While her daughter naps, Bridget Collins spends an hour reviewing and role-playing activities with her home visitor, Amanda Pedlar, in the front room of her house in San Antonio, Texas.

This week, the pair starts by discussing 3-year-old Brook’s burgeoning curiosity. Pedlar notes that it’s normal, at this stage of development, for Brook to ask “Why?” often, to want to try new things and to explore her environment. Then she gives Collins some suggestions for encouraging her daughter’s inquisitiveness.

Together, they work through an activity packet, covering topics such as language and motor skills. Collins will introduce these same activities to Brook in the coming days.

Bridget Collins, left, and home visitor Amanda Pedlar role-play washing their hands ahead of a "tasting party" where they will distinguish between sweet and crunchy foods. Photo by Emily Tate Sullivan.

When Pedlar and Collins role-play a “tasting party” — surrounded by stuffed toys and dolls, in the spirit of a tea party — and try to distinguish between foods that are sweet and those that are crunchy, Collins leans into the persona of her daughter, simulating the 3-year-old’s tendency to become distracted, to be silly and to interject with a defiant “no!”

It allows Pedlar the opportunity to model different reactions.

“It really helps to see her respond the way I should respond,” says Collins, who notes that she used to tell her kids “no” a lot but now sees a host of other ways to reply, such as with redirection.

Week after week, the activities help strengthen the bond between parent and child. Collins also says it’s boosted her confidence.

Kids are learning from their parents and caregivers from birth. But what they’re learning, and how they’re learning, varies widely. By connecting families with trained educators, home visiting programs give parents a chance to learn high-quality, developmentally appropriate activities to do with their kids and ask questions about their child’s needs and progress.

This year, EdSurge has been reporting on voluntary, evidence-based home visiting services and the difference they can make for children and families in the United States.

In one story, we examined how a home visiting program, Home Instruction for Parents of Preschool Youngsters (HIPPY), is supporting immigrant families and connecting them to their communities. In another, we looked at how two long-running home visiting programs have adapted their models to serve home-based child care providers.

Over the past five months, we’ve observed home visits in two different states, attended a home visitor training and have spoken with more than 30 people to understand the home visiting landscape in this country and to see how these services support child development, improve school readiness, empower families and promote safe and healthy home learning environments.

Here are five key takeaways from our reporting:

1. Home visits do more than empower parents to be their child’s first and best teacher.

Home visits provide parents and caregivers with invaluable lessons and insights about their child’s learning and development. This can lead parents to become more confident teachers and more vocal advocates for their children. But the role of a home visitor extends beyond that.

“It's almost equally … about helping our families find the proper resources to improve their lives and improve maternal mental health,” notes Pedlar, the home visitor in San Antonio. “Things as simple as helping a family find a food resource and taking that burden off their shoulders can be really helpful.”

Home visitors provide goods such as diapers and wipes. They can connect families to resources such as food pantries, domestic violence prevention and early childhood intervention. And they’re often alerting parents to family-friendly events in the community, such as free days at the zoo.

Many home visiting programs also offer regular group meetings to convene participating families. For families new to this country, those meetings can provide a rare opportunity to meet others who come from their home country or speak their native language.

“At the end of the day, when you really deconstruct home visiting, it is about relationships,” notes Mimi Aledo-Sandoval, senior policy director at Alliance for Early Success, a nonprofit that works with early childhood advocates across all 50 states.

2. Home visiting programs can be beneficial for every family, but for now, their reach is limited.

More than 17 million families nationwide, including 23 million children, stand to benefit from voluntary, evidence-based home visiting services, according to the National Home Visiting Resource Center. That is to say, every pregnant woman and family with a child under age 6 has something to gain from these regular, in-home services.

“Being a parent is hard. Being a new parent is hard. I think that’s true regardless of socioeconomic strata, regardless of where you live. It is a life-changing event,” says Dr. Michael Warren, associate administrator of the Maternal and Child Health Bureau at the Health Resources and Services Administration, an agency within the U.S. Department of Health and Human Services (HHS). “So it is helpful to be able to get resources and get assistance when you need help. Home visiting can help fill in those gaps.”

