IntroductionConducted as part of the Massachusetts MIECHV evaluation, this study examined the role of home visitors (HVs) in facilitating families’ connections to early childhood systems of care. The aims of this study were to document the full range of HV behaviors related to service coordination.MethodsThe study sample was 65 participant cases from five program sites, comprising two home visiting models (HFM and PAT). We coded and analyzed 11,096 home visiting records, focusing on identifying referrals, connections, disconnections, and supportive behaviors across 20 service areas. Qualitative pattern analyses were conducted on a subsample of records to identify unique pathways from referral to connection.ResultsHVs discussed an average of 30 different programs with each participant, and overall, only 21% of referrals resulted in a service connection. This rate varied, with some (e.g., housing) requiring much more intensive HV support and yielding far fewer connections. HVs also worked to keep participants engaged once they were connected to a service, often discovering challenges in need of attention through monitoring activities.DiscussionHome visiting is often thought of as a key entry point into a system of care. Findings from this study confirm this premise, highlighting both the centrality of home visiting in helping families navigate local systems of care, and the insufficiency of these systems to meet family needs.
The dyadic early intervention POC may influence mother's mental health and indirectly impact children's well-being during critical stages of their development by strengthening their mother's sensitivity towards them.
This study explored emotional availability (EA)— an individual's emotional responsiveness and attunement to another's needs and goals (R.N. Emde, 1980)— among a high social risk group of 226 adolescent mothers and their infants (average = 12 months old). The aim was to identify dyadic patterns of EA and to examine their association with multiple indicators of the ecological context. Maternal sensitivity, maternal nonhostility, and child responsiveness were assessed with the Emotional Availability Scales, Third Edition (Z. Biringen, J. Robinson, & R.N. Emde, 1998) during free play and teaching observations at home. Four EA patterns were identified using k‐means cluster analysis: (a) “low functioning,” (b) “high functioning,” (c) “low functioning dyads with nonhostile mothers,” and (d) “inconsistently sensitive mother and responsive child.” These patterns had distinct associations with (a) mothers’ parenting attitudes regarding children's power and independence and parent–child role reversal, (b) mothers’ strategies in conflict resolution with their partners and their children, and (c) the dyads’ living arrangements. This study makes a contribution to the understanding of the mother–child relationship from a systemic and relational perspective and explores the association of EA patterns with the dyads’ relational context. Implications for programs and treatment approaches aimed at supporting dyads at social risk are discussed.
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