The Art and Practice of Home Visiting

Dr. Cook earned her doctorate degree with an emphasis on developmental psychology and two related master of arts degrees from the University of California at Los Angeles. She focused her interest on young children with special needs while serving as Director of the Early Childhood Center at Southern Illinois University at Edwardsville and the Child Development Center at Mount Saint Mary's College in Los Angeles. Daily involvement with families of children from highly diverse backgrounds convinced her of the importance of fully involving families in all aspects of their children's development. More than 25 years ago, Dr. Cook recognized the value of providing practical training based on evidence-based practices designed to facilitate inclusion of young children with special needs in natural environments. To this end, she initiated the publication of the coauthored Adapting Early Childhood Curricula for Young Children with Special Needs (Prentice Hall, 2007). This pioneering text is now in its 7th edition. In addition, she is a co-author of Strategies for Including Children with Special Needs in Early Childhood Settings (Thomson Delmar Learning, 2000). She has directed several federal training grants that provide tuition assistance to prepare students to work with young children with special needs both in their homes and in center-based programs. Dr. Cook consults widely and presents often in the areas of family-professional relationships and strategies for effective inclusion. While at Western Michigan University, Ms. Sparks spent a sabbatical year with the department of public health in Battle Creek, Michigan, doing home visits with public health nurses. More recently she was an adjunct faculty member in the Department of Early Childhood Education at Santa Clara University, Santa Clara, California. She received her Bachelor of Arts degree in speech pathology and audiology from the University of Iowa, her Master of Arts degree also in speech pathology and audiology from Tulane University, New Orleans, and completed all but her dissertation in the Ph.D. program in the School of Public Health at the University of Michigan, Ann Arbor. Ms. Sparks was a pioneer in early intervention, working with families, home visiting, and giving numerous presentations throughout the county. She has felt strongly that it is necessary to remain a practitioner in the field to experience real problems that early interventionists encounter. Until very recently, she served as a consultant to HOPE Homestart in San José, California, a home program for children with special needs between age 0 and 3. A fellow of the American Speech-Language-Hearing Association, Ms. Sparks has authored training modules and many articles and chapters on early intervention and the family in addition to a book on genetics in speech-language disorders and a book on the effects of prenatal substance abuse on speech and language.

About the Downloads
About the Authors
About the Contributor
Foreword
 By Kathy Wahl
From a Mother to Her Home Visitors
Preface
Acknowledgements
Section I
Chapter 1: An Overview of Home Visiting
Learning Outcomes
History of Home Visiting
 Eradication of Poverty by Changing Environmental Conditions
 Massive Arrival of Immigrants
 Rapid Transformation of Society
 Early Home Visitors
 Lessons from The Past
Home Visiting Today
 Competencies Needed
 Home Visitors as Coaches
 Remote Home Visiting
Philosophy and Approach to Home Visiting
 Approaches to Home Visiting
  Child Focused
  Family Focused
  Collaborative Team
Evidence-Based Practice
