duangphorn-wiriya-661992-unsplashAs the heat continues to rise for the summer, many of us will find ourselves seeking relief in water activities. Great memories can be created with water. You might have childhood memories of spending weekends at the lake, vacationing by the ocean or simply running through a sprinkler on those extra hot summer days. When there is water, typically fun is involved. Children especially enjoy water activities as they can splash in a pool, jump in a puddle or use the bathtub as a place to experiment with how toys may float or sink. Amid creating all these wonderful memories with children this summer, please consider how the experts recommend staying safe in and around water.

It is a devastating fact to report, but drowning is one of the leading causes of accidental death in countries all around the world (Vähätalo, Lunetta, Olkkola, & Suominen, 2014; Wallis, Watt, Franklin, Nixon, & Kimble, 2015). Children aged 1 to 4 face the highest drowning rates, making it critical to share water safety information with all parents (Centers for Disease Control and Prevention (CDC), 2016; Government of Canada, 2016). At this age, most drownings occur in swimming pools (CDC, 2016). It is important to understand that young children are particularly vulnerable to drowning because they can drown in only a few inches of water (American Academy of Pediatrics, 2015). In addition to this, drowning can happen very quickly and quietly, which leaves little time for individuals to respond in these tragic situations (Government of Canada, 2016). This topic is difficult to discuss, as is any topic that threatens the well-being of young children. As the summer season swings into gear, make wonderful memories with the children in your life, while keeping these water safety tips in mind.

Water Safety Tips from the Experts!

• When a pool is not in use, put toys away. These can capture a child’s attention and be used as a tool for climbing when an adult is not around.

• Empty blow-up pools when they are not in use.

• Be aware of small bodies of water as these attract a child’s attention. These include: bathtubs, fishponds, fountains, and even buckets used for cleaning. Most infant drownings occur in bathtubs and buckets.

• Keep a cover on pools when not in use and always completely remove the cover before swimming. Never let children walk on a pool cover.

• Always have children wear a life jacket when they are swimming or riding in a boat. Do not let children use inflatable toys or mattresses in place of a life jacket.

• Eliminate distractions while supervising children in water. Adults should avoid: talking on the phone, working from a laptop, or any other task that could distract a parent from giving children their full attention.

(American Academy of Pediatrics, 2013; American Academy of Pediatrics, 2015; Government of Canada, 2016)

As you embark on your summer adventures, keep in mind that the experts recommend infants and toddlers should have extra supervision when around water. The American Academy of Pediatrics (2017) shares that newborn infants and children through age 4 should NEVER be left alone around any water, not even for just a moment. Infants and young children should always be supervised by an adult and not another child when in or near water.

Because children this age are at such a high risk for drowning, pediatricians now teach a technique called “touch supervision” to parents. This means that anytime a child 4 or younger is in or near water, an adult should be within arm’s length of the child and have their full attention on the child at all times. By doing this, parents can be assured that their children are having fun, while being kept safe.

Though we hope to never have to use CPR, parents can also consider finding out about becoming CPR certified. Parents may speak with their child’s pediatrician if they would like more information about learning how to perform CPR during emergencies. As you enjoy your summer, keep children close to you, particularly in and around water. Take a swim, walk by the beach, ride in a boat, but remember, be safe and always stay focused on the children.



American Academy of Pediatrics. (2017, May 16). Drowning prevention:

information for parents. Retrieved from: https://www.healthychildren


American Academy of Pediatrics. (2013, August 6). Swimming pool safety.

Retrieved from: https://www.healthychildren.org/English/safety-


American Academy of Pediatrics. (2015, November 21). Water safety: Tips for

parents of young children. Retrieved from: https://www.healthychildren



Center for Disease Control and Prevention. (2016, April 28). Unintentional

drowning: Get the facts. Retrieved from: https://www.cdc.gov


Government of Canada. (2016, March 3). Swimming safety. Retrieved from:



Vähätalo, R., Lunetta, P., Olkkola, K. T., & Suominen, P. K. (2014). Drowning

in children: Utstein style reporting and outcome. Acta Anaesthesiologica

Scandinavica58(5), 604-610. doi:10.1111/aas.12298

Wallis, B. A., Watt, K., Franklin, R. C., Nixon, J. W., & Kimble, R. M. (2015).

Drowning mortality and morbidity rates in children and adolescents 0-19

yrs: a population-based study in Queensland, Australia. Plos One10(2),

e0117948. doi:10.1371/journal.pone.0117948




It is that time of year for cookouts, baseball games, swimming, and many more activities that are fueled by the summer sun. This time of year is certainly preferred by many individuals as it lacks the bitter winds of winter and gloomy skies. Children especially appreciate this season as they can enjoy the warm weather and embrace the adventures that await them outside. Though summer is a fun time for many families, the season can be dangerous for children. Due to this time of year bringing rising hot temperatures, children face risks associated with vehicles.

Many of us have jumped into a car on a summer day only to find that the inside is sweltering hot. It hurts to touch the steering wheel, the metal clip of the seatbelt feels like an oven, and catching your breath feels like a hopeless task until the air conditioning finally starts blowing cool air. Vehicles can get hot extremely quickly leaving children at risk for heatstroke when they are left unattended in a vehicle or gain access to a vehicle.

The American Academy of Pediatrics (AAP) (2015) and the Centers for Disease Control and Prevention (CDC) (2017) both report that temperatures inside a car can rise 20 degrees F within just 10 minutes. Researchers have found that if a car is parked in direct sunlight, temperatures inside the car can reach as high as 131 degrees F to 171 degrees F in only 15 minutes (Koul et al., 2010). Vehicles and heat create a dangerous situation for children, but there are steps caregivers can take to ensure children remain safe in and around vehicles.

