HOME VISITING PARADIGM SHIFTJUSTIN M. PETKUS, MS, CFLE, CCLS

HOME VISITING ADMINISTRATIVE SUPERVISOR

HEAD START FOR KENT COUNTY

Connecting Research & Theory to Practice

OBJECTIVE

Ensure best practice principles are utilized in Head

Start for Kent County home visits in order to provide

children and families an enriched family life through

a strength based prevention, education, and

collaborative approach.

PURPOSE

Sec 1306.33 (1) “The purpose of the home visit is to help parents improve their parenting skills and to assist them in the use of the home as the child's primary learning environment. The home visitor must work with parents to help them provide learning opportunities that enhance their child's growth and development.”

Source: Head Start Program Performance Standards and Other RegulationsAdministration for Children & Families Administration on Children, Youth & FamiliesHead Start Bureau

PREVIOUS MODEL

1. Use of Self = Model

2. Primary Source of knowledge = Home Visitor

3. Main Focus = Home Visitor to Child

4. Toys = Every visit

5. Additional Family Members = Ignored

6. Visits = Home Visitor Agenda

7. Planning = Curriculum Needs

8. Methodology = Infant Mental Health/Family Case Management/Family Therapy

9. Monitoring= Non-evidence based subjective approach

NEW MODEL:

1. Use of Self = Observer. Home visitor acts as narrator of Parent-Child interaction.

2. Primary Source of Knowledge = Caregiver. Empowering primary caregiver. Building their confidence to “see” child’s progressing development.

3. Main Focus = School Readiness that is done through parent-child attachment.

4. Toys = None. Extend existing natural experiences.

5. Additional Family Members = Include in experiences.

6. Visits = Family planning/parents agenda

7. Planning = Ask questions to empower. Joint problem solving. Extended sustainable learning & demonstration of skill development.

8. Methodology = Family Life Education/Family Therapy /Family Case Management (Blended agency & community distribution)

9. Monitoring- Home Visitor Rating Scale (HOVRS)

Multidisciplinary Family Service

Approaches

Goal: How can the

agency as a whole

continue offering

services from the

middle to ensure

family needs are met,

without the home

visitor doing it all?

Why: To be

intentional in

the home

visiting role

and purpose,

operate within

our scope of

practice, and

to avoid burn

out.

Figure 2 © Myers-Walls, J., Ballard,

S., Darling, C., Myers-Bowman, K.

(2011). Reconceptualizing the

domain and boundaries of family

life education. Family Relations, 60:

357-372.

Intersection at HS4KC

Family Life Education (prevention

education and coaching): - Home Visitors

-Joint problem solving

- Collaborative planning approach.

- Parent demonstration of learned skills

- Family Systems Theory, sibling involvement.

- Adverting later problems, through empowering

self-sustainability.

- Parent education through focus on attachment.

- Parent Meetings

Family Therapy

(assessment/screening & diagnosis):-Mental Health Specialist consulting

- Special Needs Specialist consulting

-Referrals to Arbor Circle

-Edinburgh, prenatal & postnatal

-ASQ

- IDA (Home Visiting Advisor)

Family Case Management

(coordination of services): -Home visitor (case) meetings with LMSW, CFLE,

CCLS & Special Needs Specialist present

-Social Services Department Resources/FSW

-IFSP

Not Home Visitor

role

Let’s Identify Who is Doing Each Piece:

Home Visitor role

Not Home Visitor

role

© Myers-Walls, J., Ballard, S., Darling, C., Myers-Bowman, K. (2011).

Reconceptualizing the domain and boundaries of family life education. Family

Relations, 60: 357-372.

Multidisciplinary Family Service

Framework

In the past model,

the home visitor

was the primary

person operating in

each approach.

Essentially, the

home visitor was

attempting to

practice 3

disciplines at once.

Figure 1 © Myers-Walls, J., Ballard, S.,

Darling, C., Myers-Bowman, K. (2011).

Reconceptualizing the domain and

boundaries of family life education. Family

Relations, 60: 357-372.

