Understanding perceptions of child maltreatment risk: A qualitative study of Early Head Start home visitors

Abstract

Infants and toddlers enrolled in Early Head Start are at increased risk for child maltreatment. Within Early Head Start, home visitors are in a unique position to identify the families most likely to experience maltreatment by identifying characteristics and behaviors of children, caregivers, families, and environments that are of concern. However, research has demonstrated that home visitors are often ill-equipped to identify and address risk factors such as parental mental health concerns, substance abuse, and domestic violence. Further, little is known about how home visitors understand and perceive risk for maltreatment and identify vulnerable families. The study sought to identify how Early Head Start home visitors understand maltreatment, perceive risk for maltreatment, and work with families identified as at-risk. Qualitative interviews exploring identification of risk for maltreatment were conducted with fourteen Early Head Start home visitors and supervisors. Results indicate variable understanding of maltreatment. Home visitors identified numerous factors they believe suggest elevated risk for maltreatment and described variable approaches to working with families at risk. Findings provide rich information about the role that home visitors play in maltreatment prevention within Early Head Start. Directions for effectively training home visitors to engage families and deliver program and community-based services in a manner that reduces risk for and prevents maltreatment are discussed.

Early Head Start service use by families with court-substantiated maltreatment

“…For instance, families with a maltreatment record received fewer home visits than families without a maltreatment record. It is possible that EHS home visitors may experience discomfort in addressing issues of risk for maltreatment (Schreier et al, 2018). Perhaps home visitor reluctance to visit the higher risk families on their caseloads contributes to difficulty engaging these high risk families.…”

“…The current study focuses on the home-based program option, in part because home visitation programs are in a unique position to identify risk for maltreatment and connect families to appropriate resources and services (Schreier, McCoy, Flood, Wilcox, & Hansen, 2018). Home visitation developed out of a need to provide services to high-risk families that experience complex difficulties that may interfere with participation and engagement (Bilukha et al, 2005;Daro, 2000Daro, , 2005Daro & Cohn-Donnelly, 2002).…”

Coaching home visitors: A thematic review with an emphasis on research and practice needs

“…Our review identified several interrelated characteristics of coaches that deserve further attention: roles, qualifications, strategies/practices, and the coach's relationship to home visitors‐as‐coaches. Because the elements of coaching are inter‐related and cannot occur in a vacuum (Powell & Diamond et al., 2013), the role of the coach must be operationalized (Gupta & Daniels, 2012). Generally, coaches offer an additional perspective on the coaches work while supporting the early childhood professional‐as‐coaches and learning about their competencies (McLeod et al., 2017).…”

“…Professional development is an important aspect of evidence‐based HV (Maxwell & Supplee et al., 2018). A recognized component of professional development is coaching, which, although a broad concept, is recommended by a substantial body of research (e.g., Casillas et al., 2016; Schreier et al., 2018; Schultz et al., 2019). Coaching can occur alone or in tandem with other professional development efforts (Snyder et al., 2012).…”

A Promising Approach in Home Visiting to Support Families Affected by Maternal Substance Use

“…Research findings indicate that even when maternal substance use is identified, home visitors report feeling ill-prepared to effectively respond to the needs of these mothers and their infants (S. Dauber et al 2017a , b ; Schreier et al 2018 ; Tandon et al 2008 ). Home visitors in these studies indicate a need for specialized training to address issues related to alcohol and other drug use (Schreier et al 2018 ; Tandon et al 2008 ). Home visitor education and training requirements vary widely across program models.…”