Working With Difference

Families can teach caregivers a few things.

Native American Professional Parenting Resources (NAPPR), based in Albuquerque, New Mexico, supports about 500 families with young children through home visitation, Early Head Start, early intervention, and other programs. The organization has worked in the area for more than 30 years and covers four counties and 13 pueblos, or tribal communities, in four languages—Keres, Tiwa, Towa, and Navajo.

Olga Tenorio, 24, of Santo Domingo Pueblo, and her 3-year-old son DeAnthony are in some ways typical of the types of families that NAPPR serves. She is a single mother living in a tribal community who works at the Early Learning Center that her son attends. DeAnthony has cerebral palsy, which means that Tenorio must navigate multiple agencies to meet her son's medical and developmental needs.

National Journal spoke to Tenorio and NAPPR's program director for early intervention, Amy Pickard, about what makes for the most productive interactions between families of different backgrounds, therapists, and service providers.

Listen Before You Talk

Olga Tenorio: I live on the reservation, and sometimes people I work with ask a lot of questions about life there that we don't want to answer or can't answer. But the NAPPR therapists I worked with were very observant. You need to stop and observe. I understand that you have to ask questions for intake, but you really learn the most by observing.

Amy Pickard: What we have to realize is that we are going to homes and working with people's most precious relationship, to their young child. Our staff spends a lot of time shadowing others on visits, where they are just there to see how to approach different situations.

"You need to stop and observe. I understand that you have to ask questions for intake, but you really learn the most by observing." —Olga Tenorio, mother

Blend In

Pickard: We've had service providers who go in and find a family that's very democratic, with 10 people in a small apartment as an audience, other siblings, and so on. And that plays out in different ways. Requiring they turn the TV off is not something you do. And it's not about how many classes you can send someone to, or flashy toys. We use what's in the home. With us, it's just caregiver and child. I have to work with staff so they understand that's not your environment to control.

Tenorio: Sometimes it's very simple things. When we had home-based services, sometimes the therapists would come with us to other appointments, and it made a huge difference, even just at the level of having an extra set of hands to help get him in and out of the car. And the response wasn't, this is not part of what I am here to do.

Follow Our Lead

Tenorio: We've had a lot of different people come in, because you don't know who's able to come out to the pueblo. But our best experiences have been with people who approach us without being overwhelming. I've become more vocal and an advocate for my son and other families, but it's taken time. And I appreciated therapists who were patient with me and came along.

Pickard: My boss back in 2000 threw me out there for home visits. Here I am, this blonde, blue-eyed outgoing person. I came in all, "hey, how are you?" very loud, almost overly engaging. But a year later, when I was becoming more like part of the family, I had a family member tell me, when you come in, you always give me this big hug. In our family, it's more of a side hug. When you shake hands you don't squeeze so hard; that's very Caucasian. You do a very soft handshake. All these experiences made me more aware of how I'm perceived. I learned to check myself.

We Are Partners

Tenorio: I appreciate that [NAPPR service providers] talk to me like they're training me, as opposed to someone who doesn't understand what's going on. They tell me, this is why we're doing this. If you put him in this position, it works out this set of muscles. I now know that Botox can be helpful with muscle tone. When I go out to see doctors and other physical therapists, I am confident that I know my son and I know my son's best interests.

Pickard: What I always tell my staff is that we're the emcee to the visit. The visit is not about you and the child, it's more about leading the parent or caregiver to what is already there. You point out, "wow, did you see how Jimmy was looking at you?" What you're there for is to give the mom or dad or grandma a voice.