After 40 years, community rehab runs smoothly. After 40 years, community rehab runs smoothly. (August 08, 2003)

By Diana Reynolds Roome

Alex Miller is tending the butterfly garden -- a riot of orange, magenta, blue and yellow blooms that looks as well cared for as everything else in the Heritage Garden of the Community Association for Rehabilitation (C.A.R) in Palo Alto.

"He is our most efficient transplanter," says Dina Gibbs, who along with Suzanne Redell -- both horticultural therapists -- volunteers time and skill to work with a group of C.A.R's developmentally disabled clients.

As Miller waters carefully from his motorized wheelchair, others are dead-heading geraniums or watering the pumpkin patch, where five different varieties and some succulent watermelons jostle for space. These gardeners may not do much talking but they smile a lot, and there is an almost palpable feeling of contented achievement here, despite the challenges of autism, mental retardation, Down Syndrome, and cerebral palsy, a condition which caused Miller's quadriplegia and profound deafness.

Though he has very little movement in his hands, Miller is a dedicated gardener who has loved plants since his mother, master gardener Monica Miller, started sharing her own enthusiasm with him when he was very young. Now 33, he has been coming to C.A.R for 10 years, but the garden here is a relatively new addition to the opportunities for recreation and learning offered yearly to around 2,500 individuals with developmental disabilities.

The garden, transformed from a neglected pile of dirt by the Junior League of Palo Alto-Mid Peninsula, has grown and thrived with skills and materials from many other donors. Its circular lawn and broad walkways are flanked by five waist-high planter boxes designed to allow easy access for any kind of physical limitation, including the constraints of a wheelchair.

Miller and the other members of his LEARN (Learning Experiences for Adults with Real Needs) group can get up close to dig or transplant, water or just appreciate the contents of the themed boxes. These include all the delights of a sensory garden: scents and textures such as lamb's ears, rose geranium, lavender and spearmint, an edible garden of herbs and lettuces, a red-white-and-blue garden, and an international garden of different types of tomatoes, peppers and even a curry plant, as well as the butterfly garden.

The whole area is now being prepared for the celebration of C.A.R's 40 years as a vital part of the community. The garden itself attests to the involvement of an impressive list of supporters. Four crape myrtle trees are dedicated to the four founders of the The Retarded Childrens' Guild, Betty Wright, Marion Bracken, Jane and Kevin Mallen, while a low brick wall bordering the pathway emblazons names of donors or those honored by them.

This continuity of support has resulted in a stability that is very important to C.A.R's clients. (Though with recent cuts in state funding, and reductions in private and corporate donations, C.A.R is feeling the pinch.) Compared to the dearth of options available in 1963, when C.A.R was founded, its programs offer a world of improvement.

"The only thing available then was [a full-time] institution, and the nearest was 200 miles away," said Harry Hartzell, a retired pediatrician and now C.A.R's board president. "It was a wrenching and abnormal environment."

Local origins

Started by families determined to create local services that would enable them to raise their children at home, C.A.R is now in effect a lifelong program, serving people ranging in age from three months to 65 years (and sometimes beyond). Covering all the stages of life is a challenge, and there is currently one gap in its programs -- from three to five years.

When Miller graduated from Santa Clara County's Special Education program at age 22, his parents were uncertain where to place him. "It's especially difficult to find a suitable program for someone in a wheelchair," said his mother, Monica Miller. "Though the law requires it and everyone wants it, the reality is scarcity."

They wanted a program with a high quality of experience for Miller, and C.A.R offered not only an excellent ratio of staff to clients (helped by more than 300 volunteers), but also a range of activities. The Betty Wright Swim Center is on the same Middlefield Road campus as C.A.R's client facilities, and the pool allows Miller buoyancy and freedom from the constraints of his wheelchair, as well as the caring skill of a trained swimming coach in the water.

Though routine is very important, says Miller's mother, field trips offer varied days to Miller and other LEARN clients, who walk to neighborhood parks and coffee shops and enjoy being part of the community. They also go further afield, using adapted vans with wheelchair lifts, and have visited areas as far away as, Marin, the East Bay and Santa Cruz.

"You should have seen the look on Alex's face," said Peter Girard, a community training instructor. "He really appreciates visual things, and it's very satisfying to him to be out in nature."

Staff members set goals for each student, and one of Alex's is to be aware of and participate in each part of the cycle of nature, from planting the seed and nurturing the plant to transplanting and harvesting -- and if it's a food plant, cooking and eating.

Evolving programs

"The core of the programs have evolved over 40 years of experience with families," says Chris Logan, C.A.R's development director. "It has grown as their needs have evolved, starting with the nursery school. What's unique here is the wraparound service, starting with families with a child who is not developing in a typical way. There are emotional as well as physiological issues for the families, so our focus is on helping them to deal with these and be a part of the community."

The Infant Development program (the only local program with Spanish-speaking staff), staffed mostly by therapists, starts children off on a positive path from a very early age, and can be "very miraculous," says Wendy Kuehnl, C.A.R.'s marketing director. For school-age children, the after-school Creative Recreation Program carries on the work begun earlier. "People are looked at as individuals, not in terms of their diagnosis," says Kuehnl. "What matters is their care and what they are able to do."

During family support groups at the center, parents get together to discuss issues and share ideas, solutions, and ultimately friendships. Workshops on topics such as feeding skills provide material for videos, which can be used as educational tools. The Respite Program is one of the biggest, providing in-home care by highly trained individuals, so that parents can take a break. The Independent Living Skills and Employment Services Programs help disabled adults move into the wider world, still well supported.

"The program helps them to manage behavior and move out into the community, but it's also about the community learning to accept them," said Hartzell. "In this country we're very ambivalent about this because we're so competitive. So it's a value to see that people have different roles, and some of those [with developmental disabilities] are our kids, our neighbors and our friends."

Out in the garden, Noel is swelling with pride almost as much as the pumpkins he has just finished watering. Elena has cleaned up a patch of the red, white and blue garden that is due to be replanted for the 40th Anniversary celebrations. Andy is moving along the herb planter with his watering can.

"When Andy first came, he was an observer," says Gibbs. "Every step had to be pointed out. Now he is doing things without prompting."

Miller has fallen asleep. It's unlike him, says his instructor, but maybe not surprising. C.A.R keeps everyone busy and constantly moving forward. Sometimes even the hard-driving need to take a break in the shade.

C.A.R is at 525 E.Charleston, Palo Alto, CA 94306, 494-0550, www.c-a-r.org E-mail: [email protected] The garden is open to visitors during office hours.