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Early Home Visiting:

Explore the evolution, impact, and myths of home visiting programs to enhance parental capacity and child development, advocating for a systemic shift towards collaborative, community-centric services.

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Early Home Visiting:

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  1. Early Home Visiting: A Pathway to Change; Not the Destination Deborah Daro

  2. Main Points • Home visiting is a powerful strategy to improve parental capacity and a young child’s life trajectory. • Providing an effective level of support for all families within the current fiscal climate requires thinking beyond replicating models to building systems. • Multiple agencies and providers share responsibility for enhancing the parenting context.

  3. Why Do We Love Home Visiting? • High potential to reach new parents in a non-stigmatizing, supportive manner – most new parents recognize their vulnerabilities and will accept help. • Maximizes service access – the strategy meets families where the live and reaches all those that live there. • Allows us to model relationship building. • Provides a more complete picture of the child’s most immediate environment.

  4. How Did Home Visiting Rise to the Top? • Home Visiting 1.0 • The Program (1970’s – 1990) • Home Visiting 2.0 • The Model (1990-2000) • Home Visiting 3.0 • The Initiative (2000-2015)

  5. How Available is Home Visiting? • Home visiting is the most common strategy used to prevent child maltreatment and enhance parental capacity. • Early home visiting exists in all 50 states, DC and five territories – over 300,000 families received more than 3.8 million home visits in 2016 • An estimated additional 18 million pregnant women and families (23 million children) could benefit from home visiting – so we are serving perhaps 1% of those that could benefit.

  6. What Can Home Visiting Accomplish?

  7. Is Home Visiting Working? Initiated During Pregnancy/Birth • Better birth outcomes (if offered during pregnancy) • Enhanced parent-child interactions • Positive maternal life and health choices • More efficient use of health care and community services • Enhanced child development and early detection of developmental delays • Fewer substantiated cases of child abuse and neglect Toddlers • Early literacy skills • Social competence • Parent involvement in learning

  8. What are the most common myths? • Structured home visiting models are not sufficiently flexible to adjust to variations in a family’s needs and cultural realities. • Home visiting increases a family’s odds of being reported for child maltreatment. • We cannot afford to reach out to everyone – we should only offer help those families we think need our help.

  9. How can we make it work better? • Current system continues the myth that only some children and their parents need collective assistance. • Current system places primary emphasis on “fixing” parents rather than enriching communities. • Challenge:Linking the current fragmented systems of public and private, voluntary and mandatory into a coherent response that directs the most costly and intrusive of assistance to those who truly need them.

  10. Elements of an Effective System • Set expectations high. • Establish shared decision making rules and minimal standards for parent support across agencies and across populations. • Establish common workforce standards. • Share data and build around common outcomes and indicators. • Play the long game but identify short-term outcomes.

  11. Context Matters … for programs as well as people

  12. Supportive Normative Context Strong Service Referral System And Linkages Evidence- Based Models Supportive Organizational Culture

  13. Building Interpersonal Connections Offering direct assistance Provide respite care Offer emotional support Problem-solve Referring family to local resources Family Resource Centers Home visitation options Secure health care Referring to Child Protective Services Differential response systems Family preservation services Foster care Adoption Transitional Care Advocating for change Advocate for a given family Lobby policy makers Advocate with neighbors Sustains Individualism Moves Toward Interconnection

  14. Everyone can contribute … we need to help each other even if we don’t agree

  15. Why do we stay in our silos? • Perception that we lack common consensus. • Belief that life is a “zero sum” game. • Competition for limited funding and public recognition. • More comfortable “singing to the choir” and “staying in our tribe”. • It is often faster to do things yourself – coalition building is time consuming.

  16. Building Common Ground • Humility – enter all interactions recognizing what you don’t know; your information is not perfect. • Gentleness – put yourself in the other guy’s skin; what drives their point of view? • Patience – people don’t change their ideas after one conversation; how flexible are you?

  17. Modeling a Wise Community • Work together • Act out your values • Keep commitments • Act with humility • Stay within bounds • Open yourself to learning

  18. The Future InformalSupports Clinical Services UniversalAssessment at Birth &Re-assessment at Critical Stages of Development ComprehensiveHealthCare Family Resource Centers Income Support Tech Tools Private Home Visiting Responsive ChildWelfare System Dollars Safe Neighborhoods Data Analysis

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