Understanding perceptions of child maltreatment risk: A qualitative study of Early Head Start home visitors

Infants and toddlers enrolled in Early Head Start are at increased risk for child maltreatment. Within Early Head Start, home visitors are in a unique position to identify the families most likely to experience maltreatment by identifying characteristics and behaviors of children, caregivers, families, and environments that are of concern. However, research has demonstrated that home visitors are often ill-equipped to identify and address risk factors such as parental mental health concerns, substance abuse, and domestic violence. Further, little is known about how home visitors understand and perceive risk for maltreatment and identify vulnerable families. The study sought to identify how Early Head Start home visitors understand maltreatment, perceive risk for maltreatment, and work with families identified as at-risk. Qualitative interviews exploring identification of risk for maltreatment were conducted with fourteen Early Head Start home visitors and supervisors. Results indicate variable understanding of maltreatment. Home visitors identified numerous factors they believe suggest elevated risk for maltreatment and described variable approaches to working with families at risk. Findings provide rich information about the role that home visitors play in maltreatment prevention within Early Head Start. Directions for effectively training home visitors to engage families and deliver program and community-based services in a manner that reduces risk for and prevents maltreatment are discussed.