home visits early intervention

Resource Toolkit for Home Visiting and other Early Childhood Professionals

Welcome to the WCWPDS Home Visiting Resource Toolkit, designed to support home visiting professionals working with families. This toolkit offers a comprehensive collection of resources, including articles, webinars, websites, books, and training opportunities. Our goal is to provide current research and practical tools to enhance your practice. Explore topics such as trauma, mental health, child development, substance abuse, and much more. If you have valuable resources to share, please contact us at [email protected] .

• What is Considered Child Abuse? Psychology Today article covers the legal meaning of the term child abuse and links to states’ reporting laws and commonly asked questions about mandated reporting.
• InBrief: The Science of Neglect This short video, from the Center on the Developing Child, Harvard University, reveals the four types of unresponsive care and the impact of neglect on a young child’s brain development. Look for other resources related to neglect on this website.
• The CDC website has the original ACE study, resources, the Behavioral  Risk Factor Surveillance System ACE data, journal articles and presentation graphics.
• The Child Abuse and Prevention Board has Information related to the original ACE study and ACEs data specific to Wisconsin, including a Wisconsin ACE brief and other reports related to our state.
• Services for Families of Infants and Toddlers Experiencing Trauma: A Research-to-Practice Brief . Beginning life in the context of trauma places infants and toddlers on a compromised developmental path.  This brief summarizes what is known about the impact of trauma on infants and toddlers, and the intervention strategies that could potentially protect them from the adverse consequences of traumatic experiences. Office of Planning, Research and Evaluation.
• How Childhood Trauma Affects Health Across a Lifetime Nadine Burke Harris Ted Talk.
• Take The ACE Quiz — And Learn What It Does And Doesn’t Mean , NPR

Online Learning

• Childhood Adversity Narratives (CAN) Developed by 5 researchers from around the country, this webinar is meant to help inform policy makers and the public about the costs and consequences of child maltreatment and adversity.  Feel free to use their work, and provide appropriate citations, to educate others.
• Marks that Matter, Sentinel Injuries, and Other Opportunities for Child Abuse Prevention is a 25-minute module that will teach you about marks that matter and sentinel injuries, including why they are significant, who is at risk, and what to do if you suspect abuse. It is intended for childcare workers, child welfare workers, family support staff, and home visitors, but any person working with children will find it a useful tool.  This module can be viewed on your computer or mobile device.
• WI Mandated Reporter Online Training Reporting requirements vary slightly for a few groups.  Learners can select the affiliation that best fits their role in the WI Child Welfare Professional Development System online training.
• Coping with Early Adversity and Mitigating its Effects—Core Story: Resilience From the Center for Advanced Studies in Child Welfare, this 7 min. video addresses effective ways to help children cope and build resilience through adversity.
• NEAR@Home is a training manual with guided processes to help home visitors learn and practice language and strategies to safely and effectively talk about childhood trauma and the ACEs questionnaire in a safe, respectful, and effective way for both home visitor and family.
• Tip Sheet CES
• Childhood Experiences Survey Developed through UW Milwaukee for home visitors, this validated tool expands the framework of the original ACEs survey to include additional questions around poverty, bullying, absence of a parent, and death of a close family member.

Prevention  Advocacy

• Child Welfare League of America with the following text,.  CWLA leads and engages its network of public and private agencies and partners to advance policies, best practices and collaborative strategies that result in better outcomes for children, youth and families that are vulnerable.
• Prevent Child Abuse America PCA’s mission is to prevent the abuse and neglect of our nation’s children.  Their website offers an activity toolkit, stats and figures, tip sheets for parents, research and ways you can make a difference.
• Wisconsin Child Abuse and Neglect Prevention Board ​​​​​​​​​​​​​​​​The Wisconsin Child Abuse and Neglect Prevention Board is committed to mobilizing research and practices that prevent the occurrence of child maltreatment.  Learn about abuse and neglect risk factors and protective factors, as well as frameworks for child maltreatment prevention.
• Safe Haven for Newborns Information Safe Haven, also known as “infant relinquishment”, this law allows a parent to leave their newborn in a safe place in certain circumstances with certain individuals.  Learn more about this WI law, the Maternal and Child Health Hotline and crisis support on this webpage.
• Wisconsin Sex Trafficking and Exploitation Indicator and Response Guide for Mandated Reporters ( English ) ( Spanish )
• Awareness to Action (A2A) A2A is an initiative focused on preventing child sexual abuse by helping adults and communities take action to protect children through awareness, education, prevention, advocacy and action, through the Child Abuse Prevention Board, Children’s Hospital of WI.

Tip Sheets/ Guides

• Tip Sheet: Talking to Children and Teens about Child Abuse Children need accurate, age-appropriate information about child sexual abuse and confidence that adults they know will support them. This tip sheet can help!
• Books to Help Parents Talk About and Respond to Child Sexual Abuse The Committee for Children features a list of books which provide valuable information for parents to keep their kids safe.
• Long-term consequences of Child Abuse and Neglect fact sheets.
• Babies Cry, Be Prepared Free downloadable brochure in English, Spanish and Hmong from Child Abuse and Prevention Board.
• Signs of Child Abuse and Neglect The WI Dept of Children and Families has outlined the signs of neglect and physical, sexual, and emotional child abuse, to help readers be prepared to recognize situations that may need to be reported.

Text Resources

• Services for Families of Infants and Toddlers Experiencing Trauma: A Research-to-Practice Brief , Office of Planning, Research & Evaluation
• CTA Library The CTA is a Community of Practice  working to improve the lives of high-risk children through direct service, research and education.  CTA translates emerging findings about the human brain and child development into practical implications for the way we nurture, protect, enrich, educate and heal children.

Adult Mental Health

Pregnancy and Postpartum Mental Health

• Depression in Mothers: More Than the Blues: A Toolkit for Family Service Providers through SAMHSA (Substance Abuse and Mental Health Services Administration, 2014)
• Useful Links provides reputable weblinks relevant for different readers, including moms, dads, families, friends and professionals.
• Resources and Information about Maternal Depression , from the Center for Infant and Early Childhood Mental Health Consultation, for the U.S. Department of Health and Human Services, Substance Abuse and Health Services Administration.

For Parents: 

• Depression During and After Pregnancy , from the CDC, includes information to help parents better understand depression, post-partum depression and provides links to other depression-related resources for parents.
• Pregnancy and Postpartum Mental Health Overview , provided by Postpartum Support International, offers information on perinatal mood and anxiety disorders for women concerned about their mental health during or after pregnancy.
• Resources for Mothers and Families includes information about several support groups for mothers concerned about perinatal related mental health disorders.
• HelpLine for  Moms, offered through Postpartum Support International , 1-800-944-4773 (English and Spanish), or text 503-894-9453 .  Available 24 hrs. a day, callers will be asked to leave a confidential message and a trained and caring volunteer will return your call or text. They will listen, answer questions, offer encouragement and connect you with local resources, as needed.

Professional Reading

• Home Visiting and Maternal Depression: Seizing the Opportunities to Help Mothers and Young Children
• Supporting Infants, Toddlers, and Families Impacted by Caregiver Mental Health Problems, Substance Abuse, and Trauma: A Community Guide
• Maternal Depression: Why It Matters to an Anti-Poverty Agenda for Parents and Children Websites, CLASP
• National Institute on Mental Health
• National Center on Early Childhood Health and Wellness Mental Health Newsletter highlighting Stress Reduction for families and professionals (2016). Includes resources in English and Spanish, links to tips and articles.
• National Center on Early Childhood Health and Wellness Mental Health Newsletter highlighting Parental Depression (2016) includes links to articles, briefs, and action steps for families and professionals.

Online Training and Educational Modules

• Perinatal Mental Health Modules is a two-part series designed for home visitors to better understand the signs and symptoms of perinatal mental health issues and how they impact mothers and families. Throughout the training, you will view excerpts from a live webinar taught by Jen Perfetti, MA, LPC, a licensed therapist at Luna Perinatal Counseling and the Clinical and Professional Development Coordinator with the UW Department of Psychiatry Parent-Infant Mental Health Programs.
• WI Dept. of Health Services’ Perinatal Mental Health: Screening, Referral and Supportive Interventions for Women and Families webinar series includes videos, references, information for clinicians, and handouts for women and their families. Developed by leaders in the fields of psychiatry and women’s health, this series covers a variety of topics related to perinatal mental health.
• The Periscope Project (Medical College of WI) offers free online modules on common topics related to perinatal psychiatric disorders. While these modules target medical providers, two of the modules, Perinatal Mood Disorders and Screening and Follow-up, are relevant for family support professionals, as well.
• The Periscope Project website contains work from the Wisconsin project which hosts a consultation line and other resources to support professionals working with new parents, that may be struggling with perinatal mental health and depression. This site provides information on screening guidelines and resources beyond the Perinatal Algorithm training. On the site you will find screening tools, educational modules/ videos and tools on a variety of perinatal mental health topics.
• National Institute of Mental Health ( NIMH) offers authoritative information about mental health disorders well as information on a range of mental health topics and the latest mental health research.
• Mental Health America , learn about the signs and symptoms of mental illness, facts, statistics, how to live mentally healthy, finding help, public policy, screening, and the latest news on mental health.
• B4Stage4 is an initiative that encourages all of us to have a new perspective about mental health. Learn about both prevention and intervention strategies, including the B4Stage4 philosophy, and information and resources available through “Get informed, Get screened and Get help”.
• Mental Health, Oklahoma State Department of Health. Oklahome Home Visitor Training
• Brain Basics from the National Institute of Mental Health provides information on how the brain works, how mental illnesses are disorders of the brain, and ongoing research that helps us better understand and treat disorders.
• Health Nexus Santé’s Perinatal Mood Disorders:   An Interdisciplinary Training Video (25:03) offered in four chapters.  Reviews the risk factors and symptoms of perinatal mood disorders.  Testimonials by women diagnosed with a perinatal mood disorder and counseling vignettes are included.
• Imagine There Was No Stigma to Mental Illness | Dr. Jeffrey Lieberman | TEDxCharlottesville (22:07)
• Ending the Stigma of Mental Illness (4:33)
•   Tip Sheet PSS
• Self-Help and Mental Health Screening Tools , from Mental Health America. This webpage contains great resources for individuals exploring their own mental health, including screening tools.
• National Alliance on Mental Illness (NAMI) , Mental Health by the Numbers,
• National Institutes of Health, Prevalence, includes rates for various mental illness diagnoses in the U.S.
• Mental Health America of Wisconsin

Fact Sheets

• Depression During and After Pregnancy , WomensHealth.gov
• National Institute of Mental Health (NIMH) offers fact sheets related to a variety of mental health issues.
• Wisconsin Department of Health Services Mental Health Resources

Advocacy, Diversity, Equity, and Inclusion

Instructional

• Advocacy 101 for Family Support Professionals

Reading Materials

• Out of the Boardroom: How Nonprofit Board Members Can Be Effective Advocates in Troubled Times

Talking Points

• HV Talking Point – Home visitors can advocate for their roles and their programs as concerned citizens, during their own private time. You can use this document to help policy-makers understand the value of home visiting and your role
• Value of PD Talking Points – Professional development helps family support professionals feel more confident and competent in their roles.
• Be an Advocate for Young Children, Supporting Families Together Association – Learn about different types of advocacy, how you can get involved, who to contact, and current advocacy alerts (eg. News from the WI Children’s Caucus, webinars, etc.)
• Zero to Three Home Visiting:  Supporting Parents and Child Development includes resources and tools to help policymakers and professional understand the importance of investing in home visiting programs and support the implementation of home visiting programs as part of a comprehensive and coordinated system of services for young children and their families.

Diversity, Equity, and Inclusion

• Principles of Inclusion, Diversity, Access and Equity by Tina Q Tan (September 2019) https://academic.oup.com/jid/article/220/Supplement_2/S30/5552351?login=true
• Reflections on Research: Toward an Open Data Toolkit Centered on Diversity, Equity, Inclusion, and Accessibility Principles (12/9/2020) by Rachel Woodbrook https://deepblue.lib.umich.edu/bitstream/handle/2027.42/166087/Woodbrook_DEIADataToolkit_LYRASIS_Whitepaper.pdf?sequence=1
• Anti – Racism Daily https://antiracismdaily.com/ “Each day, we offer an overview on current events and apply an anti-racism lens. Learn how practices embedded in our politics, criminal justice system, and workplaces enforce systemic oppression – and what you can do about it.”
• Privilege 101: A Quick and Dirty Guide by Sian Ferguson (September 29, 2014) https://everydayfeminism.com/2014/09/what-is-privilege/
• How to get Serious about Diversity and Inclusion in the Workplace by Janet Stovall https://www.youtube.com/watch?v=kvdHqS3ryw0 (September 13, 2018) TED Talk “Imagine a workplace where people of all colors and races are able to climb every rung of the corporate ladder — and where the lessons we learn about diversity at work actually transform the things we do, think and say outside the office. How do we get there? In this candid talk, inclusion advocate Janet Stovall shares a three-part action plan for creating workplaces where people feel safe and expected to be their unassimilated, authentic selves.”
• The Essential Power of Belonging by Caroline Clarke https://www.youtube.com/watch?v=RNiGny7OlWg&list=TLPQMTMwODIwMjEJgfS2KPFg2Q&index=6 TEDx  (11:28) “Author and journalist Caroline Clarke explores our fundamental need for belonging and how critical it is not only to every individual’s fulfillment and success but to our collective wellbeing and future.”
• Just Belonging: Finding the Courage to Interrupt Bias by Kori Carew TEDx https://www.youtube.com/watch?v=DIf43L6hNkM&list=TLPQMTMwODIwMjEJgfS2KPFg2Q&index=3 (19:16) “A moment of racial tension presents a choice. Will we be silent about implicit and unconscious bias, or will we interrupt bias for ourselves and others? Justice, belonging, and community are at stake.”
• Colorism https://www.nccj.org/colorism-0 the National Conference for Community and Justice “In this bulletin, we will be discussing the topic of Colorism. You will find history, videos, articles/handouts, statistics and questions to ponder related to this issue.”
• People of Color Discuss the Impact of ‘Colorism’ on GMA https://www.youtube.com/watch?v=AIx131aaY6A July 22, 2020 (6:28) Research shows people with darker skin experience an increased number of problems, including socioeconomic issues. Amira Adawe of The Beautywell Project weighs in on how to fight the bias.

Cultural Humility 101

• How to Outsmart Your Own Unconscious Bias by Valerie Alexander TEDx (October 22, 2018) https://www.youtube.com/watch?v=GP-cqFLS8Q4 (17:23)
• Sometimes You’re A Caterpillar https://www.youtube.com/watch?v=hRiWgx4sHGg&t=1s
• Mental Health Services
• Children’s Bureau Express
• National Center for Cultural Competence , Georgetown University.  The mission of the NCCC is to increase the capacity of health care and mental health care programs to design, implement, and evaluate culturally and linguistically competent service delivery systems to address growing diversity, persistent disparities, and to promote health and mental health equity.
• The Cross Cultural Health Care Program offers a Cultural Competence Resource Guide for health and social service providers.
• University of Kansas Community Health and Development Center’s Community Toolbox, C ultural Competence in a Multicultural World , features 11 topics related to Culture and Diversity.
• African American Lives Today , Robert Wood Johnson Foundation & Harvard School of Public Health.  Find research data from a national survey examining African-Americans’ views on their personal and family lives, community, experiences of discrimination and financial situations.  There are links to research on health issues faced by African-Americans in our country.
• The Ways : Stories on Culture & Language from Native Communities Around the Central Great Lakes.
• The Danger of a Single Story , 2009, Chimamanda Ngozi Adichie, TED Talks
• My Year of Reading a Book from Every Country in the World , Ted Talk, Ann Morgan,  (12:03 min)
• How Culture Connects to Healing and Recovery , Ted Talk , Fayth Parks (13:40 min)

Online Training Resources

• Allies for Reaching Community Health Equity offers monthly online training events.  For a calendar of online training events, check out the Culture of Health Institute for Leadership Development (CHILD) .
• 5 Diversity Modules include a General Diversity Module, Amish Culture, Hispanic Culture, Hmong Culture and Native American Culture for general audiences and adapted modules for clinical providers from the La Crosse Medical Health Science Consortium, UW Lacrosse.
• Working With the African American Father: The Forgotten Parent Authors: California Social Work Education Center includes objectives, agenda, and trainer and trainee materials to develop professional practice working with African-American father’s and address systemic biases.
• What Works for African American Children and Adolescents: Lessons from Experimental Evaluations of Programs and Interventions Authors: Bandy and Moore Identifies programs that do and do not work and intervention strategies that contribute to program success.
• Culturally Diverse Parent-Child and Family Relationships: Guide for Social Workers and Other Practitioners Author: Webb Reviews the parent-child relationships and caregiving practices of subgroups of various racial and ethnic groups, outlines ethical issues in socialw ork with culturally diverse children, and describes a frameowrk for culturally responsive practice.
• Developing Cross-Cultural Competence: A Guide for Wokring with Children and Thier Families Authors: Lynch and Hanson Information on working with families and children with disabilities from specific cultrual, ethnnic, and language groups.
• Understanding Our New Racial Reality Starts with the Unconscious Source: Greater Good – the Science of Meaningful Life
• McK-V Inquirer: A newsletter of helpful tips & resources for serving children and youth experiencing homelessness found on the Wisconsin Early Childhood Collaborating Partners website. Scroll down to STATE RESOURCES and click on the issue you want to read.
• Standards and Indicators for Cultural Competence in Social Work Practice ,National Association of Social Workers (2015)
• Father Involvement and Child Welfare:  The Voices of Men of Color , Journal of Social Work Values and Ethics, Vol. 11, Number 1 (2014)
• Developing Culturally Responsive Approaches to Serving Diverse Populations: A Resource Guide for Community-Based Organizations This 2017 resource guide identifies easily accessible resources on cultural competency that organizations can use to become more responsive to the needs of their targeted populations, and to help attract funds to support their important work.
• Head Start’s Early Childhood Learning and Knowledge Center (ECLKC) . Administrators, teachers, caregivers, and families can use these resources to help ensure culturally and linguistically appropriate services for all children birth to 5. These resources can also help staff provide high quality services for children who are dual language learners (DLLs). Programs can promote positive experiences for DLLs by holding high expectations. They can also emphasize children’s cultural and linguistic strengths.
• Head Start’s ECLKC Family Engagement webpage, which includes the Parent, Family, and Community Engagement (PFCE) Framework, Boosting School Readiness through Family Engagement (simulation series), Engaging and Goal-Setting with Families, and the Family Engagement Family, Language and Literacy webinar series.  https://eclkc.ohs.acf.hhs.gov/family-engagement

Building Collaborations

• Chamber Executive: Where Workforce Development Begins , October 2012, Libby Doggett
• Partnerships: Frameworks for Working Together . This guidebook, developed for the Strengthening Nonprofits: A Capacity Builder’s Resource Library, is helpful to any organization or coalition of organizations that wants to know more about establishing and managing partnerships. (updated 2010)
• Guiding Principles for Public-Private Partnerships – A Tool to Support Engagement to Achieve Public Health Goals. Centers for Disease Control and Prevention, April 2018
• Nonprofit Collaborations:  Why Teaming Up Can Make Sense , Forbes Magazine, April 9, 2013.
• Business Leaders Team up to Benefit Education, Economy – ReadyNation
• Change the First five Years and You Can Change Everything – Ounce of Prevention
• Smart Beginnings and the Workforce Pipeline

Local Organizations

• Wisconsin Early Childhood Collaborating Partners
• Child Abuse and Neglect Prevention “The Wisconsin Child Abuse and Neglect Prevention Board is committed to mobilizing research and practices to prevent child maltreatment in the state.”
• Supporting Families Together Association .  SFTA is Wisconsin’s statewide member association for organizations and individuals committed to making every early childhood a great one. The core membership consists of Wisconsin’s Child Care Resource & Referral Agencies (CCR&Rs) and Family Resource Centers (FRCs). Individual membership is made up of other like-minded individuals.

