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Home > Advocacy > Home Visitation > CWLA Testimony Submitted to the House Subcommittee on Education Reform, Committee on Education and the Workforce for the Hearing on Perspectives on Early Childhood Home Visitation Programs


CWLA Testimony Submitted to the House Subcommittee on Education Reform, Committee on Education and the Workforce for the Hearing on Perspectives on Early Childhood Home Visitation Programs

September 27, 2006

The Child Welfare League of America (CWLA), on behalf of its nearly 900 public and private nonprofit, child-serving member agencies, thanks the U.S House of Representatives Subcommittee on Education Reform of the Committee on Education and Workforce for holding this hearing. The issue of in-home visiting services to targeted vulnerable or new families is an important one for our organization. We appreciate that this Subcommittee, through the leadership of the Chair, Representative Michael Castle (R-DE) and Ranking Member Representative Lynn Woolsey (D-CA), and other members of the Committee, and sponsors of HR 3628, Representatives Danny Davis (D-IL), Tom Osborne (R-NE), and Todd Platts (R-PA), have worked to assure that time was set aside in the Subcommittee's busy schedule to highlight how quality early childhood home visitation programs lead to positive outcomes for children and families, including a reduction in child maltreatment.

CWLA looks forward to future hearings and discussions on the range of child welfare issues that challenge this nation-including federal support for home visiting programs. This hearing demonstrates the willingness of the committee and bill sponsors to examine strategies that can strengthen children and families long before there is a problem, let alone a crisis. CWLA is pleased to be a part of a growing number of organizations and policymakers who have endorsed HR 3628 and its Senate companion S 503.

As we have stated in other Congressional settings, CWLA believes the best way to ensure children are safe from all forms of maltreatment are comprehensive, community-based approaches to protecting children and supporting and strengthening families. Public and private agencies, in collaboration with individual citizens and community entities, can prevent and remedy child maltreatment, achieve child safety, and promote child and family well being. There is no solution to addressing child abuse in our society short of a comprehensive approach that begins with preventive efforts and assures that we have a safe and permanent place for children who are the victims of abuse and neglect.

Studies have demonstrated the effectiveness of several approaches to prevent child maltreatment. Different communities may choose or find different solutions that best address their particular needs and that fit into their provision of child and family services. This is how home visitation programs fit into a continuum of care. Models that we describe in this testimony have produced evidence that they positively impact a variety of outcomes for children and families, including prevention of abuse and neglect. Similarly, high quality pre-kindergarten programs like the Chicago Child Parent Centers and the comprehensive Head Start programs that include parental involvement and supports have also demonstrated effectiveness. 1 Independent studies have found that the financial savings achieved by the most effective of these approaches far exceeds their costs. 2 Rigorous cost-benefit analyses conducted by the Washington State Institute for Public Policy showed cost savings for several pre-kindergarten and home visitation programs as well as for Parent-Child Interaction Therapy, a center-based intervention that provides direct coaching to parents as they interact with their young children. 3

CWLA Support For Home Visitation

In 2004 nearly 3 million children were reported to authorities as having been abused or neglected, with 872,000 of these reports being substantiated. Of the nearly 900,000 children substantiated and categorized in one or more categories of abuse and neglect, sixty-one percent suffer from neglect, nineteen percent suffer from physical abuse, ten percent suffer from sexual abuse, 5 percent suffer from psychological maltreatment and 2 percent suffer from medical neglect. An additional seventeen percent experienced other forms of maltreatment that do not precisely fit the foregoing terms. Thirty percent of victims were age 3 or younger. In 2004 1,490 children died from child   abuse.

An important statistic that is consistent from year to year are the reports that forty percent of the nearly 900,000 children who have been found to be abused and neglected never receive follow-up services. 4 States may vary in how they collect and report data in this area but this consistent report bolsters claims that we need to do much more in addressing the needs of these children and families.

Services for children and their families, both those that are substantiated and in those cases where abuse is not found, include a range of community and family based supports. For families that have been investigated, follow up services may include individual counseling, case management, and services provided to the entire family such as family support and counseling, family preservation, and home visiting.

