You have learned many strategies to offer culturally responsive environments in this training. Now that we are at the end, it’s time to implement what you have learned.
For this application activity, you will identify a specific goal that you would like to achieve to support children through offering culturally responsive environments.
You have completed the content for Advancing Equity in Early Childhood – Creating Culturally Responsive Environments!!!
A few final things to complete the course and access your certificate.
This course is the one in a series of advancing equity courses designed to help early care and education professionals understand how to support diversity and equity in classrooms, with children, with families, and with co-worker.
Check out the other trainings in the series:
To finish the course, you must successfully complete an application activity.
Note that it can take up to 3 business days for the application activity to be graded. Do not submit multiple application activities, as it will delay grading.
To receive course credit and access the certificate of completion, the application activity must be completed satisfactorily. You will receive a notification when it is completed. Please contact the course facilitator with any questions.
Press the “Mark Complete” button to complete the final steps in the training.
Need some tips?
To pick out a goal, think about:
Example Goals:
I will add additional materials showing greater age variations in people to 3 centers by mm/dd/yy.
I will add additional materials showing greater age variations in people to 3 centers by mm/dd/yy.
I will add photos of all children and families in my group to my display to serve as windows to each child and mirrors to other children by mm/dd/yy.
Example of Learning:
I learned why it is important to offer materials and activities that serve as mirrors for children to reflect their lives, and materials that serve as windows to expose children to people different from them.
I will add photos of all children and families in my group to my display to serve as windows to each child and mirrors to other children by mm/dd/yy.
Example of strengths identified:
I will add photos of all children and families in my group to my display to serve as windows to each child and mirrors to other children by mm/dd/yy.
Example of building on a strength:
My classroom is organized and tidy. I will make sure that any new materials and displays I add are organized and avoid clutter.
I will add photos of all children and families in my group to my display to serve as windows to each child and mirrors to other children by mm/dd/yy.
Dr. Stephanie Meredith
Dr. Nicholas Wright
Dr. Stephanie Meredith is the Director of the Lettercase National Center for Prenatal and Postnatal Resources at the University of Kentucky’s Human Development Institute (HDI) and the mother of a young man with Down syndrome. Her identity as a parent gave her particular access and understanding of the family experience after learning about a diagnosis. Dr. Nicholas Wright is a multiracial man who serves as Director of DEI at HDI and has a traumatic brain injury.
“We were both worried about leading this work because we both have ways in which we’re similar and different from Black and Hispanic mothers of children with Down syndrome. We were so grateful that as we started the conversations with the 20 parents who participated in this project, they were generous in sharing their thoughts and insights about what types of research were important to them and how to improve the systems. In fact, when we asked the first question about their research priorities, they were so eager to talk about their thoughts on the diagnosis experience that we had to repeat the question to gather all their important insights.”
“At the risk of being vulnerable and emotional, their willingness to share felt sacred, and they correspondingly expressed that they appreciated the opportunity to offer those insights. We were also grateful to our health equity and medical professional teams for sharing their unique insights and for being wonderful professionals who are committed to helping families.”
We want to thank our team of 36 parent and professional reviewers who made this resource possible and gave their excellent input!
We’d also like to thank our student LEND trainees who assisted in preparing this resource: Cameron Elder (currently pursuing a Doctorate in Physical Therapy) and Hannah Keene, MS (currently pursuing a PhD in Special Education).