 Critical Needs Positively Impacted by Home Visiting
  Healthy Babies
  Safe Homes and Nurturing Relationships
  Optimal Early Learning and Long-Term Academic Achievement
  Self-Sufficient Parents
Cultural Influences
Summar
Read‐Reflect‐Discuss
Chapter 2: Collaborating with Families
Learning Outcomes
Family Reaction to Vulnerability and Crisis
 Increased Stress Levels
 Denial Can Be A Friend
Viewing the Family as a Whole
Understanding Familes as Systems
 Family Structure
 Cultural Orientation
 Individualism Vs Collectivism
 Family Dynamics
  Sensitive Responsiveness
  Family-Orchestrated Child Experiences
  Health and Safety
 Fathers
  Strategies to Engage Fathers
 Siblings
Family Functions
Strategies to Facilitate Family Empowerment
 Developing Empathy
 Achieving Empathy
 Asking Questions
 Listening Attentively and With Reflection
 Avoid Jargon
 Phrase Negative Information Carefully
 Respecting Family Preferences
 Preparing Families for Change
 Focusing on Strengths, Achievements and Desires
 Identifying Strategies That Will Help Families Achieve Desired Outcomes
Summary
Read‐Reflect‐Discuss
Section II
Chapter 3: Building Home Visitor:Family Relationships
Learning Outcomes
First Impressions
 Personal Characteristics of The Home Visitor
 Emotional Needs of Both Families and Home Visitors
The Initial Visit
 Greeting
 Hand Cleansing
 Act Like You Are A Guest in The Home
 Blending Cultures
 Getting Down to Business
 Connecting with Siblings
Other Home Visitor Behaviors That Build Relationships
 Be Reliable
 Abandon Your Agenda
 Observe Yourself
Developing A Plan of Intervention with The Family
 Identifying the Family’s Most Important Concerns
 Explain and Summarize All Assessment Results
  Summarize and Prioritize
Assisting the Family with Implementation of The Plan
 Information and Services
  On-Line Information
  Resource Supports
  Social Supports
Summary
Read‐Reflect‐Discuss
Chapter 4: Facilitating Parent‐Child Relationships
Learning Outcomes
The Caregiver‐Infant Relationship
 Relationship Terminology
Types of Attachment
 Secure Attachment
 Ambivalent Attachment
 Avoidant Attachment
 Disorganized Attachment
 Interference with Attachment—Parents
 Interference with Attachment—Infants
Parent‐Infant Interactions
 Infant Communication Signals
  Eye Gaze
  Joint Attention
  Gestures
  Reciprocity
Interactional Patterns of Children with Unique Needs
 What to Consider When Encouraging Caregiver‐Infant Attachment
 Adult‐Adult Dyadic Interactions
 Intervention When Caregiver‐Infant Interaction Signals Are Unique
The Infant Mental Health Model (IMH)
 Carefully Observe the Evidence of Attachment Behaviors
 Establishing Interaction Through Reciprocity
  Serve and Return
  Establishing Attachment Through Feeding
  Establishing Attachment Through Play
Intervention in A Cultural Context
Reflecting on Success as A Home Visitor
 Green Flags of Effective Visits
 Red Flags of Ineffective Visits
Summary
Read‐Reflect‐Discuss
Chapter 5: Structure of Home Visitations
Learning Outcomes
Before Home Visiting Begins
 Assessment for Program Planning and Monitoring
  Formal Assessment
  Informal Assessment
 Factors to Be Considered in Interpretation of Assessment
Home Visiting Activities
 Format of Home Visits
  Upon Arrival
  What's New?
  Today's Activities
  Where to Begin?
  Toy Bag or Not?
  Reflect and Plan for The Next Visit
  What's Coming Up?
  Anything Else?
  Good‐Bye
 Elements of A Home Visit
  Upon Arrival
  What's New?
  Today's Activities
  Where to Begin?
  Toy Bag or Not?
  Reflect and Plan for The Next Visit
  What's Coming Up?
  Anything Else?