While home visits are proven to lead to positive outcomes for children and families, only some have access to these programs, due to lack of funding. In 2022, only about 270,000 families (about 1.6 percent of those eligible) received home visiting services.

With limited funding, many communities deploy home visiting programs for specific populations, such as low-income families, single-parent households, recent immigrants and refugee families, families experiencing homelessness and those with a history of substance abuse.

3. The U.S. government invests in home visiting programs, and funding is set to expand.

Many home visiting programs have been around for decades. Historically, they’d received state and local funds, as well as money from private foundations, says Sarah Crowne, senior research scientist at Child Trends, a nonprofit research center focused on children and families.

Then, in 2010, the federal government invested in home visiting programs for the first time with the creation of the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program. “It was a game changer for states,” Crowne says.

To access those federal funds, states must work with one of the 24 home visiting programs that have met HHS criteria for evidence of effectiveness.

There has not been an opportunity like this in the recent past to be able to do this kind of expansion for home visiting services.

— Michael Warren

“It’s very rigorous,” Crowne adds. “It’s not just that any program can get these funds.”

Before Congress reauthorized MIECHV in 2022, the program was funded at $400 million annually. Now, under a new funding formula, that allotment will double to $800 million annually by 2027. Starting this year, the federal government will match $3 for every $1 in non-federal funds spent on home visiting programs, up to a certain amount.

“It really opens that door wide for [states], and it allows them to expand into communities where they know there is need but they have not been able to serve those communities to date,” says Warren, whose department oversees MIECHV.

“It really is exciting,” he adds. “There has not been an opportunity like this in the recent past to be able to do this kind of expansion for home visiting services.”

4. Home visits are not a replacement for early childhood education, but they can help establish a solid foundation.

In a world where every family has access to high-quality early childhood education for their children, home visits would be a complementary support.

“In some countries, that is what happens,” says Miriam Westheimer, chief program officer for HIPPY International. “In this country, given very limited resources, that’s rare.” More often, in the U.S., children are either attending an early childhood program, or families are receiving home visits, she says. “It should not be one or the other,” Westheimer adds. “It often is.”

No one is arguing that home visits should be a child’s only outside learning experience before school, but with early care and education inaccessible and unaffordable for many families, that may be their only option.

In such cases, research has shown that home visits can give children a solid foundation from which to build as they begin school. Home visits help them acquire social-emotional skills, early literacy skills, and fine motor development, such as holding a pencil and using scissors.

5. The impact of home visits is expanding by serving home-based child care providers.

Home visits have traditionally been delivered to parents and primary caregivers. But in recent years, a number of home visiting programs, including HIPPY, ParentChild+ and Parents as Teachers, have seen an opportunity to expand their reach by serving home-based child care providers.

The model has proven successful, and many programs are trying to grow their presence among child care providers, including unlicensed “family, friend and neighbor” (FFN) providers, who are typically excluded from training and education programs.

A number of counties and states are finding ways to use public funds to implement this model.

Because many home-based child care providers serve multiple children and have strong relationships with the families they serve, many policymakers see them as well-positioned to translate the expertise they gain from home visits into positive outcomes for children.

© Photo by Emily Tate Sullivan for EdSurge

PUEBLO, Colorado — Standing in her living room, Isabel Valencia sets up her makeshift tennis serve with the materials on hand: a green balloon for a ball and a ruler affixed to a paper plate for a racket.

She bats the balloon to her home visitor, Mayra Ocampo, and they pass it back and forth, counting each return, offering encouragement and laughing at their mistakes.

The moment is light and playful, as it likely will be later in the week, when Valencia tries the same activity with her 4-year-old daughter Celeste. But Ocampo takes care to explain what’s happening beneath the surface: They’re not just playing tennis. They’re building social skills. They’re working on hand-eye coordination. And they’re practicing numeracy.

Home visitor Mayra Ocampo, left, and parent Isabel Valencia practice social and motor skills during a makeshift game of tennis. Photo by Eric Lars Bakke for AP.

Valencia, who came to the U.S. from Colombia a few years ago, found Ocampo through a free home visiting program that supports families with their children's early learning and development.

