Introduction
A Coordinator's Story
A Family Service Advocate's Story
ECE Home VisitContinuous Quality Improvement Checklist
Assessment is used not only to monitor children's
progress relative to Head Start Child Outcomes, but also to improve
program services. The following article describes, from the perspective
of the Coordinator of Early Childhood Education and a Family Services
Advocate, how an Early Head Start program works with a staff development
assessment tool.
A Coordinator's Story
Providing ongoing support and technical assistance to home visitors in
Early Head Start programs takes a lot of knowledge, insight, patience,
and trust. As the Coordinator of Early Childhood Education (ECE) and Disability
Services for Project Eagle/University of Kansas Medical Center in Kansas
City, one of my primary job responsibilities is to provide our Family
Support Advocates (FSAs) with technical assistance in the areas of child
development, parent-child interactions, early education, and early intervention.
In addition to helping them achieve certification in the Parents as Teachers
curriculum and the Denver II screening instrument, I conduct four to six
training sessions a year. I work with 11 staff members and am responsible
for assessing their ongoing work with families and helping them build
their skills.
One way I support the Family Service Advocates is to work closely with
them on all aspects of their home visits with families. I start out by
helping to identify major concerns, issues, and goals prior to a family
visit. We set aside time to debrief after each visit. I am required to
make two home visits with each FSA every six months. More frequently,
I am invited on a home visit by an FSA and I end up making closer to 25
home visits per quarter. When we make a visit together, I look for evidence
relevant to our earlier discussions and evaluate the strengths and areas
needing improvement. If appropriate during the home visit, I may take
advantage of a "teachable moment" and model an intervention
strategy.
Our program has developed the Continuous Quality Improvement Checklist
(see attached CQI) to help me assess interactions during the family visit.
Sixteen items focus on the Advocate's behavior. Each one is marked
as either: 'needs improvement'; 'adequate'; or 'highly successful'. This
tool emphasizes instructive and positive feedback to families. When I
am observing the Family Service Advocates, I model the same style of feedback
to them. At the end of the form, there is space for additional comments
or observations. After the home visit, the FSA and I meet to discuss the
CQI checklist and my overall observations and interpretations. He, too,
discusses what he thought was happening during the visit and how he felt
about it. We brainstorm ways to improve the quality of the visits and
consider his next steps. We both sign off at the end of the form.
This assessment process is a strengths-based approach. I look at the FSA's
abilities and learning style. Together, we come up with an action plan
to help refine skills, deepen understanding, and increase confidence.
Looking across the program, the CQI checklists help us plan staff development
for the team of Family Service Advocates.
How we assess Family Service Advocates is not much different from how
we assess children and their families. Our goal is to identify their strengths
and competencies and from there, address their needs.
A Family Service Advocate's Story
In Project Eagle Early Head Start, I work with 14 to15 families every
week. My first responsibility is to develop a partnership with parents
and help them address their family's needs. In turn, I need ongoing
support from the Coordinator to do my job well. What follows is a "family
story" about how I work with a parent and her children, and how the
Coordinator and I work together to meet the individualized needs of this
family (whose names have been changed).
At the time of enrollment, May was 22 years old and a single parent. Her
son, Tae, was one year old and she was expecting her second child in a
few months. May was experiencing a high-risk pregnancy due to medical
complications. She was living in a rent-assisted housing project and receiving
cash assistance and medical coverage through the Medical Assistance Program.
May's original goals were to have a full-term baby, find child-care
for Tae (she was confined to bedrest during her pregnancy), and once the
baby was born, work on her employment goals. May, a high school graduate,
wants to go on with vocational training. She is very motivated to improve
her family's conditions, and she has a close network of family members.
Our home visits occur weekly at May's apartment. We also have two
agency-sponsored parent-child socialization play-groups each month. I
have observed May with her children and the children with their fathers.
May has good parenting skills. She is able to describe her children's
development, understands their temperament, and sets appropriate limits.
She maintains an open relationship with the children's fathers so
that they can be involved in family life. The family is very interested
in the motor development of the baby, Journie. They want to help her learn
to move, roll over, and hold her head up. We talk about all areas of development,
but motor development continues to be the one they consider most important.
I think there is an underlying concern about Journie's motor development
because of her mother's undetermined seizure disorder. In my role,
I have to be aware of parental worries and how they can affect parent-child
interactions.
When Journie was just a few months old, I invited the Coordinator, Stephanie,
to attend the child-parent socialization group to help me identify more
home visiting strategies. I asked her to help me observe Tae's and
Journie's overall development and specifically to focus on the baby's
motor development. Stephanie evaluated me by observing the first seven
items on the CQI form. We sat together after the playgroup and reviewed
the interactions I had with the family and she gave me feedback on the
items. Stephanie pointed out that I listened carefully to May while she
discussed Journie's motor movements during the playgroup. She also
noted that I talked to May about the next developmental stages she should
expect to see now that Journie is rolling over. Stephanie made me aware
that I had pointed out to May that she had read Journie's cues correctly
when the baby wanted to be picked up. Based on her CQI observation, Stephanie
praised me for all the positive feedback I gave May. One area that I needed
to improve on was asking more open-ended questions to find out from May
what kind of progress and accomplishments Journie had shown during the
past week. I found this suggestion very helpful and a reminder of how
to improve my future interactions with May.
