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Social Policy Report BriefResearch on Social Policy Topics Concerning Children and Families

The Society forResearch in Child

Development (SRCD)is an interdisciplinary

organization ofscientists, establishedn 1933 by the NationalAcademies of Science.

SRCD Oce forPolicy and

CommunicationsDirector

Mary Ann McCabe, Ph.D.(through July 31, 2009)

Senior AssociateSarah Hutcheon, M.S.

Policy AssistantSarah Mandell

Social Policy ReportEditor

Lonnie Sherrod, Ph.D.

Associate EditorJeanne Brooks-Gunn,

Ph.D.

Managing EditorAmy Glaspie

Brief Writer

Anne Bridgman

Policy Implications

Because research on home visitation has been inconclusive (see What the ResearchSays), policymakers are divided over its value. Instead of looking at programs inisolation, home visitation is being reconsidered as part of an integrated approach tointervention and prevention for disadvantaged families.

Volume 23, Issue 4, 2

Why Does This Mater?

In the United States, 42 percent of children under 6a total of 10.2 millionchildrenlive in poverty. These youngsters are more likely than beer-o children

to experience a range of problems. One way to address the educational and healthneeds of these oen hard-to-reach children is through home visitationsendingindividuals into homes to match needs with services. Recent developmentspolicymakers renewed interest in home visitation and eorts to ensure thatprograms are more eective and coordinatedsignal a new era for this approachto early intervention.

Eective home visitation programs should be well implemented and

aligned with community challenges and strengths. A direct funding

stream would create a coordinated infrastructure that can address the

problems of vulnerable families.

This briefsummarizes a longer

report. The full reportand references areavailable online at

www.srcd.org underSocial Policy Report on the

Policy &Communications tab.

Home Visitation: Part of a ComprehensiveApproach to Improving the Lives of Poor Fami

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Facts at a Glance The eld of home visitation serves between 400,

and 500,000 children and their families in Ameriyearly, reaching about 2 percent of all childrenunder 6. Forty states have a statewide homevisitation program.

Home visitation as a service model began inEurope at the turn of the 20th century and todayis widely accepted there. In many Europeancountries, services are oered to all citizens

regardless of income as part of a comprehensiveapproach to maternal and child health care.

In the United States today, home visitationprograms include the Parent Child Home ProgrParents as Teachers, and Home Instruction forParents of Preschool Youngsters, as well as HealStart, Healthy Families America, Nurse FamilyPartnership, and Early Head Start.

Although exact gures for federal support of hovisitation interventions are not available, in 2005

less than 5 percent of Title I funding (or about$637 million of the $12.7 billion allocated) went provide services for children under 4, includingnot limited to home visitation programs.

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This brief summarizes a longer Social Policy Report by Jennifer Astuto, Assistant Director of theChild and Family Policy Center in the Steinhardt School of Culture, Education, and HumanDevelopment at New York University (NYU), and LaRue Allen, Raymond and Rosalee WeissProfessor of Applied Psychology in the Steinhardt School of Culture, Education, and HumanDevelopment at NYU and Director of the Child and Family Policy Center.

TheSocial Policy Report is published quarterly. See the Policy & Communications tab atwww.srcd.org for recent issues.

Policy Implications (continued)

With the aim of reconsidering home visitation, policymakers should:

Create a unique and coordinated funding stream for home visitation services. Currently, support comes frommany sources, including Title V Maternal and Child Health Services Block Grant, Temporary Assistance forNeedy Families, and Medicaid Federal Financial Participation. Developing a direct funding stream would creatthe necessary coordination and infrastructure to address the educational and health needs of at-risk children anfamilies.

Develop an integrated database to allow states to survey the models implemented to increase coordination andaccountability.

Invest in programs that conduct rigorous evaluations using diverse methods to assess eectiveness anddemonstrate improved quality; this is important because the most eective programs are those that areimplemented well and consider the distinct characteristics of their communities.

Consider the diversity in existing models and goals in addressing local needs. For example, home visitation mabe well suited to children of immigrant families, many of whom dont participate in center-based early childhooprograms.

What the Research Says Opinions on the eectiveness of home visitation

programs are mixed. This is partly because researchhas looked at a variety of program models and goals,and used a variety of evaluation methods. Somestudies have shown that the approach is eectivefor some populations but not others (for example,mothers benet more than children, and Latinofamilies more than non-Latinos). And some studiessay the benets are not strong, while others say itcan improve child health and development, school

readiness, and parenting.

To provide eective services in communities,programs must be fully implemented as they areintended. If they have been tested, they must beimplemented as they have been shown to be eectivein research, with expected outcomes and evaluationtied to programs goals and models.

Although the eect of home visitation as part of largerprograms has not been well studied, home visitationservices are thought to be best when they are part of a

comprehensive, integrated approach to services.