For Organizations & Professionals

Model Partner
Theoretical Framework and Essential Elements

Our model approach provides relevant, practical, and reflective resources that support families learning in the areas of health, wellness, development, safety, and overall family stability.

Model Partners are programs approved to deliver the First Born and More evidence-based model.

Theoretical Framework

We have integrated the key concepts of the following theories and the Diversity-Informed Tenets for Work with Infants, Children & Families English – Diversity-Informed Tenets for Work with Infants, Children, and Families – Irving Harris Foundation (diversityinformedtenets.org) in our practice.

Self-Efficacy/Empowerment Theory

Provides a way to understand how the belief in one’s capabilities to organize and execute an action required to attain a goal, regardless of the variety of circumstances, is a key factor in the formation of an individual’s competence (Bandura, 1997). According to this theory, cognitive, motivational, affective, and selection processes regulate human functioning within the context of three causal factors: personal, behavioral, and environmental.

We encourage parents to reduce risk factors (e.g., parental attitudes that diminish health and development) and increase protective factors (e.g., a parental attitude that support health and development) to increase child and maternal health, safety, and overall family stability.

Our curricula and training program emphasize the value of reflecting on prior and current experiences and developing realistic goals and achievable objectives to strengthen a caregiver and child’s self-believe influence their own motivation, leading to increased confidence, resilience, persistence, and effort (Schunk & DiBenedetto, 2021) to ultimately achieve optimal child development and family functioning.

Family Ecology Theory

Provides a way to understand how an individual’s development is shaped by the complex relationships between individuals and their environments. It identifies five interconnected key systems, each representing different levels of influence on a child’s growth, development, and behavior (Bronfenbrenner, 1979).

Our curricula and training program emphasize the importance of a child’s immediate environment (microsystem) where they learn essential skills, values, and behaviors through interactions with parents, siblings, caregivers, and any other individual within their immediate family support system. By helping caregivers to understand that they are the first teacher for their child, we encourage them to construct their family’s life course by choosing how to define, advocate, and negotiate their relationship with other systems within the context of their evolving family needs and changing communities to prevent adverse childhood experiences (ACEs) and to achieve positive health and developmental outcomes for themselves, their children, and their family.

We acknowledge that families alone have the needed expertise to determine whether professional recommendations can be successfully incorporated into their own family lifestyle.

Attachment Theory

Provides a way to understand how secure attachments in the early years can support children’s future brain development (Siegel, 2012). An infant’s brain is shaped by their early experiences (McCain et al., 2007) and the quality of these experiences has a substantial effect on development. A child’s attachment to a primary and/or few secondary caregivers is the most important factor in promoting positive psychosocial, emotional, physical, and behavioral well-being in children (McCain et al., 2007) and fostering a child’s full potential (Colmer, Rutherford, & Murphy, 2011).

Our curricula and training emphasize sensitive, responsive, and engaged parent-child relationships in the early years and encourage families to develop a “network of attachment” figures (Van IJzendoorn et al., 1992) that children can use to maintain a sense of safety that allows them to confidently continue to explore their environments and develop additional relationships that foster continuous child growth and development.

Within the context of mutual respect, acceptance, and equitable relationship between home visitors and families we strive to deliver a multi-generational, relationship-based, culturally sensitive, and family-centered program.

Essential Elements

Understanding the rapid changes occurring today, we have defined six essential elements within our model to ensure we provide purposeful interventions that result in meaningful outcomes for children, families and communities while fostering a flexibility that allows us and, allows you to honor those aspects that makes us unique.

Capacity Building:

All program staff complete model training and earn model certification before visiting families on their own.

Our program’s core competencies assure that home visitors have the knowledge and skills necessary to work effectively with families within the scope of our multi-generational, relationship-based, culturally sensitive, and family-centered approach.

Topics such as early maternal health, childhood development, nurturing relationships, safety, family functioning, and adult learning strategies are introduced during the initial training, and further explored during annual professional development training.

