The Visit: Observation, Reflection, Synthesis for Training and Relationship Building

Field-tested and shaped by feedback from directors of Early Head Start, child care organizations, and early intervention programs, The Visit is an essential professional development tool for supervisors to use with direct care practitioners who work with young children and their families. For use in homes, clinics, or group care settings, this tool guides supervisors through structured, 1-hour meetings that strengthen parent/professional relationships and capture an accurate picture of the child's development. As supervisors and direct care practitioners work as a team to uncover the child's strengths and challenges and relate them to the strengths and challenges of the family, direct care practitioners obtain professional skill.

During the visit, the parent chooses whether they would like to begin with a parent interview or tasks for the child. The practitioner may interact with the child while the supervisor conducts a parent interview to gather key insights about family supports, separation issues, cultural values, attitudes toward parenting, and caregiving needs. Then the supervisor and parent offer the child age-appropriate tasks selected from standardized assessment instruments. The team takes no notes; instead, they focus on the family and gather observations.

After the visit, the supervisor and direct care practitioner share their observations in a co-review session and compare the child to others in the same age range. Reflecting together, they synthesize their own observations with information gathered from the parent. They write a letter for the parent, illustrated with observations, that summarizes what they learned and suggests next steps.

To help make meetings successful and efficient, The Visit includes Observation, Reflection, Synthesis guides — one for each of eight age ranges from 2 to 36 months. Each guide includes photocopiable record forms with clear instructions, reflective parent interview questions, a list of age-appropriate tasks and required materials, a developmental characteristics chart, and pages to complete at the co-review session. For easy printing of unlimited quantities, all photocopiable materials are also on an included CD-ROM.

With this comprehensive tool, framed by the nonlinear dynamic systems theory of development and based on the principle of reflective supervision, supervisors will have everything they need to train direct care practitioners.

The 1-inch blocks, which are a necessary component of The Visit, are available as part of The Visit Book and Cubes Set, or individually.

Annette Axtmann, Ed.D., began her career in the early childhood field in the early 1950's, when she initiated a program in which parents observed and learned from their preschoolers at play. She founded a series of interage preschool programs as she and he family moved from state to state. The last of these programs, integrated into the College of Atlantic in Bay Harbor, Maine, was followed by her appointment as Professor of Early Childhood Education at Western Connecticut State College (now Western Connecticut State University) in Danbury. In the meantime, infancy was emerging as a field for research, theory, and practice. A delightful chance encounter with her 12-month-old granddaughter under the table-cloth at a family gathering and recognition of the growing need for infancy specialists led her to join a research group studying typical early development at the Yale Child Study Center and, simultaneously, to practice at Yale-New Haven Hospital's Infant Care Program serving health professionals at that time. The combination of research, practice, and theory yielded insights into how these influence each other, as had prior work with young children. Dr. Axtmann then co-founded, developed, and directed (from 1982 to 1996) the Center for Infants and Parents at Teachers College, Columbia University. The Visit was developed at the Center for Infants and Parents and in the field with babies, toddlers, parents, and graduate students. As Adjunct Associate Professor at Teachers College, Dr. Axtmann created graduate programs in infancy, presented at the increasing number of conferences focused on very early development and child care, and initiated a series of infancy conferences at Teachers College. Dr. Axtmann published articles in several journals and worked on a booklet for the videotape Babies, Toddlers, Parents, and Caregivers Growing Together. She created the videotape in 2001 with Daniel Polin, director of Great Films, Inc., in New York City, for use in group child care settings, home and hospital group care settings, and care by parents in their homes.

Annegret Dettwiler, Ed.D., joined the Visit's research and development team of students and colleagues in 1993. She has contributed her understanding of the nonlinear dynamic systems perspective on early development, and this perspective is now integrated into the Visit. Dr. Dettwiler began her career in Geneva, Switzerland, where she worked with children with developmental disorders at the Clinique Universitaire de Pédiatrie. She subsequently continued her graduate education in Biobehavioral Studies and Movement Sciences at Teachers College, Columbia University. Dr. Dettwiler is a research scientist at the Center for the Study of Brain, Mind, and Behavior at Princeton University, where she continues her research on the neurobiological bases of the nonlinear dynamic systems perspective and is creating a framework for the assessment and treatment of developmental disorders in early childhood. Dr. Dettwiler has presented and continues to present the Visit internationally and in the United States.