Child Development

Apps and Activities

• ASQ activities
• Milestone Tracker Mobile App , Milestones matter! Track your child’s milestones from age 2 months to 5 years with CDC’s easy-to-use illustrated checklists; get tips from CDC for encouraging your child’s development; and find out what to do if you are ever concerned about how your child is developing. Photos and videos in this app illustrate each milestone and make tracking them for your child easy and fun!
• Text4Baby . The National Healthy Mothers, Healthy Babies Coalition supports Text4baby, a free mobile text messaging service that provides  moms-to-be, new moms and family members  with information to help them care for themselves and their baby throughout pregnancy and the baby’s first year.
• Vroom This practical app helps parents to help their babies brains grow during their regular daily routines!  Using the science of early learning, this app acknowledges parents as their child’s #1 brain builder, helping turn ordinary or fussy times into fun shared moments.
• Sesame Street Fun Games for Kids Parents can use these free online educational games, videos and coloring activities for preschoolers.
• Sesame Streets’ Healthy Habits for Life – We Have the Moves ,  This resource contains fun-filled activities to help build physical activity into everyday moments. Parents will find physical activities that require minimal time and equipment; activities for both large and small spaces and groups; fun and easy ways to add more active play into everyday routines; and ways to link movement to different developmental areas.
•   Bright by Text Parents receive free, timely Bright by Three age-appropriate activities, games and resources in English or Spanish.
• Love, Talk, Read, Sing, Play Provides information for parents to support their child’s development in diverse ways.  The app is available in English, Arabic, Bengali, Chinese or Nepali.
• Kinedu Offers 1,600 activity ideas for baby’s development, 0 – 4 years.
• Activities for Babies on Pinterest  
• Preschool Games on Pinterest .
• Parents Magazine Educational Games for elementary school children.
• Breathe, Think, Do mindfulness app from Sesame Street.  This free app helps teach young children, ages 2 – 5, problem-solving, self-control, planning and task persistence. Available for iOS   and Android  
• Calm free meditation app focuses on meditation, relaxation and sleep.  Their “sleep stories” function tells tales to help users fall asleep easier. There’s also a section for “Calm Kids” that parents may enjoy, as well!  Available for iOS and Android
• Developmental screening information and fact sheet.
• Social-emotional development for infants and toddlers.
• Social-emotional development for infants and toddlers related to peer behavior.
• HHS SED Milestones
• HHS SED Research Background
• HHS SED Tips for Early Childhood Teachers and Providers
• HHS SED Tips for Families
•   Kids in the Monitoring Zone: What to Do Next, ASQ
• Screening and Assessment in Early Childhood Settings, There can be some confusion about the difference between screening and assessment in early childhood settings. This infographic helps illustrate key characteristics for each type of tool.
• Screening for Social Emotional Concerns: Considerations in the Selection of Instruments.
• How kids’ screen-time guidelines came about — and how to enforce them, Kendall Powell
• Deb McNelis Promoting Brain Development Through Play and Nurture, Jennifer Rojas
• What Babies Understand about Adult Sadness, NPR
• Strength-based parenting improves children’s resilience and stress levels, Medical Press
• The Science of Resilience – Why some children can thrive despite adversity, Harvard
• Why maternal mental health matters: a case for early childhood development, Maternal Health Task Force Blog
• How Anxiety Leads to Disruptive Behavior – Kids who seem oppositional are often severely anxious, Child Mind Institute
• What Poverty Does to the Young Brain, The New Yorker
• How to Prevent Mental Health Problems? Begin at the Beginning With Infants and Toddlers – Matthew Melmed, The Huffington Post
• The Difference Between Tantrums and Sensory Meltdowns, Understood
• The Neuroscience of Calming a Baby, Psychology Today
• What Your Baby Can’t Tell You, Janet Lansbury – elevating child care
• Infants create new knowledge while sleeping, Science Daily
• Infant temperaments may reflect parents’ cultural values, Washington State University
• Some Early Childhood Experiences Shape Adult Life, But Which Ones?, NPR
• The scientific evidence against spanking, timeouts, and sleep training, Quartz
• Boy toddlers need extra help dealing with negative emotions, experts urge, Science Daily
• Helping Your Child’s Speech and Language, In the Playroom
• How raising kids within routines boosts social and emotional health, Desert News – National
• Understanding the Relation Between Temperament and Behavior, The Urban Child Institute
• Family Engagement and School Readiness Series, National Center on Parent, Family and Community Engagement
• How Supportive Parenting Protects the Brain, The Atlantic
• Benefits of bilingual children , FastCompany
• Early Childhood Mental Health Consultation: Policies and Practices to Foster the Social-Emotional Development of Young Children , provides an overview of early childhood mental health consultation, current issues in the field and possible future directions. The brief also provides a snapshot of current programs across the nation and highlights some of the challenges and innovations that are shaping the field. (Zero to Three)
• Seeing the Importance of Vision Development, research-to-policy article from the Urban Child Institute. 
• “ Baby’s Vision development: What to Expect the First Year ” from the American Academy of Ophthalmology.

Online Training

• The Wisconsin Department of Health Services Women, Infants, and Children Program site provides an online training course on anthropometrics : weighing, measuring, and interpreting measurement results.
• The Association of Maternal Child Health Programs’ Communicating the Value of Developmental Screening for professionals working directly with families and Title V leaders and other stakeholders to articulate the value of developmental screening.

CHILDREN’S DEVELOPMENTAL SCREENING AND HEALTH RESOURCES – Milwaukee Health Department Strong Baby Program – Are you a new parent, have young children, or an agency that serves families with young children? Check out these links to learn more about your baby’s incredible growth and development – and find resources to support you and your awesome baby!

PowerPoints

• A Home Visitor’s guide for developmental and behavioral screening from Birth To 5: Watch Me Thrive

Resource Guides

• Tips and Resources for Families U.S. Dept. of Health & Human Services, Office of the Administration for Children & Families – Early Childhood Development provides web links to resources that support the development (including social emotional) of young children.
•  Zero to Three’s Parent Favorites Free parenting resources include articles (English and Spanish), series infographics and videos related to early development.
•   Resource Guide:  Child Development Resources for Parents and Providers From the U.S. Health & Human Services Child Care State Capacity Building Center, this guide provides links to resources for both parents and providers.

Resources to Share

• Prevent Blindness Wisconsin offers fact sheets about screening for and protecting children’s vision.
• Preventative Pediatric Health Care Chart
• Bright Futures Guidelines is designed to provide a common framework for well child care from birth to age 21. Explore the Bright Futures materials and tools . If you are asked for a username/password, click cancel, and you should still be routed to the page.
• Feelings Poster
• 5 Steps for Brain-Building Serve and Return
• Kids in the monitoring zone: What to do next ASQ

UW Extension’s   Just in Time Parenting  newsletters are free parenting newsletters that are delivered by email and specific to a child’s age and needs. They are designed so that information that’s relevant to a family is automatically delivered to them just in time! Newsletters are specific to prenatal, newborn, the first year, second – third years (bimonthly), and fourth – fifth years (bimonthly). Newsletters can be downloaded from this webpage, too.

Articles for Families on Play The National Assc. for the Education of Young Children (NAEYC) offers a webpage with links to articles for families that answer the question, “Why is Play Important?” and offer Play in Action ideas.

Power of Play:  Building Skills and Having Fun video (5:33 min.) View this video with parents at Zero to Three’s website.

Sensory Activities 0-18 Months Games and activities that support sensory development in very young children.

Preschooler Creative Learning and Development Ideas and Activitie s Raisingchildren.net.au provides information for parents on all aspects of children’s development, from pregnancy – teens and family life.  This website contains articles, ideas, strategies, videos and more!

The Expectation Gap Downloadable from Zero to Three, these resources help parents understand the benchmarks of social emotional development with infographics, articles and more.

Articles for Families on Behavior and Development These articles support parents as they help their child develop social-emotional competence.

An Activity Book for African American Families:  Helping Children Cope with Crisis Download this activity book, developed by the National Black Child Development Institute and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, to support the social-emotional development of children and families dealing with crisis.

• The Well-Visit Planner is based on national recommendations for parents/guardians of children 4 months to 6 years old. This web tool will result in a personalized visit guide of questions and topics for a child’s next well-child visit.  This was developed as a project of The Child and Adolescent Health Measurement Initiative and Oregon Health and Science University.  English and Spanish .
• Delighting in Writing – Center for Early Literacy Learning (CELL). When young children are given opportunities, they can actively construct meaningful pictures and stories using written symbols.
• Serve and Return Interaction Shapes Brain Circuitry – The Center for the Developing Child. Video 2 from the 3 part series “Three Core Concepts in Early Development” . Young Children naturally reach out for interaction through babbling, facial expressions, and gestures.
• 6 Core Strengths for Child Development – Dr Bruck Perry
• Love, a low tech solution – Laura Peterson, TEDx Talks
• Why is it important to Comfort your child?, Hospital for Sick Children
• Developmental Screening, Ages and Stages Questionnaire (ASQ)
• 5 Tips for Brain-Building Serve and Return – Harvard Center on the Developing Child
• Early Recognition of Child Development Problems/Educational Video (4:33 min)  The Center for Disease Control’s Learn the Signs: Act Early campaign to help parents recognize developmental milestones.  Embed link in name of video.
• Early Signs of Autism Video Tutorial (9:02 min)  Video compares/contrasts typical development with those of children showing signs of early Autism Spectrum Disorder.  Kennedy Krieger Institute, Center for Autism and Related Disorders.
• Brain Builders , First Five Years Fund Early Childhood Education
• The Power of Connection : Welcome to The Power of Connection Online Experience! The first years of life is a time of incredible potential and yet of greatest vulnerability. Join us as we share some magical moments of early development with you and highlight just how important YOU are in ensuring a strong foundation for bright futures. This is a place for families and community members to deepen understanding of the complex and rich emotional worlds of our babies and young children.
• When Feelings Overwhelm: How to Help a Child 50 resources to help children manage their emotions includes resources useful to professionals and parents.
• The Wisconsin Department of Health Services offers information on Wisconsin’s Newborn Screening program and the Wisconsin Sound Beginnings newborn hearing screening program.
• The Wisconsin Early Childhood Collaborating Partners provides information about the Wisconsin Model Early Learning Standards .
• Learn the Signs, Act Early
• Children’s Health Alliance of Wisconsin (CHAW, in the acronym lingo), implements programs and initiatives, and offers resources on many health topics, including injury prevention and child death review, oral health, asthma, early literacy, and Medical Home.
• Centers for Disease Control and Prevention offers free childhood developmental resources for professionals and parents, including developmental milestone fact sheets, information on children’s mental health, multimedia resources, research, articles, and positive parenting tips.
• Centers for Disease Control and Prevention’s Learn the Signs: Act Early downloadable resources for professionals and parents. Covers developmental milestones for newborns through age five. Downloadable resources available in English and Spanish.
• Public Broadcasting Service’s The ABC’s of Child Development for Early Care Providers includes articles, quick tips and activity ideas
• Center on the Developing Child – Harvard University . Excellent downloadable articles, briefs, and videos related to the science of early childhood, including: brain architecture, serve and return, toxic stress, executive function & self-regulation and resilience.

Children with special needs

• Wisconsin First Step is an information and referral service hotline with phone and online chat forums and a resource directory to assist Wisconsin families and providers working with children and youth with special needs.
• Family Voices of Wisconsin promotes family-centered care for all children and youth with special health care needs and/or disabilities. Family Voices provides tools for families to make informed decisions, advocates for improved public and private policies, forges partnerships with families and professionals, and serves as a health care resource.
• What are the signs of autism? Since early treatment can improve outcomes for children diagnosed with autism, Autism Speaks stresses the importance of learning early signs of autism. The side offers a helpful Video Glossary after a brief registration.
• The  Adapting Activities & Materials for Young Children with Disabilities handout, with reference citations, provides key ideas, general teaching ideas, and activity adaptations for children with special needs.
• Do2Learn This website for individuals with special needs provides thousands of free pages with social skills and behavior regulation activities and guidance.
• Child Neurology Foundation This website offers insights and suggestions from child neurology experts for caregivers to engage with special needs children to nurture their development. Their mission: To serve as a collaborative center of education and support for caregivers and their children with neurologic conditions.
• Helping Your Child with Autism Thrive with the following text.  This Help Guide provides parenting tips, treatments and services to help parents support the development of a child on the Autism Spectrum.

Language Development

• 12 Ways to Support Language Development for Infants and Toddlers from the National Assc. of Education for Young Children (NAEYC).  Simple strategies for parents to use to support language development with very young children.
• Resources for Home-Based Practitioners The Center for Early Literacy Learning model and approach includes both evidence-based intervention and implementation practices for practitioners and parents to promote the use of early literacy learning practices.
• Storyline Online The SAF-AFRA Foundations’ award-winning children’s literacy website streams videos featuring actors reading children’s books alongside creatively produced illustrations.  Great for all kids, including those with special needs. Download the free app, too!

Child Health and Safety

Immunizations

• The DHS Wisconsin Immunization Registry offers a public link so that parents may access their children’s immunizations records. Through the following link, health professionals may also access materials (in several languages), as well as trainings to support their immunization programs and data collection efforts. The WIR can also be accessed in English, Spanish, or Hmong from this site. https://www.dhs.wisconsin.gov/immunization/wir.htm
• Through these Centers for Disease Control and Prevention links, you can download Easy-To-Read Immunization Schedules for Infants and Children , and for Teens in both English and Spanish. There is also a chart for Adults . On the same page, there is a link to a downloadable tracking chart. Families can write in their children’s measurements: Immunizations and Developmental Milestones for Your Child from Birth Through 6 Years Old
• The Immunization Action Coalition offers vaccine information for families , coalitions , and health professionals .

Infant and Early Childhood Safety and Injury Prevention

• Children’s Safety Network offers information on a wide variety of child injury prevention topics, with links to further resources.
• Children’s Hospital of Wisconsin provides Safe Sleep information in English and Spanish.
• Safe Kids Wisconsin has information on child injury prevention programs and events, including statewide car seat check dates and links to resources such as the Safe Sleep Cribs for Kids .
• Car Seats:  Information for Families .
• National Highway Traffic Safety Administration’s Car Seats and Booster Seats helps parents find and provides information on how to select a car seat, based on a child’s age and size.  It includes ease-of-use ratings that lets parents compare seats to find the right one for their child.
• Children’s Hospital of Wisconsin Car Seat Safety webpage, includes information on car seat clinics, laws and best practices and fact sheets in English and Spanish.
• Pediatric Dentistry: Common Treatment Options The most common pediatric dental services include dental exams and cavity fillings. These dentists also specialize in tooth extractions, preventive treatments, and restorative treatments. From NewMouth .

Hearing and Vision

• “ The Importance of Stimulating a Child’s Vision ” research-to-policy article from the Urban Child Institute.
•   “ Vision Development in Preschool and School-aged Children” from the American Academy of Ophthalmology”.
•   “ Prevent Blindness Wisconsin” offers fact sheets about screening for, and protecting, children’s vision”

Lead Prevention

• The Wisconsin Department of Health Services offers information childhood lead poisoning and lead-free housing: https://www.dhs.wisconsin.gov/lead/create-lead-safe-housing.htm
• On this Environmental Protection Agency (EPA) website, you can Learn about Lead , learn how to Protect Your Family , and find resources to work with children and families . The EPA also offers lead (plomo) information in Spanish .
• Safe Sleep for Babies Updates to the American Academy of Pediatrics’ safe sleep recommendations to protect against SIDS and sleep-related deaths are provided in this 10/24/16 video and accompanying article.
• American Academy of Pediatrics’ Task Force on SIDS:  What’s New in 2016 , Dr. Rachel Moon, MD, internationally recognized expert in SIDS and post-neonatal infant mortality.  52:33 minutes.
• Study:  Parents not following safe sleep advice for infants in AAP News, Aug. 15, 2016.
• American Academy of Pediatrics section on Child Death Review and Prevention – Safe Sleep includes policy and publications, information for families, safe sleep campaigns and frequently asked questions related to safe sleep practices for infants.
• Safe to Sleep public education campaign led by the National Institute of Child Health and Human Development contains science-based information about SIDS/Safe Sleep, campaign materials, outreach materials, videos and more.
• March of Dimes Safe Sleep for your Baby , offers information on how much sleep a baby needs, the safest place for baby to sleep, how to put baby to sleep safely and bedtime routines.
• How to Keep Your Sleeping Baby Safe:  AAP Policy Explained .  This article for parents addresses the dangers of unsafe sleep environments for babies and the pre- and postnatal recommendations from the AAP, through babies’ first year of life.
• Your New Baby Safe at Home .
• Cribs for Kids   A national safe sleep initiative since 1998, their mission is to prevent deaths caused in unsafe sleeping environments by educating parents and caregivers on the importance of practicing safe sleep for their babies and by providing portable cribs to families who, otherwise, cannot afford a safe place for their babies to sleep.
• Children’s Health Alliance of Wisconsin , with the WI Dept. of Health Services Maternal and Child Health Title V program, provides tools that support tribal and local health departments in addressing infant safe sleep. The website includes a safe sleep video, Sleep Baby Safe training modules, training materials, newborn nest and safe sleep local campaign examples. Educational materials available in several languages.

Best Practices and Services:

• Home Visiting Best Practices: The Centers for Disease Control and Prevention’s home visiting best practices for COVID-19 are currently out of date.  However, the following is the CDC’s guidance for healthcare personnel as of March 18, 2024 – Centers for Disease Control and Prevention COVID-19 Prevention and Control Recommendations for Healthcare Personnel
• Institute for the Advancement of Family Support Professionals: Please explore a vast collection of resources for Rapid Response Virtual Home Visiting here .

Resources for Families:

• PBS Kids For Parents:  Explore PBS’ COVID-19 resources for parents here .

