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February 2006

In-home family education: Legislators must make this good investment in kids

by Joan Phillips, M.D.

As a pediatrician and parent, I know firsthand the tremendous impact that parents have on child development. I also know what a challenging job it can be. I’ve seen how important it is for parents to have good information and support when they need it most, during pregnancy and the first years of their children’s lives. That’s why my colleagues and I are urging the West Virginia Legislature to support a supplemental appropriation for in-home family education.

Many parents of infants I have treated over the past 22 years do not have the traditional extended-family support they need to help them face the challenges of parenting. Many families live great distances from grandparents, aunts and uncles. Daily encouragement and support during the stressful times of a sleep-deprived parent or 2-year-old temper tantrums is vital to the survival of well-functioning family units. Pediatricians address these issues in 15- to 30-minute office visits, but they are not always able to guide the parents in day-to-day routines that occur at home. A team approach is needed.

In-home family education is a practical and economical approach to healthy child development. These community programs send trained staff members to visit expectant and new parents in their homes. They provide information and support and link families to other resources they might need. Their services are entirely voluntary, and trust is key to this helping relationship.

The home visitors reinforce the messages about child health and safety that pediatricians give parents during their clinic visits. They do this in the home environment, where they can help parents work through challenges that might arise. Time and again, they are there to troubleshoot the small problems before they turn into big ones.

Studies show that in-home family education is a good investment — in our children and in our economy. Take low birth weight, for example, a long-standing problem on our state. The incidence of low birth weights improved by almost 18 percent among participants in one West Virginia program, according to a recent study by Vanderbilt University. An 18 percent improvement in low birth weights statewide would save $25 million per year in hospital costs alone.

Another example is child abuse and neglect, a serious problem being addressed by state policymakers. According to an extensive study by the Centers for Disease Control, up to 40 percent of all child maltreatment could be prevented if in-home family education programs were widely available. This translates into about 3,000 fewer children being harmed, as well as almost $60 million saved each year in direct health, social service, law enforcement and court costs.

I co-direct the Child Advocacy Center at Women and Children’s Hospital at CAMC. This center serves the victims of child sexual abuse in Charleston and Southern West Virginia. We treat at least 25 children a month who have suffered abuse. Sadly, our clinic is always full and in demand, and this does not take into account the number of ER visits for abuse. Repeatedly, I see children whose parents are overwhelmed and cannot provide basic protection for their children.

Partners in Community Outreach, a coalition of in-home family education programs in West Virginia, have requested $5.2 million from the state to expand these highly beneficial programs. And they’re not alone. In addition to the West Virginia Chapter of the American Academy of Pediatrics, their proposal has been endorsed by the state chapter of the National Association of Social Workers, West Virginia School-Based Health Assembly, West Virginia Association for Young Children, Prevent Child Abuse West Virginia, and many others.

The proposal mirrors similar efforts under way across the nation. All states are at some stage of developing In-Home Family Education, and 37 states have statewide systems. Last year, the Education Begins at Home Act was introduced in Congress, which would provide the first federal funding stream for in-home family education. Sen. Rockefeller is a cosponsor, and the bill has bipartisan support.

The health issues of West Virginia children are complex. In-home family education is an excellent approach to address these issues: one infant, one child, one family at a time.

Along with the members of the West Virginia Chapter of the American Academy of Pediatrics, I urge our Legislators to support a supplemental appropriation for in-home family education.

Phillips is a Charleston area pediatrician and president of the West Virginia Chapter of the American Academy of Pediatrics.  This article was published in the June 13, 2006 Charleston Gazette.


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