Early Childhood

Home Visiting Program Helps Toddlers Fill Learning Gaps

By Linda Jacobson — March 06, 2002 6 min read

Three-year-old Piel and her sister Precious, age 2, are instantly captivated by the alphabet puzzle. Sitting on their living room carpet with home visitor Sylvia Serrano, the girls clap for themselves when they fit the brightly colored, lower-case letters into the proper places.

“G is for goat,” says Ms. Serrano, a home visitor who meets twice a week with the sisters and Betty Gray, the grandmother who is raising them. To be a home visitor, Ms. Serrano had to have a high school diploma and go through special training.

“Goat,” Piel repeats, while Precious lifts the completed puzzle over her head to dump the pieces out and start over.

During these simple, 30- minute sessions, Ms. Serrano aims to introduce a new book or toy into the home and show the parent—or grandparent, in this case—how to engage a child in the activity. Her work is part of the Parent-Child Home Program, a home visiting initiative for 2- and 3-year-old children based in Manhasset, N.Y.

“I feel like this program has put them way ahead,” Ms. Gray, a registered nurse, said of her granddaughters. She said she wanted to take advantage of the service to help the girls overcome the developmental and language delays they’ve experienced because of their mother’s drug abuse.

Such reactions illustrate why Stephanie Taylor-Dinwiddie, the director of the Strong Families/Healthy Children initiative at the Eisner Pediatric and Family Medical Center here, wanted to bring the 35-year-old Parent-Child Home Program to the neighborhoods where she works.

“The program clearly understands that children acquire literacy skills via various modes—play, books, language, et cetera,” she said.

While the program has operated in Massachusetts and New York for years, some convincing research released a few years ago and heightened attention to the early literacy needs of children have led to an expansion of the program to four more states, said Sarah E. Walzer, the executive director of the program’s national center. The program is now operating in 102 sites.

Legislative Action

A 10-year study of the effects of the program in Pittsfield, Mass., released in 1998, found that 84 percent of the participating children went on to graduate from high school, compared with 54 percent of a control group of youngsters who did not participate in the program

“That kind of longitudinal study is exactly the kind of thing that state legislators can understand,” Ms. Walzer said.

Pennsylvania lawmakers responded by voting to spend $12 million to open 25 to 30 sites over the next three years. The first site in the Northwest has opened in Yakima, Wash. And South Carolina has added 16 sites since last year, bringing the total there to 22.

And now, new research on the Parent-Child Home Program, or PCHP, in South Carolina is providing evidence that a relatively inexpensive intervention—about $4,000 per child over a two-year period—can give disadvantaged children the boost they need to perform as well as their peers from middle-class families.

Researchers from the State University of New York at Stony Brook examined the scores of the PCHP children from South Carolina’s 4,600-student Florence County School District 3 on the Cognitive Skills Assessment Battery, a test administered to 1st graders in the state to determine their strengths and weaknesses in 12 areas. The skills evaluated include gross motor, fine motor, communicating with others by using expressive language, and determining similarities and differences in visual stimuli.

Children who participated in the PCHP passed the test at a slightly higher rate than 1st graders overall in the state—84.5 percent compared to 82.4 percent. And when children with severe developmental delays were excluded from the program sample of 84 children, 92.2 percent of the remaining participants passed the test.

When children in the free-lunch program were compared, the PCHP children again passed the test at a higher rate than children overall who received free lunches—84.4 percent vs. 74.4 percent.

“PCHP participation substantially lowered the risks of inadequate school readiness,” says the study, which will appear later this year in the Journal of Applied Developmental Psychology.

While the Florence County district chose to increase the number of visits by 25 percent, which allowed visitors to continue seeing children during the summer break, Ms. Walzer said the program has consistently shown positive results even when the visits stop after 23 weeks, which is the minimum number of weeks recommended.

Whether there is a break in the summer or not, she emphasized that it’s important for families to stay with the program for two years.

And in a few of the program sites, including here in Los Angeles, directors have elected to help families for an additional, third year, especially if the children aren’t going to have access to a high-quality preschool experience.

But keeping 4- or 5-year-olds interested in the sessions over the course of two or three years can be a challenge, said Gaynelle Winston, who supervises some of the home visitors from the medical center here.

“You have to be innovative,” she said.

‘Seeing a Miracle’

The Parent-Child Home Program, which was founded by Phyllis Levenstein, a clinical psychologist on Long Island, is just one home-visiting model. (“House Calls,” Feb. 11, 1998.) But it’s one that is often used in conjunction with other programs, Ms. Walzer said.

Parents as Teachers—the most widely used home-visiting program, with 2,800 programs worldwide—is similar to the PCHP, but it starts with younger children and is universally available to families, whether or not they are considered at risk.

The PCHP focuses on children who are deemed to be at the greatest risk of failure in school—those with low-income parents who have limited education. The program’s approach is to employ home visitors who know the communities they work in and provide them with the training they need to serve as examples to the parents.

“Some moms say to me, ‘No way were you on welfare,’ ” said Ms. Winston. “And I say, ‘Yes, I was, for four years.’ ”

Her goal, she said, is to show the parents how to talk and play with their children.

James Shiminski, the Title I director for Massachusetts’ 6,600-student Pittsfield school system—now in its 33rd year of operating the program—attributes the program’s effectiveness to the training of the home visitors. They receive 12 to 16 hours of initial training and have ongoing training during weekly meetings with their coordinators.

“They are experts in modeling for the parents,” Mr. Shiminski said.

And advocates for the program say that sort of modeling is paying off for youngsters like Piel and Precious.

As the granddaughters of a nurse, the girls were appropriately dressed in toddler- sized hospital scrubs during the recent home visit when Ms. Serrano showed the alphabet puzzle. “Nurse in training” was printed on the back of Piel’s shirt, while Precious’ outfit said “Doctor in training.”

For the full 30 minutes of Ms. Serrano’s visit, the girls didn’t look up from the puzzle.

Ms. Winston, who had not seen the girls in a few months but was visiting them on this February day, was impressed by their attention spans.

“When I first came, they would not sit down,” Ms. Winston said. “I feel like I’m seeing a miracle.”

A version of this article appeared in the March 06, 2002 edition of Education Week as Home Visiting Program Helps Toddlers Fill Learning Gaps

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