April Fournier: Caring for Children from City Council to the Doctor’s Office - Early Learning Nation

April Fournier: Caring for Children from City Council to the Doctor’s Office

Editor’s Note: The Early Learning Nation Studio recently attended the 2022 National League of Cities’ City Congressional Conference where we spoke with early learning researchers, policymakers, and practitioners. The full collection of video conversations can be found here.

April Fournier is not just a Portland (ME) Councilmember, she’s also an early childhood support specialist within an outpatient pediatric clinic. After the child’s medical health visit, Fournier checks in with the parents to provide support on the “social determinants of health”: housing, food and other areas critical to a child’s development.


Chris Riback:                 Council member Fournier, thank you for coming to our ELN studio.

April Fournier:              Absolutely. Thank you for having me.

Chris Riback:                 What is the state of early childhood learning in Portland Maine today? Maybe give me both pre COVID and what’s happened since COVID.

April Fournier:              Sure. I think pre COVID, just like a lot of places around the country, there’s just not enough spaces. And so we have so many parents that need childcare to work to make their household work, so that they have money coming in. Plus we also know the benefits of children being around each other socially, emotionally and being able to build their communication skills, learning how to create a community. When you don’t have all those spaces, you have children that really start to fall behind, especially as they enter public school. So I think before COVID we definitely had a shortage, but there were lots of small like family run childcares or in home childcares as well as lots of different centers.

I think what we’ve seen post COVID is a significant decrease in those programs. Whether the parents that would come and work in them couldn’t go back to the workforce because, they themselves couldn’t find childcare. Or we know that also early childcare workers are some of the lowest paid in the country. And so you’re coming out of COVID, you’re like, my bills are behind. I need to pay my mortgage. I need to pay my car and the job that I’m doing isn’t cutting it anymore, because I’m so behind.

And so you have a lot of people that have also left the workforce to go find something else that’s paying more. I think for Portland, we’re very much feeling that. What I hear on the council from a lot of families is, we need more spots. We need more childcare, or these children are just going to sit at home and then all of a sudden, they show up one day in kindergarten and they don’t know how to interact. They don’t know how to engage. And then I think you start to see, more that child’s a behavior problem, more that child is going to be tagged.

Chris Riback:                 It all connects.

April Fournier:              Yes, absolutely.

Chris Riback:                 It all connects.

April Fournier:              It’s critical.

Chris Riback:                 So you seem to be an extremely busy person. One role is council member. Can we talk about another of your roles?

April Fournier:              Sure. Yes, absolutely.

Chris Riback:                 You currently are in a grant funded position that provides barrier free support to families within a pediatric practice setting.

April Fournier:              Yes.

Chris Riback:                 What is the program? What are you doing it? And what do you see there?

April Fournier:              Yes, so I’m an early childhood support specialist within the outpatient pediatric clinic. We see typically families who either require free care, or low cost healthcare, or Medicaid. So we have very few families that are private pay insurance. So these are often families that are living in poverty or within Portland, we have a lot of Asili families that have just newly arrived in the states.

My role is to help provide that connection. So pediatricians can spend 15 to 30 minutes often with a family and they’re really focused on the medical component. Then they have to go off to their next patient. But that doesn’t mean that they’ve been able to address some of those social determinants of health. Like, do you have safe and secure housing? Do you have enough food to feed your family on a regular basis?

Chris Riback:                 So does the family start with the pediatrician and then transition to you?

April Fournier:              Yes. Yes.

Chris Riback:                 So it’s almost two separate, though, connected conversations?

April Fournier:              Absolutely. I often will come in after the visit. So the pediatrician does their visit and then we have a quick little conference, before I go in and talk to the family. And so that could be, Hey, so mom mentioned that she’s working with this domestic violence agency to get some counseling because, her and dad were separated. Or this mom mentioned that she’s really struggling to get diapers on a regular basis. The baby has a diaper rash because, she’s trying to use diapers for longer periods of time because of that insecurity.

By having that quick little conference, I know what I’m walking into. I’m not asking the same questions. So the parents are like, I just told the doctor all this information. So one, it’s honoring that time for the family, but also jumping into the conversation that is most important for them.

Chris Riback:                 And you can really cover a wide range of risk factors.

April Fournier:              Absolutely.

Chris Riback:                 I understand you collect data off of these conversations as well. What do the data show? What have you seen?

