Tentative Table of Contents
Introduction
Chapter 1. Brief history and philosophical approach to art of home visiting
A. The historical precedent of home visiting as effective intervention
B. The legal precedents leading to current program practices
C. Philosophical changes resulting in an emphasis on relationship-building techniques.
1. Old way – directive (We assessed the situation and told the family how to remedy the problem and move the child's behavior toward goals we gave them).
New way – collaborative with a polyocular approach (everyone's viewpoint is considered; parents, grandparents, others who interact with the child). Relationships must be built first, then goals are formed together.
2. Old way – the child and family "worked" on assigned tasks from the visitor.
New way – all learning activities are developmentally appropriate and imbedded into existing family routines as much as possible. Therefore, all those who spend time with the child must be considered and informed.
D. Cultural Considerations
Chapter 2. Building Home Visitor–Family Relationships (Using a relationship-based approach rather than a task-based approach)
A. Personnel and professional competencies as prerequisites for success
B. Techniques for building effective relationships during first contacts
1. Encouraging the family to "tell their story"
2. Critical communication skills, including reflective listening, non-verbal communication, cultural differences, etc.
3. Recognizing degrees of understanding and acceptance of life circumstances
4. Understanding what the literature says about stages of the grief cycle
5. Watching for environmental cues that assist in rapport building
C. Assisting families in identifying the developmental stages and needs of their child.
1. Where to begin – family priorities and interventionist's assessment of needs
2. Where we are going – helping the family to develop expectations of the next step in development
D. Case illustrations
Chapter 3. Understanding Families as Systems
A. Recognizing and understanding family reaction to vulnerability and crisis
B. Viewing families from a systems context
1. Family structure (incorporating all family members)
2. Family interactions (cohesion, adaptability and coping styles)
a. Focus on adult-child interactions
3. Family functions
4. Family life cycle
C. Encouraging family empowerment
D. Linking conversation and activities to families' present concerns and priorities while focusing on family strengths.
E. Encouraging parent-to-parent support
F. Case illustrations
Chapter 4. Structuring Home Visitations
A. Outline of a home visit. We have a plan but it can be modified.
1. Greeting – who is in the home today?
2. What has happened in the last week? What's new? Note progress. Anything coming up such as a physician appointment? IFSP?
3. What shall we work on today? Incorporate any new concerns or questions. Use the IFSP as a guide.
4. Activities for goals – explain what we are doing and why. Incorporate caregiver in the activity. Can we put this in home routine?
5. Identifying appropriate family routines and facilitating development of skills within these routines Adapting household objects and toys to facilitate play that stimulates learning
6. Document progress with the activities by making notes as we move through our agenda or modified agenda
7. Reflect and summarize. Were the strategies successful? Were caregiver questions answered? What can be done during the week in home routine. What should be added to the agenda for next week?
8. Make new appointment or confirm standing appointment.
B. What to do when encountered with the unexpected We must be ready to "abandon our agenda" when we go into a home and encounter serious and non-serious distractions.
C. Developing organizations skills (record keeping, agenda planning, etc.)
Chapter 5. Facilitating Adult–Child Interaction
A. Assessing adult–child interaction
1. Assessment instruments and observations
2. How children with disabilities differ in their interactions
3. Cultural differences in adult–child interactions
B. Facilitating reciprocal language and social skill development - techniques
1. Play based and mand models
C. Case illustrations
Chapter 6. Guidelines for intervention for children with various disorders
a. vision impairment – case illustration
b. speech and language disorder – case illustration
c. autism – case illustration
d. general developmental delay – case illustration
e. medically fragile – case illustration
f. multiple disabilities – case illustration
Chapter 7. Working with Families
A. Providing for involvement of siblings and other family members
B. Role of the home visitor in relation to various family conditions
a. parents with developmental delay, mental illness, etc.
b. families distracted by other worries
c. families who don't follow through
C. Case illustrations
Chapter 8. Developing Collaborative Relationships with Related Professionals
A. Understanding medical terminology and diagnoses
1. Accompanying families on medical or specialist appointments
B. Conducting collaborative visitations with other specialists
C. Empowering families to utilize their own strengths and those of their community
D. How and when to refer families for additional services
E. Smooth transitions to other programs and services
F. Alternative therapies
G. Case illustrations
Chapter 9. Special Issues and Concerns
A. Personal safety
B. Personal and professional ethics
C. Personal boundaries
D. Personal emotional well being and development
1. The highly emotional nature of our work
2. Burnout
E. Supervision, e.g., reflective supervision, peer mentors, etc.
F. Case illustrations
Chapter 10. When you need an Interpreter
A. Differences of language and culture
B. Roles of interpreter, interventionist, family member
1. How active should the interpreter be?
C. Recommended skills for interpreters
D. Recommendations for those working with interpreters
E. Questions and answers for interpreters
F. Questions and answers for service providers
G. Case illustrations
Appendices
A. Resources
B. Record keeping forms
C. Sources for materials to facilitate learning
References
Index
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