Children are vulnerable to heatstroke for many reasons such as their small blood volume in relation to their body and their inability to sweat the same amount as adults (Adato, Dubnov-Raz, Gips, Heled, & Epstein, 2016). Though no parent wants to imagine that their child can be left in a vehicle or become trapped in a vehicle, we know this tragic occurrence does happen. The AAP (2015) reminds caregivers that anyone can mistakenly leave a child in the back seat, even a loving and attentive parent. Children are at a higher risk for being left in the back seat if the individual driving is distracted or there is a change in the typical routine. Researchers also share that sometimes children gain access to a vehicle that is unlocked and become trapped in the vehicle, which can also lead to heatstroke (Adato el al., 2016; Koul et al., 2010). The experts provide caregivers with tips they can use to make sure children are never left in a vehicle or gain access to an unlocked vehicle.

Let’s review the tips provided by the AAP and the National Highway Traffic Safety Administration (NHTSA).

• Always check the back seat to make sure no children are present before locking the car and walking away (AAP, 2015; NHTSA, n.d.)

• Avoid being distracted while driving like talking on a cell phone (AAP, 2015)

• Be extra alert when there is a change in the usual routine like having to take a different route to work (AAP, 2015)

• If someone else is driving the child to childcare or school, check to make sure the child arrived at their destination safely (AAP, 2015; NHTSA, n.d.)

• Ask childcare providers to call a parent if the child is more than 10 minutes late (AAP, 2015)

• Place your purse, cell phone, or bag in the backseat so that when you arrive to your destination you must check the back seat (AAP, 2015; NHTSA, n.d.)

• Keep a stuffed animal in your child’s car seat when it is empty. When you place your child in the car seat, move the stuffed animal to the front seat to serve as a reminder that your child is in the vehicle (NHTSA, n.d.)

• Keep vehicles locked and always store keys out of sight and out of reach of children to prevent children from gaining access to a vehicle and getting locked inside (AAP, 2015; NHTSA, n.d.)

The summer season provides us the opportunity to discuss heatstroke in children because the warm temperatures cause vehicles to get extremely hot. Remember that this is an important conversation to have with caregivers outside of summer. Even when the temperature is as low as 57 degrees F, the inside of a vehicle can still reach 107 degrees F, which still makes children susceptible to heatstroke (AAP, 2015; NHTSA, n.d.). It’s also important to remind caregivers that when a vehicle window is cracked, a vehicle will still reach high temperatures and children can suffer a heatstroke (CDC, 2017).

Let’s help caregivers keep children safe in and around vehicles all year around!


Adato, B., Dubnov-Raz, G., Gips, H., Heled, Y., & Epstein, Y. (2016). Fatal heat stroke in children found in parked cars: autopsy findings. European Journal Of Pediatrics175(9), 1249-1252. doi:10.1007/s00431-016-2751-5

American Academy of Pediatrics. (2015, June 30). Prevent child deaths in hot cars. Retrieved from: https://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Prevent-Child-Deaths-in-Hot-Cars.aspx Centers for Disease Control and Prevention. (2017, June 19). Heat and infants and children. Retrieved from: https://www.cdc.gov/disasters/extremeheat/children.html

Koul, R., Al-Futaisi, A., Al-Sadoon, M., El-Nour, I., Chacko, A., Hira, M., & ... Jain, R. (2010). Vehicular Entrapment and Heat Stroke in Three children: Is it a Form of Child Neglect?. Oman Medical Journal25(3), 222-224. doi:10.5001/omj.2010.61

National Highway Traffic Safety Administration. (n.d.). It can happen to anyone; know the facts to protect your kids. Retrieved from: https://www.nhtsa.gov/heatstroke-kills-children

t2p cover hv

Hopefully Spring is here for most of us…along with the newness and change the season brings. As the grass turns green and the flowers begin to bloom, it seems like the perfect opportunity to announce the birth of a new product from GKI. It’s official…GKI will be releasing our new Tier 2 Premium(T2P) this month!

We are SO excited to share this product with home visitors and their supervisors. It has been under development for quite some time and we know that several of you have anxiously awaited the release. Today, we’ve decided to use this blog to share with you some more information about the new Tier 2 Premium. It is our hope that after reading today’s post, you will feel comfortable with what you can expect and curious to begin your explorations of T2P.

When developing T2P, GKI wanted to strongly focus on what it takes to be an effective and skilled home visitor and to provide you with a deeper understanding of the ways that the Growing Great Kids™ and Growing Great Families™ curricula support that. We know…as do each of you know how important your job is as a home visitor! You are given the honor of entering homes and creating opportunities for joyful parent-child interaction all while being able to take part in each family’s unique culture.

Considering this, our goal was to design a product that would further your professional development by providing you with an in-depth exploration of GKI’s 8 Competencies for Effective Home Visiting. As you begin your work in T2P, you will see that GKI wanted the exploration of these 8 Competencies engage you with excitement and a thirst for learning more. Hopefully, you will experience this as you read content, view videos, challenge your understanding with reviews, play around with virtual flip-cards, and participate in interactive exercises. Speaking of interactive, we also worked to provide home visitors the opportunity to interact with their learning experience. In T2P, you will find yourself completing a variety of tasks within each competency to keep you engaged and motivated to learn more. Did we mention that all this learning gets to take place on online? That’s right! All of the T2P content is presented online through the GK Academy.

With T2P living in our online environment, GKI wanted to offer home visitors a wholistic approach to learning. Once you dive into T2P, you will learn that we talk about a variety of topics. Some of these topics include: curricula, activities, Attachment Boosters, Daily Do’s, and Action Tools. GKI believes in you, the home visitors we to serve, so we wanted to take T2P one step further. We wanted you to do more than explore the depths of the curricula, we wanted to challenge your critical thinking skills as an individual and a professional. As you begin T2P, you will learn quickly that we give home visitors the opportunity to review the research that guides GKI’s products. You will find yourself engaging with research on a variety of topics such as cultural humility, serve-and-return interaction, and adverse childhood experiences. Even though all the T2P content is available as an online learning experience, GKI still wanted to ensure that home visitors received a chance to put this content into practice in a real-world way.

