Little Talks: Developing the Role of Early Head Start Home Visitors to Provide Evidence-Based Intervention to Families
Grantee: Lehigh University
Principal Investigator: Patricia Manz
Project Number: R62MC24948
Project Date: 9/1/2012
Final Report
Age group(s)
- Perinatal/Infancy (0-12 months)
- Toddlerhood (13-35 months)
Targeted/Underserved Population
- Hispanic/Latino
Abstract
Now is the time for advancing home visiting's focus on child development by providing evidence-based interventions. The creation of the Maternal, Infant, and Early Childhood Home Visiting Programs (MIECHEV) clearly shows the current Administration's commitment to advancing home visiting. At the same time, the comprehensive search conducted by Home Visiting Evidence of Effectiveness (HomVEE) illuminates home visiting's insufficient impact on young children's development, particularly in language. Among the programs HomVEE identified as having the strongest scientific support, eight assessed child outcomes. The grand majority (87%) of these outcomes showed no impact on child development. These findings are disturbing given that children under 36 months are most likely to live in poverty. The rate of 66% for Hispanic children is simply shocking (Addy & Wight, 2012). This research aims to integrate an evidence-based, child development intervention into Early Head Start (EHS) home visiting. Uniquely, it entails a concentrated effort on developing implementation supports for home visitors to ensure their successful provision of interventions to caregivers and children. Little Talks (Manz, 2011), an intervention that assists families' in formulating book sharing routines and engaging their children through dialogic techniques, will be integrated into a EHS home visiting (EHS-Little Talks) program that serves a largely Latino population. Complementing the integration of Little Talks, the structure of home visits will be modified to provide a systematic means for home visitors to support caregivers' use of Little Talks with their children. Additionally, home visitors will receive bi-weekly supervision, which innovatively includes performance feedback that is derived from continuous monitoring of the fidelity with which they deliver Little Talks to caregivers. Several outcomes will be assessed before, during, and immediately following EHS-Little Talks: home visitors' perceived competence, the home visitor-caregiver relationship, caregiver-child interactions, parental stress, EHS program attrition, and children's communication and vocabulary skills. Following sufficient time to collaboratively plan with the EHS program, two randomized clinical trials (RCT) will be conducted. The first will involve six home visitors and their corresponding families (60 families) who are randomly assigned to the EHS-Little Talks or a comparison group of routine EHS services (EHS-only). The second RCT will involve 10 home visitors and 100 caregivers and children. Each RCT entails a 24-week implementation of Little Talks, consisting of four assessment points. The measures were carefully selected to ensure that EHS-Little Talks and comparison home visitors could be readily trained and supervised to collect data so the home visiting relationship and context was minimally disturbed. Data from both RCTS will be combined and analyzed. This study is expected to show that EHS-Little Talks home visitors deliver Little Talks to caregivers with high fidelity and that the fidelity of their delivery of routine EHS services is enhanced, relative to the comparison home visitors. EHShome visitors are also expected to have elevated perceptions of competence. Due to the extensive supports caregivers' receive through the enhanced home visiting, their implementation of Little Talks with children is expected to have strong fidelity. Further, EHS-caregivers are hypothesized to have improved interactions with their children, report less parental stress, and experience less EHS program attrition than comparison caregivers. In the end, EHS-Little Talks children are expected to have significant gains in their communication and vocabulary skills, relative to comparison children.<< Previous Next >>