## The Art and Practice of Home Visiting

### The Art and Practice of Home Visiting

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by  
Ruth E. Cook, Ph.D.  
Santa Clara University  
California

and  
Shirley N. Sparks, M.S., CCC-SLP  
Western Michigan University

Excerpted from The Art and Practice of Home Visiting, Second Edition By Ruth E. Cook, Ph.D., & Shirley N. Sparks, M.S., CCC-SLP

## Contents
- About the Downloads
- About the Authors
- About the Contributor
- Foreword Kathy Wahl
- From a Mother to Her Home Visitors
- Preface
- Acknowledgments

### Chapter 1 An Overview of Home Visiting

**Learning Outcomes.**  
- Explain the value of home visiting services
- Identify the key elements in the history of home visiting
- Discuss how the focus of home visiting has changed over time and why the change is significant
- Describe the importance of evidence-based practices in home visiting

Home visiting is a service delivery strategy that traditionally matched expectant parents and parents of young children with a designated support person—typically a trained nurse, social worker, or early childhood specialist. Services were and still are voluntary and provided in the family’s home or another location of the family’s choice, often reaching geographically or socially isolated families. Now, home visiting has become a two-generation approach; home visiting delivers both parent- and child-oriented services to help the whole family, viewing child and family development holistically.

**HISTORY OF HOME VISITING**  
Home visiting is not a new profession. Historically, educators, along with other professionals such as doctors, nurses, and social workers, have used home-community visits as an effective tool to provide support and services to children. In the 1960s, the war on poverty increased scrutiny on social issues such as poverty, teen pregnancy, and the increasing number of low birthweight babies.

**MASSIVE ARRIVAL OF IMMIGRANTS**  
The United States Immigration Commission reported that in 1909, 57.8% of schoolchildren in the nation’s 37 largest cities were of foreign-born parentage. As of 2017, one of every four children age 5 years and younger had at least one immigrant parent in the United States.

**EARLY HOME VISITORS**  
The early home visitors were volunteers who visited the homes of people living in poverty—mostly immigrant families—to promote the importance of education. They established rapport with families and were welcomed into the families’ homes.

**HOME VISITING TODAY**  
In light of the positive research found in home visitation programs, today's home-visiting focus has evolved to a two-generational approach in which the home visitor focuses on both self-improvement for the parents and child development. Home visitors must be well-educated in several dynamics related to family needs.

**COMPETENCIES NEEDED**  
Home visitors must be trauma-informed, culturally sensitive, able to coach, and knowledgeable about infant mental health, physical health, and developmental problems.

**HOME VISITORS AS COACHES**  
The movement toward family-guided routines-based intervention required a shift to the model of home visitors as coaches, encouraging parents to take credit for their positive changes.

**EVIDENCE-BASED PRACTICE**  
Contemporary approaches to evidence-based practice favor research-based interventions. Home visiting methods should consider what works under specific conditions.

## CRITICAL NEEDS POSITIVELY IMPACTED BY HOME VISITING  
- **Healthy Babies**: Home visiting promotes infant caregiving practices like breastfeeding, leading to positive long-term outcomes related to cognitive development.
- **Self-Sufficient Parents**: Parents receiving home visiting services are more likely to become employed with higher incomes and better overall well-being.