You will receive a hard copy T2P Home Visitor’s Guidebook allowing you to view your assignments. Though these assignments are printed in this guidebook, you will be able to record your work with these assignments in the Academy. We recognize that all home visitors are busy and may fear the thought of another task, so let’s take time to discuss the assignments.

GKI wants to provide home visitors with an interactive learning experience, while keeping in mind the chaotic schedule that so many home visitors face every day. As a result, we developed assignments that allow you to explore each of the 8 Competencies while being able to complete most of them during your home visits. After you complete each Competency, you will locate the assignments in your guidebook. These assignments include tasks like completing a module or using a specific Daily Do. Once you finish these tasks, you will reflect on your experiences. Your reflections will be entered online in the Academy and then printed out for you to discuss your thoughts, feelings, and experiences with your supervisor. We did not develop these assignments so that you would feel you have extra work on your plate, but rather we created these assignments to give you a chance to enhance your skillset as an effective home visitor.

You will have plenty of time to complete these tasks and you will find that many of the tasks are things you already do during home visits. This is just a method of organizing your efforts in an intentional way to deepen your understanding of how our curricula support the crucial work you do each day.

T2P is a new way to expand your learning as a home visitor. As you dive into the content of each Competency, it is our hope that you will broaden your knowledge base. After completing each Competency online, you will have the opportunity to turn newly learned knowledge into skills. As you venture into your T2P journey, you will be exposed to many ideas, theories, and concepts. You will bring this all to life in the way that matters most…with the children and families you serve!

More information will be available about this product as we get closer to our actual release at the end of this month. Stay tuned!!


At GKI, ocaleb-woods-182648-unsplashur vision is to “protect children and their childhoods, while giving every parent the opportunity to feel confident and competent.” With April kicking off Child Abuse Prevention Month, it seems like the perfect opportunity to focus on the roots of what guides our practices as home visitors. As each of you enter homes and create conversations around the topics laid out in your GGK and GGF curriculum, you are striving to protect children and their childhoods, while empowering parents to feel confident and competent. As home visitors we often hope for a world that is child abuse free. We want to imagine a place where every child feels loved, valued, and safe. Home visitors are working hard every day to provide families with the information and support needed to foster children who grow up with childhoods they cherish as adults. In our blog this month, we will be focusing on the topic of child abuse, punishment and what modules can be used as tools in preventing child maltreatment.

According to the CDC (2016), there are various types of child abuse/neglect, including physical abuse, sexual abuse, psychological abuse, physical neglect, and emotional neglect. Though there are multiple forms of child abuse/neglect, in this post we will focus on physical abuse, leading us into our conversation about punishment.

Researchers have found that physical child abuse (PCA) is a serious health problem worldwide. PCA has a high prevalence and is known to increase the risk of physical and mental health problems and harmful social outcomes (Annerbäcka, Sahlqvistb, Svedina, Wingrenc, Gustafssond, 2012; Nillsson, Nordås, Pribe, Svedin, 2017). A history of PCA is linked to the use of alcohol, drugs, and tobacco (Annerbäcka et al., 2012). In addition to these behaviors, children who experience PCA may also have concerns with anxiety, depression and low-self-esteem in adulthood (Nilsson et al., 2017).

Sometimes we think of childhood as something that can be forgotten or left in the past. We don’t want to imagine that because children are exposed to physical abuse, their adult life may present extra challenges. Fortunately, home visitors have the opportunity to help prevent PCA by starting conversations with parents about punishment and the negative effects that can arise from physical punishment.

Before we dive into this, let’s first discuss some of the reasons PCA may occur. The CDC (2016) shares that caregivers who use physical punishment may not intend for some of the the consequences that can result. When parents use physical punishment without the intention of injuring a child, but injuries occur, PCA is still the result. You might be asking what you can do as a home visitor to ensure that the families you serve do not experience these situations. An important step in preventing PCA is helping caregivers understand the difference between punishment and discipline.

According to Ginsburg (2016), discipline is about guidance, not punishment. Punishment often happens when a parent reaches their crisis point. For example, a parent may tell a child to clean up their toys, but the child decides not to listen to this command. As a result, the parent begins to threaten the child to clean up their toys, yet the child still does not respond to the threats. This can lead parents to their crisis point where punishment might occur. The concern with parents reaching their crisis point is that the punishment the parent assigns to the child is usually much worse than the “crime” carried out by the child. Daniel Siegal and Tina Payne Bryson, well acclaimed psychiatrists that have extensive knowledge of how a child’s brain is wired, remind us of the purpose of discipline.

According to Siegal and Bryson (2016):

"Effective discipline means that we’re not only stopping a bad behavior or promoting a good one, but also teaching skills and nurturing the connections in our children’s brains that will help them make better decisions and handle themselves well in the future. " (p.xix)

When we look at this quote in combination with how Ginsburg (2016) defines discipline, we begin to realize that discipline is about guiding a child into good behavior, yet punishment usually occurs from a crisis point. If parents provide a punishment at a time when they are overwhelmed, angry and exhausted then it’s possible that PCA may occur. Remember the CDC (2016) explains that even though a caregiver seeks to use physical punishment, intending not to cause injury in the process, harm may still be done to the child. Many of us have reached our crisis point at one time or another and can probably remember that when we reach this level, we don’t feel like we have much control. As a home visitor who probably works hard to advocate for a world free of child abuse, you might be asking yourself how you can encourage discipline instead of punishment.

