No Place to Call Home

      The 1980s saw an enormous rise in poverty, and an equally dramatic decline in the quality of life for the poor. As more families competed for fewer affordable housing options, the number of homeless people grew and, for the first time since the Great Depression, there was a dramatic increase in homelessness among families with children. In New York City, approximately 200,000 children are doubled up in overcrowded community housing. Families who do not have this option find themselves in the homeless shelter system. In 1987, at the peak of the crisis, most of New York City's homeless families were living in welfare hotels. The most notorious welfare hotel in New York was the Hotel Martinique.
 

The Hotel Martinique

      The Hotel Martinique was once a grand place. Signs of its former splendor were still visible, despite the heavy steel doors and security checkpoint. The high ceiling was in ornate beaux arts style, but its majesty no longer created the sense of spaciousness and elegance of the past. Instead, it caused reverberations that endlessly magnified the loud sounds of the hotel and intensified the atmosphere of imminent violence. A basement cabaret was once an important off-Broadway showcase. During the 1960s, the Martinique was home to the Theater of the Ridiculous. How ironic this seems in light of its revealed destiny.

      After the noise level, the odor was the most overwhelming characteristic of the Martinique. It was an unfamiliar and pungent smell that instantly identified this very special place. The odor clung to your clothes and many child care staff had clothing they wore only to work for this reason.

      The residential rooms were very small, with barely enough room for the dilapidated beds, cribs, and dressers they held. On average, there was one bed for every two occupants of a room. Infants and toddlers had no floor space on which to crawl and school-aged children had nowhere to do homework. Nearly all of the children were without toys or books.

      There were no kitchens and, although hot plates were strictly forbidden, nearly everyone used one. Sometimes security guards demanded sexual favors from the women in the hotel to keep from reporting their use of hot plates to the management. This would be grounds for eviction--possibly into the street.

      About 440 large families lived in this hotel, more than 1,000 of the residents being children. Nearly half of the children were 5 years of age or younger. More than 200 were infants and toddlers, for whom there were no programs at all.
 

An Oasis

      On the first floor of this once grand hotel, we created a child care center for 32 children between 2½ and 5 years of age--a safe space in the midst of near chaos. The hotel residents soon started calling it The Oasis.

      The first child who entered the child care center did so while the renovations were still underway. The 2 1/2-year-old boy happened upon the open doorway and wandered in with his mother in close pursuit. The child care center was about 1,100 square feet with an extremely high ceiling. At this time, it was completely empty. There were two sheds being built for overnight storage of play materials. One shed would double as a play house when the center was in operation, and the other was a tiny shared office for the director and social worker.

      The boy took one look at this vast space and ran as fast as he could, crashing hard into the roll-down steel gate protecting one of the sheds. He fell backward, hitting the floor very hard. Much to our suprise, both he and his mother laughed delightedly at the incident. My first thought was how disturbed this behavior was, but then I realized how starved for physical movement a child this but then I realized how starved for physical movement a child this age might be at the Hotel Martinique. Behavior that seemed bizarre in another context may be perfectly normal in the abnormal environment of a homeless shelter.

      There is a misconception in some administrative circles that homeless parents do not want to be separated from their children. This is often used as a justification for not providing child care services at shelters. Much to the contrary, we found that parents were very happy to have their children included in our child care center after they got to know us. Homeless parents do not always trust the services they are offered and, like all good parents, they want to be sure that their children are safe and well supervised. In a shelter, this usually means you have to keep your children with you.

      As is true in any child care, the first day was difficult for many of the children. They cried and clung to their mothers when they tried to leave. For those children who were particularly fearful, we invited the mothers to stay and some of them seemed to enjoy playing with the toys as much as the children did. After the children felt comfortable being left in child care, the mothers welcomed the respite from some of their child care responsibilities. Some children just walked away from their mothers and did not look back. This behavior left more of an impression on the staff than the tearful separations.

      Most parents readily answered all questions about their children. They were nearly overwhelmed with gratitude when we would ask, "What can we do to help you?" It was as if that offer had never before been made.
 

