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The Art and Practice of Home Visiting

The Art and Practice of Home Visiting

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 ©2022 Brookes Publishing Co., Inc. All rights reserved.

Contents

An Overview of Home Visiting

LEARNING OUTCOMES

"The test of morality for a society is what it does for its children."
After studying this chapter, you should be able to:

  1. Explain the value of home visiting services.
  2. Identify key elements in the history of home visiting.
  3. Discuss how the focus of home visiting has changed over time and why the change is significant.
  4. 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; it delivers both parent- and child-oriented services to help the whole family.

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. Home visiting can be documented as being in operation during the reform era (1870–1920). Pioneer home visitors recognized the unique feature of home visiting: that the visitor’s willingness to enter a family’s home and neighborhood signals a less formal, more relaxed relationship between visitor and parent, thereby equalizing the balance of power between the two.

HOME VISITING TODAY

In light of positive research found in earlier programs, the focus has turned from child-centered to a two-generational approach where home visitors work with parents on self-improvement while also focusing on the children. These home visiting programs consider the entire family as a system, and the home visitor acts more as a consultant.

COMPETENCIES NEEDED

Home visitors must be well-educated regarding all dynamics related to the family. They must be trauma-informed, culturally sensitive, knowledgeable about infant mental health, and possess the ability to build and maintain empathic relationships. The expertise of the primary home visitor should coincide with the family's major concerns about their child.

HOME VISITING PHILOSOPHY

As home visitors, our philosophy of early intervention provides an overarching framework for how we interact with children and families in their homes. It encompasses how we believe a child learns and how the child’s nature and environment interact in normal development.

APPROACHES TO HOME VISITING

Approaches to home visiting have undergone significant changes in recent years, with a shift toward family-centered intervention. This involves considering the family’s needs and point of view as well as those of the child. A collaborative approach involving parents and other family members is preferred now.

EVIDENCE-BASED PRACTICE

Home visiting is a method for delivering service rather than a service in and of itself. It is crucial to consider what works for what challenges and under what conditions. Multiple home visiting models exist in the U.S. and abroad, and their effectiveness can be assessed based on research and outcomes.

CRITICAL NEEDS POSITIVELY IMPACTED BY HOME VISITING

The National Home Visiting Resource Center highlights the benefits of home visiting in several areas which include:

CULTURAL INFLUENCES

Culture influences all aspects of human development and is reflected in child-rearing beliefs and practices. Home visitors must become culturally competent, respecting the beliefs and practices of the families they serve.

SUMMARY

This chapter introduced the essence of effective home visiting, including lessons learned from pioneers in the field and the role of home visitors today. It covered essential competencies, philosophies, approaches, evidence-based practices, and cultural influences on home visiting.