KIPS Blog: Parenting Assessment in Practice & Research

Home Visiting’s Role in Supporting Parents in Addressing Toxic Stress

Posted by Marilee Comfort on Wed, Jan 29, 2014 @ 09:30 AM

This week I’m going to the Fourth National Summit on Quality in Home Visiting Programs in Washington DC, sponsored by the Pew Trust and Every Child Succeeds.  Hundreds of  practitioners, model developers, researchers and policy makers are gathering to learn and share current experiences and program outcomes from the Maternal, Infant, Early Childhood Home Visiting Program (MIECHV). I am excited to hear about innovations in the home visiting field.  We are all hopeful that the 2014 federal budget will continue to support and expand early learning and family support programs, and replace some of the funds lost during the 2013 sequester.

Plenary: The Importance of the Early Years by Dr. Andrew Garner

parenting assessment stressI was delighted to see that one of the keynote speakers at the Pew Summit is Andrew Garner, a pediatrician at Case Western Research University, speaking on “The Importance of the Early Years”.  According to the Summit Agenda, “This plenary will define toxic stress and describe its role as a biological mediator between early childhood adversity and poor outcomes in health, education, and prosperity. Addressing toxic stress and its lifelong consequences will require a layered approach that engages early childhood professionals from a wide array of disciplines.”

Dr. Garner is well qualified to enlighten us on this topic , as he recently authored a 2013 article in Pediatrics  titled, Home Visiting and the Biology of Toxic Stress: Opportunities to Address Early Childhood Adversity.  His article highlights the role of home visiting in addressing the lifelong impact of adversities that may be experienced in early childhood.   If neglected, the accumulation of stressors can lead to a negative cycle, resulting in “toxic stress”, which has a range of negative consequences including the development of unhealthy behaviors, such as smoking, substance abuse,  inactivity and overeating.  As our readers may recall, we’ve discussed toxic stress in previous blogs, both its consequences and how quality parenting can reduce its impact on children.

The good news is that our work with families of young children can make a difference.  We have the opportunity to give the gift of supporting parents in developing the knowledge and skills to prevent the impact of adversity for their infants, toddlers and preschoolers.   Garner recommends that we learn from the extensive research showing that safe, stable and nurturing relationships shield children from the effects of toxic stress.  In addition, we have the opportunity to help parents support children in learning the fundamental developmental skills needed to adapt and cope with adverse experiences.  Taking advantage of these early opportunities will require collaborative and coordinated community efforts with a continuum of care and support for diverse families from those working in health, education and social service settings. 

Ultimately the prevention of all childhood adversity is an unrealistic objective and, to a certain extent, an undesirable one. Positive stress is not the absence of adversity, but it results from adversity that is dealt with in a healthy, adaptive manner, thereby building confidence and resilience for the future. This challenges the pediatric, home visiting, and early intervention communities to intentionally and proactively build skills, rather than waiting and screening for delays before intervening. . . . The current challenge, then, is for pediatricians, home visitors, and early educators to collaboratively increase the capacity of caregivers and communities to nurture those rudimentary but foundational SE, language, and cognitive skills as they emerge developmentally. Home visiting with well-trained specialists is an important opportunity to build the capacity of mothers to support the child’s social, emotional, and cognitive development within the natural environment of the home. -- Garner, page 7

Reliable and valid parenting assessment tools, like the Keys to Interactive Parenting Scale, can identify parents needing support, and guide the tailoring of services to meet each parent’s specific strengths and needs.  Using validated assessment tools we can convince funders that the work we do is making a difference.

Have a Question I can Ask for You?

Do you have any questions for Andrew Garner? He speaks on Thursday morning, January 30, 2014.  If you leave a question in the comments section, I will ask it for you.


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Tags: Parenting Assessment, home visiting, adverse experiences/toxic stress