1. Ansong EO, Jones K, Santoro SL. Timing of referrals to a Down syndrome parent group by race. Pediatr Qual Saf. 2023;8(1):e632. doi:10.1097/pq9.0000000000000632
2. Chung J, Krell K, Pless A, et al. Healthcare experiences of patients with Down syndrome from primarily Spanish‐speaking households. Am J Med Genet A. 2023;191(8):2132-2141. doi:10.1002/ajmg.a.63250
3. Krell K, Pless A, Michael C, et al. Healthcare experiences of patients with Down syndrome who are Black, African American, of African descent, or of mixed race. Am J Med Genet A. 2023;191(3):742-752. doi:10.1002/ajmg.a.63069
4. May CP, Dein A, Ford J. New insights into the formation and duration of flashbulb memories: Evidence from medical diagnosis memories. Appl Cogn Psychol. 2020;34(5):1154-1165. doi:10.1002/acp.3704
5. Carter EW, Bumble JL. The promise and possibilities of community conversations: Expanding opportunities for people with disabilities. J Disabil Policy Stud. 2018;28(4):195-202. doi:10.1177/1044207317739408
6. Sheets KB, Best RG, Brasington CK, Will MC. Balanced information about Down syndrome: What is essential? Am J Med Genet A. 2011;155(6):1246-1257. doi:10.1002/ajmg.a.34018
7. Barros Da Silva R, Barbieri-Figueiredo MDC, Van Riper M. Breastfeeding experiences of mothers of children with Down syndrome. Compr Child Adolesc Nurs. 2019;42(4):250-264. doi:10.1080/24694193.2018.1496493
8. Levis DM, Harris S, Whitehead N, Moultrie R, Duwe K, Rasmussen SA. Women’s knowledge, attitudes, and beliefs about Down syndrome: A qualitative research study. Am J Med Genet A. 2012;158A(6):1355-1362. doi:10.1002/ajmg.a.35340
9. Riggan KA, Close S, Allyse MA. Family experiences and attitudes about receiving the diagnosis of sex chromosome aneuploidy in a child. Am J Med Genet C Semin Med Genet. 2020;184(2):404-413. doi:10.1002/ajmg.c.31781
10. Christopher D, Fringuello M, Fought AJ, et al. Evaluating for disparities in prenatal genetic counseling. Am J Obstet Gynecol MFM. 2022;4(1):100494. doi:10.1016/j.ajogmf.2021.100494
11. Canedo JR, Miller ST, Myers HF, Sanderson M. Racial and ethnic differences in knowledge and attitudes about genetic testing in the US: Systematic review. J Genet Couns. 2019;28(3):587-601. doi:10.1002/jgc4.1078
12. Infant Mortality. Georgia Department of Public Health. Accessed May 18, 2023. https://dph.georgia.gov/infant-mortality
In this lesson, we’ll review recommendations for medical professionals as reported by both Black and Hispanic parents of children with Down syndrome. We’ll also examine suggested implementation strategies for each recommendation.
[ld_video]
When referring to Black parents of children with Down syndrome in this course, we are describing parents who identify as Black, African-American, of African descent. When we refer to Hispanic parents of children with Down syndrome, we are referring to parents with ancestry from Spanish-speaking countries.
Research shows significant health disparities exist when comparing Black and Hispanic children with Down syndrome to White children with Down syndrome, in addition to more limited access to services and support.1–3
One problem is the extent to which parents of color learning about a diagnosis receive the latest accessible and research-based information about Down syndrome from their medical providers. The moment of diagnosis is the first point on the life course, often described as a flashbulb memory that is remembered with vivid clarity for decades.4 That moment frames the whole experience and establishes a trajectory for understanding the condition and accessing services and healthcare.
Research shows that families of children with Down syndrome are able to cope better when they receive information about the condition in that moment; however, new and expectant parents often experience emotional distress when they receive limited or no additional resources or support systems during that vulnerable time.4 Parents also report experiencing emotional harm when the information is exclusively negative, so they also need positive information to be included.
“Yes, in relation to the doctors, really, they are the ones who give you the news, they give you the diagnosis. Yes, they should be more steeped in the topic. Because badly handled news affects mothers a lot.” —Spanish-speaking caregiver
Therefore, it is essential that all new and expectant parents of children with Down syndrome receive accessible, understandable patient-centered outcomes research (PCOR) to make informed decisions about healthcare and to access support and services.
Dr. Brian Skotko and Albert Pless, MS lead a discussion about their project regarding the experiences of Black and Hispanic parents of individuals with Down syndrome also funded by the Patient Centered-Outcomes Research (PCOR) that we will reference throughout the course. Here they provide background on the health disparities faced by these parents. They also discuss the importance of the diagnosis moment.
[ld_video]
Watch this video to learn more about Hispanic adults thriving with Down syndrome and how to approach the condition with open expectations:
1. Ansong EO, Jones K, Santoro SL. Timing of Referrals to a Down Syndrome Parent Group by Race. Pediatr Qual Saf. 2023;8(1):e632. doi:10.1097/pq9.0000000000000632
2. Chung J, Krell K, Pless A, et al. Healthcare experiences of patients with Down syndrome from primarily Spanish‐speaking households. Am J Med Genet A. 2023;191(8):2132-2141. doi:10.1002/ajmg.a.63250
3. Krell K, Pless A, Michael C, et al. Healthcare experiences of patients with Down syndrome who are Black, African American, of African descent, or of mixed race. Am J Med Genet A. 2023;191(3):742-752. doi:10.1002/ajmg.a.63069
4. May CP, Dein A, Ford J. New insights into the formation and duration of flashbulb memories: Evidence from medical diagnosis memories. Appl Cogn Psychol. 2020;34(5):1154-1165. doi:10.1002/acp.3704
This course is designed to share recommendations and strategies for disseminating patient-centered outcomes research (PCOR) findings to Black and Hispanic new and expectant parents learning about Down Syndrome.