Explaining to Families

“We want to help you identify your skills and creativity, and build your confidence to support you in being your child's first teacher.”

“We collaborate on finding what items and environments are already in your home that can be used for playing with your child, rather than bringing toys to you each week.”

“Your child is learning most when I leave your home and you continue to play and talk with her.”

“When at your home, you can expect me to observe as you play and talk with your child. I will provide explanation of how the play and words you use are supporting your child’s development.”

Red Flags of Ineffective Visits

Parents leave the room or go in & out during a

home visit.

Child races to greet home visitor and rummage thru

bag.

More time on family problems than on child

development.

Not much gets done when other family members

are there.

Parent says, “Oh, you are so good with children!”

Roggman, L.A., & Boyce, L.K., & Innocenti, M.S. (2008). Developmental parenting: A guide for early childhood practitioners. Baltimore: Paul H. Brookes Publishing.

STOP

STOP

STOP

STOP

STOP

Green Flags of Effective Visits

Parent and child interact during most of the visit.

Child exceedingly turns to the parent when you arrive, expecting fun together.

You comment on positive interactions you observe.

Other family members are involved in the activities.

Parent says, “We enjoy doing these things together.”

Roggman, L.A., & Boyce, L.K., & Innocenti, M.S. (2008). Developmental parenting: A guide for early childhood practitioners. Baltimore: Paul H. Brookes Publishing.

GO

GO

GO

GO

GO

Measuring Outcomes

New Measuring Tool: HOVRS (Home Visiting Rating Scale)

Purpose: Evidence based way to ensure deliverance of high quality

sustainable parenting skill development in home visits.

From the Authors:

“HOVRS emphasizes a developmental parenting support approach that respects each family’s strengths and culture. The HOVRS measures were developed with input from practitioners and supervisors in home visiting programs and rate aspects of home visiting quality that are supported by the research literature on various home visiting programs. HOVRS measures have been used to provide feedback to practitioners and supervisors for program improvement.”

*Roggman, L. A., Cook, G. A., Innocenti, M. S., Jump Norman, V. K., Christiansen, K., Boyce, L. K., Aikens, N., Boller, K., Paulsell, D., & Hallgren, K.

(2010). Home Visit Rating Scales -Adapted and Extended (HOVRSA+). Unpublished Measure.

Keys to Desired Outcomes

SCALE 1: HOME VISITOR RESPONSIVENESS TO FAMILY

This scale assesses the extent to which the home visitor is (1) prepared for the home visit, (2)

attempts to get needed information from the parent, (3) observes and responds to the parent

and child during the home visit, and (4) elicits input on the content and activities of the home

visit from the parent. A high rating on this scale suggests that the home visitor is frequently

engaging in responsive behaviors during the home visit.

SCALE 2: HOME VISITOR FAMILY RELATIONSHIP

This scale examines the nature of the relationship between the home visitor and the family, as

observed during the home visit It focuses on (1) warmth between the home visitor and parent,

(2) parent comfort with the home visitor, (3) positive interactions of the home visitor with the

child and other members of the family, and (4) the home visitor’s respect and understanding of

the family as a whole. A high rating on this scale suggests that the home visitor and family are

frequently engaging in warm, positive behaviors during the home visit.

*Roggman, L. A., Cook, G. A., Innocenti, M. S., Jump Norman, V. K., Christiansen, K., Boyce, L. K., Aikens, N., Boller, K., Paulsell, D., & Hallgren, K.

(2010). Home Visit Rating Scales -Adapted and Extended (HOVRSA+). Unpublished Measure.

Keys to Desired Outcomes

SCALE 3: HOME VISITOR FACILITATION OF PARENT CHILD INTERACTION

This scale assesses the effectiveness of the home visitor at facilitating and promoting positive

parent-child interactions during the home visit. It reflects how much the home visitor (1)

encourages the parent’s leadership when guiding parent-child interactions, (2) involves and

responds to both the parent and the child during interactions, and (3) uses materials available

in the home for promoting parent-child interactions. A high rating on this scale suggests that the

home visitor is frequently engaging in facilitative behaviors during the home visit.

