Occupational Therapy Instructor Dr. Mary O’Donnell testifies at Massachusetts Statehouse for improving services to improve their lives.

On a humid Tuesday morning earlier this month, Dr. Mary O’Donnell sat down at a table inside the Massachusetts State House.

O’Donnell, an instructor of Occupational Therapy at the Institute, was there to testify before the Legislature’s Joint Committee on Children, Families, and Persons with Disabilities on behalf of Bill H.147, “An Act Providing Immediate Childcare Assistance to Homeless Families,” which would provide automatic childcare assistance and access to early intervention services to homeless families by the Department of Public Health. 

As an occupational therapist at the Spaulding Outpatient Center for Children in Lexington, O'Donnell's research focuses on advocacy and policy to improve access to early intervention services for young children experiencing homelessness, O’Donnell told the legislators how early intervention for young children can help mitigate long-standing problems that include reducing healthcare spending, decreasing the strain on public school special education departments, and providing equitable access to health-promoting, family-centered, and federally mandated services – challenges she said were worsened by the Covid-19 pandemic.
 

mary sits at a dark wood table with a microphone and faces a horseshoe shaped desk with 8 people sitting at it
In advocating for early intervention services, O’Donnell testified that the operational standards in Massachusetts are not adequately meeting the needs of families experiencing homelessness.

“The current early intervention operational standards in Massachusetts are not adequately meeting the needs of children and families experiencing homelessness,” she told the legislators. “The categorical eligibility outlined in this bill will ensure that these families have access to the services they need and deserve.”

O’Donnell testified that children who are homeless have double the rate of development delay compared to their peers who live in homes and are at considerable risk of developing disabilities. She noted that children aged 18 to 41 months who have just one emergency shelter stay are significantly more likely to experience mental health problems, developmental delays, behavioral challenges, and poor acquisition of pre-academic skills.

“Early intervention clinicians don’t just treat delays in children, they support the whole family in understanding their child’s needs. They educate caregivers on how to play with their children to support their development and they connect families with resources to prevent challenges from exacerbating,” she testified. “Left unchecked, these children end up in our school systems and medical facilities with problems that could have been mitigated at a much younger age.” 

O'Donnell's June 13 appearance was due to her work with Boston Healthcare for the Homeless and Horizons for Homeless Children while in the Institute’s post-professional Doctor of Occupational Therapy program, from which she graduated in 2022. When Horizons asked if she wanted to testify in support of the bill, O’Donnell jumped at the chance.

While the bill focuses on childcare assistance for homeless families, Part C of the federal Individuals with Disabilities Education Act (IDEA) would allow homeless families who qualify for other services to also qualify for early intervention services for their children from birth to three years. The services would support children who have a disability or who are at risk of developing a disability so they could receive preventative services before they begin school.

O’Donnell’s journey to get to this point has been a passionate one. 

She became fascinated with the specialists who supported a child with cerebral palsy while working as her nanny. Eventually, it led her to getting her bachelor’s degree in therapeutic studies and then a master’s degree in occupational therapy. O'Donnell has worked at Spaulding since 2019, where she noticed the distance that homeless families had to travel to receive early intervention and OT services for their children. Often, it took hours for them using public transit to the suburbs going to and from appointments.

“I noticed the resilience of these families heading all the way out to our clinic,” she said. “It was extraordinary, yet unfair.” 

It spurred O'Donnell to pursue research on the subject, which has led to her being a co-author of several peer-reviewed articles and presenting at state and national conferences.

“I've always been passionate about advocacy, and I think that as practitioners, educators, and students, we need to be more involved in political advocacy for issues that affect our patients, practice, and education system,” she said after giving testimony on Beacon Hill. 

O’Donnell noted that while families often fear possible government intervention such as having the state Department of Children and Families become involved, she believes rebranding these services could change the narrative.

“If we can create wraparound services that exist within shelters and early childhood education centers that serve homeless families and promote these early intervention programs as a service that is just part of the other services that they have access to, more families will feel comfortable accessing it,” she said. “Then, this service will be seen as what we know it to be – a health-promoting free and accessible resource.”

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