Whats Happening November 2017

Home Visiting: It’s All About Family

 

Early childhood home visiting is complicated. Depending on the program, home visits might include anything from interviews, assessments of child and family strengths and/or needs, provision of information on child development and progress, structured parent-child activities, family goal setting, assistance addressing crises or resolving problems, coordination with needed community services, and/or emotional support during stressful times. While home visiting can be profoundly challenging, it is also extremely important. Programs using evidence-based home visiting practices can positively impact the caretaker-child bond leading to improved social emotional outcomes.

Successful providers engage the entire family to improve outcomes for children in the home. Effective home visitors view families from a holistic perspective, understanding that developmentally, young children exist within the context of their caregiver relationships and home environment. Creating positive caregiver relationships and home environments supports optimal brain architecture development. Constructing strong architecture early enables children to build upon a firm foundation later in life. Home visitors can’t control how children’s lives turn out, however, they can help caregivers develop positive relationships with their children and understand the value of providing a caring home environment.

There are ways for home visitors to work towards this goal with families in their homes. The Joint Taskforce on Social-Emotional Development in the New York State Department of Health Early Intervention Program has published 7 guidelines on strengthening family engagement to deepen the social-emotional skills of infants and toddlers.* The guidelines outline seven research-based recommended practices, of which, a few are shared below and include some skills explanations and home visiting specifics.

1. Listen to parents/caregivers by asking questions and listening to responses. Parents/caregivers are the experts on their child and family. Ask clarifying questions to make sure what is being communicated is truly understood. Make certain to account for language or cultural barriers to minimize misunderstandings so that the family’s perspective can truly emerge.

2. Discuss developmental milestones with parents/caregivers on a regular basis. Screening tools, assessments, and interviews are helpful in determining both children’s strengths and areas the parent-provider team can work on together to develop children’s skills and capacities. Referrals to other services that a child might be eligible for or benefit from and that interest the family should be provided.

3. Be mindful of the multiple and potentially interactive origins of infant and toddler behavior. Home visitors must understand the history of children and caretakers, including past and current environmental experiences, in order to accurately interpret the communications of infants or toddlers. Environmental influences can shape the biological expression of numerous genes and developmental processes, therefore the behavior and communications of families should be considered within this broader context.

4. Identify and share observations of strengths in infant and toddler relationships with their parents/caregivers and teachers. Focusing on specific strengths of caregiver relationships and caring environments reinforces positive interactions. Sincerely reflecting strengths back to caregivers promotes a solid relationship between family members and home visitors. Concrete feedback is much more powerful than general praise during these reflective sessions.

5. Seek immediate expert consultation and referral when the social-emotional well-being of the parents/caregivers or the young child appears compromised. Home visits vary by day and family. Service providers are legally bound to abide by the codes of conduct and statutes of their particular discipline. If stretched beyond capacity, home visitors should reach out to other experts and providers for consultation and referral or consult with supervisors for reflective mentoring. Utilizing supports and mentors is a productive way of coping with reactions to particularly challenging home visits and could help prevent burnout or isolation.

Resources:

NYS Department of Health Early Intervention Coordinating Council and NYS Council on Children and Families Early Childhood Advisory Council Joint Task Force on Social-Emotional Development (2017). NEW YORK STATE DEPARTMENT OF HEALTH EARLY INTERVENTION PROGRAM Meeting the Social-Emotional Development Needs of Infants and Toddlers: Guidance for Early Intervention Program Providers and Other Early Childhood Professionals. Retrieved from https://www.health.ny.gov/publications/4226.pdf

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