The Art and Practice of Home Visiting

About the Authors

Ruth E. Cook, Ph.D.

Professor Emerita, Director of Special Education, Santa Clara University, California Ruth E. Cook, Ph.D. is professor emerita and was director of special education at Santa Clara University in Santa Clara, California. Her primary focus as an educator was on inclusion of young children in early childhood settings. Formerly, she was also director of two inclusive campus preschool programs.

Shirley N. Sparks, M.S., CCC-SLP

Associate Professor Emerita, Western Michigan University, Kalamazoo Shirley N. Sparks, M.S., CCC-SLP, is Associate Professor Emerita, Department of Speech Pathology and Audiology. While at Western Michigan University, Ms. Sparks spent a sabbatical year with the department of public health in doing home visits with public health nurses.

An Overview of Home Visiting

Learning Outcomes

After studying this chapter, you should be able to:

1. Explain the value of home visiting services.
2. Identify the 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 traditionally matching expectant parents and parents of young children with a designated support person. Services are usually voluntary and provided in the family’s home or another location.

History of Home Visiting

Home visiting has been documented as being operational during the reform era (1870–1920). Mary Richmond acknowledged its challenges and wrote about conducting friendly visits among the poor. The unique feature of home visiting is the relaxed relationship between visitor and family, providing an opportunity for trust and engagement.

• Eradication of Poverty by Changing Environmental Conditions: Many believed that poverty could be improved by changing urban environments.
• Massive Arrival of Immigrants: The demographics of schoolchildren in urban areas shifted with increasing immigrant populations, necessitating culturally competent home visiting techniques.
• Lessons From the Past: The early home visitors achieved major successes, such as promoting educational activities in play and establishing rapport with families from diverse backgrounds.

Home Visiting Today

Increasing attention has been paid to child health needs amid historical movements like the war on poverty. The focus of home visiting has shifted from child-centered to a two-generational approach, addressing the needs of both parents and children.

Competencies Needed

Home visitors must be:

• Trauma informed
• Culturally sensitive
• Good team members
• Knowledgeable about infant mental health, physical health, and developmental issues.

Home Visitors as Coaches

The model of home visitors has evolved to one where they act as coaches, empowering parents to take an active role in their children's development.

Approaches to Home Visiting

The approaches to home visiting have experienced significant changes:

• Child Focused: Traditional methods concentrate on child needs.
• Family Focused: Concentrates on the needs of the family as a whole, promoting family empowerment.

Evidence-Based Practice

There are many home visiting models, some of which focus on specific demographics and varying age groups. The effectiveness of these models is often evaluated through rigorous scientific study.

Critical Needs Positively Impacted by Home Visiting

• Healthy Babies: Increased prenatal care and improved caregiving practices.
• Self-Sufficient Parents: Parents receiving support are more likely to gain employment and provide nurturing environments for their children.

Cultural Influences

Cultural competence is crucial for effective home visiting. Home visitors must respect and honor the beliefs and practices of the families they assist. Understanding the dynamics of various cultural practices can significantly affect the success of interventions.

Summary

This chapter discusses the essence of effective home visiting, incorporating lessons drawn from historical contexts, the necessary competencies today, and evolving philosophical approaches. It emphasizes the significance of evidence-based practices and acknowledges the evolving landscape of family dynamics and cultural considerations in home visiting.