Home visitors, there is great news for you! There are discipline modules located throughout your GGF and GGK curriculum. You can even find a module that describes the difference between discipline and punishment. Please see the list below for modules and subsections that can guide you in your journey of creating conversation around safe and effective discipline strategies for parents.


Unit 3 Module 1: Discipline and Punishment: What Is the Difference?

Unit 3 Module 2: Discipline: Strategies for Growing Self-Regulation

Unit 3 Module 3: Discipline: “Dial It Down Time” And Spanking

GGK Birth to 12 Months

10-12 Months Social and Emotional Development: Subsection-Discipline Follow Up

13-24 Months

13 to 15 Months Cues and Communication: Subsection-Yelling: Can Toddlers Listen?


Remember April is Child Abuse Prevention Month. Be an advocate for all children. Kids deserve a childhood free of trauma and memories that they can cherish as an adult.



Annerbäcka, E.-M., Sahlqvist, L., Svedina, C. G., Wingrenc, G., & Gustafssond. P. A.

(2012). Child physical abuse and concurrence of other types of child abuse in

Sweden-associations with health and risk behaviors. Child Abuse & Neglect, 36,

585-595. doi: http://dx.doi.org/10.1016/j.chiabu.2012.05.006

Centers for Disease Control and Prevention. (2016, April 5). Child abuse and neglect:

Definitions. Retrieved from: https://www.cdc.gov/violenceprevention/


Ginsburg, K. R. (2016, January 16). Discipline strategies. Retrieved from:



Nilsson, D., Nordåsa, E., Pribe, G., Svedin. C.G. (2017). Child physical abuse-high school

student’s mental health and parental relations depending on who perpetrated the

abuse. Child abuse and neglect, 70, 28-38. doi: http://dx.doi.org/


Siegal, D. J., & Bryson, T. P. (2016). No-Drama Discipline. New York, NY: Bantam Books.


Imagine a sweet 6-month-old baby girl tucked in the arms of her father as he reads her a bedtime story. She snuggles in close to his chest as he calmly sways her back and forth in a rocking chair. As he exaggerates his voice with the story, the baby reaches her hands for the book and pats the pages with excitement. The father continues with the story as the little one grasps for his face to find reassurance in his presence…the one who soothes her every night before she is put to bed. This beautiful moment occurs every night between this sweet father and daughter and it always begins with a book.

Reading to infants is encouraged in American society. Research has clearly confirmed the benefits children receive from being read to in the early stages of life. According to Murray and Egan (2014), we have known for a long time that there is a connection between language and literacy. Organizations like the American Academy of Pediatrics (2014), the Canadian Pediatric Society (2018), and the Centers for Disease Control and Prevention (2017) recommend that reading to children should begin during infancy. Despite the abundance of literature that encourages reading in early infancy, research suggests that, on average, parents begin reading with their babies at around 7 to 9 months (Murray & Egan, 2014). We may look at this research and think losing 7 to 9 months of reading time is not that significant considering parents have an infant’s entire childhood to read and tell stories. Though this research may seem insignificant when looking at the whole picture, researchers are finding that WHEN parents begin reading to their infants matters.

Researchers like Thacker (2014) explain that when caregivers can establish a reading routine before children turn 2 years of age, children can be exposed to a rich vocabulary that betters their language development and sets the stage for future exposure to reading materials. The American Academy of Pediatrics (2017) has released new research that suggests reading with young infants is linked to enhancing their vocabulary and reading skills four years later. Murray and Egan (2014) report that children undergo a rapid pace of development between 9 to 12 months of age. This explains why the amount of time a parent reads with their child at 9 months can predict a child’s vocabulary at 34 months and even at 58 months of age.

Research is consistent in demonstrating that reading during infancy can have a multitude of benefits for children. It supports their literacy, language, vocabulary, and writing development (American Academy of Pediatrics, 2017; Holland, 2007; Murray & Egan, 2014; Thacker, 2014). Most home visitors are aware of these developmental benefits, but did you know that reading during infancy is linked to more than just these developmental benefits? Research is now finding that reading during infancy does much more than provide a child with rich reading and vocabulary skills.

As we go about our day in home visiting, we know that each of us has one characteristic in common…we are all trying to promote parent-child engagement. Research is providing great news for home visitors! When reading begins early, children experience a stronger parent-child relationship (American Academy of Pediatrics, 2015). According to Thacker (2014), “As soon as an infant can sit on a caregiver’s lap, the child can learn to associate the act of reading with a sense of being loved” (p.16). How amazing is it that a tiny infant can learn that reading time means Mommy and Daddy love me? Reading to infants is so much more than teaching babies words; reading is an opportunity for a parent and child to spend time together enhancing their growing bond.

Home visitors understand that the idea of reading to an infant is challenging to some families for various reasons. Some caregivers may struggle with literacy, while others may not feel confident in their reading abilities. We must remember to be sensitive to the parents we serve, but we also have to spread the word that parents do not have to be great readers in order to have reading time with their babies. Research reminds us that until children attend school, they spend more time looking at pictures in books as opposed to the words (Thacker, 2014). The Canadian Pediatric Society (2018) shares that babies love to look at pictures in books and that simply talking to an infant about the pictures in a book is beneficial. As a GGK home visitor you also have access to amazing activities like the Talking Box Book where parents can simply tell a story using a decorated box. This means that parents can tell a story to their baby without having to read words. Also know that any Cues and Communication module can support you in encouraging parents to focus on vocabulary and language skills but be aware that there are activities and subsections throughout the curriculum that encourage reading parent-child reading time. Please see the provided list below:


GGK Birth to 12 Months

4-6 Months: Play and Stimulation

Activity: Picture Storybook

7-9 Months: Cues and Communication

Activity: Talking Box Book

7-9 Months: Physical and Brain Development

Subsection: Read Now…Read Forever

Activity: Read to Me

10-12 Months: Physical and Brain Development

Activity: Bedtime Stories

GGK 13-24 Months

13 to 15 Months: Play and Stimulation

Subsection: Reading: Making Words Live

Activity: A Book About Me

19-21 Months: Play and Stimulation

Activity: Going to The Library

22-24 Months: Cues and Communication

Subsection: Reading: Making Words Live

Activity: The Word for The Day

25-30 Months: Cues and Communication

Activity: Color Me A Story

31-36 Months: Cues and Communication

Subsection: Making the Most Of Storytime

Activity: Where, What, And Why Storytelling

As you go about your home visits this month, remember that a book is more than words; it is the start of a beautiful lifelong parent-child bond.