Home visitation, in addition to the few examples we cite here and the benefits that others have addressed here today, can also be an appropriate prevention strategy before any reports of abuse and neglect take place. Home visitation services can be effective in stabilizing at-risk families, and may potentially reduce the disproportionate representation of children and families of color while improving outcomes for these families. Research shows that families who receive at least 15 home visits have less perceived stress and maternal depression while also expressing higher levels of paternal competence. 5 Also, home visitation programs have been shown to reduce juvenile delinquency by reducing abuse and neglect, thereby reducing the likelihood that these potential victims of violence may one day engage in criminal behavior or become violent themselves.

Although we speak in support of HR 3628 and S 503 because we feel home visitation can provide an important component in a continuum of care that we need in the child welfare field, we also know that these programs can assist in improving education and health outcomes for children. Home visitation can show improved outcomes in the areas of prenatal care, access to health care and improved rates of immunizations.

Home Visiting Programs

Home visitation programs refer to a number of different model programs that provide in-home visits to targeted vulnerable or new families. Approximately 400,000 children between the ages of 0-5 receive the benefits of home visitation programs per year 6 as either stand-alone or are part of a center-based program. Eligible families may receive services as early as the pre-natal stage. The early years of a child's life are the most critical for optimal development and provide the foundation for success in school and life. 7 Nurses, professionals, or other trained members of the community conduct the visits on a weekly, bimonthly or monthly basis. Program goals include an increase in positive parenting practices, an improvement in the health of the entire family, an increase in the family's ability to be self-sufficient and enhanced school readiness for the children in the family.

In the state of Missouri, Senator Christopher Bond, (R-MO), as governor of that state signed the Early Childhood Education Act of 1984. This legislation helped expand the Parents as Teachers (PAT) programs in all state school districts. As the PAT model spread, it was later included in the reauthorization of the federal Elementary and Secondary Education Act. PAT joins several other model programs used by states across the country. States have decided to follow these different models depending on local needs and preferences. Other home visitation programs include Nurse-Family Partnership (NFP), Healthy Families America, Early Head Start, Home Instruction for Parents of Preschool Youngsters (HIPPY), and the Parent-Child Home Program.

These programs have similar goals and offer diverse approaches to targeted populations in fulfilling their purpose. A review of each demonstrates their wide acceptance and how they are an important source of community and family support in many states including states represented by members of the committee.

Nurse-Family Partnership (NFP) is an evidence-based nurse home visitation program that improves the health, well-being and self-sufficiency of low-income, first-time parents and their children. The Nurse-Family Partnership National Service Office, located in Denver, Colorado is a nonprofit organization that provides service to communities in implementing and sustaining this program. 8 Meanwhile, NFP program serves in states as diverse as California, Oregon, Washington State, Arizona, Wyoming, North and South Dakota, Nebraska, Oklahoma, Colorado, Minnesota, Missouri, Louisiana, Illinois, Michigan, Ohio, Kentucky, Georgia, North Carolina, Pennsylvania, New York, and New Jersey.

Healthy Families America (HFA) is a national program model designed to help expectant and new parents get their children off to a healthy start. Families participate voluntarily in the program and receive home visiting and referrals from trained staff. By providing services to overburdened families, Healthy Families America fits into the continuum of services provided to families in many communities. The program was launched in 1992 by Prevent Child Abuse America and was developed based on existing research in prevention and child development. 9 The HFA program can be found in Oregon, California, Arizona, Alaska, New Mexico, North Dakota, Nebraska, Kansas, Texas, Missouri, Iowa, Minnesota, Illinois, Kentucky, Indiana, Alabama, Georgia, Hawaii, Florida, Virginia, West Virginia, North and South Carolina, Michigan, Ohio, New York, New Jersey, Maine, Massachusetts, Connecticut, and Washington, D.C.