Jessica Aguera

      Jessica Aguera was among the first group of children to attend the Hotel Martinique Day Care Center. Jessica, almost 3 years old, was the older of Mr. and Mrs. Aguera's two children. The family was evicted from substandard city-owned housing for non-payment of rent. They were placed in more than seven shelters in less than a year, including several congregate shelters and small welfare hotels.

      Congregate shelters are generally converted armories. A huge room is lined with hundreds of cots side by side. There is no privacy, with bathrooms being shared among many. These facilities were designed for homeless single adults but were also used--sometimes illegally--for families with infants and children.

      Jessica had been identified by a pediatrician as having developmental delays and was diagnosed as having a hearing impairment before the family became homeless. When Jessica began child care at the hotel, she did not speak at all. She also had serious motor delays. Her balance was poor, and she could not run or hold a pencil or crayon firmly. Chewing was also difficult, and food would drip from Jessica's mouth when she ate. All in all, Jessica appeared to be a child with brain injury and possible mental retardation.

      At first, Jessica made no friends. Although she was receptive to attention from the teachers and volunteers, she would not seek out adults or other children independently. At circle time, Jessica did not participate and did not appear to understand any of the activities. Her attention span was extremely limited, being less than a minute in length. The other children generally ignored Jessica. If no adult specifically sought her out, Jessica would spend her days sitting by herself at a table and staring at the group. As we spent more time working individually with Jessica, she blossomed in ways that we never expected. She began to speak, using progressively longer sentences. After nearly 5 months with us, Jessica was saying things like, "I want to play with this. Will you help me?" She was one of the very few children in the child care center who could use dolls dramatically and narrate her play.

      Jessica learned to enjoy the company of the adults in the child care center and requested their attention, but she remained isolated from other children. Given more time, coaxing, and encouragement, Jessica eventually developed a friendship with an electively mute girl in her class. In fact, it was only through overhearing her whisper to Jessica that we learned she could talk. After about 6 months of child care, Jessica began to play with the other children and, for the first time, we heard her laugh. Although completely nonverbval when she first arrived, her expressive language skills were now at age level. She remained clumsy and hypotonic and had trouble chewing.

      It was only after Jessica made notable progress that Mr. Aguera began to keep appointments with our social worker, who tried to gather birth and health histories. Mr. Aguera answered all questions with "I don't remember. You'll have to ask my wife."  This would have been fine except Mrs. Aguera did not keep any appointments we made with her. We knew that she had just had another baby, Lisa, and that she was overwhelmed by her responsibilities. It was only later that we learned she was suffering from postpartum depression.

      The little history we could gather revealed that Jessica had been a full-term baby, with a normal birth weight. She was delivered by Cesarean section because of breech presentation and spent 2 weeks in a neonatal intensive care unit with jaundice and a dislocated hip. An allegation of child abuse made against her parents resulted in Jessica's placement in foster care for a short time. We could only speculate that Mrs. Aguera might have been seriously depressed when Jessica was an infant as well. However, it is also possible that her depression may have developed only after the family lost their housing and began being moved from one shelter to another.

      When Mrs. Aguera finally began to keep appointments with us, she brought Lisa. At 9 months of age, Lisa did not make any spontaneous sounds. She did not move her head in the direction of sound or appear able to track objects with her eyes. Lisa could not sit up on her own and looked extremely floppy when strapped in a stroller. Many our meetings with the family focused on their need for housing.

      Mr. Aguera said, "I'll never accept housing from New York City. That's how I got homeless in the first place. The next time I'm homeless, I may not be lucky enough to be in a hotel as good as the Martinique."

      It took months to develop a trusting relationship with the Agueras but, in the end, they agreed to follow through with our suggestion to take Jessica to a local hospital for a more complete evaluation. Mrs. Aguera even agreed to have Lisa evaluated, acknowledging for the first time that, "She isn't doing what babies her age are supposed to do." We were hopeful that the two little girls would get the services they needed to grow and develop.

