Home Visitation Services

Home visitation services represent one of the dominant early prevention strategies targeting physical child abuse and neglect in the United States and in a growing number of other nations. As the name implies, home visitation services provide services to families directly in their homes, most typically during the perinatal and early childhood phases of the children's lives. Home visitation programs are varied in the specific activities and strategies employed, and seek to promote an array of positive family and child developmental outcomes, including the early prevention of physical child abuse and neglect. Typically home visitation programs initiate services very early in the life of a child, often at birth or even shortly before birth. With regard to physical child abuse and neglect prevention, families are usually engaged in services prior to any identified abuse and/or neglect (unlike child protective services), and therefore home visitation services are most appropriately categorized as a primary or secondary (and sometimes universal or selective) prevention strategy. As no maltreatment has yet been identified, home visitation services identify families via universal service systems, such as the health care system, and are therefore designed to be nonstigmatizing and voluntary.

Service activities focus on ways of strengthening families that promote positive parenting patterns and child developmental trajectories and, in so doing, aim to reduce risk for future physical child abuse and/or neglect. Most typically, direct services focus on ways of supporting the development of a healthy parent-child attachment through parenting guidance, education, and skill development. As well, home visitors often focus efforts on helping families with information and support around infant health, home safety, and environmental challenges, and home visitors often link families up with needed resources and supports in the local community. Services are typically available during the first few years of each child's life, and taper off as families' risks and stated goals are addressed over time. Depending upon the program type, home visitors may be nurses, social workers, or paraprofes-sionals with intensive training in the role.