The model — and others like it — has provided a lifeline for families, especially those for whom access to quality early education is scarce or out of reach financially. These programs, which are set to expand with new federal support, are proven to help prepare children for school but have reached relatively few families.

It was during a trip to the grocery store in 2022 with her two young kids that somebody told Valencia about the home visiting program. She had moved to Pueblo, Colorado, only a few months earlier and was feeling isolated. She hadn’t met anyone else who spoke Spanish.

“I didn’t leave my house,” she says through an interpreter, “so I thought I was the only one.”

This story was published in collaboration with The Associated Press.

The Home Instruction for Parents of Preschool Youngsters program, known as HIPPY, provides families with a trained support person — in Valencia’s case, Ocampo — who visits their home every week, showing them how to engage their children with fun, high-quality, developmentally appropriate activities.

The HIPPY program is unique for its two-generation approach. Through regular home visits and monthly group meetings, parents learn how to promote early literacy and social-emotional skills from staff who went through the program themselves and often share the same language and background as the families they serve.

The program is primarily implemented in low-income neighborhoods, as well as through school districts and organizations reaching immigrant and refugee families, says Miriam Westheimer, chief program officer for HIPPY International, which operates in 15 countries and 20 U.S. states.

Many other home visiting models exist, each with distinct features. Some employ registered nurses as home visitors, focusing on maternal and child health; others send social workers or early childhood specialists. They can begin as early as pregnancy or, as in the case of HIPPY, serve families with toddlers and preschool-aged children.

In the U.S., two dozen home visiting models have received a stamp of approval — and with it, access to funding — from the federal government’s Maternal, Infant and Early Childhood Home Visiting (MIECHV) program.

Dr. Michael Warren, associate administrator of the Maternal and Child Health Bureau at the Health Resources and Services Administration, which oversees the MIECHV program, has seen first-hand the way home visiting can strengthen families but says that, right now, its scope is too limited.

An estimated 17 million families nationwide stand to benefit from the type of voluntary, evidence-based home visiting services that Valencia receives. Yet in 2022, only about 270,000 did.

“That is purely because of resources,” notes Warren. “If more resources exist, more families can be served.”

Fortunately, he says, reinforcements are on the way.

The federal investment in the MIECHV program is set to double from $400 million to $800 million annually, by 2027. Beginning this year, the federal government will match $3 for every $1 in non-federal funds spent on home visiting programs, up to a certain amount. Since many states already have funding mechanisms in place — through a combination of public, nonprofit and private contributions — it is expected to be an easy win.

In interviews with more than 20 individuals who conduct, receive or research home visits, and in observation of two home visits in Colorado and Texas, the extent of this service’s impact on families and communities became clear.

Now in her second year of the HIPPY program, Valencia is a more confident parent. She says the structured curriculum she follows, paired with Ocampo’s support, have helped her prepare her daughter to thrive in preschool.

© Photo by Eric Lars Bakke for AP

A program that began in Kentucky as a novel idea to rebuild the early childhood workforce — and, in effect, buoy the broader labor market — has quickly spread to states across the country.

To draw early educators back into classrooms, legislators in the Bluegrass State made a change in fall 2022 that expanded the eligibility requirements of Kentucky’s child care subsidy program to include all staff who work at least 20 hours per week in a licensed early care and education program. In effect, early childhood educators became automatically eligible for free child care for their own kids, regardless of household income.

It was an instant boon. In its first year, 3,200 Kentucky parents working in early care and education participated in the program, with some 5,600 children benefitting.

Early childhood advocates, policymakers and business leaders in other states took notice. A creative solution with immediate impacts? They wanted in.

“It blew up,” says Lauren Hogan, managing director of policy and professional advancement at the National Association for the Education of Young Children, a nonprofit membership organization that advocates for high-quality early learning. “There’s a reason it’s gotten steam. It’s proven valuable.”

A year-and-a-half into Kentucky’s experiment, more than a dozen states have either launched their own programs or are seriously considering it, including Arizona, Colorado, Indiana, Iowa, Massachusetts, Nebraska and Rhode Island.

