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Home Visit Tips

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As a former Head Start teacher I know from personal experience that Home Visits can be very challenging. Organizing, preparing for, and conducting home visits can be exhausting and overwhelming.

Home Visit Tips for Teachers

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Home Visit Help

Here are some things to keep in mind when conducting home visits:

  • Have an activity for the child to do while you meet with the family. Paper and crayons work well, then you can keep the picture the child drew and hang it up in the classroom for the first day of school.
  • Student Information: Use a form to gather important information from the parents.
  • Student Profile: Use a form to find out about any concerns the parent may have about the child but might not know how to address. Include questions covering a wide variety of areas such as behavior and developmental delays.
  • Have a schedule and stick to it. It’s easy to get behind on home visits, so be sure to set the expectation for time up front so you won’t be late to your next home. A general rule of thumb is no more than 30 minutes per visit.

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Home Visits 101

Home visits can be a valuable tool for increasing parents’ involvement in their kids’ education. Here’s how you can get started.

A teacher and a parent meet at a cafe.

Teachers often find themselves wondering why their efforts at organizing opportunities for parents to become more involved in classroom activities do not pan out. They send written reminders home with their students, make phone calls, email, and text. When their repeated attempts to communicate with parents are left unanswered, many teachers become discouraged and begin making negative assumptions about parents’ involvement.

Home visits can establish positive contact and communication with families. They are not a replacement for parent-teacher conferences, but are a process through which teachers demonstrate their support for students’ families by visiting the home environment or an alternative location where the family feels at home and comfortable. Home visits should originate from a sincere desire to assist and work with families (see examples of two teachers’ best and worst home visits ). Home visits promote proactive interactions through which teachers provide authentic support while recognizing families’ strengths.

For teachers interested in conducting home visits, here is some guidance for getting stated.

Do Your Research

Teachers may be reticent to implement home visits because of the time commitment and effort involved. There are many testimonials from teachers and families about successful home visits, but without systemic school and district support, a teacher’s ability to carve out time during the school day to conduct home visits is limited.

For those who are determined, being well-informed about the benefits and rewards as well as the challenges of home visits is important. Once teachers commit to making home visits, they can take steps to research, plan for, implement, and document the process.

Know Your Families

One consideration is learning about students’ families, their communities and neighborhoods, languages and/or cultural differences, and work schedules. Being culturally responsive when conducting home visits communicates respect while demonstrating genuine interest in families’ rich heritages.

Investigating how others have conducted home visits is important if you want to create a process that is doable, realistic, and beneficial to students and their families.

Plan Strategically

Teachers who regularly conduct home visits advise establishing contact with parents before the school year begins. Some home visit models emphasize the benefits of teachers pairing up , traveling together to students’ homes, and introducing themselves to parents during the summer. The first visit should focus on building a relationship, extending support, and actively listening to parents’ concerns and insights. For transparency and safety, the home visit schedule (including location, time, and date) should be provided to school staff.

Be Flexible

Parents may not always feel comfortable meeting in the home. Alternative locations such as a local library, a quiet café, or even a fast-food restaurant may be appropriate venues for family-centered visits. Being flexible may also mean meeting on weekends, before schools begins, or at the end of the school day. Home visits planned in advance allow teachers to pair up strategically to coordinate visits when they have students who are siblings or who live in the same neighborhood.

Focus on Strengths

A teacher who enters the home with a nonjudgmental attitude views the home through the eyes of the family living there and sees the family’s strengths. A culturally responsive approach and appropriate, equity-minded language convey trust and respect. And if the teacher has concerns about the student, they can use the sandwich feedback technique to voice concerns sandwiched between strengths-based praise that is concrete and genuine.

Create an Action Plan

Actively listening to parents’ insights, concerns, and ideas for their child demonstrates authentic interest and respect. On a first home visit, teachers should not take notes since the act of collecting information may arouse parents’ distrust or suspicion. Rather, the teacher can ask parents if they have questions and take mental notes, and then, at a later time, create a voice memo or write out notes of what was discussed.

Before subsequent home visits, teachers can inform parents that they will take notes about concerns or ideas that arise from the discussion. These notes may build on other school-centered meetings and provide a plan of action upon which the teachers and parents can build.

Report Back

One way to remain accountable to students’ families is to maintain, revisit, and keep current the plan of action generated jointly by the teacher and family. Finding out from parents which method of correspondence is most effective and then checking in regularly with them about mutually established goals for the child provides both teachers and parents an open, ongoing platform through which to communicate and interact.

Home visits are a great beginning to positive communication and relationships between teachers and their students’ families. Establishing a strong foundation through home visits is only a first step—nurturing these relationships through consistent communication is critical to maintaining them.

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Home Visitor’s Online Handbook

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All Head Start programs are authorized by the Improving School Readiness through Head Start Act of 2007. The Act describes the general scope and design of Head Start and Early Head Start programs. Section 636 states the purpose of Head Start as promoting the school readiness of low-income children by enhancing their cognitive, social, and emotional development. This takes place in a learning environment that supports children's growth in language, literacy, mathematics, science, social and emotional functioning, creative arts, physical skills, and approaches to learning. It is accomplished through the provision of health, educational, nutritional, social, and other services to low-income children and their families that are determined to be necessary based on family needs. 

The Head Start Program Performance Standards (HSPPS) define the specific regulations for all programs serving infants, toddlers, preschoolers, and pregnant women. They also include the requirements for the home-based program option. As described in the HSPPS, home visits and group socializations are guided by a research- and home-based curriculum that is aligned with the Head Start Early Learning Outcomes Framework: Ages Birth to Five .

The HSPPS are referenced throughout the Home Visitor's Online Handbook to help you become familiar with the unique and comprehensive approach of the Head Start and Early Head Start home-based program option. Your own program will further define this information within its own procedures and protocols. In addition, this handbook relates research on the efficacy of home-based programs, strategies for best practices, video examples for reflection, resources, and wisdom from your colleagues shared in the Voices from the Field video series.

