Supporting Families Who Have Children with Developmental Delays

The Confederated Salish and Kootenai Tribes (CSKT) of the Flathead Reservation in Montana manages a home visiting program for pregnant women, expecting fathers, and families of children up to 5 years old. The program offers support on a wide range of parenting issues and is often the first responder when it comes to helping families recognize and address developmental delays. CSKT home visitors credit the trusting relationships they have with families, where parents feel comfortable sharing concerns and asking for help.

Home visitor Juanita Swaney recalled a family whose toddler had an apparent speech delay. “I put it in the parents’ hands first and asked, ‘how do you think his speech is going?’” said Swaney. “They paused to think about it. I asked if they would like a screening to be done to see where their child was at. And the mother said yes, she had been kind of worried but didn’t want to say anything. So I made a referral and got her connected with a speech therapist. That interaction with the family and building that trust is really key.”

The CSKT home visiting program is supported by grants from the Tribal Maternal, Infant, and Early Childhood Home Visiting program and Tribal Early Learning Initiative (TELI), which are administered by the U.S. Department of Health and Human Services, Administration for Children and Families (ACF). The home visiting model that CSKT has chosen to follow is Parents as Teachers, which uses a developmental screening tool called Ages and Stages.

The home visitors bring valuable information to families and, equally important, they bring patience. “Personally, I like to be a fixer,” said home visitor Veronica Matt. “With certain families you have to have a lot of patience because things aren’t going to happen the next day. It takes time and commitment.”

Matt described a family whose two young children had obvious dental problems. Over the course of several home visits, she shared information about the importance of dental care and dispelled the common myth that baby teeth don’t matter.

“They felt a little intimidated about making the phone call for an appointment,” said Matt. “So I offered to make the call together. One of the children completed his surgery last month, and I sat with the mom until he came back to the room. He ate three bowls of spaghetti that night after she brought him home. She was very pleased because he had been losing weight.”

Home visitor Luanne Kickingwoman remembers visiting a mother and her new baby. “After four or five home visits I was comfortable also asking her about her 3-year-old son, who wasn’t talking,” said Kickingwoman. “I had noticed how frustrated he was due to mom not understanding what his needs were. He would grunt and point at objects like the kitchen or the box of toys. I was able to get the family connected with the local hearing specialist, and then the Child Development Center agreed to work with the family. Both children’s needs were being met, and the family stress level started to show signs of improvement.”

Respect is at the heart of relationships between home visitors and the families they serve. “Every single one of my families is different,” said Ashley Parisian, the Lead Parent Educator. “So it’s about getting to know them and being aware of what their beliefs are. Some are more traditional than others but all are still members of this tribe, and there’s still a certain amount of respect you have to show. It’s important to know each family before trying to work on an issue with them.”

For more information, contact Lisa LaCroix, Program Manager, at 406-675-2700. Lona Boushie also contributed to this story.

The Flathead Indian Reservation occupies 1.3 million acres in Northwest Montana and is home to three tribes: the Bitterroot Salish, Upper Pend d’Oreille, and the Kootenai. The reservation has a tribal college, is home to major tourism destinations including Flathead Lake and the Mission Mountains, and has a Salish Language Immersion School and both Salish and Kootenai Culture Committees. Find out more.

ACF’s Tribal Maternal, Infant, and Early Childhood Home Visiting program provides grants to tribal entities to develop, implement, and evaluate home visiting programs in American Indian and Alaska Native (AIAN) communities. The grants are intended to help develop and strengthen tribal capacity to support and promote the health and well-being of AIAN families, expand the evidence base around home visiting in tribal communities, and support and strengthen cooperation and linkages between programs that serve tribal children and their families. Find out more about the Tribal Home Visiting program and grantees.

ACF’s TELI supports American Indian tribes in growing and sustaining critical early childhood systems to meet the needs of young children, families, and the community as a whole and increase the number of children in quality early care and education settings. The TELI is administered by ACF’s Office of the Deputy Assistant Secretary and Inter-Departmental Liaison for Early Childhood Development, in partnership with the Office of Head Start, the Office of Child Care, and the Tribal Maternal, Infant, and Early Childhood Home Visiting program. Find out more about the Tribal Early Learning Initiative.

Last Reviewed: November 9, 2016