Local Information:

• Wisconsin DHS COVID-19 Updates:  Stay informed with the latest updates from the Wisconsin Department of Health Services .

Domestic Violence

• Survivors of Domestic Violence May Enroll in Health Care at ANY TIME Health centers and domestic and sexual violence advocacy organizations can partner to support survivor health and prevent violence. Through cross-trainings and warm referrals, providers and advocates are able to provide comprehensive coordinated care for survivors and their families.
• National Network to End Domestic Violence Take Action NNEDV asks advocates and allies to contact Congress at key times to influence legislation and funding for domestic violence programs.  NNEDV will ask you to make phone calls, send an email or take action on social media sites.  Taking a few minutes to contact your elected officials can mean a world of difference to a survivor of domestic violence.
• Building Domestic Violence Health Care Responses in Indian Country: A Promising Practices Report, The Family Violence Protection Fund
• Stop Asking Already: 6 Reasons Why Intimate Partner Violence Survivors Stay in Their Relationships, Everyday Feminism
• In February 2012, the American College of Obstetrics and Gynecology (now the American Congress of Obstetrics and Gynecology) issued a position paper recommending universal screening for intimate partner violence .

Learning Modules

• Domestic Violence: Understanding the Basics
• DVeducation.ca , sponsored by Women’s College Hospital, Canada, has learning modules targeting health care professionals and others can benefit from the information, as well.  You must register to access the free modules.  Embed link in title. 
• How Much Do you Know About Stalking? Quiz from the Stalking Resource Center of the Nat’l Center for Victims of Crime, from the Office of Violence Against Women, U.S. Dept. of Justice. Embed link in title of quiz.
• Intimate Partner Sexual Abuse:  Adjudicating this Hidden Dimension of Domestic Violence This online course covers the legal, medical and social science aspects of intimate partner sexual abuse. It is focused on judges but is also intended for a multidisciplinary audience including court personnel. You can treat this website as a course and take it straight through or as a resource, accessing the background resources, modules, developing issues, recommendations and case studies on an as-needed basis.  Registration is required for the free modules, developed by the National Judicial Education Program of Legal Momentum.
• See the Signs: Speak Out Free bystander training programs available from a partnership of the Ohio Domestic Violence Network, the New York Society for the Prevention of Cruelty to Children, JWI, No More and Avon Foundation.  Be an Upstander, learn how to Recognize, Respond and Act. Check out these free online modules, available in English and Spanish, with registration.

Resources for Parents

• Children and Domestic Violence Fact Sheet Series – The National Child Trauma Stress Network Domestic Violence Collaborative Group announces a new series of fact sheets created for parents whose children have been affected by domestic violence. The set of 10 fact sheets gets to the heart of the experiences and needs of these children and families, and offers education in support of their resilience and recovery.
• Resources for Families What do kids need?  Find Best Practices for serving children, youth and parents experiencing domestic violence.
• The Childhelp National Abuse Hotline  is available 24 hrs. a day, every day of the year.  All calls are anonymous and toll-free.  Communication is available in 170 languages.  Downloadable resources, related to safety plans, dealing with difficult behavior words of encouragement for children and more, are also available.
• The Domestic Violence Resource Network (DVRN ) is funded by the U.S. Department of Health and Human Services to inform and strengthen domestic violence intervention and prevention efforts at the individual, community, and societal levels. It currently includes two national resource centers, four special issue resource centers, three culturally-specific resource centers, the National Domestic Violence Hotline, and the National LGBTQ DV Capacity Building Learning Center
• The National Domestic Violence Hotline aids victims of domestic violence 24 hours a day. Hotline advocates assist victims, and anyone calling on their behalf, by providing crisis intervention, safety planning and referrals to local service providers. The hotline receives more than 24,000 calls a month.  800-799-SAFE (7233)
• End Domestic Abuse Wisconsin mission is to promote social change that transforms societal attitudes, practices and policies to prevent and eliminate domestic violence, abuse and oppression. Their website includes resources access to services, economic justice, legal issues, public policy, outreach to underserved communities and more.
• Futures Without Violence provides resources and training related to all aspects of violence, including webinars, resources on a continuum of topics related to violence, and downloadable articles/manuals.
• For almost two decades, the National Health Resource Center on Domestic Violence (The Center)  has supported health care professionals, domestic violence experts, survivors, and policy makers at all levels as they improve health care’s response to domestic violence. The U.S. Dept. of Health and Human Services, Family & Youth Service Bureau, funds the Center. Embed link in italicized name.
• The National Center on Domestic Violence, Trauma & Mental Health was established in 2005 with funding from the FVPSP. Its mission is to develop and promote accessible, culturally relevant, and trauma-informed responses to IPV and other lifetime trauma so that survivors and their children can access the resources that are essential to their safety and well-being.
• State and national resources for domestic violence , includes a safety plan, national domestic violence hotline, state-by-state legal information, and more
• Help for Abused and Battered Women provided by HELPGUIDE.org, a trusted guide to mental, emotional and social health through a partnership with Harvard University
• National Indigenous Women’s Resource Center The Mission of NIWRC is to support culturally grounded, grassroots advocacy and to provide national leadership to ending gender-based violence in Indigenous communities through the development of educational materials and programs, direct technical assistance, and the development of local and national policy that builds the capacity of Indigenous communities and strengthens the exercise of tribal sovereignty. Access educational and advocacy resources on this website.
• The National Network to End Domestic Violence (NNEDV ), a social change organization, is dedicated to creating a social, political and economic environment in which violence against women no longer exists.
• Youth.gov Victims of teen dating violence often keep the abuse a secret. They should be encouraged to reach out to trusted adults like parents, teachers, school counselors, youth advisors, or health care providers. They can also seek confidential counsel and advice from professionally trained adults and peers.  Find resources for teens involved in abusive relationships here.
• Transitional Housing Toolkit This toolkit is meant to provide transitional housing providers with easy access to information and resources to enhance services to survivors. The information provided here addresses frequently asked questions, common challenges, best practices, templates for adaptation, and resources for additional information and assistance.
• Domestic Violence Oklahoma State Department of Health. Oklahoma Home Visitor Training. Enter ‘Oklahoma Home Visitor Training, Domestic Violence webinar’ in website’s search bar to gain access to the training.
• Child Abuse and Neglect Reporting Oklahoma State Department of Health. Oklahoma Home Visitor Training. August 2008 – Prevention Webinar presented by the Federal Interagency Work Group on Child Abuse and Neglect’ in website’s search bar to access webinar

Engaging Families

• Boosting School Readiness through Effective Family Engagement Series, “What you do and say matters! Explore and practice everyday strategies to develop Positive Goal-Oriented Relationships with a family. Four different simulations provide strategies and opportunities for you to practice skills to build bonds with families, help families develop and set goals, explore strength-based attitudes during challenging times, and have conversations about developmental concerns.  Head Start Early Childhood Learning and Knowledge Center, U.S. Dept. of Health Services
• “ Engaging Families in Case Planning ,” Child Welfare Information Gateway, 2012
• Strength-based parenting improves children’s resilience and stress levels Medical Press
• Why Don’t We Prepare Men for Fatherhood? The Good Men Project
• Engaging Families in Home Visiting: Why Does Family Engagement Matter? , The Institute for Child and Family Well-Being (UW-Milwaukee and Children’s Hospital of Wisconsin)
• Engaging Families: Field Guide to Making Home Visits Matter.   “This field guide intended for social workers in child welfare, includes strategies for engaging families, steps for working with resistance and developing a working agreement, and tasks that a worker or support person can do to assist families through each stage of the process.”  Maine Dept. of Children and Families Div. of Youth and Family Services, 2012.
• Family Engagement:  Partnering with Families to Improve Child Welfare Outcomes , Bulletin for Professionals, Sept. 2016. Child Welfare Information Gateway. Children’s Bureau/ACYF/ACF/HHS.
•   News You Can Use: A Circle of Support for Infants and Toddlers – Reflective Practices and Strategies in Early Head Start, Explore strategies and issues to consider to overcome a break down in reflective practice, and suggestions for encouraging parents to reflect and build on parenting practices.

Recognition

• Appreciation Coupon_English
• Appreciation Coupon_Spanish
• Resources including Public Service Announcements, media strategies and talking points are available by clicking the link to the Parents Anonymous NPLM toolkit.

Early Intervention Video Library “This video library is designed to be a central resource for EI videos which can be used for professional development, preservice preparation, public awareness, and individual study. These videos address a variety of topics and represent EI as provided in a variety of states. All videos embedded in this site are available as free resources.”

Ethics and Boundaries Ethics and Boundaries

• ANA – Code of Ethics
• NAEYC – Code of Ethical Conduct and Statement of Commitment
• NOHS – Ethical Standards for Human Service Professionals
• NASW – Code of Ethics of the National Association of Social Workers
• NASW Setting and Maintaining Professional Boundaries
• Home Visitors’ Handbook: Ethical Considerations , The Office of Head Start, in the Administration for Children and Families provides an interactive online handbook for home visitors. This page of the handbook focuses on ethics.
• Maintaining Professional Boundaries and Ethics in the Home Visitation Setting , (PowerPoint) Michael Provost, LCSW, Parents as Teachers Program Director (Parents Possible).
• Analysis of an Ethical Dilemma in Child Welfare in The New Social Worker (Fall, 2008).
• Client Relationships and Ethical Boundaries for Social Workers in Child Welfare in The New Social Worker (Winter, 2009).

Health Insurance and Other Benefits

•   A Minor’s Right to Consent to Treatment and Authorize Disclosure of Protected Health Information .  
• Crisis Services: Someone to Contact .   The State of Wisconsin provides several health hotlines (and warmlines) to connect individuals to crisis and non-crisis services.
• Prenatal Care Coordination.   Prenatal Care Coordination is a Medicaid and Badger Care Plus benefit that helps pregnant women get the support and services they need to have a healthy baby.
• Covering Kids Wisconsin The Covering Kids & Families initiative seeks to enroll eligible, uninsured children and adults in Medicaid and the State Children’s Health Insurance Program (SCHIP).
• Covering Wisconsin , Their mission is to connect residents with and promote effective use of insurance coverage and other programs that support health. The site includes How to Sheets, Find Local Help, Help Using Health Insurance, tips for applying for Medicare, BadgerCare Plus (Medicaid) and the Health Insurance Marketplace.
• IPV Health . IPV Health cultivates partnerships between health care providers and domestic violence advocates to promote survivor’s health and safety.

Home Visitor Safety Reading Materials

• Bed Bugs – Home Visiting
• Home Visitor Safety – 2023 – Early Childhood Learning & Knowledge Center
• Safety Best Practices for Home Visitors .   Center for Prevention Research and Development, Oct. 2015.
• Meth Watch Program Home Visitor Safety Tips  https://secure.in.gov/meth/files/Employees_Home_Visitors_Safety_Tips.pdf
• Personal Safety for Visiting Professionals – (PowerPoint) Indiana Dept. of Children Health Services

Videos and Training Modules

• Home Visitor Safety:  Staying Safe and Aware on the Job
• Staying Safe as a Home Visitor Webinar : Presented by Police Department of Manchester, NH
• Home Visiting Safety and Other Practical Matters webinar Presented by New York State Community Action Association
• Preventing Lice and Scabies
• Causes, Symptoms and Treatment of Scabies

Human Service Agencies

Wisconsin Community Program, Social Service, and Human Service Agencies – Links are provided to every county health and human services department in the state of Wisconsin

• Want Happier Kids? Cuddle More , Yahoo Parenting
• Abusive Head Trauma: How to Protect Your Baby , HealthyChildren.Org
• The Neuroscience of Calming a Baby , Psychology Today
• Forbes: Can We Stop A Traumatized Child From Becoming A Traumatized Adult?
• Penn State: Helping parents understand infant sleep patterns
• In the Playroom: Helping Your Child’s Speech and Language
• Desert News – National: How raising kids within routines boosts social and emotional health
• The Atlantic: How Supportive Parenting Protects the Brain
• Why Don’t We Prepare Men for Fatherhood? Huffington Post

Online Learning Activities

• The Protective Factors Overview learning activity is an introduction for anyone who would like to gain a better understanding of the five Protective Factors. This interactive learning activity provides a synopsis of the five Protective Factors, their relevance and their characteristics, opportunities to practice identifying them and an understanding of how a strengths-based approach is integral to building these Protective Factors.
• Hospital for Sick Children: Why is it important to Comfort your child? (1:08)
• Love, a low tech solution – Laura Peterson, TEDx Talks (16:40)
• Parenting Newsletters and Other Parenting Resources from the University of WI Extensio n, includes audio podcasts and downloadable resources for expecting parents and parents of children in every stage – from infants through teenagers, related to developmental stages, temperament, and useful strategies for parents.
• Head Start: National Center on Parent, Family and Community Engagment
• Zero to Three
• Intimate Partner Violence (IPV) presents complex and difficult issues for families, communities and home visiting programs. Research articles about IPV and its effects can be found at the U.S. Dept of Health and Human Services’ Child Welfare Information Gateway.

Breastfeeding

• The Wisconsin Department of Health Services (DHS) offers breastfeeding information and links to breastfeeding promotion and education resources .
• The Centers for Disease Control and Prevention (CDC) provides breastfeeding information for families, communities, and health providers, including answers to Frequently Asked Questions, approaches to promotion and support, and recommendations for safe handling of human milk, and links to programs such as the Baby-Friendly Hospital Initiative .
•   AllBabiesCryBrochure

Parent Leadership

• Five Similarities Between Leadership and Parenting , Forbes Magazine, Brent Gleeson, 2014.
• Effective Leadership and Parenting for Challenging Times Foster Cline, MD. Happy Heart Families,
• Parenting Styles: the Situational Approach , Penn State Leadership Blog
• Leadership and Parenting:  Parallels , Penn State Leadership Blog
• Leadership Begins at Home , Michael McKinney, Leadership Minute: Building a Community of Leaders
• The   Role of the Parent Co-Presenter  learning activity is designed provide Parent Co-Presenters with an understanding of what is involved in co-facilitating the  Bringing the Protective Factors Framework to Life in Your Work  training for family serving professionals. The learning activity defines the roles of the Parent Co-Presenter and the Certified Trainer. Video montages, by current Parent Co-Presenters, highlight the benefits of serving in this role and sharing one’s story in an impactful way.
• From Leadership to Parenthood:  The Applicability of Leadership Styles to Parenting Styles , Group Dynamics:  Theory, Research, and Practice, 2006, Vol. 10, No. 1, 43-56.
• Building Parent Leadership Manual, Georgia Dept. of Education.  This manual was created to assist organizations and parent leaders in organizing, planning, and implementing events, activities, and outreach programs to promote parent leadership in schools and communities.
• Parents Anonymous
• The Influence of Fathers on Young Children’s Development Zero to Three National Center for Infants, Toddlers, and Families

Poverty and Financial Capacity Building

• Stresses of Poverty May Impair Learning Ability in Young Children .   U.S. Dept. of Health & Human Services, National Institutes of Health
• Children in Poverty:  Key Facts About Child Poverty (Jan. 2019) Child Trends.
• Estimating the Economic Cost of Childhood Poverty in the United States , Social Work Research, Vol. 42, Issue 2, June 2018, found on Oxford Academic Social Work Research website.
• American Psychological Association’s journal, Monitor on Psychology, July/Aug. 2015 cover story, Fighting Poverty .  New research is finding ways to help people overcome poverty and avoid the mental and physical health problems associated with low socioeconomic status.
• How to Reduce Poverty in the United States , University for Poverty Research, UC Davis, 2015.
• Five Ways to End Poverty in the United States (BorgenProject.Org, 2016).  These tips help all of us think about the roles we can take to reduce poverty in our country.
• Poverty and Parenting Young Children: The Role of Parenting in the Intergenerational Transmission of Poverty.  (Focus. Vol. 33, No. 2. Spring/Summer 2017. Found on Institute for Research on Poverty, UW-Madison’s website.)

Reports/Statistics

• United States Census Bureau’s I ncome and Poverty in the United States: 2015 . This report presents data on income, earnings, income inequality, and poverty in the United States based on information collected in the 2016 and earlier Current Population Survey Annual Social and Economic Supplements (CPS ASEC) conducted by the U.S. Census Bureau.
• United States Census Bureau’s Poverty Data , provides poverty data from several household surveys and programs. Here you can find poverty estimates, learn about these surveys and programs, and get guidance on how to choose the right estimate for your needs.
• Wisconsin Poverty Report: Treading Water in 2017: the Eleventh Annual Report of the Wisconsin Poverty Project (2019) is from the Wisconsin Poverty Project, Institute for the Research on Poverty, UW Madison.
• Poverty’s Effect on Infants and Toddlers Infographic (Sept. 2018).  Zero to Three.
• WI ALICE (Asset Limited, Income Constrained, Employed) Report . United Way of Wisconsin 2016. Despite recent reports of overall improvement in employment and gains in median incomes, the economic recovery in Wisconsin has been uneven. This Report updates the cost of basic needs in the Household Survival Budget for each county in Wisconsin, and the number of households earning below the amount needed to afford that budget (the ALICE Threshold). The Report delves deeper into county and municipal data and looks at the demographics of ALICE and poverty-level households by race/ethnicity, age, and household type to reveal variations in hardship that are often masked by state averages.
• U.S. Census Bureau Library for Income and Poverty data contains static, printable materials.
• 2Gen Tools to Help Children and Families Thrive is a resource for programs implementing state, federal and local programs serving children and families, published by the Dept. of Education.
• Pediatricians’ Guide to Poverty Resources – Wisconsin
• Federal Poverty Guidelines determine enrollment in state health care and other programs.
• 99 Great Resources Confronting Poverty and Hunger , from MSWOnlinePorgrams.org, resources for social workers.
• National Center for Homeless Education Wisconsin data and information.
• Wisconsin Community Action Association , whose goal is to help low-income individuals and families escape poverty. WISCAP believes in personal and in community responsibility to ensure economic opportunity.
• Wisconsin Homeless Assistance Agencies , U.S. Housing and Urban Development.
• Benefits.gov – Your Path to Government Benefits in Wisconsin .
• Wisconsin Fathers for Children and Families: Legal Services for Low-Income Parents – Low Income Legal Resources by regions of the state.
• Financial Literacy Resource Directory provides information on financial literacy resources, issues and events that are important to bankers, organizations, and consumers of all ages. The directory includes descriptions and contact information for a sampling of organizations that have undertaken financial literacy initiatives as a primary mission, government programs, fact sheets, newsletters, conference materials, publications, and links to Web sites. Office of the Comptroller of the Currency, U.S. Dept. of the Treasury
• MyMoney.gov contains information, games and fun facts related to money, saving and planning for youth; curricula, tip sheets, lesson plans, guidance and helpful tools for teaching financial capability for teachers/educators; and a clearinghouse of federally-funded research reports, datasets, and articles on financial capability and related topics for researchers/other professionals.
• The Balance : The Balance Money Website is a great tool for people new to budgeting. “Use this budget calculator to plan for your savings goals and manage your expenses. Fill out all fields that apply to you and make adjustments to see how you could save more.”
• Good Budget : Share this budgeting website and app with families, help them to…“Spend, save, and give toward what’s important in life”

Tools for Professionals

• Your Money, Your Goals Toolkit i s a financial empowerment toolkit designed by the Consumer Financial Protection Bureau (CFPB). The toolkit helps organizations understand when and how to introduce to clients’ financial empowerment concepts such as goal- setting, saving for emergencies, managing debts, understanding credit, and choosing safe and affordable financial products. English | Spanish
• National Human Services Directory (NHSA) is comprised of over 55 of the largest national nonprofit human service organizations. In aggregate, members and their affiliates and local service networks collectively touch, or are touched by, nearly every household in America—as consumers, donors, or volunteers.   NHSA staffs four different initiatives through which leaders can work together to improve family stability and well-being.  
•   9 Ways to Reduce Poverty, from PBS’s Raising of America:  Early Childhood and the Future of our Nation.