American Academy of Pediatrics. 2014. Healthy children radio: Reading aloud to infants.

Retrieved from: https://www.healthychildren.org

American Academy of Pediatrics. 2015. Parent child reading and story time promote

brain development prior to kindergarten. Retrieved from: https://www.aap.org

American Academy of Pediatrics. (2017). Reading with children starting in infancy gives

lasting literacy boost. AAP News & Journal Gateway. Retrieved from:


Canadian Pediatric Society. (2018). Read, speak, sing to your baby: How parents can

promote literacy from birth. Retrieved from: https://www.caringforkids.cps.ca

Centers for Disease Control and Prevention. (2017).  Developmental milestones.

Retrieved from: https://www.cdc.gov

Holland, J. (2008). Reading aloud with infants: The controversy, the myth, and a case

study. Early Childhood Education Journal35(4), 383-385. doi:10.1007/s10643-007-0203-6

Murray, A., & Egan, S. M. (2014). Does reading to infants benefit their cognitive

development at 9-months-old? An investigation using a large birth cohort

survey. Child Language Teaching & Therapy30(3), 303-315.


Thacker, D. C. (2014). Playing with the text: The importance of sharing books with

babies. International Journal Of Birth & Parent Education2(1), 15-17.

Retrieved from: web.a.ebschohost.comeb.a.ebscohost.com Does reading to infan10.1177/0265659013513813



January has arrived and It is officially the new year! For many, the month of January represents a time of newness and change. January is famous for hosting the New Year holiday, but it is also well known for bringing about freezing temperatures, snow, and ice. Throughout the country, many have witnessed a dusting of snow, while others have already bundled up in multiple layers of clothing in an attempt to face the snowy sidewalks that pave their communities. Not everyone will face these changing temperatures, but many individuals will soon experience the bitter winds of winter and the chilling temperatures the season produces. As January begins, winter will make its appearance, thus sending many Americans to seek shelter in the warmth of their homes.

It is second nature to many us of to switch our thermostats to the heat setting once we begin to feel our house getting cold, but it is easy to forget the dangers that can arise from heating a home. According to the United States Energy Information Administration (2013), using natural gas is one of the most common ways for Americans to heat their homes. When natural gas is used, there is a risk for carbon monoxide (CO) poisoning.

The United States Fire Administration (2017) explains that CO is a colorless and odorless gas that can be deadly. Due to CO being an invisible gas, individuals may not realize when they are being exposed to it. Accidental CO poisoning accounts for roughly 400 to 500 deaths and more than 15,000 emergency room visits in the United States each year (American Academy of Pediatrics, 2017). The beginning stages of CO poisoning can present with various symptoms. These symptoms include:

• headache

• fatigue

• shortness of breath

• dizziness

• nausea

CO poisoning impacts individuals of all ages, but children are particularly sensitive to the dangerous gas. The American Academy of Pediatrics (2017) explains that when someone breaths in CO, the gas impacts their ability to transport oxygen. This creates more of a danger for children because they breathe faster, meaning children inhale more of the CO per pound of body weight.

Since so many families use natural gas and other heating techniques that can release CO, it is critical for parents to know how to prevent CO poisoning. The American Academy of Pediatrics (2017) shares that in order to prevent CO poisoning, CO detectors should be installed near every sleeping area in a home and checked frequently to ensure the detectors are working properly. Organizations like the United States Fire Administration (2017) recommend that CO detectors should be tested at least once a month to ensure that the alarm works properly.

While installing CO detectors is an effective way to prevent CO poisoning, experts also suggest that heating sources should be inspected annually or as recommended by the manufacturer to ensure they also function correctly. This includes fuel burning appliances, fireplaces, woodstoves, and space heaters (American Academy of Pediatrics, 2017). Even though CO can create dangers for families, especially during the winter months, it is important that caregivers understand that CO poisoning is preventable when detectors are used, and heating sources are properly inspected.

When discussing how to safely heat homes in the winter, it is crucial to also discuss the dangers of fire. According to the United States Fire Administration (2017), home fires are most prevalent in the winter. Half of all home heating fires to occur in the months of December, January, and February. In fact, heating equipment is involved in 1 in every 7 home fires. Unfortunately, statistics also show that in 1 in every 5 deaths caused by a home fire, heating equipment is involved.

When we look at these statistics, we realize quickly that heating a home poses a risk for fires. However, just as with CO poisoning can be prevented, home fires can be prevented. The United States Fire Administration recommends the following so that home heating fires can be avoided:

  • Use a certified professional to inspect chimneys and vents to ensure they work        properly each year
  • Keep any object that could burn at least three feet away from heat sources such as a fireplaces, wood-stoves, space heaters, or radiators
  • Never plug more than one heat-producing appliance such as a space heater into   an outlet at time

In addition to these tips, the American Academy of Pediatrics (2015), recommends that all families install smoke alarms outside every bedroom and there should be at least one smoke alarm on every floor of a home. These smoke alarms should be tested monthly and every family should have and practice a fire evacuation plan.

