When 3-year-old Miley Kaleikula-Velleses kept rubbing her ear, her mother figured it was wax buildup and tried to remedy it with a cotton swab.
It wasn't until the youngster was later screened at preschool by the School Readiness Project that her mom discovered that her hearing was impaired.
The goal of the pilot project on the Waianae Coast is to uncover hidden problems and handle them before they trip children up in school and life. Results have been so good that it is now expanding islandwide.
In the past six years, 5,600 children have been screened for vision, hearing and developmental problems by the project, headed by the Learning Disabilities Association of Hawai‘i and funded by Aloha United Way. More than a fourth — 28 percent — had potential disabilities and were referred for further evaluation and services.
"Interventions we're doing with the smallest of children could change their lives forever," said Michael K. Moore, executive director of the Learning Disabilities Association. "The possibility that 1 in 4 children may fail when they could have succeeded is devastating to contemplate."
The school readiness initiative focuses on children ages 2 to 5 who might not otherwise be screened, reaching out at preschools, community agencies, shelters, events, even beach parks. It also educates parents on early childhood health and growth, helping them address common challenges.
The association provides case management to ensure services are obtained for children in need, linking them with pediatricians as well as state programs. At later re-screenings, the original problem had been handled in 78 percent of cases, Moore said.
The most common impairment identified was hearing loss, followed by social-emotional difficulties. About a third of the children referred for services had their problem resolved quickly while others needed longer term help, Moore said.
As an example, he recalled the case of a little boy who was acting up at home and fighting with his classmates.
"When we identified that he couldn't hear and got him treated, all that other stuff went away," he said.
Fortunately for Miley, now 5, her problem was easily fixed as well. A visit with a doctor revealed the culprit: a tiny rubber pebble from a preschool playground mat had gotten wedged deep in her ear. She was sent to a specialist who removed the chip, along with a second one he found in her other ear.
"I wouldn't have known that something was in her ear unless I went through the program," said Miley's mother, Amanda Kaleikula-Velleses, a preschool teacher who lives in Waianae. "We're really grateful."
She wishes the free screening program had been available when her older son, now 11, was a toddler. He had to have years of speech therapy and tutoring after being diagnosed with hearing loss in preschool.
"They didn't have these type of services way back when that could help us," Kaleikula-Velleses said. "I work with families now a lot. I tell them, why not take advantage of it, especially when it's free. It's important to screen our children and make sure they're OK."
While many children get wellness checkups at medical clinics, some don't get a thorough developmental screening. And other kids lack regular medical care. Community-based screening is an effective and low-cost way to reach them, said Marc Gannon, AUW vice president of community impact.
"It's very strategic in targeting kids who are unlikely to receive screening in other settings," Gannon said. "There's a huge gap in providing universal screening for all kids."
Not long after the School Readiness Project was started in Waianae in 2009, a similar effort got underway in the Kalihi-Palama area, led by Parents and Children Together and also funded by AUW.
AUW has given $600,000 this year to providers working collaboratively to extend the screening effort islandwide, including a $250,000 "impact award grant" to the Learning Disabilities Association, Gannon said.
Jean Johnson, associate professor at the University of Hawaii Center on Disability Studies, praised Aloha United Way for stepping up after screening efforts failed to get funded at the Legislature. She credits Moore with spearheading the program and forging collaborations across the Waianae Coast.
"It has made an incredible difference," said Johnson, who used to be acting director of the center. "They are doing a really good job."
Moore, a gregarious man with a passion for his work, is excited about extending the reach of the School Readiness Project. Soon it will be able to go "on the road" wherever there is a need, with a 15-seat van donated by Soderholm Bus Sales and Leasing.
"It's going to have mobile screening units and we're going to drive that baby around," Moore said. "It's going to be like an ice-cream truck for developmental screening."
UH-Manoa's Center on Disability Studies gave Moore the 2014 award for Outstanding Community Contribution to Persons with Disabilities. Since he took the helm, the Learning Disabilities Association has broadened its mission beyond parent advocacy to preventing disabilities, Johnson said.
"They are trying to identify children very early and get them the services they need so that they don't wind up needing special education," she said.
Along with the personal toll to individual children who aren't helped early, the impact on the bottom line is compelling.
"We can provide early intervention sometimes for pennies," Johnson said. "Even a really intensive program through the Department of Health is roughly about $8,000 a year. In comparison, if a child needs to go to preschool special education, the annual cost is in excess of $25,000."
The School Readiness Project screens children for vision, hearing and developmental delays and gets them help before they start kindergarten.
Lead agency: Learning Disabilities Association of Hawaii
Number of keiki screened so far: 5,600
Referred to services: 28 percent
Most common problems: Hearing, socia
Number of parents trained: 2,700 Main funder: Aloha United Way