Terminology for the name of the person who conducts home visits in the home-based option varies from program to program. You may be called a home visitor, family advocate, or an infant/toddler educator. In this handbook, we use the term "home visitor." The terms "parent" and "family" are used interchangeably throughout, except where the law and regulations require the work be done with parents. This represents all of the people who may play both a parenting role in a child's life and a partnering role with Head Start and Early Head Start staff. This includes fathers; mothers; expectant parents; grandparents; kith and kin caregivers; lesbian, gay, bisexual, and transgender (LGBT) parents; guardians; teen parents; and families with diverse structures that include multiple co-parenting relationships.

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Last Updated: September 27, 2023

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Home Visits: What Are They and Why Do We Do Them?

So, what exactly is a home visit?  A home visit is basically a play date for the student and his teacher.   The visit is an opportunity for your child to get to know his new teacher on his own turf, so to speak.   In the coming weeks, if your child is new to our Toddler program, your child’s teacher will reach out to you and ask if you would like to have a home visit.   The choice is entirely yours and you are not required to have a home visit.   The home visit is simply one more tool for easing your child’s transition.   The teacher will arrive and her focus will be establishing a bond between her and the child.   She will allow the child to lead the visit, allowing him or her to select where they play and what they do together.   She will stay for about 30-45 minutes.  She may leave a small gift with the child or ask him or her to bring an item to school on the first day, such as a picture of his or her family.  Overall, it is a casual time meant to introduce the child to his teacher and establish bonds of trust.

Now, you might be thinking won’t the teacher and my student have to bond eventually or why only for the Toddler students.  Absolutely your child and his or her teacher will develop a special bond even without a home visit.  But, home visits are an added resource for helping your child with this transition which is uniquely difficult for toddlers.   An infant will not be able to connect a visit in August with the start of school a few weeks later and once their parent has left, infants are easily distractible.  With infants, when the parent is out of sight, they are out of mind (don’t worry they still love you just the same!).  Older children, also benefit from home visits, but they tend to still demonstrate separation anxiety because their displays are more about testing the parents’ reaction than genuine fear. Preschoolers and Elementary students that genuinely feel separation anxiety are able to communicate and comprehend reason at a higher level so teachers are able to engage them in the activities of the room to distract from the separation much faster and with more ease.

The toddler, on the other hand, is in a unique developmental limbo where he or she is capable of deep, complex emotions, but does not have the communication skills to express those feelings or the reasoning abilities to understand the explanations, the time frames, and the obligations that are associated with parents dropping and picking children up for school.  A preschooler understands “I will pick you after nap,” (although they may not accept that).  A toddler does not because they are rooted in the present. They have yet to understand that crying no longer satisfies their desires as it does for infants so.   They want what they want and they want it now!   Additionally, for toddlers, entering school may be the first time that they are away from Mom and Dad or a home environment for an extended period of time.  As such, separation anxiety is often most difficult on toddlers, so we try to give you as many tools as possible to help minimize the stress for your entire family.   Knowing your child is entering a classroom with a teacher who already has a sense of who he or she is and who is not a complete stranger, is not just a relief for the child, but for you as parents as well.  We encourage to take this wonderful opportunity and make the most of it.

Here are some tips and items to keep in mind to make the most of your home visit:

  • The visit is entirely about your child
  • It is not a time of evaluation. The teacher is not evaluating your home, your family, your parenting, or anything at all.   Similarly, it is not a time for you to evaluate the child or teacher
  • It is not a conference between the parent and the teacher. While it will be tempting to ask questions about the program, discuss parental anxieties or point out your child’s capabilities, it is crucial that the child remain the focus of the visit.   If you have such questions, let the teacher know and she will find another time when you can speak privately
  • Naturally, parents have anxieties about a new phase in their child’s life and that is OK. However, the home visit (as well as in the first weeks of school), is not a time to show it.  If you are anxious, your child will pick up on it, which will only reinforce and increase his or her anxieties.  Remain positive and excited about school
  • Do not stress about the visit. Do not run around cleaning the house or make elaborate snacks.  Try to act as regularly as possible
  • The act of inviting the teacher into your home is significant to the child. It unconsciously signals to the child that this is a safe person, a friend, and while a child cannot verbalize this feeling, you are establishing his or her sense of security with this teacher
  • Allow the child to plan and lead the visit. It is important for your child to feel in control.  He or she many plan to do one activity and then totally change his or her mind when the teacher arrives.  This is ok.  Go with your child’s flow.
  • Don’t worry about planning an elaborate activity.  Blocks, puzzles, games, and/or outdoor play are just fine.  Again, allow your toddler to choose.
  • Schedule the visit for a time your child is alert and happy. Avoid meal times, nap times, or too close to bedtime.   A mid-morning or early afternoon visit, usually works best for a toddler
  • Try to schedule the visit when other siblings are not present.  If this is not possible, minimize sibling involvement as much as possible.
  • Be respectful of the teacher’s time. Do not expect her to stay more than 45 minutes. She is conducting home visits for many students and many visits happen during her personal time
  • In the event the home visit does not go well, don’t panic. Some children may not want to engage with the teacher or may get upset.  Such a reaction is perfectly normal.  Do not force the issue.  Instead, have a quick, casual visit between the parents and the teacher.  Seeing you have a friendly exchange is also beneficial.  Just remember to keep it light!
  • Most importantly, do not hover or attempt to interfere with the visit. Stay nearby so your child feels safe, but try to participate as little as possible.  Preferably remain within an earshot, but out of sight.  Take the opportunity to treat yourself to some quiet time!

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Lead  Teacher

Ms. Mika comes to us with a wealth of experience and a deep passion for Montessori education. She earned her Early Childhood Credential from the American Montessori Society at the Northern Virginia Montessori Institute. Having started her journey with Montessori during her teen years, Ms. Mika has accumulated over ten years of experience in the field, with six of those years serving as a Lead Teacher

Her love for young children, coupled with her dedication to the Montessori philosophy, makes Ms. Mika an excellent addition to our team. In addition to her educational background, Ms. Mika is passionate about zoology, art, and music. She dedicates her free time to studying arthropods, particularly insects.

Ms. Brianna

Lead Teacher

For the past three years, Ms. Brianna has led toddler classrooms and has found this work to be deeply rewarding. The Montessori pedagogy and beliefs align closely with her teaching mission; to show children they are capable and to give knowledge that will last a lifetime. With a 0-3 Montessori certification and 8-plus years of experience working with children, she is so excited to continue educating young minds. In her free time, Ms. Bri enjoys reading, baking, drawing, and, most of all, making memories with her daughter, who will begin attending The Springs this summer.