Home Instruction for Parents of Preschool Youngsters (HIPPY) is a home-based, family focused, parent involvement, and school readiness program that helps parents provide educational enrichment for their three, four, and five year old children. Although HIPPY is for any parent who wants educational enrichment for his/her child, the program was designed to assist families who might otherwise not get involved with their children's education because of barriers such as poverty, social isolation or lack of education. 10 The HIPPY program is in Maryland, Washington, D.C., Rhode Island, Oregon, California, Nevada, Arizona, Colorado, Nebraska, Kansas, Texas, Louisiana, Arkansas, Iowa, Minnesota, Hawaii, Wisconsin, Illinois, Kentucky, Tennessee, Alabama, Florida, Ohio, Indiana, Pennsylvania, New York, and South Carolina.

The Parent-Child Home Program (PCHP) is a home-based, early literacy, school readiness, and parenting program serving families with two- and three-year-olds who are challenged by poverty, low-levels of education, language and literacy barriers, and other obstacles to educational success. It is in Washington State, California, Nebraska, Florida, Ohio, South Carolina, New Jersey, New York, Maine, Pennsylvania, Massachusetts, and Michigan. Eighty-five percent of the families who start the program complete the two years of home visits. PCHP has 137 sites in the United States and 10 sites in other countries. 11

Parents as Teachers (PAT) is an early childhood, parent education, and family support organization serving families throughout pregnancy until their child enters kindergarten, usually age 5. Its Born to Learn model is designed to enhance child development and school achievement through parent education being made accessible to families and can be adapted to fit community needs. While a national model, it is a "local" program. Family participation is voluntary. 12 PAT serves all states and the District of Columbia.

Early Head Start (EHS) is a Head Start program that can begin before birth and serves children and their families until children reach three years of age. Early Head Start is a federal program funded through the Administration for Children and Families (ACF), and like all Head Start programs follows the Head Start Program Performance Standards. Congress initially funded EHS in 1994 through the Head Start Act. At least 10% of all enrollments are reserved for children with disabilities. EHS children and families receiving home-based services are visited weekly and have the option to attend bi-monthly group socializations in which they interact with other children and parents. 13 EHS serves all states and the District of Columbia.


CWLA commends the Subcommittee for its hearing today on home visiting-highlighting its successful outcomes for children and their families. Such successful outcomes of home visiting contributing to familial continuity, educational enrichment, as well as physical and mental health will be expanded by increased federal support. CWLA hopes that this hearing today is merely a first step taken by Congress to further home visitation initiatives nationally and to ultimately accomplish the passage of the legislation before you. This commitment will make the benefits of in-home visiting services accessible to many more families and improve outcomes for many more children.

  1. Alexander, R., Baca, L., Fox, J., Frantz, M. & Huffman, L., et al. (2003). New hope for preventing child abuse and neglect: Proven solutions to save lives and prevent future crime. Washington, DC: Fight Crime, Invest in Kids. Available onlineback
  2. Ibid. back
  3. Aos, S., Lieb, R., Mayfield, J., Miller, M., Pernucci, A. (2004). Benefits and costs of prevention and early intervention programs for youth. Olympia: Washington State Institute for Public Policy. Available onlineback
  4. Administration on Children Youth and Families. (2006). Child maltreatment 2004. Washington, DC:, US Government Printing Office. back
  5. Daro, D., Howard, E., Tobin, J. & Hardin, A. (2005). Welcome home and early start: an assessment of program quality and outcomes. Available online. Chicago, IL: back
  6. Chapin Hall.Center for Children at the University of Chicago. (2006). Challenges to building and sustaining effective home visitation programs: lessons learned from states. Available online. Chicago, IL: Author. back
  7. Daro, D., Howard, E., Tobin, J. & Hardin, A. (2005). Welcome home and early start: an assessment of program quality and outcomes. Available online. Chicago, IL:  back
  8. Nurse-Family Partnership. (2005) Factsheet. Available onlineback
  9. Healthy Families Americaback
  10. Home Instruction for Parents of Preschool Youngsters (HIPPY) back
  11. The Parent-Child Home Program back
  12. Parents As Teachers back
  13. Early Head Start back

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