As you read this blog, you might be asking yourself, “How can I as a home visitor make sure the families I serve stay safe when they heat their homes?” This is a great question to ask because home visitors only visit with families for about an hour each week, so it’s hard to ensure the families you serve are heating their homes safely.

Keeping this question in mind, did you know that Great Kids provides a tool for you so that you can have conversation about how to keep families safe from CO and fires? This tool is known as the Home Safety Checklist for Families with Babies 6 Months And Older. It can be found in the 7 to 9 Months Basic Care section of the Birth to 12 Months Manual. When you use this checklist with families, you’ll have the opportunity to discuss how to prevent CO poisoning, and if families have checked the batteries in their smoke detectors.

It is easy to simply make checks on this list and move along to the next topic of discussion with families. However, Great Kids encourages home visitors to take their time with this list and follow up with families on CO and fire safety. Please learn about the resources available in your community that helps families to obtain carbon monoxide detectors and smoke alarms. Some fire departments will provide smoke alarms for free! As we approach these winter months, pull out the Home Safety Checklist. Remember this checklist is more than a simple to-do list, it is a conversation guide that can help save lives. Let’s work to keep families safe, while families work to stay warm.


American Academy of Pediatrics. 2015. Fire safety what is the best way to keep my family          safe from a home fire? Retrieved from: https://www.healthychildren.org

American Academy of Pediatrics. 2017. How to prevent carbon monoxide poisoning.  Retrieved from: https://www.healthychildren.org

United States Energy Information Administration. 2013. Use of energy in the United States           explained energy use in homes. Retrieved from: https://www.eia.gov

United States Fire Administration. 2017. Carbon monoxide safety outreach materials. Retrieved from: https://www.usfa.fema.gov

United States Fire Administration. 2017. Winter fire safety outreach materials. Retrieved           from: https://www.usfa.fema.gov

no smokingSitting down to write this December blog was more difficult than anticipated. Even though it is officially the holiday season and tons of topics are relevant to this time of the year, it was overwhelming to pick just one subject for this month. As I explored the past blog topics written around the holidays, I realized that many of my ideas had already been discussed on former blog postings. It never hurts to repeat certain information, especially information that is critical to the health and safety of children, but the more I read the former topics, the more motivated I became to discuss a different subject. After exploring the Centers for Disease Control and Prevention (CDC) website, a fact floating about their webpage caught my attention. It’s not usually a topic of discussion for the holiday season, but the more I studied the fact, the more I realized this is a subject that needs to be discussed year around. So, what was this fact that caught my eye? According to the CDC (2017), research shows that as of 2015, 1 in 5 adults were still using tobacco products. Of the 49 million tobacco users in the United States, cigarette smoking is the most common way to use tobacco. As someone who grew up in a generation where children were taught the dangers of tobacco usage, this statistic was shocking. Knowing that tobacco usage is still a public health concern for the nation makes this a topic that warrants time for discussion.

We have known for many years that smoking cigarettes poses a serious health concern, yet research is still suggesting that many people smoke. There are many reasons people take part in smoking. The U.S. Department of Health and Human Services (n.d.) shares that individuals begin smoking for stress relief, pleasure, or adhering to social situations. Research suggests that tobacco products can virtually harm every organ in the body, while smoking causes more deaths each year than Human Immunodeficiency Virus (HIV), illegal drug use, alcohol use, car accidents, and firearm-related incidents combined (Centers for Disease Control and Prevention, 2017). A major concern with smoking is that more than just the smoker can be affected by cigarette smoke. As time has progressed, we have learned that individuals who do not smoke, but are exposed to cigarette smoke can also face serious health concerns. This means that the children you serve through home visiting face health concerns when exposed to cigarette smoke.

Secondhand smoke, a term that has become familiar to many individuals, refers to the smoke that a smoker exhales from their cigarette, pipe, or cigar. This smoke is made up of about 4,000 chemicals and 50 of these chemicals are known to cause cancer. (American Academy of Pediatrics, 2017). When children are exposed to individuals who smoke, they breathe in these dangerous chemicals. Even children who are raised by caregivers who choose to smoke outside still face health concerns caused by thirdhand smoke.

Thirdhand smoke is the smoke that is left behind by smokers (American Academy of Pediatrics, 2017). This means if a parent chooses to smoke in a car without their child present, when the child does ride in the car, they are still exposed to the leftover smoke. Smoking impacts both the smoker and those who are exposed to the smoke from the tobacco product. We know that children being exposed to cigarette smoke is not good, but how does this smoke harm children?

According to the American Academy of Pediatrics (2017), secondhand smoke can cause copious health concerns for children. These concerns include:

• Ear infections

• Coughs and colds

• Respiratory problems like bronchitis or pneumonia

• Tooth decay

In addition to these health concerns, secondhand smoke may cause more frequent and severe asthma attacks in children, and children who are exposed to secondhand smoke have a more difficult time recovering from colds. Smoking does not wait to affect only the post-natal child. Research has shown that when women who are pregnant smoke, their soon to be born infant may face serious health complications.

The American Academy of Pediatrics (2015) reports that when a fetus is exposed to a mother who smokes they are at risk for:

• Sudden Infant Death Syndrome (SIDS)

• Learning Problems

• Respiratory Disorders

• Adult Heart Disease

When we look at all the health complications that children face because they are exposed to secondhand and thirdhand smoke, we begin shouting in our heads that caregivers must stop smoking. Organizations like the America Academy of Pediatrics and the American Cancer Society even share that the only way to stop the dangers caused by smoking is to have individuals quit smoking (American Academy of Pediatrics, 2017; American Cancer Society, 2017). This task is a lot easier said than done.