  Good‐Bye
Approaches to Intervention
 Home Visitor Direct Approach
  Unique Role of Modeling
 The Eight Steps of Modeling
  Applied Behavior Analysis (Aba)
  Naturalistic Developmental Behavioral Intervention (NDBI)
 Home Visitor Indirect Approach
  Family‐Guided Routine Based Intervention
 Points to Keep in Mind
 Problems to Avoid
 Direct Vs Indirect Approaches
 Home Visitors as Coaches
 Parents as Interventionists
Summary
Read‐Reflect‐Discuss
Section III
Chapter 6: Specific Family Challenges
Learning Outcomes
Adverse Childhood Experiences
 Trauma Informed Care and the 2020 Pandemic
 Role of the Home Visitor
 Potential Resources
Parents with Mental Health Challenges
 Role of the Home Visitor
 Potential Resources
Parents with Cognitive Disabilities
 Role of the Home Visitor
 Potential Resources
Teenage Parents
 Role of the Home Visitor
 Potential Resources
Foster and Adoptive Parents
 Role of the Home Visitor
 Potential Resources
Grandparents In The Role Of Parents
 Role of the Home Visitor
 Potential Resources
Military Families
 Military Families are Resilient
 Military Family Separations are Difficult and Complicated
 Most Military Parents Were Not Military Children
 Change is Constant
 Peers can Pave the Way for Service Members
 Military Lingo
 Not Everyone in Uniform has Access to the Same Programs
 Role of the Home Visitor
 Potential Resources
Poverty
 Homelessness
 Role of the Home Visitor
 Potential Resources
Immigrant And Refugee Families
 Avoiding Communication/Cultural Barriers with Effective Interpreters/Translators
 Role of the Home Visitor
 Potential Resources
Summary
Read‐Reflect‐Discuss
Chapter 7: Responding to Children's Challenges
Learning Outcomes
Primary and Secondary Conditions
Daily Challenges
Feeding
 Oral‐Motor‐Skill Deficits
 Feeding within the Cultural Context
 Children with Gastroesophageal Reflux Disorder
 Children on Gastrostomy Tubes
 Need for a Feeding Specialist
 Role of the Home Visitor
  Structure
  Social Modeling
  Behavioral Treatment
  Make Foods Manageable
  Encourage Children to Use Their Cognitive Skills
 Potential Resources
Sleeping
 Sleep Routines within the Cultural Context
 Need for Concern about Sleep Disturbances
 Signs of Possible Problems with Sleep
 Role of the Home Visitor
  Establishing a Consistent Bedtime Routine
 Potential Resources
Speech and Language Challenges
 Characteristics of a Possible Language Disorder
 Characteristics of a Possible Articulation Disorder
 Characteristics of a Possible Fluency Disorder
 Role of the Home Visitor
  Imitation
  Taking Turns
  Shared Regard
  Play Games
 Potential Resources
Hearing Challenges
 Types of Hearing Loss
 Role of the Home Visitor
Medically Fragile
 Staying Healthy
 Multiple Challenges
 Role of the Home Visitor
 Potential Resources
Visual Challenges
 Self‐stimulating Behaviors
 Language Development with Children with Visual Challenges
 Role of the Home Visitor
 Potential Resources
Summary
Read‐Reflect‐Discuss
Chapter 8: Enduring Challenges With Carole Osselear
Learning Outcomes
Common Enduring Challenges
Motor Challenges
 Role of the Home Visitor
 Potential Resources
Developmental Challenges
 Cultural Differences in Developmental Challenges
 Down Syndrome
 Pointers for Working with Children with Down Syndrome
 Role of the Home Visitor
Autism Spectrum Disorders
 The Autism Spectrum
  Facilitating a Diagnosis
  Responding When Parents Suspect ASD
  Responding When Parents Look for Answers
 Role of the Home Visitor
 Potential Resources
Fetal Alcohol Spectrum Disorder
 Diagnosis
 Symptoms of FASD are Variable
  Intervention Concepts
 Role of the Home Visitor
 Potential Resources
Summary
Read‐Reflect‐Discuss
Chapter 9: Personal Concerns of the Home Visitor
Learning Outcomes
Ethical Issues
 Confidentiality
 Boundaries
 Cross-cultural Conflicts
Agency Guidelines
 Home Visitor—Agency or Legal Issues
Boundaries in Family Service
Noncooperative Families
 Making Compromises
 Discontinuing Visits
Personal Safety
Nurturing the Nurturer
Personal Organization
Summary
Read‐Reflect‐Discuss
References
Appendixes
 Appendix A: Infant Development from Birth to 3 Years — Heads Up
 Appendix B: Infant Development from Birth to 3 Years — The Crawler-Creeper
 Appendix C: Infant Development from Birth to 3 Years — The Cruiser
 Appendix D: Infant Development from Birth to 3 Years — The Walker
 Appendix E: Infant Development from Birth to 3 Years — The Doer
 Appendix F: Infant Development from Birth to 3 Years — The Tester
 Appendix G: Speech and Language Development of Infants and Young Children
 Appendix H: Home Visit Record Form
 Appendix I: Toys Cleverly Disguised as Household Items
 Appendix J: Guidelines for Referral: Red Flags
 Appendix K: Suggested Resources (by Subject)
Glossary
Index