch) he or she is said to have a sensory disorder.  Although autism is the most common and most pervasive sensory disorder, and the numbers of children diagnosed with autism is on the rise, little is known about its cause and treatment.  A person with autism may indeed be extremely intelligent, but something short circuits the information received by the brain and does not allow the brain center to process it accurately. 

David’s story began in 1978, when he entered preschool at First Step’s Petty Center in Malvern.  “David came to us when he was about three years old,” said Linda Kemp, First Step Associate Executive Director.  Susan Smoke, another First Step staffer, remembered David’s early years, “He was a beautiful child with brown hair and big brown eyes.  He was nonverbal but very observant.  He would stand and watch the children play but was very tentative about joining in.”  David’s early classroom instructors were Jan Kirk and Hester Hopkins who spent a great deal of time with him, singing songs and teaching him to sign the ABC’s.  Even with regular speech therapy his instructors never heard David speak. First Step continued to serve David after he began public school.  His teacher, Martha Hurst, reported that he would walk around with his head down and his eyes narrowed to slits or closed altogether.  He did begin speaking in short phrases, but would only talk to certain people and kept to himself.  His family moved to Hot Springs and upon graduation, David was admitted to First Step’s Hot Springs Adult Development program and remained there for several years.  In 2003, his family moved to Bismarck and David transferred back to the Petty Center.  With the smaller adult population at the Malvern center, David began to open up and talk to more consumers and staff.  He became friends with another male consumer who did not talk much and was difficult to understand.  Staff observed them sitting together and laughing.

When David told Linda Kemp that he wanted to live in one of First Step’s adult apartments, she couldn’t believe her ears.  “I knew I needed a witness for this one,” said Kemp.  “Before I left to find someone, I told David that I was going to bring in a person to confirm what he had told me.  I told him to speak up and talk plainly so that the witness could understand what he was saying.  I came back with Debbie Meeks, Adult Development Supervisor.  I asked, ‘David, do you want to live in an apartment?’ He answered me loud and clear.  ‘“Yes,” he said, “I want to live in an apartment.”’

Chancellor remembers, “David had no social skills and was considered nonverbal.  After moving into the apartment, he stayed to himself.  When anyone entered, David would run to the bathroom and lock the door.  Once, when I was with him, David stayed locked in the bathroom for two hours, screaming incoherent words at the top of his lungs.  I finally talked him out, and he calmed down a little. That was a pretty tough one.”

Chancellor continued, “About a year ago, different staff members began commenting to me about the words they had heard David say.  Our maintenance staff even mentioned things he had said to them.  That’s when I began to take notice of the change in David.  I had never heard him say anything, and all these people were telling me what they had heard.  I’ll never forget the first time I heard David speak.  We had taken the group of adults to a local fast-food restaurant, and David was sitting next to me.  We had been there a while, and the group was having a great time.  Johnny Brown (not his real name) is the class clown.  He’s always having a good time and trying to make the others laugh.  Well, out of the blue, David turned to me and said ‘Johnny Brown’s gettin’ on my nerves.’  I just about passed out, but I held it together long enough to comment, ‘Well, he’s kind of getting on my nerves, too.’  At that point, I knew David’s life was changing in a major way, and that change was for the better.”

Just a few weeks ago, Chancellor was standing in the hall of the Petty Center’s adult development facility, “David came up to me and said, ‘I want a job.  Can you get me a job?’ I couldn’t imagine that was even a remote possibility, but I thought that if David wanted to work, we would find him a job.  We arranged for David to assist the janitorial staff at the center as part of First Step’s Supported Employment program.  When he heard the news, David was ecstatic and couldn’t wait to start to work. “

The weekend before David was to begin work, Chancellor and other staff took the group on a trip to Branson and the Silver Dollar City theme park.  While waiting in line at one of the rides, the operator turned and asked David, “Are you excited?” meaning, of course, about the prospects of the ride.  David said, “Yep. Got a job; start Monday.  I’m excited.”  That evening the group ate at a Branson restaurant.  Chancellor said he was prepared to order David’s meal for him, but when the server came to David, he looked up and said, “I want a rib eye, medium well, and a baked potato.”  “I couldn’t believe it,” said Chancellor.  “I just couldn’t believe it! That was more than we were prepared to spend, but I thought if David could order a rib eye, I was going to buy him a rib eye.