The U.S. Department of Health and Human Services (n.d.) reminds us that cigarettes contain nicotine, which is an addictive substance. Quitting smoking is no easy task, but as home visitors, you have great resources that you can share with families to support them along their journey to being smoke free. If you work with parents who smoke, remember you can refer them to their local health department or healthcare provider, these places are usually excited to talk with individuals about the benefits of giving up smoking. Do not forget there are various modules that include subsections addressing the dangers of smoking for parents and children. These subsections include:

Growing Great Kids Prenatal Manual

Unit 3 Module 3: Healthy Pregnancy…Healthy Baby-Smoking And Fetal Development  

Growing Great Kids Birth to 12 Months

0-3 Months Module 1: Basic Care…Infant Safety/Preventing Shaken Baby Syndrome

4-6 Months Module 1: Basic Care…Smoking: Facts About Exposing Children

10-12 Months Module 1: Basic Care…Smoking Revisited

In addition to these subsections that directly address smoking, know that you can always use your Body Builders Daily Do to discuss the dangers of smoking as this concern is addressed by this Daily Do. Smoking can be a difficult topic to discuss with families you serve, but know that you have so many resources that are available to help ease these conversations with families. Remember that having these kinds of difficult conversations with families provides them optimum opportunities for growth. Please help America become smoke free!


American Academy of Pediatrics. 2017. The dangers of secondhand smoke. Retrieved        from:           https://www.healthychildren.org

American Academy of Pediatrics. 2017. Where we stand: Smoking during pregnancy.        Retrieved from: https://www.healthychildren.org

American Cancer Society. 2017. The great American smokeout. Retrieved from:           https://www.cancer.org

Centers for Disease Control and Prevention. 2017. Smoking & tobacco use health effects   of cigarette smoking. Retrieved from: https://www.cdc.gov

Centers for Disease Control and Prevention. 2017. One in five US adults still using tobacco products in 2015. Retrieved from: https://www.cdc.gov

Centers for Disease Control and Prevention. 2017. Smoking & tobacco use fast facts.        Retrieved from: https://www.cdc.gov

U.S. Department for Health and Human Services. (n.d.). Reasons people smoke. Retrieved           from: https://smokefree.gov

suhyeon-choi-251615Today we are going to start our discussion by painting a picture with our minds. Envision the sights, sounds, and even smells of this description and drift into the shoes of this couple that is about to be described. It’s the beginning of November, the air that once felt like fall now brings about the chilling winds of winter. A couple expecting their very first child rushes about their home early in the morning to prepare for their work day. The aroma of breakfast cooking on the stove fills the home as the expectant mother slowly sits down at the kitchen table to have a morning meal. Only moments after taking a seat, the mother’s water breaks. Shrills of excitement fill the mother’s and father’s voice as they rush to deliver their baby at exactly 40 weeks. Delivery is difficult of course, but after a long night, a beautiful baby is placed in the arms of the mother. After spending a couple of days in the hospital, the couple is sent home with their new bundle of joy. We wish every single delivery could go as smoothly as the one described, but we know this scenario is not the reality for so many parents.

Parents all hope for routine deliveries that provide them with a healthy baby who can return home in just a few short days, but many babies are born into this world before spending 40 weeks in the womb. In these emotionally trying times, babies are not sent home after delivery, but usually placed in the Neonatal Intensive Care Unit (NICU). No parent should have to watch their precious newborn from afar, but thousands of parents have to visit their baby in the NICU each year. As November marks National Prematurity Awareness Month, let’s take an opportunity to discuss prematurity further and how parents can promote a healthy and full-term pregnancy.

Prematurity among infants is a public health concern in the United States. Each year, roughly 400,000 babies are born preterm leaving about 1 in 10 infants to face prematurity in the year 2015 (Barfield, 2016; Centers for Disease Control and Prevention (CDC), 2017). These numbers pose a serious threat to babies as preterm birth has been listed as one of the top 5 leading causes of infant death in past years (CDC, 2017). The American Academy of Pediatrics (2015) explains that a baby is considered preterm when they are born before 37 weeks of pregnancy. Infants born prematurely can face a number of concerns. These concerns include: respiratory problems, feeding difficulties, cerebral palsy, developmental delay, and problems with hearing and vision (CDC, 2017). As a home visitor, it is highly likely that your heart breaks at the thought of a baby being born into a world where they have to fight extra hard to keep up every day. Prematurity is a difficult topic to discuss as we don’t want to think that the smallest humans in the world are starting out life with struggles. Luckily, research is showing there are precautions that can be taken to promote a healthy and full-term pregnancy.

It is important to mention that even what seems like the healthiest of pregnancies can end in a preterm birth (CDC, 2016). There is no way we can guarantee parents that their pregnancy will be problem free. Despite this, research has identified factors that can increase the risk of preterm labor (CDC, 2016; Thomas, Copen, Kirmeyer, 2016). These factors include:

• Cigarette smoking

• Substance abuse

• Stress

• Depression

• Short interpregnancy intervals

Many of these factors may seem out of your control, but there are ways you can help. That’s right, you as a home visitor have wonderful opportunities to talk with parents about how they can have a healthy pregnancy! You even have your Growing Great Kids (GGK) and Growing Great Families Curricula (GGF) available to you which provides conversation guides around what can be uncomfortable subject matter. For example, you might be thinking how do I even begin a conversation around using drugs or smoking while pregnant? These are extremely difficult conversations to have with parents, but not to worry. There are modules like Healthy Pregnancy…Healthy Baby that provide a conversation guide around prenatal smoking and drug use. GGF even offers numerous modules on stress which we learned can be a contributing factor in preterm birth. Before wrapping up this discussion, please review the list of GGK and GGF modules that can provide support for healthy pregnancies and help prevent preterm births.