By the end of the course, the learner will be able to do the following:
This training/learning course contains 8 recommendations. Each recommendation includes implementation strategies/solutions for improvement, additional resources, knowledge checks, etc. It should take you approximately 2 hours to complete. You can pause at any time and go back to finish the module where you left off.
Studies show that there is research that is universally valued by all parents of children with Down syndrome, and there are also specific research questions and information that are particularly valued by Black and Hispanic parents of children with Down syndrome. The table below highlights these research questions and shows which research findings were most important among different demographics.
[ld_video]
| Research Priorities for All Parents of Children with Down syndrome | Research Priorities for Black and Hispanic Parents of Children with Down syndrome | |
| Benefits and drawbacks of different prenatal testing/screening options | Yes1 | Yes: Black parents raised concerns about possibly receiving less information about prenatal screening options than White counterparts. |
| Benefits and drawbacks of different treatments for common medical issues experienced by people with Down syndrome (such as heart defects, gastrointestinal defects, etc.) | Yes1 | Yes |
| Impact of prenatal care and insurance coverage options on miscarriage and stillbirth rate | No | Yes: Black mothers noted specific concerns about higher rates of maternal morbidity and mortality during pregnancy, and Hispanic mothers who were recent immigrants noted concerns about insurance coverage. |
| Benefits and drawbacks of different feeding strategies, like breastfeeding, pumping, formula-feeding, and supplementing, and methods to optimize feeding and weight gain in children with Down syndrome | Yes2 | Yes: Black mothers noted specific concerns about historic discrimination in breastfeeding. |
| Impacts of different social determinants of health on short and long-term outcomes for people with Down syndrome | Yes3 | Yes: Hispanic parents raised concerns about health insurance options. Black parents raised specific concerns about the impact of marital status and financial resources. |
| Impact of early connection to parent support and advocacy groups on all members of the family (including mother, father, siblings) | Yes4,5 | Yes: Black and Hispanic parents wanted additional information about the long-term impact of racially and ethnically concordant sub-groups within local Down syndrome organizations |
| Outcomes and potential benefits of peer mentors, Down syndrome organizations, and social supports provided at the moment of diagnosis | Yes1 | Yes: Black and Hispanic parents added specific focus on peer mentors with racial and ethnic concordancy. |
| Best treatment options for psychological support and counseling for parents following a Down syndrome diagnosis | Yes5 | Yes |
| Impacts of different early intervention strategies on meeting developmental milestones and long-term outcomes | Yes1 | Yes |
| Benefits and drawbacks of raising a child with Down syndrome to be bilingual, including sign language | Yes3 Parents of children generally express they want this information about sign language instruction. | Yes: Hispanic parents who are bilingual or Spanish-speaking specifically expressed an interest in this information. |
Learn from families about what matters most to them at the moment of diagnosis in this video from Boston Children’s about the Diaz family:
Black Down Syndrome Association Founder, Kelli Caughman, and Mercedes Lara discuss their experiences raising children with Down syndrome as women of color on The Lucky Few podcast focusing on “A Conversation About Race & Down Syndrome w/Mercedes Lara & Kelli Caughman.”
1. Ansong EO, Jones K, Santoro SL. Timing of referrals to a Down syndrome parent group by race. Pediatr Qual Saf. 2023;8(1):e632. doi:10.1097/pq9.0000000000000632
2. Chung J, Krell K, Pless A, et al. Healthcare experiences of patients with Down syndrome from primarily Spanish‐speaking households. Am J Med Genet A. 2023;191(8):2132-2141. doi:10.1002/ajmg.a.63250
3. Krell K, Pless A, Michael C, et al. Healthcare experiences of patients with Down syndrome who are Black, African American, of African descent, or of mixed race. Am J Med Genet A. 2023;191(3):742-752. doi:10.1002/ajmg.a.63069
4. May CP, Dein A, Ford J. New insights into the formation and duration of flashbulb memories: Evidence from medical diagnosis memories. Appl Cogn Psychol. 2020;34(5):1154-1165. doi:10.1002/acp.3704
5. Carter EW, Bumble JL. The promise and possibilities of community conversations: Expanding opportunities for people with disabilities. J Disabil Policy Stud. 2018;28(4):195-202. doi:10.1177/1044207317739408
Resources
1. Ansong EO, Jones K, Santoro SL. Timing of referrals to a Down Syndrome parent group by race. Pediatr Qual Saf. 2023;8(1):e632. doi:10.1097/pq9.0000000000000632
2. Chung J, Krell K, Pless A, et al. Healthcare experiences of patients with Down syndrome from primarily Spanish‐speaking households. Am J Med Genet A. 2023;191(8):2132-2141. doi:10.1002/ajmg.a.63250