In addition, programs are encouraged to draw on the expertise of its own unique community to enhance their knowledge and skills on locally relevant and specialized topics such as immunizations, breastfeeding, domestic violence, safety, car seats appropriateness, nutrition, and more. By inviting local agencies to provide specific training, programs enhance intra-agency collaboration, referrals, and service coordination.

While not required by the model, programs are encouraged to allow trainees to spend time shadowing trained home visitors as they interact with families and complete documentation protocols. This experiential part of the trainee’s initial professional development is an important aspect because it provides the necessary link between theory and practice.

The core certification training requirements are:

  • Completion of eight (8) competency areas on basic home visiting skills in an online platform, including successfully completing the knowledge assessment at the end of each module.
  • Completion of ten (10) hours of live instructor-led training offered virtually or in-person by model staff. Instructor-led training is offered each month for new home visitors, with a two (2) hour session each week. This supports the integration of the online platform learning.
  • Successful completion of the knowledge assessment. If necessary, a one on one (1:1) remedial session can be offered.

Annual professional development training is offered to deepen and broaden home visitors’ knowledge base. Well-prepared staff leads to lower rates of staff burn-out, less turnover, increased quality in service delivery and higher family retention rates.

Essential Element 1

Curricula:

The core curricula are implemented through home visitation services.

  • The First Born® and More Prenatal Core Curriculum
    This curriculum provides information to support, mentor, and guide families during pregnancy, starting at the first week through delivery.
  • The First Born® and More First Years of Life Core Curriculum
    This curriculum provides information to support, mentor, and guide families with children between the ages 0 to 12 months.
  • The First Born® and More Toddler Years Core Curriculum
    This curriculum provides information to support, mentor, and guide families with children between the ages of 2 to 3 years.
  • The First Born® and More Three to Five Core Curriculum
    This curriculum provides information to support, mentor, and guide families with children between the ages of 3 to 5 years.

Each curriculum is:

  • Available in English and Spanish.
  • Appropriate for any literacy level.
  • Easily tailored to match the caregiver’s individualized learning style — visual, auditory and/or kinesthetic and tactile.
  • Easy to share in paper format, electronically or verbally.
  • Intended to be used by home visitors and families alike.
    • It is a learning and home visit preparation tool for home visitors.
    • It is a support resource for families.
  • Design to include:
    • Information
    • Activities
    • Reflective Questions
    • Resources

During a home visit, home visitors should be prepared to assess the family’s current situation, to share curriculum, and to facilitate a developmentally appropriate play activity and early literacy activity in the context of sharing information related to child development. However, it is important that home visitors are also prepared to adapt their visit plan according to the feedback provided by the family during the “check in” portion of the session. The amount of time spent on each of these four (4) activities will vary based on family needs, age of child, and family goals.

Home visitors are not required to share every piece of curriculum. Home visitors share what is of interest to the family, and regularly address health, development, safety, nutrition, and early literacy related topics. This strengthens the family’s resilience by increasing their knowledge and empowering them to advocate for themselves and their children.

Essential Element 2

Home Visitor to Family Ratio:

Home visitor to family ratio is important to ensuring effective service delivery, client support and satisfaction, improve client outcomes, enhance service coordination, focus on essential tasks and prevent burnout.

Caseloads should be no more than twenty-five (25) assigned families for a full-time home visitor, and no more than twelve (12) assigned families for a part-time home visitor. This is crucial in providing home visitors with the ability to spend adequate time with families and children to properly assess, plan, coordinate, advocate, and evaluate. Programs should consider the complexity of each family’s needs including the frequency of visits needed, and whether additional service coordination will be required when assigning a caseload.

Essential Element 3

Visit Frequency:

A minimum of two (2) monthly family visits, twenty-four (24) visits each year, is offered during the duration of the services. However, additional visits may occur depending on each family’s individualized needs. The frequency of the visits during the month is also determined by the family’s needs and schedule. For example, the two visits may be scheduled during the first and third week of the month, the second and fourth week of the month or during consecutive weeks if more appropriate and/or beneficial to the family.