Pregnancy and Maternal Health

Professional Readings

• Breastfeeding Protects against Environmental Pollution.  (2015). Science Daily.  https://www.sciencedaily.com/releases/2015/05/150522083414.htm
• Substance Abuse While Pregnant and Breastfeeding   https://www.drugabuse.gov/publications/research-reports/substance-use-in-women/substance-use-while-pregnant-breastfeeding
• Fetal Alcohol Exposure Fact Sheet.  National Institute on Alcohol Abuse and Alcoholism.  https://pubs.niaaa.nih.gov/publications/FASDFactsheet/FASD.pdf
• Racial and Ethnic Infant Mortality Gaps and Socioeconomic Status (2014) Institute for Research on Poverty research publication. http://www.irp.wisc.edu/publications/focus/pdfs/foc311f.pdf
• Understanding Racial and Ethnic Disparities in U.S. Infant Mortality Rates.  Data Brief, National Center for Health Statistics, U.S. Dept. of Health and Human Services.  (2011). https://www.cdc.gov/nchs/data/databriefs/db74.pdf
• The Periscope Project Website contains work from the Wisconsin project which hosts a consultation line and other resources to support professionals working with new parents, that may be struggling with perinatal mental health and depression.  This site provides information on screening guidelines and resources beyond the Perinatal Algorithm training. On the site you will find screening tools, educational modules/ videos and tools on a variety of perinatal mental health topics.
• Promote, coordinate and develop perinatal care in Wisconsin
• Aid in the development and implementation of programs to improve the health and health care of pregnant women and newborn infants
• Improve public understanding and awareness of perinatal health care
• Prenatal Care Coordination , Wisconsin Department of Health Services
• March of Dimes has information for families, communities, and professionals on a variety of topics designed to promote healthy pregnancies and babies, including prenatal care, and preterm labor and premature birth .
• Text4baby is a free health education text message service (with most cell carriers) for pregnant women and mothers of babies under one year of age. Anyone can sign up!
• National Maternal and Oral Health Resource Center   – Georgetown University https://www.mchoralhealth.org/highlights/pregnancy.php This collection of selected resources offers high-quality information about pregnancy and oral health. Use the website tools for further searching, or contact them for personalized assistance.
• Maternal and Child Health Bureau   https://mchb.hrsa.gov/ Covers MCH domains: maternal/women’s health, perinatal and infant health, child health, adolescent health, and children with special health care needs, data, research & epidemiology and more.
• Breastfeeding Facts and Research. https://www.cdc.gov/breastfeeding/index.htm   The CDC’s webpage includes Guidelines and Recommendation, Diseases and Conditions, Data and Statistics, Research, Promotion and Support, National Policies and Positions, Frequently Asked Questions.
• Breastfeeding vs. Formula Feeding – Medline Plus (U.S. National Library of Medicine) https://medlineplus.gov/ency/patientinstructions/000803.htm
• Tip Sheet Edinburgh Postnatal Depression Scale (EPDS)
• Saving Our Babies “The gap in birth outcomes between Black and white women in Dane County and Wisconsin has persisted for decades, while Black mothers and birthing people across the state face consistently higher rates of maternal deaths each year. We are collaborating across sectors to implement community-driven solutions to end this crisis and produce better birth outcomes for Black families.”
• Nips and Babes “Forging a way for all birthing people to access a new model of comprehensive care: quality doula, lactation, emotional and parenting supports in Dane County.”

Professional Practices and Skills

Competencies and Best Practices

• Challenges and Best Practices for Scaling Home Visiting Programs, New America education policy program, Conor P. Williams, 4/15/14.   
• Infant Mental Health Competency Guidelines for Infant Mental Health Endorsement , Providing services that promote healthy social-emotional development during the first years requires a unique knowledge base and skill set.  Learn more about the competency guidelines that provide a framework for establishing and recognizing expertise of professionals who work with pregnant women and families with children ages birth to 3 years old.
• Competencies and Best Practices, add Home Visiting:  Supporting Parents and Child Development, Zero to Three policy briefs and planning tools.
• Best Practices in Early Childhood Home Visiting , MSW research paper is a qualitative research exploration of the best practices surrounding the specific realm of home visiting, focused on ages three to five, specific to school readiness.  Author:  Shannon Melody Karsten
• Tips for Making Home Visits in Child Welfare, The New Social Worker
• FAN tool developed by Erikson’s Fussy Baby Network becomes a national model
• Motivational Interviewing
• Online Tutorials for Early Childhood Mental Health Consultants, Center for Early Childhood Mental Health Consultation, Georgetown University Center for Child and Human Development free modules.
• The National Family Support Network’s Standards of Quality for Family Strengthening & Support were issued by the California Network of Family Strengthening Networks (CNFSN) in 2012, and adopted by the National Family Support Network in 2013. They are the first and only standards in the country to integrate and operationalize the Principles of Family Support Practice with the Strengthening Families Frameworks and its research-based evidence-informed 5 Protective Factors. The vision is that their implementation will help ensure that families are supported and strengthened through quality practice.

Program Administration MIECHV Home Site

Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program

Federally Recognized Evidenced-Based Home Visiting Models

• Healthy Families America
• Parents As Teachers
• Nurse-Family Partnership
• Early Headstart

Program Evaluation Professional Reading

• The 2017 W. K. Kellogg Foundation Evaluation Handbook is designed for people with little or no experience with formal evaluation, making evaluation practices accessible to grantees, nonprofits and community leaders.
• Designing Evaluations , 2012 Revision Author: U.S. Government Accountability Office Description: “This methodology transfer paper addresses the logic of program evaluation designs. It introduces key issues in planning evaluation studies of federal programs to best meet decision makers’ needs while accounting for the constraints evaluators face. It describes different types of evaluations for answering varied questions about program performance, the process of designing evaluation studies, and key issues to consider toward ensuring overall study quality.”
• How Nonprofits Can Use Data to Solve the World’s Problems , December 2012 Author: Victor Luckerson
• National Conference of State Legislatures, Home Visiting:  Improving Outcomes for Children (4/26/2018) .   
• Using Data to Measure Performance of Home Visiting explores a new framework for assessing effectiveness of home visiting programs. (2015)
• A Framework for Program Evaluation:  A Gateway to Tools provides a synthesis of existing best practices and a set of standards that can be applied in almost any setting.  It provides a stable guide to design and conduct a wide range of evaluation efforts in a variety of specific program areas, made available through the Center for Community Health and Development at the University of Kansas – Community Toolbox.
• An Introduction to Evidence-based Programming is an implementation resource guide for social service programs provided by the Office of Family Assistance, U.S. Dept. of Health and Human Services.
• Center for Disease Control and Prevention; Other Evalaution Resources Purpose Statement: This page is a list of evaluation resources such as: program evaluation guides/manuals, manuals on specific evaluation steps (e.g., logic models, data collection methods), evaluation-related websites, key professional associations and journals.
• MDRC, Design Options for Maternal, Infant, and Early Childhood Home Visiting Evaluation (DOHVE) Project Resources Purpose Statement: This page is a list of resources for Maternal, Infant, and Early Childhood Home Visiting (MIECHV) programs (such as WI’s Family Foundations home visiting sites) on issues related to strengthening their evaluations of promising programs, developing and adapting data systems to facilitate tracking and reporting on federal benchmarks, and implementing quality improvement systems.
• American Evaluation Association Purpose Statement: The American Evaluation Association is an international professional association of evaluators devoted to the application and exploration of program evaluation, personnel evaluation, technology, and many other forms of evaluation. Evaluation involves assessing the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness. AEA has approximately 7300 members representing all 50 states in the U.S. as well as over 60 foreign countries.

Research/Frameworks in Home Visiting Professional Reading

Specific reports/articles:

• Home Visiting Evidence of Effectiveness Review , Office of Planning, Research, and Evaluation, Administration for Children and Families, April, 2024
• Visiting Nurses, Helping Mothers on the Margins , New York Times
• Opening Up Avenues of Success for New Parents , Huffington Post
• Which families gain most from home visiting? , PeventionAction.Org
• Policy solutions that work for low-income people , CLASP
• Home Visiting Programs: An Early Test for the 114th Congress , Brookings
• Police chiefs call on Congress to fund home visits for at-risk mothers , Milwaukee Journal Sentinel
• EDUCATION: Home visits promote early learning , The Press-Enterprise
• Home Visiting Family Support Programs: Benefits of the Maternal, Infant, and Early Childhood Home Visiting Program .
• Home Visiting:  A Service Strategy to Reduce Poverty and Mitigate Its Consequences , in the Academic Pediatrics Journal.  (2016)
• County Health Rankings & Roadmaps , sponsored by the Robert Wood Johnson Foundation, features the expected beneficial outcomes, other potential beneficial outcomes, evidence of effectiveness, implementation examples and resources.

Journals that often carry Home Visiting research articles:

• Children and Youth Services Review
• Prevention Science
• Tribal Home Visiting Evidence of Effectiveness Review: Process and Results , USDHS, February 28, 2011
• U.S. Department of Health and Human Services, Home Visiting Evidence of Effectiveness
• Pew Charitable Trust, Center on the States, home Visiting Campaign, Research
• Early Head Start Research and Evaluation project
• Nurse Family Partnership – “Proven Results” (includes links to internal and external research)
• Darkness to Light
•   National Home Visiting Resource Center provides comprehensive information about early childhood home visiting. Its goal is to support sound decisions in policy and practice to help children and families thrive.
• Sponsored by the U.S. Dept. of Health and Human Services, Home Visiting Evidence of Effectiveness (HomVEE) offers a thorough and transparent review of the home visiting research literature and assess evidence of effectiveness for home visiting programs that serve families with pregnant women and children from birth to age 5.
• HRSA Maternal & Child Health The Maternal, Infant, and Early Childhood Home Visiting Program gives pregnant women and families, particularly those considered at-risk, necessary resources and skills to raise children who are physically, socially, and emotionally healthy and ready to learn. Learn more about home visiting, evidence-based models, current grantees, research and development platform, outcomes measures and download the 2017 Home Visiting Infographic related to MIECHV funded programs.https://mchb.hrsa.gov/maternal-child-health-initiatives/home-visiting-overview
• Nurse Family Partnership: Helping First-Time Parents Succeed . Learn about this evidence-based nursing model of home visiting on their website.
• Head Start Learning Outcomes Framework resents five broad areas of early learning, referred to as central domains. The framework is designed to show the continuum of learning for infants, toddlers, and preschoolers. It is grounded in comprehensive research around what young children should know and be able to do during their early years. Explore this framework through interactive software .
• Head Start’s Framework for Effective Practice uses the model of a house to represent five integral elements of quality teaching and learning for children ages birth to 5.
• Tribal Evaluation Institute’s mission is to help Tribal Home Visiting Program grantees build capacity in gathering, using and sharing information to improve the health and well-being of children and families.  The website makes the TEI technical assistance resources available to a broader audience of tribal program staff, community members and professionals who partner with tribal communities.
• Family Spirit Home Visiting Program is a unique, evidence-based home-visiting model with a reputation for success: dependability with flexibility. It addresses intergenerational behavioral health problems, applies local cultural assets, and overcomes deficits in the professional healthcare workforce in low-resource communities. It is the only evidence-based home-visiting program ever designed for, by, and with American Indian families.
• Adverse Childhood Experience’s (ACE’s) Study Video Summary
• Example of home visiting/coaching

Self-Care Articles

• The Power of Good Habits – Using High-Performance Habits to Achieve Significant Goals , Mind Tools
• How to Transform Stress into Courage and Connection , Greater Good – the Science of a Meaningful Life
• Stress Diaries – Identifying Causes of Short-Term Stress , Mind Tools
• Doing More Than One Job – How to Juggle Multiple Roles at Work , Mind Tools
• Minimizing Distractions – Managing Your Work Environment , Mind Tools
• Secondary Traumatic Stress: A Fact Sheet for Child-Serving Professionals , The National Child Traumatic Stress Network (NCTSN)
• The Importance of Mindfulness , PsychAlive (2:41)
• What is self-care and why is it important?, Anna Freud NCCF (2:55)

Sound Beginnings Module Resources

• Sound Beginnings Website
• Hearing Milestones Checklist
• Vision Milestones Checklist Strengthening Family Coping Resources

Strengthening Family Coping Resources

• Strengthening Family Coping Resources for Home Visitors (SFCR-HV) is an adaptation of SFCR, a trauma-focused, multi-family, skill-building intervention. The Milwaukee Child Welfare Partnership has two resources for home visitors to use when practicing SFCR:  Strengthening Family Coping Resources: A Guide for Home Visitors  and  Strengthening Family Coping Resources: A Module for Home Visitors.
• The Protective Factors Overview learning activity is an introduction for anyone who would like to gain a better understanding of the five Protective Factors. This interactive learning activity provides a synopsis of the five Protective Factors, their relevance and their characteristics, opportunities to practice identifying them and an understanding of how a strengths-based approach is integral to building these Protective Factors
• Strengthening Family Coping Resources (SFCR) is a manualized, trauma-focused, skill-building intervention. You can learn more about SFCR by visiting their main website .

Substance Abuse

Online Modules

• Relationships Matter!   Learn what professionals need to know about the role of relationships in the lives of women with mental health and substance use issues.  Transcripts, slides and audio recordings of the 2017 SAMHSA (Substance Abuse and Mental Health Services Administration) webinars available. Online registration for these tutorials required. Tutorials are free to earn a Certificate of Completion, fee of $7.50 to earn NAADAC or NBCC CE units.
• National Center on Substance Abuse and Child Welfare (NCSACW) – U.S. Dept. of Health and Human Services, Understanding Substance Use Disorders, Treatment, and Family Recovery: A Guide for Child Welfare Professionals .     This free tutorial requires online registration with the NCSACW.
• Understanding Substance Abuse and Facilitating Recovery: A Guide For Child Welfare Workers , PDF
• Parenting Under the Influence: The Effects of Opioids, Alcohol and Cocaine on Mother-Child Interaction , Author(s): Slesnick, Natasha.;Feng, Xin.;Brakenhoff, Brittany.;Brigham, Gregory S. Published: 2014, Journal Name: Addictive Behaviors
• World Health Organization Guidelines on Substance Use and Pregnancy , PDF
• Coalition Against Substance Abuse
• The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think , Huffington Post
• A parent’s heroin addiction, a newborn’s death sentence , Milwaukee Journal Sentinel
• Supporting Infants, Toddlers, and Families Impacted by Caregiver Mental Health Problems, Substance Abuse, and Trauma: A Community Guide 2012 SAMHSA: Substance Abuse and Mental Health Services Administration
• What are the Effects of Maternal Cocaine Use?
• Principles of Substance Abuse Prevention for Early Childhood: a Research-based Guide highlights seven evidence-based principles of prevention for use in the early years of a child’s life (prenatal through age 8), developed from research funded in full or part by the National Institute on Drug Abuse (NIDA).  This guide also lists evidence-based prevention and intervention programs that work with different populations and age groups.
• Drugs, Brains, and Behavior:  The Science of Addiction. This publication aims to help readers understand why people become addicted to drugs and how drugs change the brain to foster compulsive drug use by providing scientific information about the disease of drug addiction, including the many harmful consequences of drug abuse and the basic approaches that have been developed to prevent and treat substance use disorders.
• Sex and Gender Differences in Substance Use, DrugFacts (2015). Do special issues related to women’s hormones, menstrual cycle, fertility, pregnancy, breastfeeding and menopause impact their struggle with drug use?
• Fetal Alcohol Spectrum Disorders (FASD) Fact Sheet Series.   SAMHSA provides many different downloadable fact sheets related to alcohol abuse, including: The Physical Effects of Fetal Alcohol Spectrum Disorders, Effects of Alcohol on Women, Fetal Alcohol Spectrum Disorders and the Criminal Justice System, Fetal Alcohol Spectrum Disorders by the Numbers, and more.
• DrugFacts .  Information from the National Institute on Drug Abuse describes methamphetamine, how it’s used, how it affects the brain, its short and long-term affects on users and treatment.
• This guide to Assessment and Intervention in the Home: Women and Infants Affected by Opioids is offered by the Wisconsin Association for Perinatal Care.
•   My Baby and Me is a program through the Wisconsin Women’s Health Foundation that is designed to help women with their alcohol use during pregnancy.
• Bath Salt Intervention (3) Power Point Presentation
• Fetal Alcohol Spectrum Disorder Factsheets The Substance Abuse and Mental Health Services Administration (SAMHSA)Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence recently published two Technical Assistance (TA) Impact fact sheets.
• The Recovery of Hope This video helps women explore the ramifications of their substance abuse during pregnancy, as women share their personal stories.
• Born Addicted
• Working with Pregnant Women with a History of Substance Abuse
• Pregnancy and Drug Use
• The Growing Issue of Women and Substance Abuse
• Sex and Gender Differences of Importance to Addiction Science. (5:29 min.)  National Institute on Drug Abuse.
• The Reward Circuit:  How the Brain Responds to Methamphetamine  (2:40 min)  https://www.drugabuse.gov/videos/reward-circuit-how-brain-responds-to-methamphetamine
• My Baby and Me  https://www.wwhf.org/mybabyandme/   A free program, sponsored by the Wisconsin Women’s Health Foundation, to help Wisconsin women achieve a healthy and alcohol-free pregnancy through screenings, research-based education, phone counseling and text message support.
• Fetal Alcohol Spectrum Disorders. CDC’s webpage that defines Fetal Alcohol Spectrum Disorders and provides facts, causes, signs, diagnosis and treatment information.  Headings on this web page include:  Research and Tracking, Data and Statistics, Free Materials, Alcohol Use During Pregnancy, Education and Training, Articles, Multimedia and Tools, and Information for Specific Groups. https://www.cdc.gov/ncbddd/fasd/index.html
• National Institute on Alcohol Abuse and Alcoholism. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) is one of the 27 institutes and centers that comprise the National Institutes of Health (NIH). NIAAA supports and conducts research on the impact of alcohol use on human health and well-being. It is the largest funder of alcohol research in the world. https://www.niaaa.nih.gov/