3. Krell K, Pless A, Michael C, et al. Healthcare experiences of patients with Down syndrome who are Black, African American, of African descent, or of mixed race. Am J Med Genet A. 2023;191(3):742-752. doi:10.1002/ajmg.a.63069
4. May CP, Dein A, Ford J. New insights into the formation and duration of flashbulb memories: Evidence from medical diagnosis memories. Appl Cogn Psychol. 2020;34(5):1154-1165. doi:10.1002/acp.3704
5. Carter EW, Bumble JL. The promise and possibilities of community conversations: Expanding opportunities for people With disabilities. J Disabil Policy Stud. 2018;28(4):195-202. doi:10.1177/1044207317739408
6. Sheets KB, Best RG, Brasington CK, Will MC. Balanced information about Down syndrome: What is essential? Am J Med Genet A. 2011;155(6):1246-1257. doi:10.1002/ajmg.a.34018
7. Barros Da Silva R, Barbieri-Figueiredo MDC, Van Riper M. Breastfeeding experiences of mothers of children with Down syndrome. Compr Child Adolesc Nurs. 2019;42(4):250-264. doi:10.1080/24694193.2018.1496493
8. Levis DM, Harris S, Whitehead N, Moultrie R, Duwe K, Rasmussen SA. Women’s knowledge, attitudes, and beliefs about Down syndrome: A qualitative research study. Am J Med Genet A. 2012;158A(6):1355-1362. doi:10.1002/ajmg.a.35340
9. Riggan KA, Close S, Allyse MA. Family experiences and attitudes about receiving the diagnosis of sex chromosome aneuploidy in a child. Am J Med Genet C Semin Med Genet. 2020;184(2):404-413. doi:10.1002/ajmg.c.31781
10. Christopher D, Fringuello M, Fought AJ, et al. Evaluating for disparities in prenatal genetic counseling. Am J Obstet Gynecol MFM. 2022;4(1):100494. doi:10.1016/j.ajogmf.2021.100494
11. Canedo JR, Miller ST, Myers HF, Sanderson M. Racial and ethnic differences in knowledge and attitudes about genetic testing in the US: Systematic review. J Genet Couns. 2019;28(3):587-601. doi:10.1002/jgc4.1078
12. Infant Mortality. Georgia Department of Public Health. Accessed May 18, 2023. https://dph.georgia.gov/infant-mortality
Dr. Stephanie Meredith is the Director of the Lettercase National Center for Prenatal and Postnatal Resources at the University of Kentucky’s Human Development Institute (HDI) and the mother of a young man with Down Syndrome. Her identity as a parent gave her particular access and understanding of the family experience after learning about a diagnosis. Dr. Nicholas Wright is a multiracial man who serves as Director of DEI at HDI and has a traumatic brain injury.
“We were both worried about leading this work because we both have ways in which we’re similar and different from Black and Hispanic mothers of children with Down syndrome. We were so grateful that as we started the conversations with the 20 parents who participated in this project, they were generous in sharing their thoughts and insights about what types of research were important to them and how to improve the systems. In fact, when we asked the first question about their research priorities, they were so eager to talk about their thoughts on the diagnosis experience that we had to repeat the question to gather all their important insights.”
“At the risk of being vulnerable and emotional, their willingness to share felt sacred, and they correspondingly expressed that they appreciated the opportunity to offer those insights. We were also grateful to our health equity and medical professional teams for sharing their unique insights and for being wonderful professionals who are committed to helping families.”
In this section, you will learn some strategies for incorporating culturally responsive materials and activities. You may remember from the introduction that we are using the term culturally responsive to refer to a strengths-based approach with a foundational respect for the role of culture in children’s learning and development.
We hope not to give you a list of required materials or activities but to offer you some strategies to use when evaluating and planning classroom materials and activities.
But, above all…..
It all starts with YOU!
An important part of creating a culturally responsive learning environment is to make sure the materials and activities you are using do not promote biased and stereotypical thinking from children as they learn by exploring their world.
Did you know? Stereotypes can contribute to the formation of bias2. It can be especially challenging when stereotypes contribute to implicit bias that we aren’t aware we have.
Preventing the formation of stereotypes helps reduce both adult’s and children’s biased thinking. As educators, one important way we can do that is to evaluate our own existing classroom materials and activities for stereotyping and bias.
Reference:
2NAEYC, Advancing Equity and Embracing Diversity in Early Childhood, Elevating Voices and Action, book, 2021
In this lesson, we’ll review recommendations for advocacy organizations as reported by both Black and Hispanic parents of children with Down syndrome. We’ll also examine suggested implementation strategies for each recommendation.
