For those new to home visiting initiatives, a quick primer: These are programs designed to boost children’s health and development by assisting low-income and first-time mothers. Nurses or social workers go to the homes of pregnant women and mothers who have signed up, providing them with advice about parenting and connecting them to resources to help their babies thrive. The Affordable Care Act heightened attention to home visiting in 2010 by creating the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, which has served about 15,000 families to date. In March 2014, the federal government extended funding through March 2015, building on the initial $1.5 billion investment. (For more on how these programs fit into a birth-through-third-grade vision for early education, see New America's reports Subprime Learning and Beyond Subprime Learning.)
The impact of home-visiting programs can vary widely, depending on program design and target. A 2009 review of nine home-visiting programs by Kimberly Howard and Jeanne Brooks-Gunn in the journal Future of Children found that programs that target child abuse and neglect, for example, often are less likely to see immediate results than programs that seek to improve mother-child bonding or other parenting practices that affect child development.
As part of the MIECHV program, the Department of Health and Human Services in 2010 created criteria for deeming programs “effective” and therefore eligible for the new federal funding. (Here’s a handy table – part of a significant new report on federal home visiting – that shows the 14 programs that currently
[caption id="attachment_5106" align="alignright" width="396"] This post is part of Seeding Reading, series of articles and analysis by New America’s Ed Policy Program and the Joan Ganz Cooney Center at Sesame Workshop. See also the Learning Tech section of EdCentral.org and the JGCC blog.[/caption]
meet the mark.)
You may be wondering: What is the link between home visiting and children learning to read? Part of it is rooted in research showing that the way parents interact with their children can have a huge bearing on children’s language development -- and that language development is inextricably tied to reading success. Research shows that if problems are caught early, interventions can help to keep children on track. All of the MIECHV-funded programs, according to a new government report, use a screening tool known as the Ages and Stages Questionnaire to help determine whether young children might be experiencing delays in speaking and communicating,
Another key piece of evidence for the links between parent-child conversation, language and literacy come from an oft-cited study by Betty Hart and Todd Risley that showed that by age 4, children in low-income families have heard 30 million fewer words than higher-income children. This “word gap” and the home literacy environment, other studies have shown, can help explain the enduring gap in educational achievement between high- and low-income children that persists as they grow up. The word gap has gained prominence as a theme in early education over the past year, in no small part due to the attention of former Secretary of State Hillary Clinton and her Too Small to Fail initiative, which we’ve followed since last summer. The gap was also a key theme at an early literacy convening in Washington, DC this February hosted by the Institute of Museum and Library Services with the Health Resource and Services Administration (the office that runs the MIECHV program) and FirstBook (a non-profit that connects publishers to communities in need of books.)
In short, because of this recognition of the importance of language development, many home visiting programs are explicitly encouraging parents to converse with and read books with their babies – behaviors that can seem counterintuitive given that the children are too young to talk back.
This is where new technologies are starting to play a role. It’s not always clear whether parents are gaining anything from lectures or printed handouts from professionals, even if that advice is distributed in the comfortable environment of their homes. So home visiting programs are trying out new forms of outreach using technology to show instead of tell. DVDs, for example, have been employed for years to provide parents with tips and techniques for promoting their children’s development.
A Texas-based program called Play and Learn Strategies (PALS), takes video to another level by employing hand-held video recorders to capture moments between parents and children. Home visitors and mothers view those moments at home together to open up dialogue about why children respond in various ways depending on how their parents communicate with them. Several years’ worth of studies by Susan H. Landry, director of the Children’s Learning Institute at the University of Texas’ Health Sciences Center in Houston, have shown a positive impact on children’s early literacy skills. [Seeding Reading will feature an in-depth look at PALS later this summer.]
Another example comes in our post last month about the use of a tiny recording device known as LENA, for Language ENvironment Analysis, to help parents see how simple, back-and-forth conversations with their children could help them build their language and vocabulary skills. LENA is being used bythe Thirty Million Words initiative -- an 8-week home-visiting program underway in Chicago. (Thirty Million Words is not one of the programs currently receiving MIECHV funds.)
Shurand Adams, 24, is one of the parents in Thirty Million Words. Interviewed for our Seeding Reading project, Adams said she enrolled to give her daughter Teshiya, 19 months old at the time, every possible advantage. “I didn’t know a child’s most crucial time in learning is from birth until 5 years old,” Adams said. “I knew you could start at home doing little things, but I thought the learning was from teachers. They’re trained to do that. I didn’t feel like I had the ability.”
Dana Suskind, a pediatric specialist at the University of Chicago who specializes in speech and hearing loss, directs Thirty Million Words and is leading a research team evaluating its effectiveness. Early results in a yet-to-be-published study show that parents in the treatment group, like Adams, showed a significant increase in understanding how children’s language develops and spoke more words to their children. While the increase is notable, the effects had faded when the researchers retested the families four months later, perhaps because the program was only eight weeks. The study was also small—only 23 families—making it hard to tell whether the families that volunteered for the program were somehow different from those in the control group in ways that could affect outcomes. The team is planning a second randomized, controlled trial involving 200 families with toddlers approximately 15 months old in 2015.
In yet another example, a new program run by Parents as Teachers (PAT), a home visiting program based in St. Louis, MO, will test whether online question-and-answer sessions could help to extend the reach of home visiting. Parents as Teachers launched a series of Google Helpouts this summer to answer parents’ questions via online hangouts with a professional. These Helpouts use Google’s Hangout software to connect people in an online video chat at specific times of the day – such as 2 pm ET on a Monday – when they can have real-time conversations about topics as varied as sleep schedules and child nutrition. While the Helpouts do not yet delve into language development specifically, they will be worth watching to see how parents use them, what barriers arise (do parents have enough Internet connectivity at home or on their smart phones?), and whether similar high-tech, high-touch approaches can lead parents to feel more empowered to foster their children’s development.
Given the potential of home visiting programs in supporting language and literacy development, Seeding Reading will continue to zoom in on how and where new tools could help provide resources and training to parents, educators, and caregivers. We’d love to hear your take. If you know of initiatives using media and technology tools in new ways, please jump in with comments about your experiences, pros and cons.
Barbara Ray contributed to this report.