Meaningful Interventions: Strategies for Effective Home Visiting Bonnie Keilty, Ed.D. University of North Carolina, Charlotte South Carolina Early Intervention Conference May 22, 2008

Reflecting on home visiting  How are you: Promoting child learning and development in between visits? Promoting child learning and development in between visits? Supporting family use of suggested intervention strategies? Supporting family use of suggested intervention strategies? Determining how well the strategies work? Determining how well the strategies work? Determining family fidelity of implementation? Determining family fidelity of implementation?

Principles of early intervention home visiting  Interventions occur in the context of the everyday routine activities that are individualized to the family  Interventions promote child participation and engagement in the routine activities  Interventions are designed so family members are actively participating in home visits to understand and appreciate the recommended intervention strategies  Interventions are designed so family members are confident and competent in using intervention strategies in between visits

Interventions occur in the context of the everyday routine activities that are individualized to the family  Context characteristics: Family-identified priorities and concerns Family-identified priorities and concerns Repeated opportunities for practice Repeated opportunities for practice Where the caregiver will use the strategies Where the caregiver will use the strategies Implementation vs. discussionImplementation vs. discussion Family “traditions” Family “traditions”  How will you explain this practice to families?

Interventions promote child participation and engagement in routine activities  Child engagement characteristics: Identified routine activity (during home visit) Identified routine activity (during home visit) Attention to interest Attention to interest Actively participating vs. on the “sideline” Actively participating vs. on the “sideline” Necessary adaptationsNecessary adaptations A “just enough challenge”A “just enough challenge”  How will you make sure the engagement strategies work during the home visit?

Interventions are designed so family members are actively participating  Family engagement characteristics: Understand and appreciate purpose of visits Understand and appreciate purpose of visits Ensure comprehension of rationaleEnsure comprehension of rationale Home visits depend on caregiver engagement Home visits depend on caregiver engagement Consistent expectation of participation: Consistent expectation of participation: Initiation of home visitsInitiation of home visits Beginning of each home visitBeginning of each home visit All team membersAll team members  How will you explain this practice to families?

Interventions are designed so family members are confident and competent  Confidence and competence characteristics: Fidelity of implementation question Fidelity of implementation question Family outcome as well as intensity of interventionFamily outcome as well as intensity of intervention Practices are: Practices are: Dependent on recommended strategyDependent on recommended strategy Demonstration and explanationDemonstration and explanation Caregiver practice and iterative feedbackCaregiver practice and iterative feedback Questions and reservations are addressedQuestions and reservations are addressed Strategies do not require interventionist presence Strategies do not require interventionist presence Adequate frequency and intensity of support Adequate frequency and intensity of support Reasonable number and type of strategies Reasonable number and type of strategies  How will you explain your role and the family’s role to families?

Seamless, context-based intervention process  Explanation of early intervention process  Family assumptions and expectations  Eligibility evaluation  IFSP outcomes and strategies

Shifting practices  Feel comfortable and confident with the concepts Find more information if needed Find more information if needed  Use team members as support  Have an open dialogue with the family  Identify successes  Don’t give up!

Reflecting on home visiting  What might you do differently to: Promote child learning in between visits? Promote child learning in between visits? Support family strategy use? Support family strategy use? Know the strategies will work for each family? Know the strategies will work for each family? Balance flexibility and meeting professional expectations? Balance flexibility and meeting professional expectations? Ensure a seamless system in: Ensure a seamless system in: Eligibility evaluationEligibility evaluation IFSP strategiesIFSP strategies Determine fidelity of implementation Determine fidelity of implementation

Bonnie Keilty, Ed.D. Department of Special Education and Child Development University of North Carolina, Charlotte (704) For additional information on topic, see: Keilty, B. (2008). Early intervention home visiting principles in practice: A reflective approach. Young Exceptional Children, 11(2)