Thursday, October 17, 2019

Twenty Things That Can Go Wrong on Home Visits

This listicle comes from the preparation for a presentation I'm doing with Kimberly Tomeny at the Alabama Early Intervention Conference next week. It's minimalist, so write to me if you have comments or questions at

Toy bag: Covers a multitude of sins
Implies the family’s stuff isn’t good enough
Toys are not there for when intervention occurs (between visits)
Must be a child-focused visit
Teaches the parent erroneously about how children learn (through home visits)
Professional sets the agenda
Professional works with the child
Professional wishes parents would be more “involved” in the visit
Parent’s role is to observe
Skills are discussed as they occur during the visit or without any context (e.g., “I notice he stops playing when he hears us talking. Is he easily distracted?” Discussing language without any time of the day).
Professional is quick to make suggestions for previously undiscussed issues
Home visit in rural Paraguay
Professional asks questions and doesn’t make a suggestion (or doesn’t say she’ll think about it or talk to teammates)
Professional gives parent homework
Professional fails to follow up on topics and decisions from previous visit
Professional leaves without concrete strategies the family is interested in
Professional leaves without knowing what the family would like the next visit to focus on
Professional suggests nonfunctional or non-evidence-based strategies (abnormal, no context, not in naturally occurring learning opportunities)
Professional discusses skills happening only during “play” (like HV) time (not evening or outings routines)
Professional addresses only child issues, not family outcomes
Professional assumes interventions are one parent to one child, when other adults and children are involved in everyday routines
Professional fails to check in with parent about whether strategy will work and will be feasible
Professional doesn’t follow up with opportunities to talk about the Big Four of Caregiving: talking, reading, playing, teaching
Professional mentions no family needs/outcomes
Professional doesn’t ask about emotional well-being of primary caregiver (e.g., “How are YOU doing?”)