SCALE 4: HOME VISITOR NON-INTRUSIVENESS/COLLABORATION WITH FAMILY

This scale focuses on the lack of intrusiveness by the home visitor on parent behavior and

parent-child interactions during the visit. It assesses (1) home visitor control and (2) home visitor

flexibility and responsiveness. A high rating on this scale suggests that the home visitor rarely

engages in intrusive behaviors during the home visit and that he or she uses effective strategies

to collaborate with the parent. A high rating on this scale means the home visitor is non-

intrusive in a manner that promotes collaboration with the parent as a partner in supporting

the child’s development.

*Roggman, L. A., Cook, G. A., Innocenti, M. S., Jump Norman, V. K., Christiansen, K., Boyce, L. K., Aikens, N., Boller, K., Paulsell, D., & Hallgren, K.

(2010). Home Visit Rating Scales -Adapted and Extended (HOVRSA+). Unpublished Measure.

Keys to Desired Outcomes

SCALE 5: PARENT-CHILD INTERACTION DURING HOME VISIT

This scale examines the nature of the parent-child relationship, as observed during the home

visit. It assesses (1) parent-child warmth and physical closeness, (2) parent attentiveness to the

child, (3) parent responsiveness to the child, and (4) parent-child joint attention. A high rating

on this scale suggests that the parent and child are frequently engaging in warm, positive

behaviors during the home visit.

SCALE 6: PARENT ENGAGEMENT DURING HOME VISIT

This scale examines the engagement of the parent and the activities of the home visit. It

focuses on (1) parent interest, (2) parent involvement and initiative, and (3) the parent’s

physical closeness to the home visitor and child. A high rating on this scale suggests that the

parent is frequently displaying behaviors that indicate interest and engagement in the home

visit activities and discussions.

SCALE 7: CHILD ENGAGEMENT DURING HOME VISIT

This scale focuses on the child’s engagement in the activities of the home visit. It focuses on (1)

child involvement and (2) child interest. A high rating on this scale suggests that the child is

frequently displaying behaviors that indicate engagement and interest in the home visit.

*Roggman, L. A., Cook, G. A., Innocenti, M. S., Jump Norman, V. K., Christiansen, K., Boyce, L. K., Aikens, N., Boller, K., Paulsell, D., & Hallgren,

K. (2010). Home Visit Rating Scales -Adapted and Extended (HOVRSA+). Unpublished Measure.

Resources

http://www.ncfr.org/cfle-certification/what-family-life-education

http://naturalenvironments.blogspot.com/

http://www.ksde.org/Portals/0/Early%20Childhood/Foundations%20for%

20School%20Success/FSSHomeVisitRatingScale.pdf

http://www.hellobee.com/2012/05/31/household-items-that-double-as-

toys-for-babies-toddlers/

https://www.ncfr.org/professional-resources/archived-webinars/domains-

family-practice-model-differentiating-roles-famil-0

“Go to the people. Live with them. Learn from them. Love them. Start with

what they know. Build with what they have. But with the best leaders, when

the work is done, the task accomplished, the people will say "We have

done this ourselves.'" -Lao Tzu

Previous Home Visiting Administrative Supervisor Contact:

Justin M. Petkus, MS, CFLE, CCLS

Child Life Specialist

Hamad Medical Corporation

Doha, Qatar

Email: Jpetkus@hamad.qa

+ 974-5006-7994

Home Visiting + Preschool = ONE

Birth to 5 Head Start for Kent County

© 2014 This presentation not to be distributed without the expressed written permission of the author and/or Head Start for Kent County

Current Home Visiting Administrative Supervisor Contact:

Michelle Cossar

2626 Walker Ave. NW

Walker, MI 49544

www.hs4kc.org

Email: mcossar@hs4kc.org

Desk 616-453-4145 ext. 2208