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A Special Place for Children With HIV

After John's mother died of AIDS, the four-year-old was placed in one foster-care setting after another within a matter of months. So it should surprise no one that he became angry. He tested those around him, to see if they really accepted him. And he started to bite people.

Since John himself is HIV-positive, his biting frightened adults.

The one constant in John's life was the daycare program at Jacobi Medical Center in the Bronx -- designed for children who are either HIV positive or have AIDS, as defined by the Center for Disease Control. "We saw very little of his anger," said Nancy Oskow-Schoenbrod, a Teachers College graduate who directs the center, "because he knew he was accepted here."

The 25 to 30 children at the Jacobi center, ranging in age from two to six, receive a lot of individual attention. In addition to several teachers, a social worker and a nurse are on half-time duty, and the children "most of whom take daily medication" can see a consulting physician from Jacobi in an emergency.

There is also support for parents of the children, whether they are biological parents or foster parents. "We do not take over the role of the parent; we want the parent to make the decisions," said Oskow-Schoenbrod, who wrote her special-education dissertation at Teachers College on parental decision-making in medical and educational situations.

Founded in 1986, Jacobi Medical Center's Day Care Program is the only one of its kind in New York. It is open only to children from the Bronx but it has become a national model for the care of children with HIV. Acording to Oskow-Schoenbrod, the center offers the children -- who are often isolated by their disease -- a sense of community. "They belong to a group and they help each other," she said.

The center also gives a sense of community to the families, Oskow-Schoenbrod said. "This is a place where they do not have to feel they are carrying a secret."

Oskow-Schoenbrod grew up in Glencoe, a suburb of Chicago, and earned her Bachelor of Arts degree at Connecticut College in New London. She majored in American history, but after graduation, became a child-care worker with autistic and schizophrenic children in Los Gatos, California.

"I became interested in issues of cognitive development," she said, "in how people's perceptions of the world differ."

She came to TC to study those issues and earned three degrees in special education: a master of arts degree with a specialty in the education of children with learning disabilities, a master of education degree in early childhood and a doctor of education degree with a focus on administration.

Her son has learning difficulties and that fact makes Oskow-Schoenbrod especially sensitive to the needs of parents in special education. "I have a lot of respect for parents who have to put in that extra effort," she said. "As a teacher of children with special needs, you learn to see every small improvement as a giant step. But, as a parent, you are often fighting personal frustration."

She is vice president of her local special education PTA in Somers, New York.

Jacobi Medical Center is part of the Health and Hospitals Corporation, New York City's municipal hospital system. The daycare center receives its funding from both the Health and Hospitals Corporation and the City's Agency for Child Development.

Oskow-Schoenbrod has been working in the field of special education for nearly two decades, but her work at the Jacobi center is different from most of her other professional experiences: "Ironically, I am now working with children who are, for the most part, cognitively at their age level. You can see so much potential in these children. You can see that many of them could go a long way."

Even though children who are infected with HIV are living longer now, "you also know their time will be limited," Oskow-Schoenbrod said. "That is why you have to make the best use of the time you do have with them."

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