Have a Heart for Kids Day 2020

Home visiting offers help when parents need it most

siobhan 03/16/09

At age 19, Laura Montejano had cut off ties to her family in a fit of teenage anger and rebellion. Partly to spite her family, she got married—and didn’t tell them. Her new husband, Francisco, was young too, and new to Washington state, with no community ties. Neither had a college diploma; Laura worked as a nursing assistant and Francisco bused tables in a restaurant.

So when she found herself pregnant, she panicked.  “I felt so alone,” Laura said. She knew she needed help. “I knew I needed something, but I didn’t know what.”

The community health center where she got medical care referred her to Healthy Start's Parents as Teachers program, which links young parents with home visitors who have been trained to support and teach new parents through their children’s first years. Laura’s home visitor talked about developmental milestones and what she could do to help her daughter, Yazmin, reach them. She helped connect her with health care and brought her donated diapers and clothes.

She also helped Laura set goals for herself and offered information for Laura’s husband about where to get English classes. “She talked about us as adults,” Laura said, at a time when she was just learning to think of herself as an adult. 

The stress of a newborn baby can be difficult for any family. For low-income parents like Laura Montejano who lack extended community or family support, the stress can be overwhelming. Healthy Start is just one of a number of home-visiting programs designed to help vulnerable families successfully navigate the first years of their children’s lives. Home-visiting programs have been shown to prevent a host of serious--and expensive--problems from child abuse to future crime, saving communities large amounts of money down the line.

These voluntary and intensive services work directly with families for approximately two years. Some programs, including Healthy Start, begin prenatally or soon after delivery, and others focus on ages two and three.

The science behind these programs is well-established. Researchers have found that the stress of poverty communicates to children, and children who grow up in families facing economic hardship commonly exhibit elevated cortisol levels, a stress hormone that can negatively affect brain development.

As neuropsychiatrist Pat Levitt testified to the House Early Learning and Children’s Services Committee on February 19, frequent or sustained stress on children in their first months and years affects the development of the brain, increasing the risk of learning problems, depression, anxiety disorders, alcoholism, drug abuse, cardiovascular disease, diabetes, and strokes. But these negative effects can be reversed through early intervention programs—and the earlier the better.

Home visiting is a prevention program that promotes children’s health and helps them to develop the social, emotional, and intellectual skills they need to succeed in school and life. Home-visiting programs also have been demonstrated to decrease the risk of child abuse, neglect, and future violent crime. For example, only 6 percent of the young parents enrolled in the Healthy State program were referred to Child Protective Services in 2006, compared to the statewide average of 18 percent for young parents.

A study of another home-visiting program, the Nurse-Family Partnership, found that by age 15, the children of the mothers in the treatment group had 48 percent fewer substantiated reports of abuse or neglect as compared with peers not enrolled in the program. Mothers and children in the program also had significantly lower arrest rates (61 percent fewer for the mothers and 59 percent fewer for the children) than the control group that was not enrolled in the program.

However, these successful and money-saving programs are at risk of losing their state funding this year. Evidence-based home-visiting programs like Healthy Start received $3.5 million in state funds over the last two years. Washington State is facing a massive budget deficit. Yet families are facing daily budget crises of their own. Economic stress makes child abuse and neglect more likely; data are already beginning to show increases in child abuse since the national economic crisis began.

The families served by state-funded home-visiting programs are the most vulnerable, just the population that most needs support in difficult times like these. The Children’s Alliance is advocating for inclusion of $3.5 million administered by the Council for Children and Families in the next state budget to protect evidence-based home-visiting programs; the Senate’s budget, the first to come out, is expected to be released March 20.

Even with the help of her home visitor, Laura Montejano struggled, and she hit rock-bottom after the birth of her second child, Cristian. With two small children to care for, she wasn’t initially able to return to work after his birth. At Christmas that year, she and her husband were broke and discouraged.  Healthy Start volunteers brought the whole family Christmas presents.

“Why would someone do that for you?” she remembers thinking. The gifts gave her hope.

Buoyed by the encouragement she received from Healthy Start, Laura enrolled in nursing school, sticking with it despite having two children and working full time. Now, twelve years after being helped through her rocky start at having a family, she and Francisco are still married. Laura is an RN, working in the neonatal intensive care unit. She loves helping new moms. “It’s like I’ve come full circle,” she said.

--by Carolyn McConnell