Hailing originally from China, Ms. Miko’s journey led her to the United States in 2007 to pursue her studies in accounting at the University of Virginia. Her true passion has always been working with children. For several years, she dedicated herself to serving as a Mandarin interpreter, enriching the lives of others through language and culture. She began her Montessori journey in 2017 as an Infant Montessori Assistant and completed her Infant and Toddler certification in 2020. She has served as a lead Toddler Teacher for the last three years. Beyond her dedication to education, Ms. Miko finds fulfillment in her involvement with her church community. In her free time, she indulges in baking, skillfully crafting delicious creations that bring joy and warmth to those around her.

Ms. Elizabeth

Meet Ms. Elizabeth McCawley, our new Toddler Teacher in Classroom 2! Ms. Elizabeth hails from Barranquilla, Columbia, and has a Technical Degree in Merchandise Marketing from the Institute Tecnicor and has worked in retail for several years. However, her true passion has always remained with children and she loves working with toddlers because each day brings something new. She has been a Montessori Toddler Teacher for two years and has four years of experience working in a Montessori Classroom, both Children’s House and Toddler House. Ms. Elizabeth completed her 0-3 Montessori Diploma from the Prepared Montessorian and is thrilled to be joining The Springs! In her free time, she loves going out dancing, hiking, trying new foods, and visiting museums.

Bio coming soon…

Before and After School Coordinator & PE Teacher

Ms. Peggy was born in New York City and grew up in Queens. She is both a runner and a softball player, having played professionally for the New York Cheetahs. She also played for her college team while majoring in Physical Education.

At the start of her career, Ms. Peggy taught for Millbrook Central School District in New York, but she moved to the DC Metro area over twenty years ago and began working at a Montessori School as a PE Teacher. Ms. Peggy joined The Springs just about one month ago! She is excited to bring PE to all age groups at The Springs! She remains an avid runner, knitter, and voracious reader when she’s not teaching at our school! Ms. Peggy has three adult sons and five grandchildren who know her as Gigi.

Ms. Peggy is at the front desk during aftercare wishing everyone a great evening!

Mrs. Diana Glaukaj

Ms. Diana was born and raised in Albania! She came to the states as an au pair in 2007 for a family of four and completed her Bachelor’s Degree in Information Technology from George Mason simultaneously. Always loving children, Ms. Diana began in the Montessori world as a Children’s House Assistant in 2013 and eventually became an Assistant Head of School for another Montessori School in 2018. Ms. Diana is pursuing her Children’s House Montessori training from the Prepared Montessorian.

Ms. Diana enjoys travel, sports, music, and dancing in her free time and is a mom to her daughter, Jora.

Ms. Ayla Beg

Ms. Ayla was born in Turkey and came to the states at four years old. Settling in New Jersey upon arriving in the states, Ms. Ayla was a stay-at-home mom of four before moving to Virginia and joining a local Montessori school three years ago. Ms. Ayla has been with The Springs since July and loves saying hi to families, operating the phones, and making everyone feel welcome at the front door.

When Ms. Ayla is not greeting and organizing, she enjoys travel, shopping, walks and spending time with her three daughters and one son.

Ms. Elisa Zago

Ms. Elisa is originally from Italy and came to the US for the first time in 2019 as an au pair. Before embarking on this journey, she completed a Bachelor’s Degree in Linguistic and Cultural Mediation from the University of Padova and got a CELTA certificate from Cambridge University. She worked in customer service and communications for almost three years and has a certification in event planning and marketing. She loves languages and speaks Italian, English, Spanish, and French. Ms. Elisa has always loved children and used to lead children’s church programs in her hometown. She joined The Springs’ staff in January 2022 and manages the admission process, social media presence, and planning of school-wide events.

I completed the AMI Montessori Assistance to Infancy training in 2017 and am excited to join The Springs team. I also have a degree in Accounting.

I enjoy traveling, watching movies, exercising, and spending time with my two children in my free time.

Ms. Nikki joined THE SPRINGS in 2016 as an Infant House Assistant Teacher. She then moved to the Toddlers House the following year. She knew she was passionate about Montessori and wanted to be a Lead Teacher at The Springs. Ms.Nikki completed her AMS certification in 2020 and is now embarking on a new challenge as the Toddler House Lead Teacher.

Ms.Nikki has two children of her own who have also attended THE SPRINGS.

Ms.Nikki is excited to welcome each child as her own and is always willing to learn more every day.

preschool home visit form

I am Ms. Beth, and I joined The Springs in 2014. I hold an AMI diploma from the Montessori Education Center of Arizona and a BS in Sociology from Presbyterian College. I started at a Montessori school in NC.

As a Montessori teacher, I enjoy seeing the children gain skills that will help them in life and carry over into their future. I enjoy teaching in all classroom areas, but the Sensorial area resonates with me, and I hope with the children too.

I enjoy reading, playing tennis, fishing, and spending time with my family.

My name is Deepa Sinha, and if you’ve been around the schools with children in the primary class, you may know me as Ms. Deepa. My teaching journey started when I started tutoring at the age of sixteen and soon realized that teaching was not only my work but my passion. I was introduced to Montessori when one of my kids entered the school, and I just fell in love with its philosophy.

I hold a Bachelor’s degree in Psychology, an American Montessori Society (AMS) Early Childhood Credential, AMS in Lower Elementary, and currently finishing up my AMS in Upper Elementary through CGMS. Additionally, I have extensive experience working as a behavior therapist for children with ADHD, autism, and dyslexia. I have been in the field of Montessori for the past 20 years and as a lead teacher for the last 16 years. I am starting my 6th year at THE SPRINGS. After four years of teaching Early Children House, I embarked on my new journey at THE SPRINGS as an Elementary Lead Teacher.

When I am not working at school, I am busy entertaining my huge extended family and friends with my love of cooking, working out, or hanging around with my family.