      Soon after the family agreed to the evaluations, Jessica was absent for  several consecutive days. Because her attendance at child care had been excellent, we felt the need to investigate. We went to the family's room, but no one was there. The room was empty. We asked around and were told by neighbors that the family had moved to Florida and live with Mr. Aguera's parents. They left no message for us, no address, and no telephone number-not even the name of the city or town to which they had moved.
 

Eric Johnson

      Eric Johnson was also in the first group of children at the child care center. He and Jessica were classmates for about 5 months, but the two children never interacted. Eric did not appear to notice that Jessica no longer attended the classroom.

      Ms. Johnson was a single mother from a middle class economic background. She had run away from home as a teenager to escape a very strict and abusive mother and an "uninvolved" father. Shortly after running away, she married.

      "Things were great at first," Ms. Johnson told us. "Then he started using more and more crack and beating me all the time. I went to court and got a protection order against him. Well, a lot of good that did me...He attacked me in the street and the cops wouldn't do anything. I locked him out and changed the key, but he just knocked down the door. Then I called the police, but they didn't come. I was afraid he'd kill the kids, so I took them with me and moved in with my mother." Eric had just turned 2 years old and his sister, Nichole, was 6 years old at the time.

      Eric had already been showing signs of hyperactivity. The household was tense and tempers flared. Finally, Ms. Johnson's mother told her that Eric couldn't stay with her because he was too active and difficult. The family was separated. Ms. Johnson and Eric entered the homeless shelter system, and Nichole remained with her grandmother. Once homeless, Eric and his mother first slept in city offices because all of the homeless shelters were full. They spent 3 weeks in a huge congregate shelter. Eric developed a sleep disturbance, which continued for as long as we knew him. He was calmer in a small welfare hotel in the Times Square area, but 4 weeks after being placed there, the family was moved to another congregate shelter. There, Eric's activity level increased to the point that he was "out of control."

      When the family was transferred to the Martinique, Eric was so wild that another hotel resident told Ms. Johnson, "You better get him to a special school." She even recommended an appropriate therapeutic preschool. Ms. Johnson looked into this program and Eric was accepted and enrolled. Unfortunately, it was a 3-hour program that required more than 1 hour of bus transportation each way.

      "I couldn't do anything with my life when he was in the school," Ms. Johnson explained. "I would have had to drop out of the job training program I'm in, and then I wouldn't be able to get a job and afford rent so I can get out of here."

      Eric was very difficult to manage when he started child care at the Martinique. He ran around the room aimlessly and threw objects without regard for whether children might be hit. Many of the homeless children we served ran around aimlessly their first week of child care. Similar to the toddler who happened into our center during renovations, the children were often overwhelmed by the contrast between this colorful and stimulating place and their usual surroundings. Most children gradually learned to follow the class routine and to accept structure. Eric did not.

      Eric could not sit still long enough to eat his lunch. He would put food in his mouth while he was standing and then run around the room as he chewed. When a teacher attempted to limit Eric, he would have a tantrum, banging his head repeatedly on the floor.

      Eric breathed through his mouth and frequently drooled. One eye watered incessantly. He could not follow simple spoken directions or answer simple questions. His speech was difficult to understand.

      Naptime was initially a very difficult time for most of the children. Some were just unable to sleep, others screamed in fear as soon as the lights were turned off. Unlike most of the other children, however, Eric did not gradually calm down and try to nap. He would run around the room, tapping the other children, who would shout in protest. Eric had to be removed from the room at naptime.

      We hired an additional teacher assistant to work one-on-one with Eric. Otherwise, the other children would not be safe. It was impossible for one teacher assistant to keep up with Eric throughout an entire, so we put the child care staff on rotation, taking turns working individually with him for an hour.