If all 50 states, plus Washington, D.C., adopted a policy like Kentucky’s, more than 234,000 staff in early care and education settings with children under age 6 could benefit, according to an estimate from the Center for the Study of Child Care Employment.

The premise of the initiative is simple: Better-staffed early care and education programs will increase the supply of child care, allowing more parents to re-enter the workforce. But the field has struggled to retain and attract staff.

Over the last few years, amid the pandemic and rising inflation, many early educators left the field because they found they could make more money elsewhere. Everyone from Amazon to Target to Chick-fil-A was offering higher wages. Child care providers, already operating on the tiniest of margins and charging families more than they can reasonably afford, simply couldn’t compete.

The result was understaffed early care and education programs, leading to closed classrooms and more families without access to care.

Kentucky’s approach works because it gives early care and education providers a tool to retain the staff they have and sweeten the deal for prospective educators.

“If you can’t directly increase the money in folks’ pockets, you can at least reduce their costs,” explains Hogan. “A lot of them have child care costs.”

Some of our educators can’t even pay for their own children to go to the program where they work, and that just doesn’t make sense.

— Lisa Hildebrand

Beyond how attractive it is for the economy, the program is also snuffing out a bitter irony that has long persisted in the field: Those who provide child care can seldom afford it themselves.

“Some of our educators can’t even pay for their own children to go to the program where they work, and that just doesn’t make sense,” says Lisa Hildebrand, executive director of the Rhode Island Association for the Education of Young Children. “Now, there is a way for them to be able to afford that.”

Rhode Island is eight months into a year-long, $4 million pilot of a program modeled on Kentucky’s — one that Hildebrand hopes will be renewed in the state legislature come June.

There is certainly evidence to support its continuation, she shares.

As of March, 475 children were participating in the pilot program. Their parents work across 162 different center- and home-based early education programs throughout Rhode Island.

Of those participating, 23 percent were already eligible for the state’s existing income-based Child Care Assistance Program. But more than three-fourths have had child care expenses waived through the pilot. (Rhode Island’s program differs from Kentucky’s in that it does have an income cap, just one that is notably higher than that available to other families in the state.)

Providers have shared that they’ve been able to bring back former classroom teachers and attract new ones to their programs, which is a huge relief to the sector, Hildebrand says.

“Staffing right now is at such a critical level [for some providers] that if they lose one teacher it means closing a classroom with a large number of children,” she explains. “We [already] have long wait lists, families waiting years for a slot. That’s less people in the workforce.”

In a survey conducted by the Rhode Island Department of Human Services, which administers the program, one provider called the pilot “life changing” for staff with young children. Others mentioned an influx of job applicants and new hires who are experienced and excited to work in the field — neither of which is a given in the underpaid profession.

Another provider said, “This has been an amazing experience. We were able to attract a top-notch toddler teacher who had chosen to stay home because the cost of child care was too high in comparison to her income.”

“Categorical eligibility” for child care workers is a rare policy solution that “can be embraced by red states and blue states,” notes Hogan.

We cannot solve our workforce crisis without solving our child care crisis.

— Katie Bass

In Nebraska, a bipartisan group of legislators has been pushing for a bill with expanded eligibility for early care and education staff this legislative session.

“We are in a workforce crisis in Nebraska, and we’re in a child care crisis,” says Katie Bass, data and policy research advisor at First Five Nebraska, a bipartisan public policy organization focused on expanding opportunities in the early years. “We cannot solve our workforce crisis without solving our child care crisis.”

The Nebraska bill ultimately did not pass before the end of the session in mid-April — there just wasn’t enough money this time, Bass explains, but says “it’s certainly not stopping here.”

Representatives from conservative and liberal groups alike testified in favor of the program. The bill’s sponsor, State Sen. John Fredrickson, intends to reintroduce the legislation in the next session, which begins in January 2025, Bass says. In the meantime, he has introduced an interim study to evaluate the different approaches other states are taking and determine the version that will best suit early educators in Nebraska.

“It’s kind of unprecedented,” Bass says of the bill’s wide base of supporters. “The lack of child care is affecting every single sector’s ability to operate.”

© Lordn / Shutterstock