Home visiting programs have a rich history in the United States. As early as the nineteenth century, nurses and social workers went door-to-door to care for expectant mothers and young families. The underlying idea was that home-based education and service delivery would improve health outcomes, particularly in low-income and working class urban neighborhoods.
By and large, the model worked. Home visiting programs have proliferated nationwide, providing everything from home-based addiction recovery services to lactation support.
There are a growing number of home visiting programs that focus specifically on families with young children. Given the demanding nature of parenting infants and toddlers, home visiting is a particularly effective way to ensure that young families are receiving the services and support that they need. In Onondaga County, Nurse-Family Partnership and Healthy Starts, among other programs, provide healthcare and education to expectant moms and parents with infant children.
A closer look at the local home-visiting landscape, however, reveals a troubling gap. After a child’s second birthday, the number of home visiting programs operating in Onondaga County plummets.
“The only available home visiting program for parents with children over two necessitates a referral from welfare services” says Bethany Creaser, Director of Educational Services at Catholic Charities. “We’d get calls from families with two year olds, three year olds, and unless they self-refer to child protective services, there are just no programs available.”
This programmatic drop off occurs during an especially formative time for young children and their parents. Two and three year olds are learning the intricacies of emotional expression and regulation. They’re also laying the neurological groundwork for kindergarten and beyond. The oft-quoted ‘Word Gap’ unfolds in the two to five year old range, with real implications for a child’s academic trajectory.
Dr. Phyllis Levenstien understood the connection between the toddler years and high school graduation. Levenstien was studying for her psychology doctorate in 1965 when she was asked to develop a program to reduce high school dropout numbers in New York City. Her research led her to believe that programmatic intervention in high school, or even elementary school, was too late. She created an intensive home-visiting program aimed at equipping and empowering parents to be their children’s first and most important teachers. The Parent-Child Home Program (PCHP) was born.
Over fifty years later, PCHP largely abides by Levenstien’s original model. Home visitors, known as Early Learning Specialists in the PCHP universe, visit families with toddlers twice a week for up to two years. Parents self-select into the program, and can opt out if they choose. At each visit, the early learning specialist brings a new book or toy for the child to keep. The early learning specialist then ‘models’ age-specific play with the child and their new toy, focusing on building early literacy and math skills. Instead of lecturing parents about child-directed play or behavioral management practices, the early learning specialist simply shows parents how they can support their child’s development.
While the model’s pedagogy may sound obvious, Creaser and her colleagues can attest to the power of teaching play.
“We’ve had many parents break down in class, saying things like ‘Nobody ever played with me, I don’t know how to play with my child’”, says Creaser. Adds Ondalee Kelley: “I hear a lot of moms say that they don’t know what effective praise looks like because they were never praised as children.”
A parenting class at Catholic Charities.
The key to success for any home visiting program is strong, trusting relationships between home visitors and client families. It’s partly why PCHP is launching in Onondaga County under Catholic Charities. Catholic Charities has been operating in Syracuse since 1923, and already offers a wide range of parenting resources and services. Ondalee Kelley, the newly appointed site director for PCHP in Onondaga County, taught parenting classes at Catholic Charities for seven years. She’s still in contact with many of the parents that ‘graduated’ from her classes, and occasionally refers them to other Catholic Charities services like the CASS program.
PCHP also insists on hiring local community members to fill early learning specialist roles. They emphasize the importance of matching families with an early learning specialist of a similar cultural, geographic, and linguistic background.
“We knew pretty quickly that Parent Child Home Program was a good fit,” says Kara Williams, the Director of Strategic Initiatives at the Allyn Family Foundation. “The equity and social justice framing really appealed to us - the program prioritizes recruiting staff from within the community, and they’re known for employing graduates of the program.”
Over the course of its fifty year history, PCHP has consistently demonstrated strong programmatic outcomes for participating families. Children who ‘graduate’ from PCHP after two years are at a lower risk for familial abuse and neglect, score higher on third grade math and literacy tests than their peers, and graduate high school at higher rates than their socioeconomic peers.
PCHP has been operating in Buffalo, NY for the past eleven years. An independent study revealed that PCHP children in several Buffalo schools scored better on literacy tests at the beginning of the kindergarten school year than other students at the end of the school year.
A graph comparing vocabulary test results from kindergarten students that received PCHP services and those that did not receive PCHP services in Buffalo, NY. To read the full study, click on the image.
Creaser says that the national PCHP center is excited about a PCHP replication site in Syracuse. It takes about two years to become a recognized and certified PCHP site - the organization has strict procedures in place to protect the efficacy of its model - and Creaser and Kelley look forward to growing the program during that time. They already have about eighteen family clients lined up for PCHP’s debut in June.
“Ultimately,” says Creaser, “you can’t choose who your parents are, you can’t choose your childhood, but you can choose what kind of parent you’re going to be. It’s the message we pass along in all of our parenting classes: love your children and keep them safe.”