Structured, Child-Focused Home Visiting

Adults support learning when they plan experiences and are prepared to support a child's interests and discoveries. You and the family use observations, ongoing assessment, the curriculum, the ELOF, and the child's interests to plan learning opportunities for the visit and during the week. Learning opportunities that are planned and structured are more likely to have an effect. The visits are child-focused. It is inevitable that sometimes family members will want to talk about other events in their lives. That is part of having a relationship. When a parent is distracted by personal concerns or crises, you balance listening to the parent and honoring their choice to share concerns with you. It is important to deal with crisis situations while eventually bringing the focus back to the child. In addition to child development, you work with other program staff and community partners to coordinate such services as health, mental health, and oral health services for the family.

Home visitors help parents identify their child's emerging skills and learn how they can strengthen these skills and develop new ones. In a home-based program, staff have very little time with children and families. Parents who are with their child every day have many opportunities to facilitate learning experiences. Home visitors recognize, encourage, and help families build on their efforts to support their children. For example, the goals for a 6-month-old infant might be to begin eating solid foods and learn how to sit unassisted. A toddler may be working on increasing his or her vocabulary or identifying shapes and colors. A preschooler might be learning letters of the alphabet or classification skills (e.g., sorting things into categories based on variables such as color, shape, or size). These skills are learned through interactions and experiences that can be embedded in children's everyday routines and experiences. As you partner with families to develop learning experiences to foster these emerging skills, it can help parents to explore the importance of certain experiences in promoting development and learning.

While there is structure, there must also be flexibility. As the home visitor, you have unique knowledge about the child, family, and home environment, as well as best practices in supporting healthy growth and development. The home visitor can look for opportunities to bring up and integrate all topics into a visit. For example, when working on increasing vocabulary, you may choose to do so around a nutritious meal or while going on a walk, thus also promoting good nutrition and physical activity.

How To

You support structured, child-focused home visiting that promotes parents' ability to support children's cognitive, language, literacy, social, emotional, and physical development by:

• Having a deep understanding of current, research-based early development to support families in interpreting the meaning behind a child's behavior
• Stressing the importance of the family's role in the child's learning
• Identifying the opportunities in everyday moments when children are working toward their goals
• Understanding and talking to parents about how particular parent-child interactions and experiences provide opportunities for specific learning
• Conducting assessments, including parent insight, observations, and feedback, while supporting parents' role in exploring their child and child development
• Observing closely with parents to understand the child's current interests and goals
• Using a research-based curriculum for home-based services to support planning with the parents

Experience It

Watch as a mother and child engage in an everyday activity, washing hands, before preparing to make a fruit salad for a snack during a home visit. The home visitor suggests the mother take the opportunity to make handwashing a learning experience for her child. Language development is one of the goals this mother has for her child.

Structured, Child-Focused Home Visiting 1

Open Doors
Chapter 8a: Structured Child-Focused Home Visiting Experience It

Mom: Wash your hands. Mmm, wash, wash, wash. Wash your hands.

Home Visitor: Do it a little longer than you would just so I can get --

Mom: Wash your hands. Yeah, you can't lick the water. [chuckle] It's cold.

Toddler: It's cold.

Mom: Can you rub your hands together?

Toddler: It's cold.

Home Visitor: Oh, you already did dinner.

Mom: I'm working on it.

Home Visitor: Yes, you did.

Mom: There you go. Clean.

Toddler: Water. Water.

Mom: Mm-hmm. Clean.

Mom: Clean. You do it. Wash your hands. Wash, wash.

Toddler: Wash my hands.

Mom: Can you wash your hands?

Mom: Unh-unh. Can you rub your hands together?

Toddler: Hot. Hot.

Mom: [Laughs] It's nice and cool. It's cool?

Home Visitor: That's good.

Mom: Turn the water off. Shake, shake, shake. Ooh! Dry. Dry. Good girl.

Home Visitor: And just go back into the room when you're done.

Mom: Okay. Come on. Ready?

Reflections

What do you observe?

Answers may include:

• Mother and child wash the child's hands
• Mother talks to child about what she is doing
• Child rubs her hands together and briefly splashes the water
• Mother uses various words to describe the water and drying her hands
• Child dries her hands on the towel with her mother's help

What strategies did the mother use to support her child's language development?