Supervision/Reflective Supervision

• “6 Ways to Create a Culture of Innovation”, 2020, Kaplan
• What is Reflective Supervision?
• Reflective Supervision: A Planning Tool for Home Visiting Supervisors

Reflective Supervision: What We Know and What We Need to Know to Support and Strengthen the Home Visiting Workforce

Honoring Race and Diversity in Reflective Supervision: Guiding Principles to Enhance Relationships

• Three building blocks of Reflective Supervision Wisconsin Alliance for Infant Mental Health, Best Practices and Guideline for Reflective Supervision , Zero to Three

Trauma/Brain Development

•   Recognizing and Addressing Trauma in Infants, Young Children and their Families.   “This five module tutorial, from the Center for Early Childhood Mental Health Consultation, addresses the effects of trauma on young children and their families, healing and recovery, resources, publications and interventions for childhood mental health consultants and family support professionals.” https://www.ecmhc.org/tutorials/trauma/index.html
• Congressional Briefing: Elizabeth Hudson remarks Elizabeth Hudson addresses the mental health impact of violence and trauma on children. Elizabeth Hudson is a Trauma-Informed Care Consultant; University of Wisconsin-Madison, School of Medicine and Public Health; Consultant to the Wisconsin Department of Health Sevrices.
• Jill Botle Taylor’s Stroke of Insight Neuroanatomist Jill Bolte Taylor had an opportunity few brain scientists would wish for: One morning, she realized she was having a massive stroke. As it happened — as she felt her brain functions slip away one by one, speech, movement, understanding — she studied and remembered every moment. This is a powerful story about how our brains define us and connect us to the world and to one another.
• How Childhood Trauma Affects Health Across a Lifetime (16:03) https://www.youtube.com/watch?v=95ovIJ3dsNk Childhood trauma isn’t something you just get over as you grow up. Pediatrician Nadine Burke Harris explains that the repeated stress of abuse, neglect and parents struggling with mental health or substance abuse issues has real, tangible effects on the development of the brain. This unfolds across a lifetime, to the point where those who’ve experienced high levels of trauma are at triple the risk for heart disease.
• The Paradox of Trauma (12:23) https://www.youtube.com/watch?v=jFdn9479U3s Dr. Vicky Kelly, psychotherapist, administrator, and consultant is also a nationally known trainer in the areas of trauma and attachment. The common thread across her career has been helping victims of trauma heal. She has been an early advocate for human services to adopt “trauma-informed care,” an approach that calls for a focus not just on someone’s behavior, but, more importantly, on what drives behavior.
• How Do We Stop Childhood Adversity from Becoming a Life Sentence? (15:54) https://www.youtube.com/watch?v=qp0kV7JtWiE Adverse childhood experiences are physical, sexual or emotional abuse and neglect as well as witnessing family violence, addiction or mental health episodes in the household. Evidence on the prevalence of adverse childhood experiences is presented-to give a sense of the magnitude of the problem. Research is presented which demonstrates a direct link between the level of adversity in childhood and worse outcomes in adulthood related to health, addiction, imprisonment, education and life success and evidence from the field of neuroscience, which explains this link. Ways to prevent and respond to childhood adversity and support victims are presented
• The Center for the Developing Child Short PDF article regarding Early Childhood Mental Health
• A series of information and tutorials from the Center for Early Childhood Mental Health Consultation.
• Creating a Culture of Care This toolkit is the result of the STARS project trauma-informed care project, sponsored by the Texas Dept. of State Health Services (2011). The toolkit can be used across human service settings and was developed broadly for this purpose.
• Creating a Trauma Informed HV Program Issue Brief . This issue brief features useful strategies for implementing trauma-informed care in home visiting programs and the section Snapshots of Success From the Field: Trauma-Informed Approaches in Home Visiting , highlights Wisconsin home visiting programs.”

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What Makes Home Visiting So Effective?

By engaging in a warm, accepting relationship with parents, you support a strong and secure relationship between the parent and child. You help parents become more sensitive and responsive to their child. The secure relationship between young children and their families creates the foundation for the development of a healthy brain. The home environment allows you to support the family in creating rich learning opportunities that build on the family's everyday routines. You support the family's efforts to provide a safe and healthy environment. You customize each visit, providing culturally and linguistically responsive services.

The home visiting model allows you to provide services to families with at least one parent at home with the child or children. Families may choose this option because they want both support for their parenting and for their child's learning and development in their home. For example, you are available to families who live in rural communities and who otherwise would not be able to receive needed services. You bring services to families whose life circumstances might prevent them from participating in more structured settings or families challenged by transportation. Some programs are able to be flexible and offer services during non-traditional hours to families who work or go to school.

Every parent and home visitor brings his or her own beliefs, values, and assumptions about child-rearing to their interactions with children. Home visiting can provide opportunities to integrate those beliefs and values into the work the home visitor and family do together.

In addition to your own relationship with the family during weekly home visits, you bring families together twice a month. These socializations reduce isolation and allow for shared experiences, as well as connect them to other staff in the program.

Resource Type: Article

National Centers: Early Childhood Development, Teaching and Learning

Last Updated: December 3, 2019

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Developmental Milestones Resources for Home Visiting Programs

CDC’s milestones and parent tips have been updated and new checklist ages have been added (15 and 30 months). For more information about the updates to CDC’s developmental milestones, please review the Pediatrics journal article and these important key points .

FREE resources from the Centers for Disease Control and Prevention (CDC) to help you engage families in monitoring children’s developmental milestones from 2 months to 5 years of age.

CDC’s Learn the Signs. Act Early. materials help you…

• Complement and support developmental screening
• Enhance individualized developmental support
• Help with making referrals
• Help parents better understand their child’s development
• Communicate with parents about their child’s progress
• Guide parents when there is a concern about their child’s development

1 in 6 children has a developmental delay or disability. You can help identify children with signs of developmental delay, strengthen family engagement, and better support children by…

• Enhance developmental screening by using milestone checklists [4 MB, 24 Pages, 508] and the Milestone Moments booklet [3 MB, 60 Pages, 508]  to track each child’s development between screenings.
• Help parents understand age-appropriate milestones by showing pictures and videos from Milestones in Action .
• Share children’s books Amazing Me  and Where is Bear?  to help parents learn about developmental milestones while reading with their child.
• Increase your knowledge of signs of potential delay and what to do if there is a concern.
• Encouraging parents to use the Milestone Tracker app   and review the My Child’s Summary page with you to facilitate communication about developmental progress.
• Helping parents take action on developmental concerns by sharing CDC’s How to Get Help for Your Child [727 KB, 2 Pages, 508] tip sheet.

What Home Visitors Are Saying!

“ My clients enjoy looking for their babies’ milestones. They use the booklet to “glimpse into the future” of what their babies will be doing next! It allows them to prepare for what is to come even after they have graduated from our program. ” – Nurse Home Visitor, South Carolina

It’s Working in Home Visiting!

Help Me Grow South Carolina and Maternal, Infant, and Early Childhood Home Visiting (MIECHV) programs have developed a model to successfully integrate Learn the Signs. Act Early . materials. The model includes

• An engaging training on developmental milestones for families.
• Discussions with families at each visit about their child’s development, using materials like CDC’s Milestone Moments booklet [3 MB, 60 Pages, 508] .
• A process to refer children to appropriate providers for further evaluation if parental concerns arise during visits.

Brazelton Touchpoints Development is a Journey Roadmap This roadmap is designed for home visitors to facilitate  conversations if there are developmental concerns and/or after developmental screening using seven short and simple steps to actively engage parents and other caregivers in planning for their child’s developmental needs and enhance the provider-parent partnership. Development is a Journey conversation roadmap PDF | Roadmap Background and Guidance

• English [1 MB, 2 Pages, 508]
• Spanish [791 KB, 2 Pages, 508]

Looking for family-friendly resources on caring for children and helping them cope during COVID-19? Click the links below for more information.

• COVID-19: Caring for Children
• COVID-19: Stress & Coping Information for Parents

Brief Home Visiting: Improving Outcomes for Children

What is Home Visiting?

Home visiting is a prevention strategy used to support pregnant moms and new parents to promote infant and child health, foster educational development and school readiness, and help prevent child abuse and neglect. Across the country, high-quality home visiting programs offer vital support to parents as they deal with the challenges of raising babies and young children. Participation in these programs is voluntary and families may choose to opt out whenever they want. Home visitors may be trained nurses, social workers or child development specialists. Their visits focus on linking pregnant women with prenatal care, promoting strong parent-child attachment, and coaching parents on learning activities that foster their child’s development and supporting parents’ role as their child’s first and most important teacher. Home visitors also conduct regular screenings to help parents identify possible health and developmental issues.

Legislators can play an important role in establishing effective home visiting policy in their states through legislation that can ensure that the state is investing in evidence-based home visiting models that demonstrate effectiveness, ensure accountability and address quality improvement measures. State legislation can also address home visiting as a critical component in states’ comprehensive early childhood systems.

What Does the Research Say?

Decades of research in neurobiology underscores the importance of children’s early experiences in laying the foundation for their growing brains. The quality of these early experiences shape brain development which impacts future social, cognitive and emotional competence. This research points to the value of parenting during a child’s early years. High-quality home visiting programs can improve outcomes for children and families, particularly those that face added challenges such as teen or single parenthood, maternal depression and lack of social and financial supports.

Rigorous evaluation of high-quality home visiting programs has also shown positive impact on reducing incidences of child abuse and neglect, improvement in birth outcomes such as decreased pre-term births and low-birthweight babies, improved school readiness for children and increased high school graduation rates for mothers participating in the program. Cost-benefit analyses show that high quality home visiting programs offer returns on investment ranging from $1.75 to $5.70 for every dollar spent due to reduced costs of child protection, K-12 special education and grade retention, and criminal justice expenses.

Maternal, Infant and Early Childhood Home Visiting Grant Program

The federal home visiting initiative, the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program, started in 2010 as a provision within the Affordable Care Act, provides states with substantial resources for home visiting. The law appropriated $1.5 billion in funding over the first five years (from FYs 2010-2014) of the program, with continued funding extensions through 2016. In FY 2016, forty-nine states and the District of Columbia, four territories and five non-profit organizations were awarded $344 million. The MIECHV program was reauthorized under the Medicare Access and CHIP Reauthorization Act through September 30, 2017 with appropriations of $400 million for each of the 2016 and 2017 fiscal years. The Bipartisan Budget Act of 2018 ( P.L. 115-123 ) included new MIECHV funding. MIECH was reauthorized for five years at $400 million and includes a new financing model for states. The new model authorizes states to use up to 25% of their grant funds to enter into public-private partnerships called pay-for-success agreements. This financing model requires states to pay only if the private partner delivers improved outcomes. The bill also requires improved state-federal data exchange standards and statewide needs assessments. MIECHV is up for reauthorization, set to expire on Sept. 30, 2022.  

The MIECHV program emphasizes that 75% of the federal funding must go to evidence-based home visiting models, meaning that funding must go to programs that have been verified as having a strong research basis. To date,  19 models  have met this standard. Twenty-five percent of funds can be used to implement and rigorously evaluate models considered to be promising or innovative approaches. These evaluations will add to the research base for effective home visiting programs. In addition, the MIECVH program includes a strong accountability component requiring states to achieve identified benchmarks and outcomes. States must show improvement in the following areas: maternal and newborn health, childhood injury or maltreatment and reduced emergency room visits, school readiness and achievement, crime or domestic violence, and coordination with community resources and support. Programs are being measured and evaluated at the state and federal levels to ensure that the program is being implemented and operated effectively and is achieving desired outcomes.

With the passage of the MIECHV program governors designated state agencies to receive and administer the federal home visiting funds. These designated  state leads provide a useful entry point for legislators who want to engage their state’s home visiting programs.

Advancing State Policy

Evidence-based home visiting can achieve positive outcomes for children and families while creating long-term savings for states.

With the enactment of the MIECHV grant program, state legislatures have played a key role by financing programs and advancing legislation that helps coordinate the variety of state home visiting programs as well as strengthening the quality and accountability of those programs.

During the 2019 and 2021 sessions, Oregon ( SB 526 ) and New Jersey ( SB 690 ), respectively, enacted legislation to implement and maintain a voluntary statewide program to provide universal newborn nurse home visiting services to all families within the state to support healthy child development. strengthen families and provide parenting skills.    

During the 2018 legislative session New Hampshire passed  SB 592  that authorized the use of Temporary Assistance to Needy Families (TANF) funds to expand home visiting and child care services through family resource centers. Requires the development of evidence-based parental assistance programs aimed at reducing child maltreatment and improving parent-child interactions.

In 2016 Rhode Island lawmakers passed the Rhode Island Home Visiting Act ( HB 7034 ) that requires the Department of Health to coordinate the system of early childhood home visiting services; implement a statewide home visiting system that uses evidence-based models proven to improve child and family outcomes; and implement a system to identify and refer families before the child is born or as early after the birth of a child as possible.

In 2013 Texas lawmakers passed the Voluntary Home Visiting Program ( SB 426 ) for pregnant women and families with children under age 6. The bill also established the definitions of and funding for evidence-based and promising programs (75% and 25%, respectively).

Arkansas lawmakers passed  SB 491  (2013) that required the state to implement statewide, voluntary home visiting services to promote prenatal care and healthy births; to use at least 90% of funding toward evidence-based and promising practice models; and to develop protocols for sharing and reporting program data and a uniform contract for providers.

View a list of significant  enacted home visiting legislation from 2008-2021 . You can also visit NCSL’s early care and education database which contains introduced and enacted home visiting legislation for all fifty states and the District of Columbia. State officials face difficult decisions about how to use limited funding to support vulnerable children and families.

Key Questions to Consider

State officials face difficult decisions about how to use limited funding to support vulnerable children and families and how to ensure programs achieve desired results. Evidence-based home visiting programs have the potential to achieve important short- and long-term outcomes.

Several key policy areas are particularly appropriate for legislative consideration:

• Goal-Setting: What are they key outcomes a state seeks to achieve with its home visiting programs? Examples include improving maternal and child health, increasing school readiness and/or reducing child abuse and neglect.
• Evidence-based Home Visiting: Have funded programs demonstrated that they delivered high-quality services and measureable results? Does the state have the capacity to collect data and measure program outcomes? Is the system capable of linking data systems across public health, human services, and education to measure and track short and long-term outcomes?
• Accountability: Do home visiting programs report data on outcomes for families who participate in their programs? Do state and program officials use data to improve the quality and impact of services?
• Effective Governance and Coordination: Do state officials coordinate all their home visiting programs as well as connect them with other early childhood efforts such as preschool, child care, health and mental health?
• Sustainability:  Shifts in federal funding make it likely that states will have to maintain programs with state funding. Does the state have the capacity to maintain the program? Does the state have the information necessary to make difficult funding decisions to make sure limited resources are spent in the most effective way? 

Related Resources

Housing and homelessness toolkit, policies for the jurisdiction of the children, families and human services standing committee, promising trends emerge in recent health and human services bills.

The chairs of NCSL’s Children, Families and Human Services Committee recently met to discuss the health workforce, prevention of child maltreatment, behavioral health, maternal and child health, Medicaid and other timely issues.

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Early Intervention Strategies for Success

Sharing What Works in Supporting Infants & Toddlers and the Families in Early Intervention

• Research to Practice Brief #6: Home Visiting Beliefs and Practices (current)

Research to Practice Brief #6: Home Visiting Beliefs and Practices

The article below challenged me to look at EI from a cultural point of view. We talk all the time about how individualized EI must be in order to be most effective, but the reality is that the way in which home visits are conducted is often similar across providers. Having a similar framework for visits doesn’t preclude individualizing; it seems to me that this could be fine line, though.  Visits could be conducted in such a similar, even predictable manner that the ability to individualize to child interests, family routines, or changing priorities becomes challenging. Or, having a similar, cultural framework across visits could provide the stability needed to allow the provider to individualize. Read on and see what you think.

Source: Brorson, K. (2007). The culture of a home visit in early intervention.  Journal of Early Childhood Research. 3 (1), 51-76. (PDF, New Window)

Research: What Do We Know?

Brorson (2007) conducted a qualitative study of one EI program to examine how services were delivered. Four families and seven service providers participated in the study. Families and providers participated in multiple videotaped observations of visits and multiple interviews. A review of program documents was also conducted. Results revealed information about the structure of a typical home visit, values and beliefs of providers, and program philosophy.

Typical Home Visit – Brorson noted that the typical home visit included eight parts: 1) planning,  2) greeting, 3) activities, 4) observation, 5) demonstration, 6) shared knowledge, 7) follow-up, and 8) scheduling.

Beliefs of Providers – Providers espoused a belief in collaborative, family-centered interactions with parents, but this was not seen in observations of visits, interviews, or in the reviewed documents. Instead, providers were observed to educate rather than reciprocally collaborate with parents.

Program Philosophy – Brorson described five assumptions that appeared to guide staff in the delivery of services. These assumptions were:

• Structured activities provide the frame for the visit and the means through which the family learns what to expect.
• The culture of a home visit is stable across families, providers, treatment techniques, etc. This stability is established by how the provider conducts visits, which tends to be similar across families though does allow for individualizing.
• Delivery of EI services “is in a constant state of change requiring therapists to become perpetual learners.” (p. 64)
• Providers play a leadership role during visits in educating families about the culture of visits.
• Providers have their own individual definitions of family-centeredness (rather than a shared understanding and implementation).

Because this study only focused on a single program and a small sample of families and providers, generalization is not really possible. However, insights learned from this study can be used by providers and program administrators to reflect on the culture of how EI is provided in their programs.

Practice: How Can You Use What You Know?

Yes, this article is older now, but I think that the insights learned in this small study are fascinating. Let’s think about these insights and how they might apply today:

Typical Home Visit – These 8 parts of a visit look very familiar to me, especially when I think of a more traditional model. When I compare these parts to more recent thinking related to caregiver coaching and collaboration, a few important pieces appear to be missing – the opportunity for the caregiver to be in the lead and practice using strategies with the child, reciprocal reflection and feedback, and joint planning for what happens between visits. Spending a few minutes reflecting on which of these parts and pieces of a visit typically happen on YOUR visit could help you identify your strengths and where you’d like to improve.

Beliefs of Providers – We all are pretty sure we understand family-centered practices, but do our understandings match with the literature? Do we practice what we preach? On your visits tomorrow, pay attention to how much you actually collaborate with the parent. Are you doing most of the talking and the work during the visit, or are you sharing the conversation and collaborating to support parent-child interaction?

Program Philosophy – If we accept that we play a leadership role with teaching families how to interact during visits, then that reminds us that families probably don’t start out knowing what they are supposed to do. Remember to take the time on your first few visits to help them learn how the process works. Educate them in the importance of their active participation and practice during and between visits. You may do this the same way across families, but does that mean that all visits should basically look the same? I don’t think so. Your methods may be similar, and your underlying philosophy maybe similar across families, but the activities of the visit should look different – if you are individualizing to child and family interests, environments, and priorities and joining family routines.