Ms. Mary hails from India, a country with a strong Montessori heritage, and has almost 20 years of teaching experience in the US. She has been a Montessori Infant Toddler teacher for nine years. She began her Montessori Infant Toddler career at The Boyd School. She then joined the Montessori School of Chantilly, where she helped start and grow their Infant Toddler program. Chantilly tapped her again to start a second Infant Toddler program upon opening their second school, Montessori School of Gainesville. She has a wealth of experience with the Toddler age group. Ms. Mary joined THE SPRINGS in September 2014 to launch our new Infant-Toddler Program.

Ms. Mary lives with her family in Chantilly. She completed her Montessori Infant and Toddler Certification at the Center for Montessori Teacher Education in North Carolina.

preschool home visit form

My first introduction to Montessori was in 2001, when I received my Montessori teaching credential from the Toronto Montessori Institute. I’ve continued to grow in my appreciation for teaching in the Montessori way and completed my Master’s Degree in Montessori Education from St. Catherine University in 2018. Language is my passion, and I enjoy opening up children’s curiosity through the perfectly sequenced language curriculum Dr. Montessori created.

I hope to continually inspire children to reach their potential by tapping into their unique strengths and interests, leading and inspiring future educators through my dedication to the practice of teaching. I enjoy traveling, listening to music, and eating delicious food. I am an aspiring writer and am working on finishing my novel in my free time.

preschool home visit form

Ms. Bianca came to us from Cardinal Montessori in Woodbridge. She was a Lead Lower Elementary Teacher for four years but has been at Cardinal Montessori for the past 15 years. Ms. Bianca has a Bachelor’s Degree in Sociology with a focus in Education and Family Studies from the University of Mary Washington. Ms. Bianca received her Lower Elementary Certification from The Institute for Advanced Montessori Studies.

preschool home visit form

Ms. Fernanda

preschool home visit form

Ms. Savannah

Ms. Savannah has a Bachelor’s degree in Psychology from Centre College in Danville, Kentucky. In addition, she has her American Montessori International (AMI) Primary credential from the Montessori Institute of North Texas in Dallas, Texas. From infancy to 5th grade, Ms. Savannah was a Montessori child at Montessori of Roseborough, where she grew up in Mount Dora, Florida. Before solidifying her passion for Montessori pedagogy, Ms. Savannah worked as a toddler assistant in Nashville, Tennessee. She will obtain her Master’s in Education with a concentration in Montessori Education from the University of Hartford this Fall.

Ms. Savannah is beyond excited about what this new year at The Springs has in store for her!

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INTRODUCTION AND HISTORY

Home visiting is not a panacea, benefits of home-visiting programs, cost-effectiveness of home visiting, linking home visiting to the pediatric medical home, recommendations, national home-visiting models, council on community pediatrics executive committee, 2007–2008, past executive committee member, the role of preschool home-visiting programs in improving children's developmental and health outcomes.

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Council on Community Pediatrics; The Role of Preschool Home-Visiting Programs in Improving Children's Developmental and Health Outcomes. Pediatrics February 2009; 123 (2): 598–603. 10.1542/peds.2008-3607

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Child health and developmental outcomes depend to a large extent on the capabilities of families to provide a nurturing, safe environment for their infants and young children. Unfortunately, many families have insufficient knowledge about parenting skills and an inadequate support system of friends, extended family, or professionals to help with or advise them regarding child rearing. Home-visiting programs offer a mechanism for ensuring that at-risk families have social support, linkage with public and private community services, and ongoing health, developmental, and safety education. When these services are part of a system of high-quality well-child care linked or integrated with the pediatric medical home, they have the potential to mitigate health and developmental outcome disparities. This statement reviews the history of home visiting in the United States and reaffirms the support of the American Academy of Pediatrics for home-based parenting education and support.

Home visiting is not a single clearly defined methodology of providing service to children and families. The term “home visiting” is used differently in varied contexts. In this review, we limit our discussion to the use of preschool home-based parenting support to enhance developmental, health, and safety outcomes. Home visiting for parents is an early-intervention strategy in many industrialized nations outside of the United States. In many other countries, home health visiting is free, voluntary, and embedded in a comprehensive maternal and child health system. Although a causative link has not been demonstrated conclusively, countries with extensive home-visiting programs generally have lower infant mortality rates than does the United States, despite per capita health spending in the United States that far exceeds expenditures in other industrialized countries. 1  

Home visiting is deeply rooted in history, going back at least to Elizabethan times in England and endorsed as a strategy by Florence Nightingale in the 19th century. 2 , 3   Home visiting existed in the United States in the 1880s when public health nurses and social workers provided in-home education and health care to urban women and children. At the beginning of the 20th century, successful reductions in mortality from summer diarrhea in central New York City were demonstrated after using student nurses in the home to instruct mothers about hygiene and breastfeeding. 4   Denmark established home visiting in 1937 after a pilot program showed lower infant mortality rates associated with home visiting. France provides free prenatal care and home visits by midwives or nurses who educate families about smoking, nutrition, drug use, housing, and other health-related issues. 5   In some European countries, many traditional child health-promotion services of American pediatricians are provided by public health nurses, often within the home. 6  

In the last quarter of the 20th century, home visiting gained renewed attention as a strategy for prevention of child abuse and neglect, promotion of child development and parental effectiveness, and reduction of health disparities. 7   C. Henry Kempe, MD, called for a home visitor for every pregnant mother and preschool-aged child in his 1978 Abraham Jacobi Award address. 8   He suggested that integral to the provision of every child's right to comprehensive care is the assignment of a home health visitor who would work with the family until each child began school. 9   His call to action was reiterated by Cal Sia, MD, in the 1992 Jacobi Award address, in part on the basis of his experience with a pioneering initiative to take home visiting statewide as a tool for preventing child abuse and neglect in the Hawaii Healthy Start effort. 10   Focusing on highly stressed families, this program has expanded and evolved into Healthy Families America and is one of the most rigorously studied of all the family-support initiatives in the United States. 11   Another pioneer in modern home visiting, David Olds, PhD, initiated the Nurse Home Visitation Program with families at risk in Elmira, New York, in 1978 and continues to study the effect of this intervention today. Within the education community, Parents as Teachers (PAT) has gained prominence as a program for promoting child development and school readiness after achieving promising results in Missouri. 12   In New Zealand, Scotland, and other countries, recent development of home-visiting efforts have replicated American models, thus indicating that the promise seen in this country with home visiting is envisioned beyond our shores. 13 , 14   Lisbeth Schorr, in her 1988 book Within Our Reach: Breaking the Cycle of the Disadvantaged , stated:

“[Home-visiting] programs that succeed in helping the children and families who live in the shadows are intensive and comprehensive, flexible, and staffed by professionals with the time and skills to establish solid relationships with their clients. Intensive medical care for fragile newborn or aged patients who are barely clinging to life, costly though it may be, encounters no general resistance. Intensive care for fragile families requires similar support.” 15  

In 1998, the American Academy of Pediatrics called for pediatricians to advocate for the inclusion of home visitors as part of the health care team and for the funding, development, and continued evaluation of home visiting in the promotion of children's health outcomes. 16   Shortly thereafter, this sense of optimism about the promise of home visiting was dampened by new information indicating limitations in the effectiveness of existing models. As comprehensive studies and new reviews of old programs developed, it became apparent that, as in other forms of support for developing children, home visiting may not, in all cases, be as efficacious as its advocates had hoped. 17  

Although much energy, effort, and research have gone into the development of home-visiting programs, the extent of potential benefits is still inadequately delineated and understood. An ambitious evaluation in 1999 of a statewide home visiting program in Hawaii failed to demonstrate any substantial improvements in either maternal or child development and health outcomes. 18   Although these findings contradicted previous smaller studies and evaluations of earlier pilot programs, the comprehensiveness of this evaluation led to further examination of the evidence base for home visiting. In considering these apparent inconsistencies, it is best to remember that home-visiting programs are heterogeneous in their makeup, thereby compounding the difficulties associated with their evaluation. Programs vary in their approaches and are designed to achieve a variety of goals. Documentation that a home-visiting program design is effective in a particular setting may not support the use of other home-visiting models in that same setting. 19   This heterogeneity cannot be avoided. It is doubtful that an optimal, cost-effective approach will be successful for all outcomes in a diverse array of situations. 20  

Some of the most studied home-visiting efforts have a primary focus on the prevention of child abuse and neglect. Other programs have a strong focus on child development and school readiness or an interest in parental lives, including encouraging mothers and helping them become self-sufficient through further schooling, employment, and delay of future pregnancies. 17 , 21   Direct provision of health care, enhancement of child development, and support of parenting and mother-child interaction are additional primary goals of some programs. 21  

Most programs provide families with social support and are built on the development of a trusting relationship between the home visitor and parents. These relationships are designed to promote parent effectiveness and help engender strong bonds between the adults and children within families. Case management, linkages to community-based services, skill building for parents, child development education, and improvement in maternal health are common components of programs. 14  

By focusing on families most at risk, programs seek to diminish disparities in health and developmental outcomes. Controversy exists as to whether to use a universal approach, designed to work with all families in a defined geographic area, versus a program focused on populations most at risk of poor outcomes. Most studies indicate that very high-risk groups are more likely to show benefit from home visiting, 22   yet programs focused just on these groups may suffer from stigmatization and lack of acceptance on the part of families being visited. Some risk factors may interfere with the effectiveness of home visitation. For example, substantial evidence exists that families most plagued by domestic violence are least likely to respond to home-visiting support. 23   Other factors that hamper success of home visiting include limited family resources, family mental illness, and families not motivated to participate in the programs. 24   Thus, the very risk factors that make children vulnerable interfere with the effectiveness of the programs that are designed to help them.

Some programs use professional nurses or masters-prepared personnel as their home visitors; others use trained paraprofessionals who are often members of the target community and culturally linked with the families they visit. Although paraprofessionals usually are associated with lower salary costs, 25   the efficacy of the professional-based model is better established. Families may perceive nurse home visitors as more valuable because of their ability to identify and intervene with medical issues. Nurse-based home-visiting programs tend to have better staff retention compared with those that employ paraprofessionals, perhaps contributing to program effectiveness. 26 , 27   Likewise, programs in which paraprofessionals remained involved over a 2-year time period were more likely to demonstrate effectiveness than those with shorter durations of involvement. 28  

Additional barriers measuring the effectiveness of home-visiting services include variable effects noted at different program sites, the need to tailor programs to the community, retention of families receiving services, maintaining program intensity, turnover in home visitors, and a drift over time in program focus. Other differences include the intensity of service, the duration of service, the caseloads of the home visitors, the population targeted for services, and training level of the visitors. To be successful, programs must focus on the risk factors that result in disparities in child outcomes, and misidentification of these factors is likely to result in poor program effectiveness. 29  

Within the context of the great heterogeneity of home-visiting programs, generalizations as to their effectiveness have been elusive and difficult to interpret. Frequently, pilot projects have shown positive effects, but many of the studies involving these small initiatives have methodologic flaws. Evaluations of home-visiting programs taken to scale have been mixed and sometimes disappointing in their findings. By itself, home visiting may be insufficient to result in satisfactory improvements in health and social outcomes. 30   It is clear that home-visiting programs are not a panacea for solving the problems of delayed child development and child abuse prevention but one of many tools to be used in a careful and thoughtful manner. Expectations for home visiting need to be tempered by realistic examinations of the current understanding of program effectiveness. Deanna Gomby, in a comprehensive review published in The Future of Children , noted

“that no home visiting model produces impressive or consistent benefits in child development or child health. Several models produce some benefits in parenting and perhaps in the prevention of child abuse and neglect, but only on some of the measures used to assess these outcomes…these research results should not dissuade us from action. Children continue to grow, and their families continue to want and need support and services. It is up to us to strengthen existing services and craft new approaches to meet the needs of families and children.” 17  