      Before he began child care, Eric had been given a physical examination at a community clinic near his former address. The physician recorded that Eric was the product of a full-term pregnancy, with a normal birth weight. He wrote that Eric was "in fine health," his development was "within normal limits," and that "Eric could tell a story." We took our own history from Ms. Johnson who reported that Eric had been a low birth weight baby (3 pounds, 11 ounces), born 2 months premature, and had spent nearly a month in a neonatal intensive care unit.

      Ms. Johnson said, "Eric was a difficult baby. He never slept well, and he cried all the time." His development was normal until he started walking. "Then he never stopped running around!" Eric did not begin toilet training until he started child care when he was 3½ years old.

      When Eric started child care, he could say only very short phrases such as, "Want this,"  "Gimme," and "I go there." Like so many other homeless children, his language improved dramatically within in a few months of entering child care. Even so, he remained difficult to understand.

      Eric's activity level was very high in the tiny hotel room. Ms. Johnson told us that we "better do something for him because he will get hurt jumping around the crowded little room." He once bumped his head on a dresser while jumping up and down, trampoline style, on the bed. Neighbors of Ms. Johnson told us that they frequently heard her yelling and threatening Eric. "She's gonna hurt him if you don't do something for him," they warned us.

      We asked Ms. Johnson about this and she told us, "I'm not an abusive mother, but I don't know how to control him. Sometimes I feel like I have to hit him to get him to stop. But then I'm afraid, if I hit him, I won't be able to stop myself."

      We referred Eric for a neurological evaluation at a voluntary teaching hospital, which was arranged on an emergency basis because of the likelihood of injury at the hotel. Eric was diagnosed with attention deficit hyperactivity disorder and Ritalin was prescribed. Unfortunately, there was a 3-week delay in filling the prescription. First, the neurology resident who wrote the prescription used the wrong form for a controlled substance. When we corrected this, no pharmacy would fill a prescription for a controlled substance for a family living at the Hotel Martinique. We had to transfer Eric's care to a hospital with an outpatient pharmacy, where the prescription was finally filled. The hospital has since closed their outpatient pharmacy because of a budget gap.

      Eric was also diagnosed as having emotional disturbances because of his preoccupation with guns and killing. "You also be a ghostbuster. We kill all the ghosts," Eric would say. After playing out a gruesome killing, Eric would say, "I'm a baby. Take care of me. Give me my bottle."

      Ms. Johnson dropped out of her job training program so she could spend more time looking for housing. She eventually found an apartment near her mother, moved in, and her daughter, Nichole, rejoined the family. We could not find a therapeutic nursery for Eric. The only preschool near the family's new home was a half-day Head Start program.

      We offered follow-up services for the family, but Ms. Johnson asked us not to pursue this. "I've got to put being homeless behind me. I've got to make it on my own now-with no help from anyone but my mother," she told us.
 

Joseline Vasquez

      Joseline Vasquez attended All Children's House, which integrated homeless children with neighborhood children. Joseline and her mother lived in a small welfare hotel. Their room was tiny, and they shared a bathroom in the hallway with six other families. When she began child care at 3 years of age, Joseline could not run, jump or climb. Her balance was very poor, and she sometimes bumped into things or tripped while walking. Joseline could not follow spoken directions, and her speech was incomprehensible. Her longest utterances were two-word phrases.

      We met with Ms. Vasquez to find out more information about Joseline and to arrange a hospital-based developmental evaluation. Ms. Vasquez could not focus on Joseline's needs because of the intensity of her own. "I was an abused child," she told us. "My brother and I were placed in foster care when I was 2 because my mother was a drug addict. When my father remarried, they made me live with him and his new wife. When I was 4, they gave my mother visitation rights and that was the beginning of the end. She introduced me to drugs. My mother beat me all the time. My stepmother beat me too. When I was 5, I started growing up in the streets.

      "I had to start working when I was 10. My stepmother charged me rent. I had to pay for my brother's clothes or else he couldn't go to school. I also had to clean the house. If I didn't do a good job, my stepmother beat me and kicked me. To this day, I cry hysterically whenever I hear on the news about a child being abused. Every abused child--that's me.

