Topics in Early Childhood Special Education
31(4) 224–231
© Hammill Institute on Disabilities 2012
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DOI: 10.1177/0271121411426488
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Home- and Community-Based
Early Intervention
According to the 2007 Annual Report to Congress (U.S.
Department of Education, 2010; the latest report avail-
able), between 1999 and 2004, the percentage of infants
and toddlers served under the Individuals With Disabilities
Education Improvement Act, Part C, increased from 68.4 to
82.7. What decreased in terms of percentage during that
time was infants and toddlers whose primary setting was a
program designed for children with developmental delay
or disabilities.
Over the past 40 years, two parallel but not necessarily
similar versions of home visiting have evolved: those for
infants and young children with disabilities and those for
young children from disadvantaged backgrounds (Ramey
et al., 1992; Sparling, n.d.). The most widespread model of
home visitation (note the terminological difference from
Part C, where “home visiting” is the customary label) is
probably the Olds Nurse Home Visitation Model (Olds,
2009; Olds, Henderson, Kitzman, Eckenrode, & Cole, 1999).
Other nationally recognized models of home visitation are
Hawaii Healthy Start, which serves families with children
at risk of abuse and neglect; Healthy Families America, which
serves the same target families; and Parents as Teachers,
which focuses on parenting and parents’ determining children’s
outcomes.
The difference between programs aimed at at-risk families
and those aimed at children with disabilities and their families
is highlighted by the different approaches to a curricu-
lum. A well-defined curriculum, which is usually found in
programs for at-risk families, suggests that a set series of
competencies are taught to all families. In Part C, however,
the curriculum is the child’s individualized family service
plan (IFSP) outcomes, making it much more individualized
than a curricular approach, unless a curriculum-based assess-
ment was used to develop the IFSP. In that case, curricular
content is likely to end up on the IFSP.
Organizationally, home visitation, with its large influx of
federal support under the Obama administration, has been
managed through Maternal and Child Health Services in the
U.S. Department of Health and Human Services, whereas
federal funds for Part C—with no large influx of funds—are
managed through the Office of Special Education Programs,
U.S. Department of Education. Part C has largely been
excluded from this recent attention on home visitation.
A simplification of the evolution of home visiting in Part
C could be as follows. In the 1970s, some early intervention-
ists made regular home visits to teach parents strategies
for ameliorating the effects of the infant’s or young child’s
disabilities (Phemister, Richardson, & Thomas, 1978). In the
1980s, the pernicious slide toward overspecialization began,
with professionals of different disciplines staking out their
scope of practice (and source of revenue), leading to a
multidisciplinary approach to home visiting (Woodruff &
McGonigel, 1988). In the 1990s, as various professional
426488TEC 31 4 10.1177/0271121411426488McWill
iamTopics in Early Childhood Special Education
© Hammill Institute on Disabilities 2012
Reprints and permission: http://www.
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1
Siskin Children’s Institute, Chattanooga, TN, USA
Corresponding Author:
R. A. McWilliam, Siskin Children’s Institute, 1101 Carter Street,
Chattanooga, TN 37402, USA
E-mail: robin.mcwilliam@siskin.org
Implementing and Preparing
for Home Visits
R. A. McWilliam
1
Abstract
The most common setting for early intervention services for infants and toddlers with disabilities and their families is the
home. This article discusses home- and community-based early intervention and how the routines-based interview (RBI)
can set the stage for successful home visits. It also addresses what has been learned about home visiting, what important
issues face the field with respect to home visiting, and what still needs to be learned. These same issues are discussed for
IFSP development.
Keywords
routines-based interview, home visits, needs assessment, early intervention, IFSP
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