Just a few months ago, the UNC Frank Porter Graham Child Development Institute (FPG) welcomed its fifth cohort of scholars in the Marvin H. McKinney Scholars Program (MSP) in Research, Practice, and Policy, which was established to offer hands-on research experience in child development to undergraduate students from North Carolina's historically Black colleges and universities (HBCUs).

The scholars spent nine weeks at FPG learning about the Institute’s role in improving outcomes for young children and families through research, evaluation, implementation, technical assistance, and policy engagement. Working with and shadowing mentors doing project-based work, the scholars had an opportunity to further their understanding of the importance of research, practice, and policy, as well as the interconnections and pathways between each of these areas of work.

At the end of the program, each scholar’s work culminated in a final presentation. In this four-part series, you will hear directly from the scholars about what they learned and what they will be taking with them from this experience.

Today, you’ll hear from Kyleigh Creighton (pictured above at far right), a senior at North Carolina Agricultural & Technical State University majoring in psychology. When asked about why she pursued the opportunity to be a McKinney Scholar, Creighton said that the chance to gain hands-on research experience, particularly within the fields of child development and autism research, aligns with her career goals. Creighton is concerned that children and autistic individuals are often placed in positions where they have little control over their autonomy, “As a vulnerable demographic, they frequently are unable to advocate for themselves,” said Creighton. 

Creighton focused on one research question throughout her rotations in the MSP program, “How do the initiatives at FPG support the autonomy of vulnerable populations?”

The McKinney Scholar experience as shared by Kylie Creighton during her final presentation

In this article, I’ll walk you through my MSP presentation about FPG’s advocacy for autonomy. The research question I pursued during the MSP program considers how the initiatives at FPG support the autonomy of vulnerable populations. And, to make sure we’re on the same page, for this I'm defining autonomy as the right or condition of self-government, which is at risk when we're confronted with oppression and/or disparities. During the program, I participated in a lot of learning activities and experiences. Some of the ones that really stood out to me include implicit bias certification, Hexagon Tool certification, cultural humanity workshop, interview structure, and Division of Early Childhood (DEC) conference.

Along with those activities and experiences, I participated in conducting focus groups, interviews, and I read several articles in scholarly journals to help me prepare my final presentation.

My first rotation was with Project Reach, which is an initiative that supports Black families with autistic children. I learned about resilience in families with autistic children and how Black families face racial and environmental obstacles such as lack of resources.

Next, I learned about the importance of obtaining assent from children with autism. So, when I use the word assent, it is about acknowledging desires, regardless of preconceived ideas or expectations of the parents, and having the right to set their own goals of therapy. Essentially, assent is used in place of consent, because children cannot consent.

I read two articles about this, “The ethical imperative to honor autistic clients' autonomy in mental health treatment" and "Children's Understanding of Informed Assents in Research Studies." The first article gives an example of a 16-year-old boy—he goes to therapy, and the therapist asks, ‘What do you want to get out of therapy?’ And he says, ‘I want to find a girlfriend.’  And the parents are like, ‘No, we want you to correct some of these behaviors.’ But if we're truly honoring the assent of the 16-year-old boy, we would acknowledge his desires, regardless of what the parents’ expectations might be.

Autonomy in this case is about honoring choice and being intentional about it and not using a parent's voice as the translator for the child. And who knows? Maybe some of the behaviors that the parents wanted corrected would actually be improved through his goal of getting a girlfriend.

My second rotation was with the National Implementation Research Network or NIRN, a group that uses implementation science and research to improve outcomes across health and human services. Although they’re a big group working with several projects, my time focused on one, Improving Community Outcomes for Maternal and Child Health or ICO4MCH. I learned about disparities in birth outcomes and that Black and Brown mothers are more likely to experience pregnancy-related death. And so, they are deprived of the agency of their birth journey, due to medical neglect and resources that don't acknowledge intersectionality. Autonomy in this case is lost when mothers have no control over how they want their birth journey to go because medicine has not acknowledged or made space for them. And, in order to combat this, we use things like the Health Equity Impact Assessment tool, which is known as HEIA for short.

In the article, "The Use of Health Equity Impact Assessments to Modify Evidence Based Strategies within Local Health Departments in North Carolina," I learned that HEIA can be used to help identify unintended potential health impacts of a policy program or initiative on vulnerable or marginalized populations. And this information can be used to make modifications to what is provided to expecting mothers like the IRTH app, which is like a forum-based app for expecting mothers. There’s also parent engagement with pediatric offices, provider selection, Doula intervention, self-care messaging as well as bilingual modification. Giving these resources to fully educate and aid mothers allows them the autonomy to not only decide how they want their birth journey to go, but to avoid medical neglect.

My third rotation was with the Trohanis group on their ECTA project, which stands for early childhood technical assistance. One of their main initiatives is to provide support to kids with and without disabilities and to promote inclusion.

Inclusion is a really important topic and relates to my research question because it's important to the autonomy of children with disabilities. I learned that isolation is very common with children with disabilities, because it restricts a certain level of autonomy, because the choice of their social environment has already been made for them. But inclusion allows for the agency of a child to navigate socially as they please, as well as teaches them to interact with others of varying needs. So, I was glad that one of the main topics we discussed in this rotation was how to help children with disabilities to be autonomous and the importance of holding high expectations, encouraging independence, offering kids choice implementing support during transition periods, exposing children to new experiences and helping children fulfill their interest.

So why does this all matter? To understand this, let’s consider self-determination theory, which refers to the need of all people for relatedness, competence, and autonomy. And as I've stated earlier, autonomy is a challenge for marginalized individuals, because it has historically been violated through oppression and disparities. Some of the questions we need to ask are: If we're fully honoring autonomy are our practitioners and teachers giving children agency to choose? What does it look like when we give children with disabilities constant choices? Are we being class conscious in the way that we give resources? And are we acknowledging intersectionality?

If all people have a right to self-determination, then we must address each factor to ensure equity across the board. And these initiatives and tools are just a start to supporting this autonomy.

As part of this presentation, I was asked to talk about what my next steps will be. For me personally, I want to build research skills as an undergrad. It will really help me in applying to grad school—I want to apply to a clinical psychology program for my PhD. And I want to focus on marginalized groups—this program has really intensified that love for research for marginalized individuals.

And a future research question I would like to consider is: How does the adultification of Black children lead to a misdiagnosis? The conversations I've had with my fellow Aggies has made me focus on the experiences of Black children, especially in the classroom. So, in other words, how does the way that we view Black children as older influence the way we may characterize their behavior, or the way they might feel limited to express their behavior.

I want to give a thank you to my mentors throughout all of my rotations, especially Sherra Lawrence, and all the people that took the time to allow me to interview them. I'm leaving FPG with better skills of networking communication, time management, and research and statistics skills. I'm very grateful for this opportunity and the growth that's come with it.