Friday, February 4, 2011

New Discovery: Home Visits

Home-visiting or "home visitation" programs have been discovered by the early childhood community and they're the new hot thing. Obama has called for support of such programs and they are proliferating and generally gaining a lot of national attention.

On February 16 and 17, the National Summit on Quality in Home Visiting Programs: Connecting Research to Policy and Practice will be held in Washington, DC (http://www.homevisitingsummit2011.org/). Where is Part C? Nowhere to be found among the confirmed speakers.

This has been true over the past 2 years, as these programs have been created and debated. Despite the fact that over 70% of the Part C children are receiving their most important service in the home, we are by and large not at the table with these Johnny Come Latelies.

To give credit where it's due, David Olds and his nurse home visiting model have been around for a long time, but they do not operate at nearly the scale of Part C home visits. Should we be at the table with these other programs or are we so fundamentally different that we're relieved to be excluded?

This is an important question the early intervention field needs to contend with. Amazingly, when the evidence base about home visiting programs is discussed, the conclusion is that it is ineffective. These findings primarily came out of the old Abecedarian Project and the Infant Health and Development Program, where these disadvantaged-family home visits were largely discredited, compared to intensive classroom-based programing.

But think of the different nature of those home visits from Part C home visits. Whereas disadvantaged-family homes visits often involve quite didactic interactions between trainers and parents, early intervention home visits, when done well, are designed to provide emotional, material, and informational support to families. The support is aimed in part at addressing specific, measurable family-chosen goals. I'm not trying to make Part C home visits sound better. Both types are designed to help with parenting.

So do we want early intervention to be associated with these increasingly popular home visitation initiatives? It seems peculiar for these programs not to learn from the history of over 25 years of early intervention home visits. But we also don't want the association to be so strong that we shy away from our special obligation to work on IFSP outcomes/goals.

It just seems peculiar to have a national summit on home visiting with no representation of Part C in it.