Answers may include:

• Talking
  • Vocabulary:
    • Clean, warm, water, cool, dry
    • Talks about temperature of water, cleaning hands
    • Is the water cool?
    • Are your hands clean?
    • Used descriptive words repeatedly

    What skills and behaviors in other developmental domains did you observe that would promote school readiness?

    Answers may include:

    • Cognition
      • Active exploration with different textures (e.g., feel of water, towel)
      • Asking questions
      • Washing hands before eating
      • Rubbing hands together
      • Mother and child spending time together
      • Mother holding child
      • Gentle touches of mother helping her daughter to wash her hands
      • Mother laughs at something the child says and speaks gently to the child
      • Paying attention
      • Curiosity about water

      What other routines could the mother use to enhance her child's language development goals?

      Answers may include:

      • All routines could enhance her goals
        • Some examples include:
          • Bath time – Develop vocabulary (e.g., washcloth, towel, names of toys or body parts, etc.).
          • Hair brushing – Enhance receptive language (e.g., talk about hard, soft, shiny, long, short, tangled, etc.).
          • Meal preparation
            • Ask questions and describe the different foods you are preparing
            • Describe what you are doing to prepare food and include the child when possible (e.g., measuring, cutting, cooking)
            • Name objects as you set the table
            • Describe how various objects are used

            This video clip shows a home visit where the home visitor and mother are working on the child's communication skills.

            Structured, Child-Focused Home Visiting 2

            Open Doors
            Chapter 8b: Structured Child-Focused Home Visiting Experience It

            Julie: So, ooh, this is co-o-ld.

            Julie: So what we want to do, when we're looking at his commun--Like that was really easy for him to communicate with because they were things that were familiar. But like this, which is, I think, the issue that we have with his communication, is, if it's something unfamiliar and out of context for us, then we don't understand what he's trying to -- Do you not like it?

            Julie: Are you telling me? Oh! Is that what you're telling me? "I don't like this stuff, Julie."

            Mom: Look at that!

            Julie: You don't like it?!

            [Dog barking nearby]

            Well, now! I guess you're telling me.

            Mom: [laughing] He's picking up every little piece.

            Julie: Look. Let's --

            Julie: Let's try this. Here, try a little bit. It's cold!

            Mom: See, Isaac's always asking to play with Play-Doh. Whee!

            Julie: Ooh, here; you feel it. You feel it. Ooh, look at that face!

            Julie: Look at that face. What are you telling me?

            Mom: Look what Mama's doing. Look! Roll, roll, roll, roll.

            Julie: Oh, you're telling us, "No, no, no," aren't you? Telling us "No, no, no. I don't like this stuff." That's funny.

            Mom: Oh, he wants --

            Julie: Yeah, we can roll it. Watch. Julie will roll. Mommy was rolling. Watch. [singing] Roll, roll, roll Can we mush it together? I'll be. Well, now we know what he thinks about Play-Doh, don't we?

            Mom: You'd have thought we offered him creamed spinach.

            Mom: What is it? Uh-oh!

            Mom: Pick it up. [Laughs] What don't you like about it?

            Julie: Is it the texture? Is it because it's something new?

            Mom: Is it because it's cold? I think cold shouldn't -- Look!

            Julie: Or do you just not understand how to work it. Here watch. Here, I'll give Mommy a shape. Mommy, have a shape. I'll get a shape. Oh, thank you! Let's put the cup away.

            Issac: That! That that that that!

            Julie: Oh, no! You didn't like it?! Do you want a different color?

            Julie: Out. Do you want it out?

            Julie: Can you give it to Mommy to take it out? Give it to Mommy. Mom: Do you want me to open it? Open!

            Julie: Blue! [Laughter]

            Mom: Squeeze! Squeeze! Ew! Okay.

            Mom: Squee-e-ze! There's your hand!

            Julie: It's your fingers. Mama made your fingers. I just don't think you know what to do with it.

            Mom: Watch. Just a minute. Now, give me your hand.

            Julie: First time, how fun. Push!

            Julie: Look at that!

            Mom: There's your fingers!

            Julie: Yeah, can you count them? 1, 2, 3, 4, 5.

            Julie: Five. Nice! Or and X. Look, X.

            Julie: Yeah, an X. Maybe because you said I, he's thinking -- Let's give Mommy some letters, too.