So here are the questions I’d like you to consider in the comments below:

Is it okay for your visits to basically work the same way across families? Why or why not?

If you espouse family-centered intervention beliefs, are you implementing them?

How would you describe the culture of visits in your program? In your individual practice? Does it match with Brorson’s findings? If not, how is it different?

Disclaimer – I’m a big believer in calling visits “intervention visits” rather than “home visits.” This reflects the evolution of practices in our field from focusing on the home as the location for EI to focusing on intervention, which can happen anywhere. I used “home visit” in this post to match the language used in the Brorson (2007) article, but in my happy little world, we’re moving away from that phrase to something more reflective of recommended practices. 🙂

• collaboration
• early childhood
• early intervention
• family-centered practices
• home visits
• parent-professional partnership
• research to practice

8 comments on “ Research to Practice Brief #6: Home Visiting Beliefs and Practices ”

Before I answer the questions, I thought it was very interesting that the sample size had parents ranging from 27-44 years old. There were literally no “young” parents (I say young, acknowledging that I am calling myself old because I am 26). I have to wonder what this study would have looked like if there were teen parents participating. I know that it takes a special set of skills to work with very young parents.

Anyway, I believe it is okay for visits to “Work the same” across families with the understanding that the content of the visit can be fluid. I would never expect child A to be able and sit with me the way Child B does but, the same flow of visit still applies. Just like I would expect Mom A to attend to me in the same way Mom B does, everyone is different and being flexible is key. I have no issue with this as long as we recognize we need to be flexible. Forcing a certain flow or order of events on a family, particularly one who hails from a different culture than your own is dangerous. I believe that is where an element of the collaboration comes in. Open, honest communication is the best way to speak to anyone, and that includes parents.

As a newbie in the field, something I have noticed is the frustration that providers experience when a family isn’t doing something the way they believe they should. Yes, we want families to follow the strategies, but perhaps the learning style that particular parent has isn’t the, “tell me and I can do it,” perhaps they have to learn through doing. I feel we as providers need to make space not only for the children to make mistakes but also space for parents to make mistakes as apart of their learning process.

Just my two cents.

Thanks for adding your two cents, Gabrielle! I really like what you write about flexibility and open communication which are so important for individualizing EI. I think my favorite thing that you wrote was about making space for parents to make mistakes as part of their own learning process. When we’re really doing EI well, we absolutely focus our energy on supporting the parent as a learner (not just the child). I’d love to know more about how you do this – what does it look like on your visits when you make space for the parent’s learning?

Great point too about the age of the parent sample – I hadn’t thought of that. Yes, the demographics of the parents could certainly make a difference!

Since I am new, I am learning along side of the parents as to what works and what doesn’t. IF you feel a parent is not “doing” something that you feel they should be it is important to take a step back and think about why you think they should be doing something. Is it your own set of morals coming in to play? Is it that you are not meeting them where they are, and expecting them to have the same understanding as you? Is it that there is a safety concern for the child? What is it? (Obviously if there is a safety concern you should be frank about it with the parents, and report to whomever you are mandated to report to :).

I make space for parents to make mistakes by first building that foundation of, “I am a safe person to talk to about life, which includes your child, you can be comfortable with me.” I also make sure to set the expectation that while I want to listen to you and your concerns, and that your concerns and feelings and thoughts are valid, I will also level with you if the need arises. Being a genuine person with families makes them so much more willing to work with you.

From there, I ask them to show me (a phrase I have heard a million times from my coworkers,) if they aren’t comfortable because they are afraid to mess up, I will show them and then ask them to try. I try to ALWAYS make sure to praise their effort and give encouraging feed back for every simple thing they did right BEFORE I go into what they might have missed.

Praising parents for the little things, as they are doing them is so important. We work on building the child’s confidence but can sometimes forget to speak words of encouragement and empowerment in the the parents lives as well. Once again, just my two cents as a newbie 🙂

Well said, Gabrielle! I couldn’t have written this any better myself! You may be a newbie but you already have wonderful insights into what it takes to partner with families. Thanks so much for adding to the discussion!

This is a great “back to school” resource! I think our team will use this as a guide to examining how our ideals and actual practice may miss the mark (or, hopefully, are aligned!). I really like activities in which the parallels of our work in reflection and that of the parents both serve us well!

I’m so glad you found this post helpful, Mary. Keep me posted on how your team uses it and what you learn about yourselves!

I feel that intervention visits should certainly have a framework within which we work that can guide and direct how we respond depending on what occurs during the session. As long as we use the parents’ needs and questions to guide our interactions, it both respects the parents and provides needed structure. We are actually working on an Early Intervention Visiting Framework over here at EDIS to help provide that to providers new to the coaching model. As for me, I think my initial approach is pretty uniform across families, but then takes on various forms once I learn about a family’s differing needs.

Thanks Jeff! I agree, I think we all bring our own structure – the way we do things – to each visit then adapt to the family’s priorities, interests, abilities, needs, routines and activities. That’s a lot that we have to adapt to, isn’t it? 🙂 I would love to take a look at the framework you guys develop, when it’s available!

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Home-Based Intervention

Implementation framework.

The intervention is conducted in the home with the child, parents or other primary caregivers, and other family members. Child First intervention addresses the highest risk families, decreases stress within the family, increases stability, facilitates connection to growth-promoting services, and supports the development of healthy, nurturing, protective relationships.

Staffing: Each affiliate site has a Child First Clinical Director/Supervisor and two to six clinical teams. The Child First team consists of a licensed, Master’s level Mental Health/Developmental Clinician and Bachelor’s level Care Coordinator, both with significant expertise with very young children and vulnerable families. They work together in the home with the family.

Caseload:  Each Child First team usually carries between 12 and 16 families, such that they are able to complete 12-14 home visits per 40 hour work week. However, this varies based on intensity of service need, success of planned visits, and travel time.

Visits: Families receive visits twice per week during the assessment period (first month) and then once a week or more, depending on the needs of the child and family. After assessment, Clinicians and Care Coordinators may visit together or separately, based on the individual family needs. Visits last 1- 1.5 hours.

Duration of services: Services generally continue for six to twelve months, but may be longer based on individual family needs.

Summary of Home-based Intervention Components

Child First home-based intervention has seven major components:

Engagement of Family

The intervention begins with engagement and trust building. We begin by asking what we can do to help the family meet their own goals and listen closely to their concerns. The Child First team members serve as family partners and advocates.  Learn More

Comprehensive Assessment of Child and Family

The Child First Team partners with the family to understand the child’s health and development, the child’s important relationships with parents as well as other individuals who care for the child (e.g., early care providers), child trauma and other stressors (e.g., violence and separation), and the multiple challenges experienced by the parents that interfere with their ability to protect, nurture, and support their child’s development. Formal measures, conversations, observations, and records from other providers are included in the process. Learn More

Development of Child and Family Plan of Care

A family-driven plan consisting of comprehensive, well-coordinated, therapeutic intervention goals, supports, and services is developed in partnership with the parents or caregivers. This plan reflects the parents’ goals, priorities, strengths, culture, and needs. This serves as the Medicaid-compliant treatment plan.  Learn More

Parent-Child Psychotherapeutic Intervention

The promotion of responsive nurturing through a parent-child psychotherapeutic approach was designed to enhance the parent-child relationship as fundamental to the child’s social-emotional health and cognitive development. Given the high level of risk and psychological challenges in the children and parents served by Child First, an intensive approach that blended parent guidance and dyadic, psychotherapeutic treatment was deemed most appropriate to meet the needs of our multi-challenged families. This approach is highly individualized and driven by the child and family’s unique strengths, needs, culture, and psychological availability. Learn More

Enhancement of Executive Functioning

The Child First Team promotes self-regulation and executive functioning capacity through both the psychotherapeutic intervention and the development and execution of the service plan. We mentor caregivers so that they are able to thoughtfully focus attention, plan, organize, problem solve, and succeed.  Furthermore, this enables them to scaffold the development of executive functioning in their own children, which is essential to their children’s educational success.  Learn More

Mental Health Consultation in Early Care and Education

The Mental Health Clinician works with the early care and education environment to provide consultation to the teacher or caregiver. This is especially critical when there are challenging behaviors within the classroom. The Clinician conducts observations, discusses past and current behavior with the teacher, and helps the teacher understand the meaning of the child’s behavior. Together they develop strategies that can meet the child’s individual needs and coordinate efforts between early care and education and the home.  Learn More

Care Coordination

The Care Coordinator facilitates the coordination of services and the family’s access to multiple resources throughout the community, based on the collaborative planning with the parents.  The Care Coordinator listens carefully, always reflecting on the meaning of the service for the family. The Care Coordinator provides hands on assistance obtaining information and partnering with community providers, researching program appropriateness and availability, and making and facilitating referrals to provider agencies. Though this process, she promotes the caregiver’s executive functioning.  Learn More

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The National Maternal Mental Health Hotline provides free, confidential mental health support. Pregnant people, moms, and new parents can call or text any time, every day.

Start a call: 1-833-TLC-MAMA (1-833-852-6262)

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• Programs & Impact

Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program

The MIECHV Program helps pregnant people and parents of young children improve health and well-being for themselves and their families. The Program does this by partnering trained home visitors with families to set and achieve goals. This work is part of our Early Childhood Systems programming .

Key summary documents

• Program Brief: Maternal, Infant, and Early Childhood Home Visiting Program (PDF - 239 KB)
• State Fact Sheets
• FY23 Home Visiting Infographic (PDF - 111 KB)

How does the Home Visiting Program help families?

Home visitors and families develop strong relationships and trust. They meet regularly to address families’ needs.

The Program aims to:

• Improve the overall health of mothers and children
• Get children ready to succeed in school
• Improve families’ economic well-being
• Connect families to other resources in their community (for example WIC , Medicaid, employment and educational resources, housing support, parenting support classes, and resources on how to stop smoking)

The Program works to prevent:

• Child injuries, abuse, and neglect
• Crime and domestic violence

What happens through home visiting?

Home visitors:

• Support healthy pregnancy habits
• Give advice on things like breastfeeding, making sure babies sleep safely, avoiding accidents with children, and eating well
• Show parents how to be positive and supportive with their children by reading, playing, and praising good behavior
• Encourage talking to babies and teaching them things from a young age
• Work with parents to plan for the future, continue their education, and find jobs and childcare
• Connect families to other services and resources in their community

How does the Program work?

Watch our video that explains this work.

HRSA and the Administration for Children and Families (ACF) fund states, jurisdictions, and tribes to develop and conduct home visiting programs. We provide funds to states and jurisdictions. ACF provides funds to tribes .

These programs must be based on evidence showing that they can meet the needs of families.

How do you ensure these programs work?

We use the Home Visiting Evidence of Effectiveness (HomVEE) review . ACF reviews home visiting program models to ensure they meet families’ needs.

There are 24 home visiting models that meet HomVEE and other eligibility criteria . States, jurisdictions, and tribes can select the best models for their communities.

How do you know how awardees are doing?

Awardees must report on how their program performs. The law requires them to do this across six benchmark areas, which include 19 performance measures (PDF - 137 KB) . They must show that they’ve improved in at least four of the six areas.

Do you offer to help awardees?

Yes. We want our awardees to succeed. Our program officers share their expertise to help improve the quality of the programs .

How is Home Visiting different from the Healthy Start program?

The Home Visiting Program and the Healthy Start program both reach pregnant women and families. But they’re different in terms of both funding and approach.

Funding differences

The Home Visiting Program awards grants to 50 states, the District of Columbia, and five territories to create state-wide networks that support and carry out HHS-approved evidence-based home visiting models.

Healthy Start provides direct funding to local entities . Healthy Start awardees serve communities in which babies die more often than the national average.

The 2023 funding increase for Home Visiting Program is the result of a five-year, bipartisan reauthorization of the Program by Congress. As such, this reauthorization further defines how the Home Visiting Program differs from Healthy Start.

Program differences

While both programs play a vital role in improving maternal and child health, they do so in distinct ways .

The Home Visiting Program:

• Preventing child abuse and neglect
• Promoting positive parenting
• Supporting school readiness
• Allows states to choose evidence-based models that fit their community’s needs

The Healthy Start program:

• Focuses on reducing infant deaths
• Providing both clinical and non-clinical health services
• Offering well-woman, maternity care, and doula services
• Helping with transportation and housing needs

And each program emphasizes different parts of the life course:

• The Healthy Start program focuses on the periods before, during, and after pregnancy.
• While some Home Visiting models focus on the time before birth, many models serve families throughout the early childhood period up until kindergarten.

Additional information

• Fiscal Year (FY) 2022 MIECHV Program Reauthorization
• Demonstrating Improvement in the Maternal, Infant, and Early Childhood Home Visiting Program: A Report to Congress (PDF - 1 MB) (March 2016)

Past funding awards for home visiting programs

• FY23 Formula Funding Awards
• FY22 Formula Funding Awards
• FY21 American Rescue Plan Act Awards
• MIECHV Innovation Awards

Resources for our awardees

• Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program Notice of Funding Opportunity (PDF - 685 KB) *
• MIECHV FY24 Notice of Funding Opportunity FAQs
• MIECHV FY24 Notice of Funding Opportunity Technical Assistance Webinar recording
• MIECHV FY24 Notice of Funding Opportunity Technical Assistance Webinar slides (PDF - 491 KB)
• COVID-19 Resources and FAQs for Home Visiting
• Data and Continuous Quality Improvement for Programs
• MIECHV Evaluation and Research
• MIECHV Program Reauthorization
• MIECHV Base Grant Awards FY23 Non-Competing Continuation Update (NCC Update) (PDF - 272 KB)
• MIECHV Formula Awards FY22 Non-Competing Continuation Update (NCC Update) (PDF - 434 KB)
• FY22 American Rescue Plan (ARP) Act Round 2 Award Instructions (PDF - 204 KB)

*Note: Persons using assistive technology may not be able to fully access information in this file. For assistance, please email Rachel Herzfeldt-Kamprath or call 301-443-2524 .

The Essentials of Home Visiting

Robust. Reflective. Relevant. Accredited online courses to support home visiting in any model.

Home visitors, doulas and family support professionals are an essential part of family wellbeing and strong program outcomes. That’s why we launched The Essentials of Home Visiting, a high-quality, online training platform designed to create confident, competent home visitors and supervisors within any home visiting model.

The Essentials of Home Visiting closes the gap in home visitor education with relevant topics and a flexible, accredited training experience. Learners earn early childhood CEUs that support the acquisition and maintenance of professional credentials across multiple fields and state and professional registries.

Our comprehensive catalog of cost-effective, self-paced courses and live webinars is competency-based and rooted in decades of home visiting expertise from Start Early. Individualized implementation support from Start Early experts ensures you meet state and system requirements while strengthening the professionalism of your entire home visiting workforce.

NEW! Adult Learning & Adult Literacy Webinars

Learn about the factors that affect adult learning and literacy and become more effective in collaborating and engaging with diverse families. These webinars are perfect for ALL home visiting and early childhood staff.

Live Webinars Available in Spanish!

Attend two of our most popular Essentials of Home Visiting webinars, presented live in Spanish. Reach out to our team to learn more.

The course helped me better organize my time and prepare myself before going to a home visit. I feel more confident in ... how I utilize my knowledge and take care of myself in order to help others. Participant

What does The Essentials of Home Visiting include?

The Essentials of Home Visiting offers research-based learning experiences that can be mixed and matched to create custom training solutions for family professionals.

Self-Paced Online Courses

The course catalog includes 10 courses, which cover everything from foundational training to advanced topics like infant mental health and trauma-informed practice. Two courses are specifically designed for supervisors of family professionals.

Online courses are self-paced and typically completed in 2-3 hours, with unlimited starting and stopping permitted. Learners have perpetual access to their courses, so they can refer back to the content at a later date.

Course Catalog

• Basics of Home Visiting
• The Impact of Trauma in Home Visiting
• Ages and Stages Questionnaire-3 (ASQ-3™) Overview & Best Practices
• Foundations of Infant Mental Health Practice in Home Visiting

Live Webinars

Webinars are live and facilitated by home visiting experts at Start Early. Each webinar is offered multiple times throughout the year.

There are 17 webinars within the course catalog, including 2 that are offered in both English and Spanish, and 4 specifically developed for supervisors. Each webinar includes a presentation, case studies and a Q & A session. Participants also have access to the recorded sessions.

• Understanding Substance Abuse Through the Family’s Lens
• Home Visiting Boundaries
• Promoting Effective Parenting With Motivational Interviewing
• Trauma in Families & Communities

Implementation Support

Start Early experts provide technical assistance to assist state and system leaders in providing the optimal professional learning experiences to meet the unique needs of professionals.

Technical assistance includes:

• Regular calls to discuss implementation progress
• User data analysis and reporting
• Custom training portal with partner branding
• Communication tools and materials to drive usage

All Essentials of Home Visiting participants receive a Certificate of Completion stating the number of hours of professional development and a description of the learning event completed. The Essentials of Home Visiting trainings can be used towards several credentials and align with many state professional development registry systems. See full list below:

Credentials

• Alliance for the Advancement of Infant Mental Health (AAIMH) : The Essentials of Home Visiting self-paced online courses and live webinars are approved by the AAIMH. Upon completion of these learning experiences, participants earn in-service training credits towards Endorsement® from their local Infant Mental Health Association, if their association is a member of the Alliance for the Advancement of Infant Mental Health. See crosswalk which details The Essentials of Home Visiting trainings that support each Endorsement Knowledge & Skill Area, as well as credit hours a professional may earn upon completion.
• Child Development Associate (CDA) for Home Visitors: The Essentials of Home Visiting trainings can be used as Professional Education Clock Hours to obtain or renew your CDA for Home Visitors. Upon course completion, participants are provided official certifications documenting all required information. See crosswalk which details the alignment of the Essentials of Home Visiting to the CDA-Home Visitor competency goals and the number of credit hours that can be earned.
• Continuing Education Units (CEUs):   Start Early is approved by IACET (International Accreditors for Continuing Education and Training) to offer CEUs in support of the workforce to earn, obtain, or renew a range of recognized credentials. Start Early is a provider of CEUs for Social Work, Education and Nursing in the state of Illinois. We can supply you with the necessary documentation so you can receive CEUs within your state.
• Nursing and Social Work: Start Early is an approved provider of CEUs in Nursing, Social Work, and early childhood workforce certifications. Many states licensing boards for Nursing and Social Work have reciprocal agreement to accept CEUs as approved by these boards in Illinois. Certificates of Completion can be downloaded to verify attendance and submitted per your license requirements.
• Certified Family Life Educator (CFLE) :The Essentials of Home Visiting online courses can be used for Contact Hours / CEUs to obtain or renew your CFLE credential. Upon course completion, participants are provided official certifications documenting all required information.