Home visits are at least forty-five (45) minutes long and are offered in the convenience of the family’s home, in a place within their community like a park or library, or in a virtual setting.

Services may continue until the child is five years of age or until services are no longer requested by the family.

Home visitors provide support and assist families in acquiring knowledge to increase parental capacity and decrease child vulnerability. Through learning experiences and positive relationships, caregivers are empowered to find solutions to challenges as they occur rather than waiting until the concern has reached a more significant level of difficulty.

Through consistent and predictable family visits, families experience:

  • Being heard.
  • Respect, validation, and affirmation of their culture, customs, values, and beliefs.
  • Honest and open communication.
  • Easy access to complete and unbiased information.
  • Connection to services and resources based on the family’s expression of needs and preferences.
  • Learning through relationships and trial-and-error.
  • Fun, play, and laughter.

Essential Element 4

Reflective Supervision:

Reflective supervision facilitates learning and professional development, enhances professionalism, improves accountability, and leads to better outcomes. It deepens the understanding of the work by allowing time to reflect on an individual’s emotions, thinking, efficiency, logic, formal knowledge, and life experiences. The reflective process supports proactive and strategic decision-making and interventions rather than a reactive approach. It also decreases the possibility of implicit and explicit bias that potentially could impact the effectiveness of the intervention.

Home visitors receive one on one (1:1) or small group reflective supervision (no more than four (4) staff members in the group) at least twice a month. Program Managers receive one on one (1:1) or small group reflective supervision at least once a month.

Essential Element 5

Screenings:

Assessments related to child development, parental mental health, and overall family functioning are conducted in a developmentally appropriate, culturally sensitive, and linguistically responsive manner.

Effective assessment of the areas mentioned above is done though documentation of observations, self-report, and the administration, when appropriate, of the following validated assessments tools:

Child Development:

  • Ages and Stages Questionnaire Social Emotional (ASQ:SE-2): pinpoint potential socio-emotional concerns, exclusively screen social and emotional skills and behaviors in children between the ages of one (1) month to six (6) years. It is administered at different months of age. The areas screened are self-regulation, compliance, social-communication, adaptive functioning, autonomy, affect, and interaction with people. Parents/caregiver complete questionnaires; professionals, paraprofessionals, or clerical staff score the assessment. This assessment should be administered at minimum every six (6) months.
  • Ages and Stages Questionnaire (ASQ®-3): pinpoints developmental progress in children between the ages of one (1) month to five in half (5.5) years. It is administered at different months of age. The areas screened are communication, gross motor, fine motor, problem solving and personal-social. Parents/caregiver complete questionnaires; professionals, paraprofessionals, or clerical staff score the assessment. This assessment should be administered at minimum every six (6) months.

Adult – Child Interactions:

  • Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO): pinpoints adult-child interactions that support children’s development through talking and play between the ages of ten (10) to forty-seven (47) months. The areas screened are affection, responsiveness, encouragement, and teaching. It is administered at program entry, at any time during services, and at program exit. This assessment should be administered at minimum every twelve (12) months starting at age one (1).

Parental Mental Health:

  • Edinburgh Postnatal Depression Scale (EPDS): pinpoints potential symptoms of perinatal depression. It is administered during pregnancy and postpartum period. This assessment should be administered at minimum once (1) at six (6) to eight (8) weeks postpartum.

Family Functioning:

  • Relationship Assessment Tool (RAT): pinpoint potential emotional abuse by measuring a partner’s perception of their vulnerability to physical danger and loss of power and control in their intimate partner relationship. This assessment should be administered at minimum within six (6) months of enrollment and re-administered at least once (1) a year.

Early identification of children, caregivers, and family needs for information, support and/or additional services may decrease the risk for Adverse Childhood Experiences (ACEs) in children.

Essential Element 6