            Mom: Let's push! Pu-u-sh them in! [gasp] What's that?

            Julie: That's a D, dog. Say "Da-da-da-da."

            Julie: A "D". You want a B? Bu-bu-bu-bu-bu.

            Mom: B, boy-y! Where's the boy?

            Mom: What is that? Ask Mama.

            Julie: Say, "What is that, Mama?" Show her. Can you show Mama?

            Mom: Let me see. Let me see.

            Julie: All done! All done! Well, I would say we really know how he communicated with us.

            Mom: Yeah, he made that clear.

            Reflections

            What do you observe?

            Answers may include:

            • Home visitor is discussing the child's communication skills with the mother
            • Child is sitting in an assisted seating device with straps crossed on his chest
            • Home visitor hands purple Pla-Doh to the child, and he returns some to the can and drops some on the floor
            • Mother points to the child's face to bring the home visitor's attention to his expression; the home visitor says, "Do you not like it, are you telling me?"
            • The mother rolls the Pla-Doh and says, "It's cold."
            • Home visitor talks for the child, indicating that he is telling them he doesn't like the Pla-Doh
            • Adults suggest reasons why the child may not like the Pla-Doh
            • Home visitor puts away the purple Pla-Doh and puts a can of blue on the tray in front of the child
            • The child picks up the can and says, "Out."
            • Home visitor tells the child to give it to mommy to take it out
            • The child begins to use some words and smiles as he interacts with the Pla-Doh with his mother
            • The home visitor hands the mother cookie cutters to play with the Pla-Doh with her child
            • Mother says some of the letters and the child repeats them

            How does the home visitor work with the parent to identify her child's emerging skills?

            Answers may include:

            • She talks with the mother about what they observed in the previous activity that made it easy to understand the child's communication.
            • She attends to what the parent is observing, both verbally and non-verbally (e.g. when the mother draws attention to her child's facial expression by pointing at it).
            • She supports the child when he speaks and says, "Nice."
            • She elaborates on the child's communicative attempts by talking for the child to indicate what he might be saying (e.g., "I don't like that, Julie.").
            • She adds new actions and elements to established interaction routines by providing a different color Pla-Doh and handing cookie cutters to the mother.
            • She balances support (e.g., suggestion, demonstration) with opportunity and expectation for independence.
            • She poses "dilemmas" for child to solve (e.g., how to open the can of Pla-Doh, how to use the cookie cutters).

            Reflect on techniques you would like to enhance to best incorporate daily routines and household materials to provide interactions and experiences that are developmentally appropriate and match the family's and child's interests, goals, and cultural practices.

            Answers may include:

            • Review the child's school readiness goals and the curriculum; think with the family about how they can use materials in the home to help the child achieve the goals.
            • Brainstorm with colleagues about how activities and materials within a home could support specific learning goals.
            • Ask family members if they would like to hear your ideas before asserting your control over the situation.

            What dimensions of development contributing to school readiness do you observe?

            Answers may include:

            • Perceptual, Motor, and Physical Development
              • Fine Motor
                • Squeezing the Pla-Doh
                • Using cookie cutters
                • Grasping and releasing
                • Smiling at the Pla-Doh and at his mother
                • Making eye contact with his mother
                • Smiling when his mother touched his hand
                • Self-regulation while removing an object he didn't like (e.g., the purple Pla-Doh)
                • Expressive Language: "Out," "blue," counting
                • Receptive Language: Responds to mother's suggestion, "Count your fingers"
                • Showing interest in the blue Pla-Doh and cookie cutters
                • Showing curiosity about what his mother was doing when she pressed his hand into the Pla-Doh
                • Using a few words to describe with what he was interacting
                • Showing awareness of change from the purple Pla-Doh to the blue Pla-Doh
                • Showing persistence in getting rid of the purple Pla-Doh
                • Noticing the color of the Pla-Doh
                • Counting his finger indentations in the Pla-Doh
                • Repeating the names of some of the letters
                • Indicating he wanted Julie to use the rolling pin

                Learn More

                Language at Home and in the Community
                Home visitors should support parents in using their home language with their children. Many families worry that using their home language will confuse their children. Actually, children can easily learn several languages at the same time. They have an easier time learning English when they have a strong foundation in their first language.