Competencies

• Institute for the Advancement of Family Support Professionals (IAFSP): The Essentials of Home Visiting courses align to the IAFSP Competency Framework. See crosswalk for additional detail.
• Head Start / Early Head Start Relationship-Based Competencies to Support Family Engagement: The Essentials of Home Visiting self-paced online courses and live webinars align with the Relationship-Based Competencies which support strengthening relationships with families, family engagement, and professional development. See crosswalk which details The Essentials of Home Visiting courses and webinars, and which Relationship-Based Competencies are supported by each.
• National Workforce Registry Alliance (NWRA) Training Organization Recognition (TOR) : Start Early is a proud member of the National Workforce Registry Alliance, which promotes high quality, coordinated, documented, and accessible career development systems that support a well-trained, well-educated, early childhood workforce. As an NWRA Recognized Training Organization, Start Early has demonstrated a commitment to best practices and continuous quality improvement. State registries may be able to expedite approval processes for training organizations already recognized by the NWRA.  See the states that accept Recognized Training Organizations.
• Illinois Gateways
• Oregon Registry

Visit our online training portal to browse learning experiences or register as an individual for a course or webinar from The Essentials of Home Visiting.

Visit Portal

(The Essentials of Home Visiting) allows rural home visitors to attend trainings and not use excessive time and money traveling. This is so important in the current financial climate. The interactive components … also allow (participants) to form relationships and feel part of … a learning community. State Leader, Illinois

What the Field Is Saying

• 94% of participants report satisfaction and 91% would recommend The Essentials of Home Visiting to a colleague
• 76% of participants report applying what they learned within one week of engaging with a The Essentials of Home Visiting experience

Resources & News

Explore resources from our home visiting experts and learn how The Essentials of Home Visiting can help your team.

Look Closer

Explore the research behind our innovative approach to early childhood education.

Have specific questions about Start Early’s professional development offerings? Reach out directly to our team.

Stay Connected

Stay up to date on our latest professional learning opportunities, events and resources to strengthen your practice.

• Research article
• Open access
• Published: 09 January 2013

Effectiveness of home visiting programs on child outcomes: a systematic review

• Shelley Peacock 1 ,
• Stephanie Konrad 2 ,
• Erin Watson 3 ,
• Darren Nickel 4 &
• Nazeem Muhajarine 2 , 5  

BMC Public Health volume  13 , Article number:  17 ( 2013 ) Cite this article

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35 Altmetric

Metrics details

The effectiveness of paraprofessional home-visitations on improving the circumstances of disadvantaged families is unclear. The purpose of this paper is to systematically review the effectiveness of paraprofessional home-visiting programs on developmental and health outcomes of young children from disadvantaged families.

A comprehensive search of electronic databases (e.g., CINAHL PLUS, Cochrane, EMBASE, MEDLINE) from 1990 through May 2012 was supplemented by reference lists to search for relevant studies. Through the use of reliable tools, studies were assessed in duplicate. English language studies of paraprofessional home-visiting programs assessing specific outcomes for children (0-6 years) from disadvantaged families were eligible for inclusion in the review. Data extraction included the characteristics of the participants, intervention, outcomes and quality of the studies.

Studies that scored 13 or greater out of a total of 15 on the validity tool ( n  = 21) are the focus of this review. All studies are randomized controlled trials and most were conducted in the United States. Significant improvements to the development and health of young children as a result of a home-visiting program are noted for particular groups. These include: (a) prevention of child abuse in some cases, particularly when the intervention is initiated prenatally; (b) developmental benefits in relation to cognition and problem behaviours, and less consistently with language skills; and (c) reduced incidence of low birth weights and health problems in older children, and increased incidence of appropriate weight gain in early childhood. However, overall home-visiting programs are limited in improving the lives of socially high-risk children who live in disadvantaged families.

Conclusions

Home visitation by paraprofessionals is an intervention that holds promise for socially high-risk families with young children. Initiating the intervention prenatally and increasing the number of visits improves development and health outcomes for particular groups of children. Future studies should consider what dose of the intervention is most beneficial and address retention issues.

Peer Review reports

Caring for infants and young children can be challenging for many parents; it can be further complicated when families are poor, lack social support, or have addiction problems [ 1 ]. Home visiting (HV) programs attempt to address the needs of these at-risk families with young children by offering services and support that they might not otherwise access. Home visiting programs have been in existence now for more than 20 years [ 2 ]. The benefit of HV programs is that the service is brought to socially isolated or disadvantaged families in their own homes and as such, may increase their sense of control and comfort, allowing them to get the most benefit from services offered. Also offering the programs in the home environment allows home visitors to provide a more tailored approach to service delivery [ 2 , 3 ].

HV programs, however, have difficulties to overcome in order to deliver services. Target families may not accept enrolment into a program or when they do agree may later elect not to begin the program [ 3 ]. Some possible explanations for this include the facts that home visitors may be viewed as intruding or because families may find it difficult to open their homes to home visitors. Achieving consistency in program delivery can also be difficult; families may not receive the planned number of visits, and visitors may not deliver the content according to the program model [ 3 ]. Despite these challenges, the benefits of HV programs outweigh the limitations. To achieve the aims of HV programs it is important that they be shaped by the community and families they serve and that their outcomes be evaluated routinely as part of program improvement.

There are a number of systematic reviews and meta-analyses that explore the effectiveness of HV programs with disadvantaged families [ 4 – 7 ], many of which focus on the prevention of child maltreatment [ 8 – 10 ]. We were not able to locate a systematic review that focused on the delivery of HV programs by paraprofessionals and the effect this method of service delivery has on children’s developmental and health outcomes, so we decided to conduct one to fill this gap in the literature. This work is important to policy-makers and program planners in that these types of programs may be desirable in regions where the higher costs associated with nurse-led HV interventions mean that they are not a feasible option.

The research question for this systematic review was: What is the effectiveness of paraprofessional HV programs in producing positive developmental and health outcomes in children from birth to six years of age living in socially high-risk families? For the purposes of this review, a paraprofessional is an individual delivering an HV program whose credentials do not include clinical training (e.g., developmental psychologist, etc.) and who is not licensed. Socially high-risk families are those who live in poor economic circumstances, receive government assistance or who have inadequate income to meet the needs of the family. We chose broad outcome measures to make the review wide-ranging. These definitions are reflective of the types of programs, families, and research being done with HV programs across North America and elsewhere.

Literature search strategies

An experienced health sciences librarian searched the CINAHL PLUS, Cochrane Library, ProQuest Dissertations and Theses, EMBASE, MEDLINE, PSYCINFO and Sociological Abstracts databases. Weekly alerts from all databases except Cochrane Library were set up to allow inclusion of newly published articles. Where possible, results were limited to the English language with a publication date of 1990 or later (up to May 2012).

Assessment of studies using relevance and validity tools

The tools utilized for assessing the relevance and quality of the studies were based on previously developed tools [ 11 , 12 ]. Article titles and abstracts, when available, were screened by one reviewer to determine whether they might meet eligibility criteria: 1) publication date on or after 1990; 2) written in English; 3) involving an evaluation of an HV program delivered by paraprofessionals; 4) study population of mothers and/or children (0-6) from socially high-risk families; 5) including one of the following outcomes: birth, perinatal, developmental, health and/or risk for occurrences of child abuse/neglect; and 6) incorporation of a control group, pretest/post-test design or quasi-experimental design. A principal reviewer assessed all the papers, and one of two secondary reviewers independently evaluated their relevance, with a third to adjudicate if needed. When necessary, we contacted researchers to clarify components of their research.

Relevant articles were then evaluated to determine the research quality using a validity tool with five items with scores ranging from 0-3, for a total maximum quality score of 15. The tool assessed studies based on how well they addressed potential biases, through assessment of the: (a) design/allocation to intervention (e.g., random assignment {3}, matched cohort {1}); (b) attrition of complete sample (e.g., <17% {3}, >33% {0}); (c) control of confounders (e.g., controlled through RCT design {3}, no evidence of controlling {1}); (d) measurement tools (e.g., well-described/pre-tested tools and blinded data assessors {3}, lack of pretesting and blinding {1}); and (e) type and appropriateness of statistical analysis (e.g., multivariate analysis {3}, descriptive analysis {1}). Two reviewers independently assessed the quality and discussed articles to reach consensus when discrepancies occurred.

Data extraction

We performed data extraction on high-quality studies (i.e., those scoring 13 or greater out of a possible 15), using these categories: (a) study design; (b) purpose or problem; (c) sample details; (d) intervention frequency, duration and provider; (e) instrument(s)/measures utilized; and (f) results and implications of the study. This process was done independently by three reviewers, consulting with each other when necessary.

Data synthesis

We used descriptive synthesis to summarize the characteristics of the participants, intervention, outcomes, and quality of the included studies, based on data extracted. Due to the diversity of the outcomes included in the studies, varying types of statistical analysis conducted, and measures of associations reported, calculation of overall summary estimates (i.e., meta-analysis) was not possible. An alpha level of 0.05 was considered statistically significant for the purposes of this review.

Results and discussion

Literature search.

By using broad search criteria (in order to locate as many potential articles as possible) we identified 2939 records through database searches, which were reduced to 2088 records after duplicates were removed. We found an additional 18 articles by searching the reference lists of all potentially relevant studies. Email alerts resulted in a review of an additional 145 articles, resulting in a total of 2233 articles reviewed. Please see Table  1 that contains a sample of the initial search strategy employed.

Relevance and validity tool assessment

Of the 2233 studies, 809 were excluded by title alone, with an additional 1265 studies excluded following review of their abstracts. A second reviewer randomly selected 10 articles and independently performed the same screening process, reaching the same decisions on exclusion in all 10 cases. Screening and assessing abstracts of studies for relevance to the review yielded 159 potentially relevant articles. One study was no longer accessible, and therefore 158 were assessed with the relevance tool, yielding 71 relevant studies. Inter-rater reliability (kappa) ranged from 0.739 to 0.861 for the reviewing dyads. We applied the validity tool to these 71 studies, with an inter-rater reliability of 0.979, measured via the intra-class correlation. Studies with a score of 13 or higher out of a possible 15 ( n  = 21) were deemed to be of high quality and included in the data extraction (see Figure  1 ).

Summary of selection process.

All studies retained in this review were randomized controlled trials with sample sizes ranging from 52-1297 participants; attrition was less than 24%, and most incorporated multivariate statistical analysis (e.g., analysis of co-variance, multiple regression analysis, or complier average causal effect). Four studies did not pilot test the measures, use well-described tools and/or blind data collectors. Most studies were conducted in the United States ( n  = 15). The relevant outcomes measured were: (a) child abuse and neglect ( n  = 6); (b) developmental delays ( n  = 11); and (c) health assessment ( n  = 10). For each outcome, we report whether the HV intervention had a demonstrable impact. Unless stated otherwise, all control group participants received the usual services offered in their community. Multiple relevant articles arose from the same projects, such as the Healthy Start Program (HSP) and Healthy Families Alaska/New York (see Table  2 for trial characteristics); for sake of clarity these articles are considered individually.

Child abuse and neglect

Child abuse and neglect was often measured using reports recorded with Child Protective Services (CPS) and/or self-reported behaviours of mothers. All of the studies focused on families deemed at-risk for child abuse. Please see Table  3 for a summary of the outcomes of the studies that assessed child abuse and neglect.

Barth [ 14 ] evaluated the Child-Parent Enrichment Project for its impact on preventing perinatal child abuse; pregnant women received, on average, 11 home visits over a 6 month period. In general, self-reported measures did not reveal significant differences in the prevention of child abuse between the intervention and control groups. Self-reported measures and lack of blinding of the assessors were seen as methodological weaknesses of this study.

Bugental and colleagues [ 16 ] assessed the effectiveness of two types of HV interventions compared to a control group. One intervention group received a program based on the Healthy Start model (called the unenhanced group) while the second group received HV with a cognitive change component (the enhanced group). Child abuse was measured on the basis of harsh parenting style using the self-report Conflict Tactics Scale. Bugental and colleagues [ 16 ] found that the enhanced intervention group had less frequent harsh parenting compared to the unenhanced or control groups ( p  = 0.05). As well, the enhanced group mothers were significantly less likely to physically abuse ( p  < 0.05) and least likely to spank/slap their children ( p  < 0.05) compared to the unenhanced or control groups. These findings suggest that enhanced programming (i.e., HV with a cognitive change component) can effectively reduce the frequency and occurrence of harsh parenting among at-risk families. On the other hand, Barth [ 14 ] questions the efficacy of paraprofessional services in preventing abuse and neglect in high-risk families because participants in the Child-Parent Enrichment Program experienced no improvement in prevention of abuse.

Duggan, Berlin, Cassidy, Burrell, and Tandon [ 21 ] undertook an evaluation of Healthy Families Alaska (HFA), assessing reports on child abuse or maltreatment measured by the number of protective service reports filed. Levels of depression/anxiety and maternal attachment were considered moderators of the impact of HV intervention on child welfare. Among non-depressed mothers with moderate to high anxiety, HV was associated with decreased rates of substantiated child maltreatment ( p < 0.05). Among mothers who were not depressed, but had high discomfort with trust/dependence, HV was actually associated with increased rates of substantiated child maltreatment. Thus, benefits of this HV intervention seemed to be limited to certain subsets of at-risk mothers where a number of complex factors were at play. Studies by Duggan, Fuddy and colleagues [ 19 ] and Duggan, McFarlane and colleagues [ 20 ] of the HSP found that there is little impact from paraprofessional services in preventing child abuse and neglect in high-risk families. The researchers surmise that it may be that home visitors are inadequately trained to work with such complex high-risk families, as they were unable to identify family risks and did not provide professional referrals. All the above mentioned studies incorporated large sample sizes, blinded assessors, utilized multiple tools, and ensured study power to detect differences, which can lend credence to the findings.

DuMont and colleagues [ 22 ] assessed Healthy Families New York (HFNY) for the program’s effect on child abuse and neglect, as measured by review of CPS records and self-report of mothers over a two-year period. The researchers indicated that no program effects were noted for the sample as a whole, but that differences were detected between subgroups. By the second year of the intervention, the prevention sub-group (first-time mothers less than 19 years old admitted to the study at less than 30 weeks gestation) was less likely to report engaging in minor physical aggression (over the previous year; p  = 0.02) and harsh parenting behaviours (within the previous week; p  = 0.02) than was the control group. The “psychologically vulnerable subgroup” (women who were less likely to be first-time mothers, were older, and had a higher rate of prior substantiated CPS reports) were less likely to report acts of serious abuse or neglect compared to the control group at year two ( p  < 0.05). The frequency of these acts was also significantly less than among the control group. DuMont and colleagues [ 22 ] suggest that intervening with specific groups of pregnant women can prevent child abuse before it has an opportunity to occur; however, unlike HFNY, assignment of intervention prenatally is not always considered in other large Healthy Families America HV programs.

Developmental delays

A total of 11 studies, one of which was a thesis, measured impacts related to developmental outcomes of children less than six years of age. Specific developmental outcomes included: (a) psychomotor and cognitive development; (b) child behaviour; and (c) language development. Please see Table  4 for the summary of outcomes for the 11 studies that assess developmental outcomes.

Psychomotor and cognitive development

Over half of the studies ( n  = 6) utilized some version of the Bayley Scales of Infant Development (BSID) to assess psychomotor and cognitive development. Black, Dubowitz, Hutcheson, Berenson-Howards, and Starr [ 15 ] undertook a study of an HV program that included weekly visits over a one-year period, conducting analysis on groups of children stratified by age (those < 12 months old and those 12-24 months old). After the 12-month study period, all of the children in the study showed a significant decline in cognitive development overall. However, younger children experienced significantly less decline ( p  = 0.02) compared to age-matched control group children. Differences among the older children were not significant, suggesting that parents of infants may be more receptive to the benefits of an HV intervention compared to parents of toddlers, whose children are undergoing more complex developmental stages. It is important to note that this study may be limited in its generalizability due to the predominantly African American, single mother sample.

The HFAK program was evaluated over a two-year period by Caldera and colleagues [ 17 ] on developmental, behavioural and child health outcomes. The researchers found that 18 months after recruitment, children in the intervention group were significantly more likely to score within the normal range on the BSID (mental development index) than control children ( p  < 0.05). The researchers cautioned that families with a low risk for child abuse may be the only to benefit from this program.

Grantham-McGregor, Powell, Walker and Himes [ 23 ] assessed effects of nutritional supplementation and psychosocial stimulation (conducted by home visitors) over a two year period with stunted 9 – 24 month old children in Jamaica. Only those findings relating to stimulation (alone and in combination) will be discussed here, as supplementation falls outside the scope of this review. Mothers and children assigned to the stimulation group participated in weekly play sessions led by the community health aides; these sessions were designed to promote the children’s development. The measures of development in this study were based on the Griffiths Mental Development Scales, including four subscales: locomotor, hand-eye coordination, hearing and speech, and performance. The researchers found statistically significant improvements in the first 12 months of the study for the stimulated group in regards to developmental quotient and the subscales of locomotor, hand-eye coordination and performance compared to the control group children (all p  < 0.01).

Further, over the whole two years of the study [ 23 ] significant results continued for stimulated children with respect to developmental quotient and all the subscales ( p  < 0.01). Multiple regression analyses of the final developmental quotient scores revealed that the group of children who received both supplementation and stimulation improved significantly more than the stimulated group ( p  < 0.05). The findings suggest that small improvements in mental development can be seen in stunted children who receive a stimulation intervention alone, however, greater benefits are seen when nutritional supplementation is added to the HV intervention. This study does have two limitations: a small sample size, and the use of a developmental tool which was not standardized for use with the local population.

Hamadani, Huda, Khatun, and Grantham-McGregor [ 24 ] conducted a study of developmental outcomes of Bangladeshi children. They measured developmental assessment using the BSID (revised version) before and after 12 months of an HV intervention. Benefits of the intervention on motor development were not significant. They found intervention effects on the mental development index of the BSID ( p  < 0.01), and further, the data were analyzed for children deemed undernourished compared to control group children. Children in the intervention group that were undernourished remained similar to the better-nourished children with respect to mental development on the BSID, but lagged behind on psychomotor development. This study, similar to Grantham-McGregor and colleagues [ 23 ], highlights the interacting or moderating effects of nutrition and its impact on overall child development.

Johnson, Howell and Molloy [ 25 ] assessed psychomotor and cognitive development using games with one-year-old children in Ireland; the intervention group received a home visit once a month. Mothers were asked how often they played either cognitive (e.g., hide and seek) or motor (e.g., playing with a ball) games with their child and this number was recorded with each game played receiving a score. The number of games was totaled with a higher score indicating children were assessed as more developmentally stimulated. Children in the intervention group were significantly more developmentally stimulated with cognitive games compared to the control group ( p  < 0.01); motor development was not significantly different between groups. A note of caution with these findings is the fact that game playing was used as a means to assess developmental outcomes rather than using a standardized tool.