The wide-ranging nature of home-visiting programs and evaluations makes it difficult to draw definitive conclusions about potential benefits. A number of recent meta-analyses have made the task less arduous. Several large literature reviews, including those conducted by the US Task Force on Community Preventive Services, 20 , 28   one conducted by a British Task Force, 30   and a 2000 study by the Canadian Task Force on Preventive Care, 31   revealed strong evidence to support the effectiveness of perinatal and early childhood programs in preventing child abuse and neglect but no effect when paraprofessionals were used as visitors. A report from the US Surgeon General concluded that nurse home visiting has shown significant effects on the incidence of violence, delinquency, and other related risk factors. 32   Benefits in child development and child health are less clear, and the evidence for their support is inconsistent. Meta-analyses of home visiting published both in the United States and Europe report sufficient evidence that home visiting, when appropriately provided, can:

improve parenting skills and the quality of the home environment 21 , 30 , 33   ;

ameliorate several child behavioral problems, including sleep problems 21   ;

improve intellectual development among children, especially among those with a low birth weight or failure to thrive 30 , 34   ;

enhance maternal life course such as employment and education 17 , 21 , 30   ;

reduce the frequency of unintentional injury and the prevalence of home hazards 30   ;

improve detection and management of postpartum depression 34   ;

possibly improve the attachment between infants and their parents 34   ;

enhance the quality of social supports to mothers 30   ; and

improve rates of breastfeeding. 30  

Existing meta-analyses include the following characteristics of successful home-visiting programs:

Socially deprived mothers show the greatest benefits from home visiting. 34  

Professional or nurse-based home visiting is generally advantageous for clients. 35   The role of lay paraprofessional home visitors is less known, but paraprofessionals may be helpful depending on the goals and objectives of the home-visiting program and the length of engagement with the home visitor. An advantage of lay home visitors may be the notable cultural bond between the home visitor and mother. Paraprofessional home visitors require more intensive guidance, training, supervision, and support from professionals. Families with significant or complex difficulties require the support of professional home visiting. 36  

Home visits may be useful for children born preterm or with low birth weight and may result in positive effects on child development. Without sustained support, these positive effects may fade as children grow older. 30 , 34  

Services of longer duration and greater intensity correlate with higher degrees of effectiveness. 30 , 34  

Generally, the more risk factors present in a child's life, the more likely that developmental outcomes will be affected. However, those families with the poorest functioning are often unresponsive to engagement and intervention. The relationship between benefit and risk status is also not linear. It seems that those at the greatest risk and those at the least risk of poor outcomes are less likely to benefit from home visiting than others. 37  

Successful home-visiting programs involve extensive staff development and supervision, the creation of appropriate protocols, adequate supervision, and quality assurance. Adequate funding is of paramount importance for home visiting to be successful. Cost-sharing issues among local, state, and national funding sources as well as the political nature of funding are major obstacles to program development. These programs are expensive, and their costs are a significant impediment to implementation.

Limited data exist to support the notion that home visiting is cost-effective. Successful programs are associated with reduced emergency department visits, decreases in foster care assignments, fewer hospitalizations, and savings in child protective services expenditures. Home visiting for the purpose of support and observation of newborns with low birth weight who are sent home early has been shown to be cost-effective by saving significant costs for the health insurer while improving overall health status. 38   Unfortunately, the savings from home-visiting efforts often accrue at some point in the future to entities other than the payer of the initial program. Home-visiting programs focused on social issues, child abuse, domestic violence, or child development, even if cost-effective, are unlikely to save costs in the health care sector. However, in all likelihood, the long-term financial savings to the community are substantial, as is the reduction of human suffering. 7 , 39   Cost savings in these instances will accrue to a variety of educational and social programs that are usually government funded. For these reasons, mechanisms for funding home visiting may be more appropriate from sources other than traditional third-party health care insurance. Payment sources will have to be tailored to the individual goals of each home-visiting program.

Pediatric primary care continues to evolve in an increasingly complex world with shifting morbidities and mortalities and expanding responsibilities for the child health care professional. Recently, Perrin noted:

“Primary care clinicians face…problems where teamwork in practice can greatly improve the services families receive. Especially in high risk communities, many families need access to a wide range of social and other supportive services…services that pediatricians know relatively little about.” 40  

A 2006 Commonwealth Fund publication reiterated this suggestion with a call for a team approach as key to high-performing systems of well-child care. Such systems require graduated levels of services to fit the acuity and range of need for individual patients and families. 41  

Home visitors may well be essential members of these teams and augment the services of the traditional medical home. 34   Home visitors can be health care advocates and improve access to providers of health care. They can be partners with pediatricians and other clinicians, working in the home setting to provide essential education and supportive services to at-risk children and families and to improve adherence to medical preventive and treatment regimens. They can enhance developmentally oriented anticipatory guidance with individualized content that meets families' individual needs. 42   Home-visiting programs include a

“degree of social support that is difficult to provide in most clinical settings; outreach and liaison between the pediatrician, the family, and the community; involvement with socioeconomic issues that directly affect the well-being of the child and family; reinforcement and follow-up of preventive care, peer helper support, as well as encouragement by the home health visitor who has the advantage of being with the family in its own home, a more accepting, less threatening setting for the family. 7  

Thus, home-visiting services should not be seen as replacing the contribution of the pediatric health care team but as a complementary service that enhances children's health and developmental trajectories.

In this context, appeals for home visiting linked to well-child care have been frequent, but the “how” and “why” of these linkages are poorly defined and require additional investigation. Little investigative work has been performed in the area of using home visiting linked to the pediatric medical home. One Colorado study showed that paraprofessional home visiting, when combined with an early-intervention program focused on children with developmental delays, resulted in improved involvement with the program. 25   In North Carolina, the combination of a public health department's home-visiting program with links into private physician's offices was helpful in overcoming personal and structural barriers to care. 43   The Commonwealth Fund's Healthy Steps intervention included home visiting by masters-level healthy development specialists with significant gains in the quality of well-child care, although the multifactorial nature of this intervention made it difficult to evaluate the effectiveness of the home-visiting component. 44 – 46   A South Carolina study showed that a program that linked school-based home visitors to group well-child visits resulted in greater retention of anticipatory guidance and improved satisfaction with care. 47  

These initiatives provide a glimpse into the potential of linking home visitors with the pediatric medical home. A working partnership between home visitors and pediatricians providing well-child care may provide, for those families most at risk, an intensive level of support resulting in better health outcomes. Home-visiting programs should be integrated into a community's existing health care system, expanding the effectiveness of private health care professionals, health maintenance organizations, and public heath nurses. Such integration should be undertaken cautiously with the knowledge that little is yet known to guide the optimal relationships between pediatric medical homes and home-based parenting support. The development of these relationships requires an ongoing evaluation to determine their effectiveness in the enhancement of optimal health and developmental outcomes for all of our children.