      "The day my brother was old enough, he joined the Army. I was going to join, too, but I met George and fell in love. Joseline was a planned baby, you know. We wanted her very much. In fact, just as soon as I realized I was pregnant, I stopped using angel dust."

      Joseline was born full term, and the family of three moved in with George's mother and his siblings. Ms. Vasquez said that she could not stay there because the place was always a mess and people were always coming and going. She implied that there was a lot of drug use in the apartment and possibly drug dealing. Ms. Vasquez and Joseline, who was then 2 months old, moved in with her only friend. The friend was homeless and lived in a small welfare hotel. Ms. Vasquez and Joseline doubled up in that hotel room until they received their own first shelter placement.

      Five months later they were moved to another small welfare hotel that was infested with mice. Two months after that, they were switched to another, and the following month to a hotel where they stayed only one week. At this point, Joseline was 10 months old. For the next 3 months, the family was moved back and forth between small welfare hotels and large congregate shelters. During this period, Joseline was frequently ill because of the unsanitary conditions at the shelters. She had many infections and still has recurrent ear infections.

      "I had to do something to protect her health,"  Ms. Vasquez explained. "These places are dangerous. You don't know whose sleeping next to you. You can't let your kid go to the bathroom without you because you don't know who's in there. I kept Joseline in a crib the whole time and strapped her in a stroller and wheeled her around because I was afraid to let her out of my sight. Joseline started crawling when she was 6 months old, but I had to force her to try to walk. Joseline would fall so hard that I sometimes had to take her to the hospital. I was always afraid they would think she got the bruises because I abused her."

      We had seen many homeless children with motor delays who caught up just from being in a normal setting where they could run and play. But Joseline's delays seemed far more serious than usual. Her movement had been severely restricted and we did not know the extent or reversibility of the damage that had been done. Ms. Vasquez reluctantly agreed to a hospital-based developmental evaluation. Less than a week later, the family got permanent housing, and despite our best efforts, we were unable to find out where they lived.

Epilogue

      The events described above took place in 1987. New York City's annual budget for sheltering homeless families that year was $125 million. The three families described here were among more than 5,000 families with more than 10,000 children living in New York City welfare hotels. The average age of these children was 6 years, and more than 2,000 were infants and toddlers. Of the children of child care age, barely 1 out of 10 ever attended a program. Those that did attend child care rarely stayed longer than 3 months. Once the families were rehoused, the program were rarely given addresses so that follow-up services could be provided.

      The abrupt departures of the children and families were not only disruptive to the children's progress, but also disheartening for staff members. Just as a staff member developed a trusting relationship with a parent and the child was making progress, they were suddenly gone without a trace. One child care director at another large welfare hotel once revealed her secret for guarding against the depressing effects of these departures. Basically, she said that staff members should do what they can in one day, without making great plans for the future, and hope that what is done will make a difference. As she put it, "Every month is September and every day is Monday." The director of All children's House had another strategy. All of the homeless children at this center made "good-bye books" during their first week. This helped them to be more prepared to leave when the time came.

      Now, 5 years later, there are still more than 5,000 homeless families in New York City shelters, with more than 10,000 of the occupants being children. Most of the large welfare hotels and their child care centers, however, are now closed. The Hotel Martinique was the first welfare hotel that New York City closed when the crisis of family homelessness appeared to have ended. The crisis has not ended. Homeless families and children are more likely than ever to be placed in congregate shelters, which are the most damaging of all shelters. Here, the children are least likely to receive early intervention services.
 

Note: The Hotel Martinique Day Care Center and All Children's House were sponsored by Association to Benefit Children. Funding was provided by New York City (Agency for Child Development), New York State (Department of Social Services and Office of Mental Health), and private sources (Kaplan Foundation, Eisman Foundation for Children, among others).

This case story originally appeared in McWilliam, P.J., & Bailey, D., (Eds.). Working Together with Children & Families, Case Studies in Early Intervention. (1993). Baltimore: Paul H. Brookes Publishing Co.

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