Stephanie also recommended additional ways I could support the family
during our weekly visits. She pointed out that children like to be in
different positions. The parents might try having Journie bear some weight
on her legs and supporting her in a sitting position. Also, she talked
about dangling a toy and moving it to the side to really encourage Journie
to explore and move in that direction. We talked about how these activities
could be incorporated into the family's routines, maybe during bathing,
mealtimes or diapering. Using the CQI observation form to guide our discussion
is non-threatening and useful; the items are specific and Stephanie finds
a number of behavioral examples to back up her comments.
In Project Eagle, we use the Parents as Teachers curriculum and
supplemental resources to individualize lesson plans for each family.
It is up to me to understand developmentally appropriate practice and
adapt the curriculum if needed. The Coordinator has helped me look at
child-initiated play and the routines of the family to work out a program
that promotes a "goodness of fit" between the parents and the
child. The parents, in this case, like activities where they interact
in active, hands-on ways. Though May likes to do things, her baby is more
passive. We have tried to show how important it is to let Journie struggle
just a little to build new skills. Journie's parents read her cues
well and do not let her struggle too long.
It is also imperative that the Coordinator looks at the Advocate/parent
"goodness of fit" when developing an appropriate plan for the
family. Stephanie has encouraged me to let May's family "struggle"
with new skills and give them time to explore new ideas. She has helped
me to look for the family's cues indicating they have reached their
limit and, in response, reduce or change activities. During one visit,
she showed me how to address a family's concern by listening, offering
suggestions, and providing immediate feedback. She has also shown me that
flexibility during a visit is sometimes more important than following
a specific plan.
The Coordinator is invaluable for helping me rethink the situation and
think "outside the box." This process of learning results in
changes in my ways of interacting during home visits and sharing information
with the family. As I work closely with the Coordinator, my skills are
enhanced so that I am able to provide family-centered, culturally sensitive,
and individualized lessons for the child and family. When assessment is
not a scary experience, but an opportunity for me to grow and learn, I
benefit and so do the families.
ECE Home VisitContinuous Quality Improvement
Checklist
Date: ________________ Advocate: _________________________
________ Advocate is able to listen carefully to parents/primary caregivers
(PCG) needs in the area of child development and parent-child relationships.
________ Advocate asks "open-ended" questions that are helpful
in gaining more information about the parent-child relationship or about
the child's development.
________ Advocate uses "instructive feedback" (i.e., Advocate
responds to something specific that she/he observes while the parent-child
are interacting) which points out why the parent/PCG's behavior is
important to their child's development.
________ Advocate uses "positive feedback" (i.e., positive,
specific & contingent on the parent's/PCG's appropriate
nurturing behavior with their child during the home visit) with the parent/PCG.
________ Advocate demonstrates knowledge of child development and is
able to review and discuss developmental domains with parents/PCG's.
________ Advocate is able to observe parent-child interactions, read
infant/toddler and parent/s or PCG's cues.
________ Advocate is able to guide, coach and model appropriate intervention
strategies that support the parent/PCG's interactions with their
child and may be integrated into their daily routines.
________ Advocate is able to administer a screening and an assessment
in a developmentally and culturally appropriate manner.
________ Advocate is able to review the ECE Recommended Practices/Outcomes
with the parent/s or PCG and write individualized family and child action
plans with them.
________ Advocate describes which PAT lesson plan is being used and why
with the parent/s or PCG.
________ Advocate clearly states the objectives of the activity/lesson.
________ Advocate presents the individualized lesson plan in a clear,
concise and friendly manner.
________ Advocate asks the parent or PCG how the "follow-up"
activity worked for them.
________ Advocate explains and reviews the focus of the next PAT lesson
with the parent/s or PCG.
________ Advocate provides parent/PCG with options for a "follow-up"
activity.
________ Advocate encourages parent/s or PCG to assess their child's
developmental progress and to complete the observation and comment sections
of the lesson plan.
Further comments/observations:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Needs Improvement Adequate
+ Highly Successful
COORDINATOR of ECE ________________
ADVOCATE_______________
Stephanie Hudson is the Early Childhood/ Disabilities Services Coordinator
for Project Eagle. T: 913-281-2648;
E: shudson@kumc.edu.
Mary Sinur is a Family Services Advocate with Project Eagle. T: 913-281-2648;
E: MSINUR@kumc.edu.