Sufficient evidence exists to endorse home-visiting services by nurses to prevent child abuse and neglect for at-risk families. Programs that are comprehensive in scope, are intensive in the visit schedule, involve positive interactions with parents, target high-risk families, and are performed by professionally trained home visitors are known to be successful. Pediatricians should encourage the further expansion and development of programs for the prevention of child abuse and neglect.

Substantial evidence exists to support the use of home visiting as a strategy for addressing inequities in children's health status, school readiness, and development. Pediatricians should advocate for additional research and work to define the critical elements of such programs. Pediatricians should work with policy makers to ensure that elements found to be critical for success are applied to home-visiting practice.

Home-visiting programs should be comprehensive in nature but have clear primary goals and objectives supported by evidence-based strategies.

Pediatricians and others interested in the welfare of children should recognize the limitations of data supporting home-visiting efforts and the need to balance expenditures against the unsupported possible promise of such programs. Further investigative work needs to be performed to define the elements of cost-effective home visiting.

Little research has been performed on the linkage of home visitors to pediatric medical homes, which is an area that deserves attention. There is ample reason to believe that the synergy of home visitors working with pediatric clinicians could have positive effects on child health and development. Home visitors should be considered to be a complementary collaborative partner in the provision of developmental assessment and other components of well-child services, especially for at-risk populations. Communication between home visitors and pediatricians ideally should be free flowing while adhering to privacy regulations.

As experts in child development, pediatricians should become aware of and participate in development of home-visiting programs in their communities. They should be willing to participate in the planning, implementation, and evaluation of home-visiting programs and work to ensure that the methodologic contents of programs are evidence based.

Home-visiting services may have effects that are wide ranging and important to the health and welfare of young children but beyond the scope of traditional pediatric health care. As such, funding streams should be developed that do not rely solely on health insurance mechanisms. Home-visiting services can be cost-effective. Those sectors of society that are most likely to accrue benefit in future cost savings from the social and educational effects of home visiting should contribute to the funding of programs.

Early Head Start: www.ehsnrc.org

Healthy Families America: www.healthyfamiliesamerica.org

Home Instruction for Parents of Preschool Youngsters: www.hippyusa.org

Nurse Family Partnership: www.nursefamilypartnership.org

The Parent-Child Home Program: www.parent-child.org

Parents as Teachers: www.parentsasteachers.org

Deise C. Granado-Villar, MD, MPH, Chairperson

Suzanne C. Boulter, MD

Jeffrey M. Brown, MD, MPH

Beverly Gaines, MD

Benjamin A. Gitterman, MD

Peter A. Gorski, MD, MPA

Murray L. Katcher, MD, PhD

Colleen A. Kraft, MD

Ronald V. Marino, DO, MPH

Karen B. Sokal-Gutierrez, MD, MPH

* Francis E. Rushton, Jr, MD, Past Chairperson

Regina M. Shaefer, MPH

All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.

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Building on the “reset” – the vice president’s visit to moscow.

Vice President Joe Biden speaks to the American Chamber of Commerce and Russian students at Moscow State University

Vice President Joe Biden speaks to the American Chamber of Commerce and Russian students at Moscow State University, in Moscow, Russia, March 10, 2011. (Official White House Photo by David Lienemann)

Today, before a packed auditorium at Moscow State University, Vice President Biden delivered a powerful speech to U.S. and Russian students and business leaders. Echoing messages conveyed during his earlier meetings with Russian President Dimitry Medvedev and Prime Minister Vladimir Putin over the course of his three-day visit, Vice President Biden hailed the successful “reset” of U.S.-Russian relations and reiterated his call for broader economic cooperation between the two countries.

Vice President Joe Biden, talks with Russian President Dmitry Medvedev at the Gorky Dacha

Vice President Joe Biden, talks with Russian President Dmitry Medvedev at the Gorky Dacha outside Moscow, Russia, March 9, 2011. (Official White House Photo by David Lienemann)

Vice President Joe Biden greets Russian Prime Minister Vladimir Putin at the Russian White House

Vice President Joe Biden greets Russian Prime Minister Vladimir Putin at the Russian White House, in Moscow, Russia, March 10, 2011. (Official White House Photo by David Lienemann)

Issuing the strongest support yet for Russia’s entry into the World Trade Organization, the Vice President said,“it’s better for Americans and better for Russians to be able to trade with each other under predictable and transparent rules.”

On the issue of human rights and the status of democracy and the rule of law in Russia – a topic discussed at length in meetings with Russian civil society and political opposition leaders earlier today, the Vice President said:  “History showsthat in industrialized societies, economic modernization and political modernization must go hand and hand.”

Vice President Joe Biden and U.S. Ambassador John Beyrle talk with civil society leaders

Vice President Joe Biden and U.S. Ambassador John Beyrle talk with civil society leaders at the U.S. Ambassador's residence in Moscow, Russia, March 10, 2011. (Official White House Photo by David Lienemann)

Yesterday, the Vice President and Dr. Biden visited the Tomb of the Unknown Soldier in the Alexander Garden. As a military honor guard looked on, the Vice President observed a moment of silence in recognition of the Russian soldiers who died in World War II and ceremonially placed a wreath that read “To those who fell in the fight against fascism, from the American people.”

Vice President Joe Biden observes a moment of silence during a wreath   laying ceremony at the Tomb of the Unknown

Vice President Joe Biden observes a moment of silence during a wreath laying ceremony at the Tomb of the Unknown Soldier outside the Kremlin Walls in Moscow, Russia, March 9, 2011. (Official White House Photo by David Lienemann)

Later, the Vice President attended a signing ceremony for the sale of Boeing 777 jets to Aeroflot – which will support more than 10,000 jobs at home - in the impressive building of the Moscow School of Management at Skolkovo, an area that Moscow hopes to develop into the Russian equivalent of Silicon Valley. Afterwards, he and Russian Deputy Prime Minister Igor Shuvalov led a roundtable discussion with Russian and American business leaders. The Vice President added that beyond negotiations between our governments, the U.S. is also relying on the growing connections between Russian and American business leaders and leaders in civil society to build a comprehensive relationship between the U.S. and Russia.

