Five Questions with Dr. Brenda Jones Harden – Home Visiting

5 Questions with Dr. Brenda Jones Harden: Home Visiting

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Jennifer Boss: Hi, I'm Jennifer Boss, director of the National Center on Early Childhood Development, Teaching, and Learning. I've been working in the early childhood field for almost three decades, and one of my most challenging yet rewarding jobs was as a home visitor with families and young children. Dr. Brenda Jones Harden, my mentor and friend, is a leading expert in home visiting. Let's listen in as she talks to education managers about important considerations when supporting home visitors.

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Dr. Brenda Jones Harden: Hello, everyone. My name is Brenda Jones Harden, I'm Alison Richmond Professor for Children and Families at the University of Maryland School of Social Work.

Woman: What are some of the unique opportunities that home visiting provides?

Dr. Jones Harden: You get an opportunity to observe a family and their interactions in an informal setting, very different than in an office or a clinic or in a lab. So, you're much more likely to get a sense of how family members interact with each other, but also the family's broader context, like the kind of environment that they live in, so the stresses that might affect them because of community violence, for example, but also what happens in their residence. Is this a stable, calm place, or is this a place full of chaos? But also, I really believe you get a better sense of the needs of a family, so you can sort of adapt the intervention to meet the family's particular needs.

Woman: What are some of the challenges home visitors face?

Dr. Jones Harden: We know from the research that families who tend to be in home-based programs like home-based Early Head Start, for example, are much more likely to be high risk than families who attend center-based. And if you think about it, families who are able to organize themselves enough to get a job and get their children to center-based, you can imagine that they are probably at lower risk than families who tend to be in home base. But we have the data on this. So, they have many more concrete and psychological needs, often. So, the burden on the home visitor is fairly high. But the other thing that I think is related to that is it's incumbent upon the home visitor to kind of balance case management with promotion of parent child interaction and child development.

Woman: How can education managers help home visitors meet these challenges?

Dr. Jones Harden: I would argue that home visitors are so stressed, not only because of the kinds of risk factors that their parents bring, but also the fact that they're going out into these communities, there's nobody with them, they're on their own, their car might break down – all kinds of other things. They're literally putting their lives on the line with their jobs. So, I think it's important for ed managers to give them an opportunity to meet with somebody on a weekly basis who helps them with their own feelings about the danger, about the families, but also what to do with families who present risk factors and also to help them be safe. The other thing I think is important is to help the home visitor focus on the moment. I think what happens, whether we're parents or home visitors or clinicians and other kinds of ways or even teachers in the Head Start classroom is we get overwhelmed with the breadth of what we have to do instead of taking each moment at a time and celebrating each moment and trying to make each moment as effective as you can be.

Woman: How can education managers help home visitors increase the effectiveness of their visits?

Dr. Jones Harden: So, one of the things that I really believe in is the use of videotape, and more and more as we do parenting interventions in the field, we are borrowing from evidence-based parenting interventions that use videotape. So, I would argue – and I always say this to Head Start programs – if you got a little extra money and you want to spend it before the budget year is over, get some video cameras. And I think what you can do is teach home visitors how to video themselves, and we've done this. You just put the camera in a corner of the room, and you pretend like it's not there. Families often forget about it. Home visitors forget about it. And then bring it back to the office and have the ed manager look at that videotape with the home visitor to see, for example, like a 12-monther. Are they pulling up to stand? So, here's an opportunity to say to mom, "Pull that little ball a little farther and see if he'll cruise." Or you got a 24-monther who says, "Cookie, cookie, cookie." You can say to the home visitor – and the ed manager knows child development like the back of their hands – of course, "Look, the child is doing a single word. Let's see if we can expand the child's language and have him say, "Mommy, cookie, please." You know, so mom can say, "Cookie, please." So, I think really looking at the child and using what the child does in the context of the home visit is the best way. Certainly, ed managers can go out with home visitors and do the coaching in Vivo, but I know that's really hard for them with the kind of workload they have, so I think using a video is a prime way to kind of get this work started.

Woman: How can education managers acknowledge the work that home visitors do?

Dr. Jones Harden: Like every professional, home visitors need validation, but I would argue they need it more than anybody because they often don't get it in the smile of children who say, "Yay, my teacher has walked in the door." Whether the children have verbal abilities or not, you can see a big smile on a baby's face when a teacher walks in the door. Home visitors go, and sometimes, the parents don't even want them to come in, and they don't answer the door, or sometimes they don't answer the phone, or sometimes when you go into the house, they're not ready for the visit. So, it's not like you're getting a lot of validation all the time from the work, so I think it's really, really critical for ed managers to really be pouring it on, as much validation as they can, celebrating the incremental changes that they might see in families lives so that home visitors see their effectiveness, but also celebrating home visitors for just every day of their work going out into the field.

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