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Home Visiting: The keys to making it work!

Home Visiting: The keys to making it work!. Amy W. Piper, MS-CCC/SLP Project Coordinator-ITSI August 25, 2010. The home is the primary location for Early Intervention services. You want to make it work for yourself, the child, and the caregiver. Home visiting doesn’t always go smoothly.

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Home Visiting: The keys to making it work!

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  1. Home Visiting: The keys to making it work! Amy W. Piper, MS-CCC/SLP Project Coordinator-ITSI August 25, 2010

  2. The home is the primary location for Early Intervention services.

  3. You want to make it work for yourself, the child, and the caregiver.

  4. Home visiting doesn’t always go smoothly.

  5. You should feel confident in providing home visits that benefit the child and the caregiver.

  6. Personal Reflection #2 • How does home visiting benefit the CHILD? • ______________________________________________________________________________________________ • How does home visiting benefit the FAMILY? • ______________________________________________________________________________________________ • How does home visiting benefit the PROVIDER? • ______________________________________________________________________________________________

  7. Discover the keys to making home visits work!

  8. Build a relationship with the caregiver.

  9. How Families Work • Ecological Systems Theory – Bronfenbrenner (1979) • Family Systems Theory – Minuchin (1984) • Stressors for the Family - Brazelton

  10. How Families WorkMaslow’s Hierarchy of Need (1954)

  11. The Parent-Provider Relationship • Expectations • Establish & Maintain Boundaries • Building on strengths • Sharing one’s own family life • Reciprocal, positive feelings

  12. Talking with Parents • Be positive • Work as partners • Be flexible • Be a good observer • Listen actively • Begin where the parent is • Ask leading questions • Make comments thoughtfully • Answer personal questions

  13. Things to keep in mind

  14. Small Group ActivityCommon Professional Dilemnas

  15. Put together a quality home visit

  16. Essential Qualities of a Home Visitor • Empathy • Respect • Perseverance & Resilience • Passion for learning that leads to growth

  17. Whole group activityBeing a professional home visitor

  18. Critical Components of Home Visiting • Occurs within the context of family’s routines • Promotes child engagement & builds family’s capacity to implement • Ensure caregiver engagement in home visiting • Supporting caregiver confidence & competence in their use of intervention strategies

  19. Effective Home Visit Approaches • Individualizing across families • Respect & rapport • Active listening & Empathic support • Observation & descriptive affirmation • Modeling • Developmental information/expectation • Developmental interpretation

  20. Effective Home Visit Approaches (cont.) • Suggestion within context • Questioning • Problem solving • Promoting active participation • Comfort with silence • Streams of interaction: Balancing & initiating

  21. Preparing for a Home Visit • Review the needs and ideas that came up during the last home visit • Review the lesson plan, challenges, & report from last visit • Make sure any follow-up tasks have been done • Review goals/Note progress • Think about characteristics/style of child & parent • Evaluate the current approach/plan • Decide next step to be taken • Write the plan for the home visit • Study and practice materials to be taught • Gather and prepare materials for the visit

  22. Handle the Challenges

  23. Reasons Families Resist • No reason to be there • Resentment at 3rd party referrals • Awkwardness, wanting to be a good client • May like to rebel • Goals are different • Previous bad experiences • Degree of change not agreed on • Needing help means failure • Feels help is being forced on them • Feels techniques are imposed • Needs personal power • Testing provider support or competence • May dislike the helper

  24. At Risk FamiliesKey Risk Factors • Poverty • Ineffective parenting • Inadequate home learning ecologies • Illiteracy • Poor health care • Malnutrition • Lack of job skills • Abuse • Chemical addictions

  25. Attributes of At Risk Families • Predominantly fatalistic belief system • Very low sense of control • Behaviors that indicate low self-esteem • Relationship systems that are closed and unresponsive • Rigid, passive-aggressive cycles of family interaction • Impulsive non-reflective cognitive structure

  26. Professional Distance • Professional distance is the boundary we, as the professionals, set with each family • To be successful at HV we need good boundaries • When we do not have appropriate professional boundaries we lose our objectivity • Without objectivity we can’t use proper judgment and fully serve the families • Don’t expect families to set the boundaries

  27. Personal Safety • Gather info • Be thoughtful • Be in contact • Be aware • Trust your instincts

  28. Final Reflections • What is something I heard/learned today that I will share with someone else? ______________________________________________________________________________________________ • What did I already know? ______________________________________________________________________________________________ • What was something completely new to me? ______________________________________________________________________________________________

  29. Final Reflections • What could I begin to do differently or make use of immediately? • ________________________________________________________________________________________________________________________________________________ • What could I do that would have long term benefits? • ________________________________________________________________________________________________________________________________________________

  30. Bouhebent, E.A. (2008). Providing the best for families: Developmentally appropriate home visiting services. Young Children, 63, 82-87. • Brady, Peters, Gamel-McCormick, & Venuto. (2004). Types and Patterns of Professional-family talk in Home-based EI. Journal of EI, 26(2), 146-159. • Dunst, C.J., Boyd, K., Trivette, C.M., and Hamby, D. (2002). Family –Oriented Program Models & Professional Helpgiving Practices. Family Relations, 51, pp. 221-229. • Egan, G. “Reasons for Resistance” in The Skilled Helper. Pacific Grove, CA: Brooks/Cole, pp. 17-171. • Keilty, B. (2008). Early Intervention Home-Visiting Principles in Practice: A Reflective Approach. Young Exceptional Children, 11(2), 29-40.

  31. Klass, C. (2003). The Home Visitor’s Guidebook : Providing optimal parent & child development,2nd ed. Brookes, MD. • Korfmacher, Green, Spellman, & Thornburg. (2007). The Helping Relationship & Program Participation in EC Home Visiting. Inf Mental Health, 28(5), 459-480. • Peterson, Luze, Eshbaugh, Jeon, & Kantz. (2007). Enhancing Parent-Child Interactions through Home Visiting: Promising Practice or Unfulfilled Promise? Journal of EI, 29(2), 119-140.

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