Vice President Joe Biden, and Russian Deputy Prime Minister Igor   Shuvalov watch as Boeing Russia CEO

Vice President Joe Biden, and Russian Deputy Prime Minister Igor Shuvalov watch as Boeing Russia CEO Sergey Kravchenko and Aeroflot General Director Vitaly Saveliev sign an agreement for Aeroflot to purchase Boeing Jets at Skolkovo School of Management in Moscow, Russia, March 9, 2011. (Official White House Photo by David Lienemann)

Vice President Joe Biden holds a roundtable discussion with American and Russian business leaders and Russian Deputy Prime Minister

Vice President Joe Biden holds a roundtable discussion with American and Russian business leaders and Russian Deputy Prime Minister Igor Shuvalov at Skolkovo School of Management in Moscow, Russia, March 9, 2011. (Official White House Photo by David Lienemann)

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The History of the World: Nixon visits Moscow

The history of the world: sixth edition.

  • May 22 nd 2013
22 May 1972 The following is a brief extract from The History of the World: Sixth Edition by J.M. Roberts and O.A. Westad.

In October 1971 the UN General Assembly had recognized the People’s Republic as the only legitimate representative of China in the United Nations, and expelled the representative of Taiwan. This was not an outcome the United States had anticipated until the crucial vote was taken. The following February, there took place a visit by Nixon to China that was the first visit ever made by an American president to mainland Asia, and one he described as an attempt to bridge ‘sixteen thousand miles and twenty-two years of hostility.’

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When Nixon followed his Chinese trip by becoming also the first American president to visit Moscow (in May 1972), and this was followed by an interim agreement on arms limitation – the first of its kind – it seemed that another important change had come about. The stark, polarized simplicities of the Cold War were blurring, however doubtful the future might be.

Reprinted from THE HISTORY OF THE WORLD: Sixth Edition by J.M. Roberts and O.A. Westad with permission from Oxford University Press, Inc. Copyright © 2013 by O.A. Westad.

J. M. Roberts CBE died in 2003. He was Warden at Merton College, Oxford University, until his retirement and is widely considered one of the leading historians of his era. He is also renowned as the author and presenter of the BBC TV series ‘The Triumph of the West’ (1985). Odd Arne Westad edited the sixth edition of The History of the World . He is Professor of International History at the London School of Economics. He has published fifteen books on modern and contemporary international history, among them ‘The Global Cold War,’ which won the Bancroft Prize.

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    This amazing home visits pack is jam-packed with essential documentation, including handy editable documents, so that you can make all of the information relevant to your early years setting. The editable documents include an EYFS transition booklet that allows you to provide essential information specifically relating to your setting, such as ...

  14. The Role of Preschool Home-Visiting Programs in Improving Children's

    Home visiting is deeply rooted in history, going back at least to Elizabethan times in England and endorsed as a strategy by Florence Nightingale in the 19th century. 2,3 Home visiting existed in the United States in the 1880s when public health nurses and social workers provided in-home education and health care to urban women and children. At the beginning of the 20th century, successful ...

  15. EYFS Home Visit Questions

    We hope that all your EYFS home visit questions have been answered in this blog and that any home visits or stay and play sessions are very successful! 97% of teachers agree that Twinkl improves their work/life balance. Inspire your students, improve your wellbeing, and regain control of your time with Twinkl. See plans and pricing here.

  16. PDF Home Visits-Completion of the Home Visit Form

    or the training video "Scheduling Home Visits" in the staff online training library. *The Home Visit (Educational Home Base ONLY) form is located in Family Services, in the HV Form tab. You will need to click the green "Add HV Form" button each time you have a new Home Visit. *The Home Visit dates entered on the Events tab need to match ...

  17. Great Start Readiness Program (GSRP)

    The Great Start Readiness Program (GSRP) is Michigan's state-funded preschool for four-year-old children. Families qualify for free preschool based on annual income guidelines. Wayne RESA receives an annual grant and administers the program in Wayne County. Our staff are responsible for ensuring the 105 school districts, public school academies ...

  18. St Peter'S School Home Visit Policy and Procedure

    Reasons for home visits: Home visits are important in helping the school to make contact with new or hard to reach Ps/Cs/Gs. They are particularly useful as they enable the Ps/Cs/Gs to still have contact with the school, but in their own environment. Home visits are to be used when: • Students are refusing to come into school

  19. Daycare Childcare Directory Listings

    Group Child Care Home Facility. Please call for more ... U of I Child Development Laboratory: University Of Idaho, Niccolls 4 Moscow ID 83844 (208) 885-6357: ... Blue Willow Preschool: Call for location Moscow ID 83843 (208) 596-4329: Contact Mary for more informtion. Mention that you found us on ... Small Steps Daycare: 214 N Main St

  20. Preschool in Moscow

    "Nasledije" school First in moscow private kindergarten/infant school Montessori. Invites children from 2,5 till 9 years old. Address: Utkina str., 39b | Phone +7 (495) 365-3778

  21. Home Visit Reminder Teaching Resources

    For many Early Childhood Educators this means coordinating home visits. This free printable form is a quick and easy way to reminder families of the time and date of your meeting, and to confirm that you have the correct address all at once. Also works great for conferences to take place at school. Form prints 2 to a page to save paper.

  22. Building on the "Reset"

    Yesterday, the Vice President and Dr. Biden visited the Tomb of the Unknown Soldier in the Alexander Garden. As a military honor guard looked on, the Vice President observed a moment of silence in recognition of the Russian soldiers who died in World War II and ceremonially placed a wreath that read "To those who fell in the fight against fascism, from the American people."

  23. 'Inexcusable': Senators grill education secretary over botched FAFSA

    Education Secretary Miguel Cardona said the Department of Education is working around the clock to make sure the FAFSA process improves, after major delays and a troubled roll out of the new financ…

  24. The History of the World: Nixon visits Moscow

    22 May 1972. The following is a brief extract from The History of the World: Sixth Edition by J.M. Roberts and O.A. Westad.. In October 1971 the UN General Assembly had recognized the People's Republic as the only legitimate representative of China in the United Nations, and expelled the representative of Taiwan.