Now, we’re back to where this article started.  Chancellor said, “David started work this morning.  He’s part of our Supported Employment program, working as a janitor’s assistant at the Petty Center.  This first day, he’ll only work for an hour, we don’t want to overwhelm or stress him.   He’s got the vacuum, and he’s running it around the baseboards of our hall areas, zapping bugs and dust and such.  It’s a bright day here at the Petty Center!  One of the women in my office has been crying all day.” After a laugh, Chancellor said, “I may have to send her home; she’s so overjoyed with David’s success.  We’re all just amazed and thrilled.”  After starting his new job, David has shown progress almost daily.  He now speaks to just about every co-worker and others he meets in the hall and is engaging them in a meaningful conversation.    According to Chancellor, “He’s a long, long way from the boy who would not speak or even look at anyone.”

The life of David Allen Williams is not the only success story at First Step.  There are many others, but to be honest, not every story is one of such accomplishment.  Sometimes we have to look through many dark clouds to find one silver lining.  This is particularly true for a parent of a child with autism and for those involved in treating children with the disorder.  Some children respond quickly and easily; for others, it may take years for a bright spot to appear, and still for others … well, that bright spot has to be diligently sought, and every leaf has to be turned over and over until one learns to appreciate even the smallest accomplishments.  The therapists, teachers and staff at First Step are too well acquainted with the search for triumphs, but they are there.

First Step has recently opened the Ann and Nick Tillman Project for Children with Sensory Needs.  Teachers, therapists and other workers are trained in a variety of methods and approaches because what works for one may not work for another.  This is a cutting-edge project and is the brain child of First Step Executive Director Pam Bland.  According to Bland, “The Ann and Nick Tillman Project brings the latest in treatment for children with autism to our service communities.  Within a few months, this project will be implemented in all of First Step’s seven service centers.  This is the most up-to-date treatment for autistic children, and we are able to offer it right here in our own community.” 

First Step’s motto is “Making a Difference in Your Community.”  First Step has lived up to this motto once again.

“Ellie was diagnosed with Trisomy 18 when she was five days old, and we were told at that time to expect severe, if not profound, developmental disability. We contacted First Step and received prompt, personal, step-by-step assistance in enrolling Ellie in early intervention, physical therapy, occupational therapy, and speech therapy at First Step in Hot Springs. She began receiving services at 3 months old, and we have been thrilled with every aspect of our time there! Ellie began full-time preschool at 18 months and graduated to Kindergarten in August 2010. Instead of sending her to public school, we were able to enroll her in the young school-age program at First Step, which provides an alternative educational setting for children who are unable to attend public school due to their disabilities. If Ellie had attended public school, she would have required full-time, one-on-one support from an aide to ensure her physical safety and sign-language interpretation to allow her to communicate. Thanks to the First Step School-Age program, I am able to concentrate on my full-time job during the day, because I know that Ellie is safe and happy in the caring, capable hands of the First Step staff.

When Ellie was diagnosed, we were told that she may never walk or talk, be able to care for herself or toilet train, and that she may never be able to communicate. Through many years of physical therapy, speech therapy, and occupational therapy, as well as special education in the classroom, Ellie has conquered most of these goals and continues to progress every day. I sincerely believe that the people of First Step do not simply go to work every day, but that they genuinely have love in their hearts for every child they treat.

Ellie has made remarkable progress far beyond what is expected for her condition for the following two reasons: 1) Ellie is a remarkable child, and 2) the support and encouragement she received from her teachers and therapists (and family) during her five years at First Step. Raising a child is never easy. Raising a child with a disabling condition is downright hard. First Step has consistently provided caring support that has enabled us not only to cope with disability, but to thrive in spite of it!”

As we started today, I thought about the similarities in our walk and raising a special child.  It was dark when we started but got a little brighter all along the way. Every step was difficult, some painful.  For every hill we climbed, we were met with another, and another and yet another.  There were times when I thought, “I can’t go another step, and one of my team (those with me and those driving by) would say, “come on, you can do it.”  Several times despite their belief, I was unsure.  But we made it.   