Nair, Schuler, Black, Kettinger and Harrington [ 31 ] compared the psychomotor and cognitive development of 18-month olds with a similar population of substance-abusing mothers. Using the BSID, children in the intervention group who received weekly visits for the first six months of life and then bi-weekly visits up to 24 months had significantly higher scores on the psychomotor developmental index at six months of age ( p  = 0.041) and at 18 months ( p  = 0.01) compared to the control group. The home visits were intended to enhance the mother’s communication with her infant. The researchers suggested there is benefit to using early intervention to improve high-risk children’s psychomotor and mental development.

Child behaviour

Caldera and colleagues [ 17 ] also assessed children for behavioural outcomes, finding that children in the HFAK program scored more favourably on the internalizing scale ( p  < 0.01) and also on the externalizing scale ( p  < 0.01) of the Child Behavior Checklist compared to control group children. The results from this study show that HFAK was able to reduce problem behaviours in young children, to a degree; other factors related to child behaviours (e.g., maternal depression or partner violence) were not influenced by the HFAK program.

Hamadani and colleagues [ 24 ] assessed child behaviour during testing using five 9-point scales. The researchers noted treatment effects for response to the examiner ( p  = 0.01), cooperation with test procedures ( p  = 0.005), emotional tone ( p  = 0.03) and vocalizations ( p  = 0.005); no treatment effect was noted for infant’s activity. This suggests that during testing children in the intervention group benefited in that they were more likely to be willing to engage with the examiner and were more vocal compared to the control group children. It is unclear what the usefulness of these five scales implies on aspects of child behaviour outside of the testing situation within the study.

Language development

Five studies considered findings with respect to language development. Black and colleagues [ 15 ] used the Receptive/Expressive Emergent Language Scale to assess differences in language development between the younger and older groups of children in their study. Both the younger and older children intervention groups experienced significantly less of a decline ( p  = 0.05) in receptive and expressive language compared to their age-matched control groups.

The study by Necoechea [ 32 ] assessed language of three- to four-year-old children using the Peabody Picture Vocabulary Test, Expressive One-word Picture Vocabulary Test-revised, and the Developing Skills Checklist. Testing was done prior to initiation of the Home Instruction for Parents of Preschool Youngsters program, and at the end of the 15-week intervention. Positive treatment effects were noted for the expressive language skills of children ( p  < 0.01) in the intervention group, but no treatment effect was detected for receptive language skills or emergent literacy skills for those same children. The author noted that results should be viewed with caution, as there was substantial variation in the implementation of the intervention, such as number of visits and quality.

Health assessment

Measures assessed included (a) physical growth; (b) number of hospitalizations, illnesses, or injuries; and (c) up-to-date immunizations. Much of the data collected for these outcomes are from medical records. Ten of the included studies assessed health outcomes. Please see Table  5 for a summary of the health outcomes for each study.

Physical growth

Aracena and colleagues [ 13 ] assessed weight among the one year olds in their study and found no statistical difference between the intervention and control groups. The small sample size (n = 45 in each group) may account for part of this finding. Further, there are other factors to consider when assessing height and weight in young children that may not be amenable to a HV intervention (e.g., biological factors).

Black and colleagues [ 15 ] assessed both height and weight for the 12-month duration of their study. They found the HV intervention did not have an impact on children’s growth rates compared to the control group. Hamadani and colleagues [ 24 ] also found that the HV intervention they studied had no impact on improving weight or height for age, or weight for height. Unlike Black and colleagues, Hamadani and colleagues found all children experienced a deterioration in weight for height irrespective of which group they were in (nourished, undernourished, control or intervention). This may, in part, be indicative of the socioeconomic conditions in Bangladesh and the impacts such conditions have on quantities and sources of food.

The Lee and colleagues [ 28 ] study of the HFNY program is one of two studies with significant findings with respect to physical growth; they also included a measurement of low birth weight (i.e., < 2500 g). The earlier in pregnancy the intervention was initiated the lower the odds were of the mother having a low birth weight baby, indicating a dose–response relationship between HV and low birth weight. Compared to control group mothers, HFNY mothers who enrolled earlier than 30 weeks gestation (5.1% versus 9.8%; p  = 0.022), at 24 weeks (5.1% versus 11.3%; p  = 0.008), and at 16 weeks (3.6% versus 14.1%; p  = 0.008) had significantly fewer low birth weight babies. Further analyses supported a dose–response, with greater benefit conveyed to those families enrolling earlier in pregnancy (i.e., thus receiving seven or more visits) (2.7% versus 7.2%; OR = 0.30; p  = 0.079). In the Lee and colleagues study, African American women had the greatest reduction in numbers of low birth weight babies ( p  = 0.022) suggesting that aspects of the environment that African American mothers may find themselves are amenable to change and can result in healthier pregnancies.

Le Roux and colleagues [ 29 ] evaluated an HV program that focused on improving the nutrition of children less than 5 years of age (average age 18 months). Over the one-year-period of the study, 43% of young children in the intervention group showed an acceptable weight-for-age and faster catch up growth compared to 31% in the control group ( p  < 0.01). Appropriate weights at birth and weight gain into toddler years in children are important as this sets the stage for longer-term health benefits [ 29 ]. Findings of this study should be viewed with caution as there was potential for children in most need of supplementation to be steered toward the intervention group despite the intention to randomize participants.

Mclaughlin and colleagues’ [ 30 ] study was designed to assess if birth weight was improved when women were enrolled in an HV program prenatally that included a multi-disciplinary team with paraprofessional home visitors. When comparing the intervention group mothers to control group mothers, the researchers found no significant effect of the intervention in reducing the incidence of low birth weight babies. This finding is in contrast to Lee and colleagues’ findings with the HFNY program.

Number of hospitalizations, illnesses or injuries

Bugental and colleagues [ 16 ] investigated child health as an outcome of their enhanced HV program. As was mentioned previously, they assessed the effectiveness of two types of HV interventions (enhanced and unenhanced) compared to a control group. After completing a health interview with parents, a health score (i.e., frequency of illness, injuries, and feeding problems) was created for each child, where subscales were converted to z- scores and summed. Assessment completed at post-program revealed that the three groups were statistically different ( p  = 0.02), with the enhanced HV group receiving the highest level of benefit in improving child health outcomes (i.e., having the fewest health problems).

In a study conducted in Ireland assessing HV impact on children’s hospitalization outcomes, Johnson and colleagues [ 25 ] found no significant differences between the intervention and control group. They did report however, that children from the intervention group had significantly longer in-hospital stays (14 days) compared to the control group children (7 days; p  < 0.05); the researchers provide no explanation for such a peculiar finding. It would seem that this HV program failed to address aspects of various conditions that can lead to the hospitalization of children.

In a four-year follow-up study, Scheiwe, Hardy and Watt [ 33 ] report findings relevant to this review that are related to improvements in height and weight, general health, and number of dental caries after a seven-month HV intervention to improve feeding practices. Mothers from both the intervention and control groups reported whether their children had experienced any health problems within the last three months; children in the intervention group were less likely to have experienced any health problems compared to the control group children ( p  = 0.01). All other health-related outcomes were statistically not significant between groups. The researchers caution that the significant findings are hard to explain and are likely only chance findings.

Up-to-date immunizations

One study assessed children’s immunization rates. Johnson and colleagues [ 25 ] found that significantly more one-year-old children in the intervention group received three of the primary immunizations (these were not listed in the study) compared to the control group ( p  < 0.01). The results suggest that by empowering parents through an HV program, their children benefited both developmentally and by receiving timely immunizations.

In summary, significant improvements as a result of participating in an HV program are noted for particular parent–child groups. First, some children (e.g., those of psychologically vulnerable women) appear more likely to receive beneficial effects (i.e., protection from abuse and neglect) from an HV intervention, particularly when the intervention is initiated prenatally, than others. Second, HV is associated with developmental improvement and is particularly seen for cognition and problem behaviours, and somewhat less consistently for language skills. Third, in terms of health benefits, improvements are seen in birth weight and appropriate weight gain in early childhood (weight-for-age), fewer health problems, and timely immunizations in children. However, not all evaluated HV programs conclusively show beneficial effects on outcomes in socially high-risk children as evidenced by some studies included in this review.

Implications for practice and future research

On the basis of participating in an HV program, studies reporting no significant benefits are far more prevalent than studies reporting statistically significant benefits. Given the vulnerability of the population and the challenges socially high-risk families encounter, these results are not particularly surprising. The findings from this review tend to point out how difficult it is to change human behaviour, particularly for families that are part of challenging social conditions. While an HV program works to support individual families it can do little to change the context in which socially high-risk families often live.

This review highlights that HV program effectiveness is greatest when: (a) a higher dose of the intervention over a longer period of time is used; (b) mothers are approached prenatally; (c) paraprofessionals are trained adequately to meet the needs of the families they are serving; and (d) the program’s focus is on a particular issue rather than trying to remedy multiple problems. This review addresses the need to assess in detail what is the most beneficial dose of a home visiting intervention in order to produce intended outcomes. Lee and colleagues [ 29 ] demonstrated the association between increased number of visits and reduced odds of having a low birth weight baby. It appears that the earlier an HV program is introduced (ideally prenatally) and the more home visits there are (increased exposure to the intervention), the better the outcomes.

Bugental and colleagues [ 16 ] utilized three groups for comparison: two variants of HV programs and a control group. They demonstrated that by focusing the HV program to improve a particular issue, in their case prevention of child abuse, the outcomes improved. This supports the notion that an intervention is of greater benefit when it is targeted to specific needs of families rather than trying to make a large number of improvements. However, some of the included studies noted that the complexity of the family situation was too multifaceted to be addressed by the HV intervention [ 14 , 17 , 19 , 20 ]. Thus, we suggest that working with multiple risk families poses the question of where to begin ? Perhaps a future consideration might be to target families with fewer challenges in order to determine if they would be more likely to experience significant benefits from HV programming. Also, no one intervention can meet the needs of every family; it may be better to consider an HV intervention as one part of a bigger system of supports and services for socially at-risk families.

Many of the included studies did not indicate the duration of the home visit or how closely home visitors followed the program model [e.g., [ 14 – 18 , 21 , 22 , 24 , 25 ]. This has implications for determining the intensity of the intervention required to generate long-lasting benefits. Perhaps future studies could also assess not only the frequency but the length and quality of visits and how these variables influence intended outcomes of HV programs. More research is required that compares the HV intervention a family receives to the actual program model; in this way it would be possible to discover what does and does not work and for whom.

Given that the majority of studies of home visiting effectiveness have failed to demonstrate benefits, it is important to also consider why that might be the case. Two possible explanations are mentioned here. The first relates to training. Many of the HV programs focused on families with multiple risks (i.e., low income, low education, and substance abuse). These stressful family situations may be overwhelming for a paraprofessional to deal with effectively. It is important to note that all the included studies discussed the paraprofessionals’ training and that they were chosen based on the similarity of life circumstances to the families they were serving. Yet, while similarity of life circumstances may facilitate rapport and trust, it may not supplant the need for home visitors to have specific training to help families in crisis.

Another possible explanation involves duration of the program. For some families in difficult circumstances, their stories involve cyclical crises. Changing such stories may require not only the right resources at the right time, but having access to these over a long period of time; perhaps considerably longer than that which is planned for in standard programs. Both of these possibilities relate to the degree of accommodation of the program to the needs of the family. In order to examine these in research, it might be useful to conduct subgroup analyses, stratifying by level of training of home visitor, complexity of needs of family, and length of time in the program. Analysis of HV program effects for families with non-complex needs may provide greater understanding of the capacity of paraprofessional home visiting to effect change in families. If families with complex needs do not appear to benefit from these programs, then efforts to improve their effectiveness or new programs can be initiated and studied to ensure that these families are well served.

Overall, most studies utilized reliable measurement tools (e.g., some version of the BSID). This type of consistency aids in comparing outcomes of various studies. However, none of the included studies examined the impact of the quality of the relationship between the paraprofessional and the family. The potential benefit of this relationship is either not currently being measured or is not amenable to quantification. It is likely that a mixed-methods approach that includes qualitative data, such as interviews, focus groups with program personnel and families, or observations would provide a deeper understanding of how HV programs provide benefits for families.

All of the included studies used randomized controlled trials, generally believed to be the gold standard in study design. This is ideal in order to address issues of potential bias and to determine if the intervention truly had an impact or not. However, many of the studies did not clearly articulate how randomization was achieved, which may raise concern regarding selection bias. Further, almost half of the studies had one year or less of follow-up and evaluation. It may be beneficial to consider the long-term effects of HV programs later in childhood; only one study in the review was a follow-up study conducted four years after the HV intervention [ 33 ].

Retention of participants is also an issue that requires careful consideration. Almost half of the included studies ( n  = 10 [e.g., [ 14 , 16 , 17 , 19 – 22 , 27 , 30 , 31 ]) had attrition rates of more than 18% of the total sample. Of the studies where attrition was less an issue other factors may have influenced whether a family stayed in the HV program. For example, Hamadani and colleagues [ 24 ] included nutritional supplementation in addition to psychosocial stimulation for one group of children; other studies had weekly or bi-weekly visits as part of the intervention [e.g., [ 15 , 18 , 23 , 24 , 26 , 28 , 32 ]. Perhaps the frequency of visits and the addition of other incentives improve the likelihood of families remaining in an HV program. What challenges a family faces and why they leave a program are important to consider in order to strengthen HV programs to meet the needs of socially high-risk families.

The aim of this systematic review was to assess the state of the literature regarding the effectiveness of paraprofessional HV programs on child outcomes. The effects of HV programs on family members (e.g., mothers, fathers or siblings) of young children would be an interesting avenue of exploration for future reviews. Other focused systematic reviews could include examination of under-developed countries alone (including consideration of non-English studies), less complex family situations (e.g., those with low income only) or follow-up studies that go beyond six years of age of the study children.

Limitations

Overall, this review is limited by the articles retrieved. Other research in this area may have been completed, but was not accessed using standard and systematic literature search and retrieval methods utilized here. None of the researchers contacted provided any other work in progress. The findings of this review must be considered in light of the potential for publication bias, selective reporting within studies and methodological limitations found in the included studies; as well as, in the conduct of the review itself. However, the authors took considerable care to ensure the integrity of the review and to be unbiased in their assessment of the included studies through the use of standardized tools.

This systematic review begins to address a current gap in the research literature by evaluating the effectiveness of paraprofessional HV programs. While this systematic review has shown that HV programs that utilize paraprofessionals often do not have significant effects on disadvantaged families, it does show that young children in these programs show modest improvements in some circumstances. The included studies found that HV intervention programs were associated with decreases in harsh parenting, improved cognition and language development in young children, reductions in low birth weight, improved weight-for-age in young children, and reduction in child health problems. However, findings that were not statistically significant were much more common than significant ones. As discussed, addressing the dose of interventions, approaching women prenatally, focusing programs on improving specific outcomes, making sure paraprofessionals receive adequate training and support, and improving the retention of families all may improve the impacts of HV programs.

Abbreviations

Home visiting

Bayley scales of infant development

Healthy families Alaska

Healthy families New York

Healthy start program.

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Peacock, S., Konrad, S., Watson, E. et al. Effectiveness of home visiting programs on child outcomes: a systematic review. BMC Public Health 13 , 17 (2013). https://doi.org/10.1186/1471-2458-13-17

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DOI : https://doi.org/10.1186/1471-2458-13-17

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9 Ways to Focus Families on Child Development During Home Visits

Families receiving home visits from early intervention professionals may be facing many challenges. But no matter what issues are demanding their attention, it’s essential for rich parent–child interactions to continue—and for parents to stay in touch with their child’s developmental needs.

In today’s post, adapted from Developmental Parenting by Lori A. Roggman, Lisa K. Boyce, and Mark S. Innocenti, discover 9 ways home visitors can keep families focused on parenting their young children, even during challenging times. Equally useful for mothers, fathers, siblings, and anyone else who plays with or helps care for the child in the home, these strategies can be used to encourage everyone in the family to keep providing opportunities for the child to explore, communicate, and learn.

1. Make clear statements about the role of family members and how vital they are to a child’s development.

Examples of what to say:

• “Parents are a child’s most important teachers.”
• “You are an important teacher because you are the one who will be in her life the longest.”
• “You’ll be able to help him learn and develop now and when he’s in school, too.”

2. Observe and comment on aspects of the child’s behavior or development.

• “I notice he’s starting to put words together; he said, ‘Book mine.’”
• “She’s pretending her bucket is a chef’s hat.”
• “I see that your child is often asking you, ‘What’s that?’ She seems interested in learning lots of new words.”

3. Ask about what you don’t see during the visit.

• “How does he do at bedtime? What’s it like when he’s getting ready to go to bed?”
• “What toys does she especially enjoy playing with?’
• “When does he most want to be held?”
• “What do you usually do when you want to entertain her or calm her down?”

4. Offer parents information about development in the context of their children’s behavior.

• “Crying is his way of letting you know he wants something. It will get easier when he starts pointing and using words.”
• “See how she’s holding the marker? Kids usually do it like that before they can hold it like we do.”
• “You’re right; he’s saying more new words, which means he’ll put together two-word sentences soon!”

5. Offer child development materials for family members to read or use (when they are relevant or requested).

• “Would you like a chart of language development?”
• “Our program has extra drawing paper. Let me know if you’d like some.”
• “We could check out a puzzle from our toy library if you’d like to try it with her.”

6. Shift focus by asking how the family’s current situation and needs are affecting the child.

• “How is she affected by what has been happening with your family?”
• “Did you notice how he looked when you were talking about that? Do you think he might be worried, too?”
• “How has she been this week when these things have been going on? What do you think would help her feel more relaxed?”

7. For other family needs, ask about how they connect with resources for meeting those needs.

• “What have you done when this happened before? Where did you get help?”
• “Is there someone you know who could help you figure it out?”

8. Provide information about community resources for help with meeting family needs.

• “Here’s a list of places in town where you can go for that.”
• “Here’s a phone number for the food bank.”

9. Be clear about roles of different staff members regarding social services.

Example of what to say:

“Here’s the number to call our social services coordinator, who has a lot more information about this kind of thing.”

A home visit can be easily diverted from its developmental purpose by a parent’s needs or challenges. While it’s important to connect families with resources that can help, it’s just as important to keep the focus of developmental home visits on parent–child interactions. Use these 9 strategies during home visits to encourage family members to stay focused on parenting and child development. And for more guidance on encouraging warm, responsive, encouraging, and communicative parenting, see the book behind today’s blog post!

Developmental Parenting

A Guide for Early Childhood Practitioners By Lori A. Roggman, Ph.D., Lisa K. Boyce, Ph.D., & Mark S. Innocenti, Ph.D.

With this research-based and reader-friendly book, early childhood professionals will learn to put parents in charge of guiding their child’s development—resulting in strong parent-child bonds, healthy families, and improved school readiness.

Stay up to date on the latest posts, news, strategies, and more!

• Early Childhood
• Family Collaboration
• Early Intervention
• home visiting

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