April Fournier:              So the things that we’re looking at is, as we’re having these conversations are they identifying a housing need, or a social services need, or diaper insecurity, food insecurity? It’s a brand new mom who’s 19 years old and is trying to figure out, I don’t know how to bathe my baby. I don’t know how to do sleep routines or I’m not sleeping. So it’s really taking this holistic look at how do we help this family be successful, so that as this child develops, as this family develops, they have the best possible outcome. So I’m taking data, asking questions and then we’re able to pull that from our medical record system to see, we met this family when the baby was three days old.

Now the baby’s four months old, what progress has this family made with this intervention? And it’s amazing what we’re seeing, we’re just seeing really, really great results. They’re not diaper insecure or they’ve been able to connect to community resources that help them with housing or getting connected to wick, or even just getting health insurance. So they’re not getting these bills from the hospital that create anxiety and fear and I don’t know how to pay this. So it’s really helping connect all of the things for the family to help them be successful.

Chris Riback:                 In learning about your story, I realized as well, this is personal for you.

April Fournier:              Absolutely.

Chris Riback:                 I mean you underwent quite a career change. Inspired, I believe, by your son.

April Fournier:              Yes. Absolutely. I was on a trajectory with an insurance company, or in the financial services industry to be project manager or operational development.

Chris Riback:                 Or CEO of a multinational bank? Yes. Something.

April Fournier:              One day. And so my youngest son, I had twins. So I actually have four children, but the youngest are twins. We noticed around age two, they weren’t exactly developing the same. They had some language development, but he was starting to do things like lining things up or he would get really frustrated and hit himself, or bang his head off the ground. And it was just like, I have no idea what’s happening with this kiddo. It just doesn’t make sense. And so the pediatrician did some screenings for autism and said, well, let’s go ahead and do some evaluation. Because he’s really kind of hitting all these different flags. And so after going through that evaluation, he was diagnosed with autism and it was like, I have no idea what to do.

Thankfully Maine has a program called Child Development Services that comes in to do early intervention. So it’s really around teaching parents, how do you work on your routines so that you’re able to bring language out or create social connections within the scope of your everyday life? Not every parent can take time off to do all of this development. So how can you do it within what you’re already doing?

And so in watching his transformation, his language development, he started to come back to us. And be like, Hey, I’m checking back into my family and I’m learning these things and we’re seeing less aggressions or less self-harm. Like, why wouldn’t you want to do something that’s going to do that for children. And just what it did for our family was incredible. So rather than going to graduate school for project management or financial services, I went to graduate school for early childhood special education.

Chris Riback:                 A different kind of education.

April Fournier:              Absolutely. Yes.

Chris Riback:                 One both in school and in the classroom, but also in real life.

April Fournier:              Absolutely. Absolutely. So then in doing different roles, I worked doing in-home services for families who have a child with autism. How do you connect them to community? How do you plan a grocery trip, knowing that you’re going to have tantrums, or knowing that you’re going to have behaviors that happen? How do you help families meet their goals?

I taught in a special education classroom and I worked connecting families in to that transition to kindergarten. And how do you work with public schools on implementing special education services? And then worked in head start. So lots of different facets to figure out, how do we most help these families within our community?

Chris Riback:                 Council member, what does it mean to you to be an indigenous Diné woman on the city council? What level of responsibility does that make you feel?

April Fournier:              I’m honored to hold that space. There are so many people that came before me to make it possible. Not necessarily in Portland specifically, but on a national level back in my homelands. Being able to see Deb Holland, secretary Holland as part of the cabinet, it’s just incredible. And so by claiming these spaces and creating spaces for indigenous officials to walk into, it just allows us to have the next generations come along with us. So my children are seeing me run for city council, or they’re seeing me take advocacy space, or they’re seeing me take pictures in Washington, in our capital doing this work.

And so I think, when you’re a minority or when you’re part of a marginalized group, it’s hard to walk through some doors. And so if you see someone who looks like you, who has the same type of life experience, has a similar identity, it’s so much easier and comfortable to walk through that door and take that space as well. I’m again, incredibly honored to be in this space. I take my responsibility, very, very seriously and I am just so excited to do it.

Chris Riback:                 I’m sure that you do, I’m sure that you are. Your children see you, your community sees you.

April Fournier:              Yes.

Chris Riback:                 Thank you.

April Fournier:              Of course, thank you.

Chris Riback:                 Thank you for the work you do and for coming to the studio.

April Fournier:              Awesome. Thank you for having me.


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