This almost completely parallels what our families go through; dark days early on, but it gets better.  Difficult and even painful steps that have to be taken.  For every challenge met, another one ahead.  I think the greatest similarity and most important thing to think on is the team part.  I would have stopped long before my goal had my team mates not pushed. 

To me that is the essence of what we are doing with The Walk/Tillman Project.  Pooling our efforts to provide that team that helps our families, take the steps, climb the hill, meet those goals.  Providing families with answers to those questions.  Providing people who make those darker days brighter.  Providing those who run along beside you and when you fall, say get up! Keep going!  And most importantly providing those who have the knowledge, skills and equipment to show you how to get up and keep going.

I mentioned earlier my son and our experience.  I have to tell you today, thanks to that team, which is only getting better!!!! We have a near teenager who talks, at times argues, really expressing himself well now.  It seems that the clothing we pick out is not longer agreed upon, which he voices well every day. It seems we have “discussions” on what time we need to go to bed.  It seems he asked to go to half a dozen places other than school every morning.  It seems things get a lot clearer for him and he seems to really understand when access to Nintendo DS or XBOX is in the balance.  We kayak, canoe, fish, ride four wheelers and sea doo(his favorite).  He packs his bags and calls his grandmother to come get him every Friday night.

It would be less than honest for me to tell you that everything in our lives is without trouble, we still have obstacles, but who does not.  What I can without doubt tell you is we have many, many more good days, ………make that great days, than bad.  We are miles and miles down the road from those first early dark days I talked about.  Seems like a different child and family talking about it now.   Each and every member of that team we had, who made such a difference for us then, owns and helped make possible a little part of every great day we have today and for the rest of our lives.  Thank you all for taking the time to change our life.   Know that your efforts with Walk for the Children today will change the lives of many tomorrow. 

  After today’s walk, I’m headed home to recoup, I can’t help think of the words of that song, “I’m not as good as I once was but I’m as good once, as I ever was!!!!!!” 

Thanks again for all your help!

Matthew Phillips of Hot Springs is one of 70 artists whose self-portraits will be on display in Washington, D.C. during a special event on September 13 to celebrate the 40^th anniversary of ANCOR, the American Network of Community Options and Resources.  ANCOR was founded in 1970 as an association of organizations that support community integration for people with disabilities. The artworks will be on display during the invitation-only special event, being held at the Smithsonian’s Donald W. Reynolds Center for American Art and Portraiture.

“This exhibit really brings the voices of people with disabilities into our celebration,” said ANCOR CEO Renee L. Pietrangelo.  “The remarkable energy, diversity and creativity of the pieces underscore the value of supporting community integration and self-expression for everyone, including individuals with disabilities.”

Also at the event, 22 individuals will be inducted into the ANCOR Foundation Legacy Leaders Circle, in recognition of their many years of service to the association and to the ideal of community supports and services.  “ANCOR is proud of these leaders, who have been at the forefront in making communities of choice a reality for people with disabilities,” said ANCOR CEO Renee L. Pietrangelo.  “And we’re especially pleased that the $30,000 raised by this class of inductees will support the professional development of the future leaders in our field.”

ANCOR is the national association representing more than 800 providers of community supports and services to more than 500,000 people with disabilities.  The association offers federal advocacy, professional and organizational development and access to innovation and best practices for and on behalf of its members.

Michael is a participant in First Step’s Art Ajar program that began in April 2008 as a means of providing a creative outlet for the adults served by the organization.  Through this program, local professional artists teach classes for interested consumers in the First Step Adult Development Program.  The group has displayed their work at Art in the Park, the Fine Arts Center and the Malco Theater.  They were invited to illustrate the publication, Natural State, a collection of 20 short stories from the Fine Arts Center’s “2009 Short Story competition.”  First Step serves individuals, birth through adulthood, with developmental delays and disabilities.  “Our organization is very proud of Matthew, and honored to have his work displayed in Washington, D.C”, said Joanne Mitchell, Art Ajar Coordinator   For more information about First Step, please call  (501) 624-6468.