Growing Great Kids Prenatal Manual

Unit 2 Module 3: Prenatal Depression In Moms And Dads Is Not Uncommon

Unit 3: Module 3 Healthy Pregnancy… Healthy Baby

Unit 4: Module 2 Power Down Stress…Power Up Happiness

Growing Great Families Manual

Unit 2: Module 2…Sizing Up Your Strengths…Reducing Stress

Unit 2: Module 5… Warning Signs For Stress Overload

Unit 3: Module 10…Planning A Family

Unit 3: Module 8…When Depression Is A Concern

November is a busy month as the holiday season begins and the new year approaches, but in the hustle and bustle of the month, don’t forget it is National Prematurity Awareness Month. Remember, you have the ability to help prevent preterm births using modules like the ones listed above. The factors that can cause preterm birth can be hard subjects to discuss, but there are already conversation guides created to make these conversations easier. We hope you have enjoyed this discussion and that have a wonderful November. Please go forth and share with parents how to turn healthy pregnancies into healthy babies!


American Academy of Pediatrics. 2015. Caring for a premature baby: What parents need to know. Retrieved from: https://www.healthychildren.org

Barfield, W. 2016. National prematurity awareness month: Celebrating successes and taking           action. Retrieved from: https://www.cdc.gov

Centers for Disease Control and Prevention. 2017. Infant mortality. Retrieved from:           https://www.cdc.gov

Centers for Disease Control and Prevention. 2017. Preterm birth. Retrieved from:           https://www.cdc.gov

Thomas, M. E., Copen, C. E., & Kirmeyer, S. E. 2016. Short interpregnancy intervals in     2014: Differences by maternal demographic characteristics. Retrieved from: https://www.cdc.gov



October is often associated with fun fall activities. Those who celebrate Halloween will fill their front porches with decorative pumpkins, while others will head to the nearest apple orchard to pick the fresh fall fruit. The sports fans will cheer on their favorite football teams and others will find themselves getting lost in the fun of a corn maze. October truly is a wonderful month for many individuals, but there is a characteristic of the month that is often forgotten. The tenth month of the year marks Domestic Violence Awareness Month. A public concern that is familiar to adults and children alike. Children living in homes where domestic violence is occurring experience the unfortunate consequence of toxic stress.

Violence has become a part of our everyday life. Children can experience violence in various settings…schools, neighborhoods, and even within their own homes (American Academy of Pediatrics, 2016). Researchers now warn that violence experienced within the family is considered the most damaging type of violence for children (Maneta, White, & Mezzacappa, 2017). This research raises concern as it is estimated that 20 to 30% of American children have witnessed violence between their parents (Fowler, Cantos, & Miller, 2016). Among the children who are exposed to intimate partner violence, roughly 57% of these children report being maltreated at some point in their lifetime (Kiesel, Pieschar, & Edleson, 2016). Unfortunately, various researchers are finding that domestic violence and child maltreatment co-occur (Casanueva, Smith, Ringeisen, Dolan, & Tueller, 2014; Katz, 2014; Kiesal et al., 2016). Some researchers are even discovering that children who live with domestic violence witness between 70-85% of the abuse (Katz, 2014). As you read these statistics, you may be wondering why such devastating numbers are being shared with you. The reason is that you, as a home visitor, can empower caregivers to prevent this violence. Domestic violence causes toxic stress for children, however, you can support parents to prevent toxic stress within their families, by guiding them as they increase their understanding of its impact.

What is toxic stress? You may know the answer to this because you have worked through the GGF module that discusses toxic stress. Maybe you have not gotten to this module yet, but you have heard the concept tossed around among individuals or maybe you have seen toxic stress mentioned in the literature. Researchers describe toxic stress as the extreme or recurrent activation of the stress response, in the absence of a supportive adult to assist with co-regulation. The Center on the Developing Child at Harvard University (2011) describes in detail how the brain responds to stress. The Center explains that when the body experiences stress, the stress response system is activated. This activated response system causes increased heart rate and stress hormones. When a child experiences stress, but a loving and caring adult responds to the child, the stress response system can return to normal. However, when a child does not have an adult to respond in moments of extreme stress, like often is the case during domestic violence, the child’s stress response system stays activated. This continuous activation can cause a reduction in the connection between neurotransmitters in the brain comprised for learning and reasoning. Does this information remind you of any specific daily do? Yes, Brain Builders!

When discussing toxic stress that is rooted in domestic violence, think of the bubble brains. We know little brains that face trauma miss out on important connections that need to form in early childhood. Even though toxic stress can be a difficult topic to explore, the great news is you have various tools in your GGK Curriculum that can guide conversations around toxic stress and healthy brain development for children. Please see the list of useful modules or subsections listed below that can guide you as you support parents to prevent toxic stress and promote healthy brain development.

Growing Great Kids Prenatal

Unit 3 Module 4: Your Baby’s Developing Brain

Growing Great Kids Birth to 12 Months Manual

0-3 Months: Physical and Brain Development

Growing Great Kids 13 to 24 Months

16-18 Months: Physical and Brain Development-Building a Great Brain: Parental Influences

Growing Great Families 

Unit 2 Module 1: Protecting Your Children from Toxic Stress

Unit 2 Module 5: Warning Signs for Stress Overload

As you settle into October, please remember it is Domestic Violence Awareness Month. When raising awareness for this type of violence, don’t forget to be a voice for the children who are a part of this violence.


American Academy of Pediatrics. (2016). Childhood exposure to violence. Retrieved from:           https://www.healthychildren.org

Casanueva, C., Smith, K., Ringeisen, H., Dolan, M., & Tueller, S. (2014). Families in need of domestic violence services reported to the child welfare system: Changes in the         national survey of child and adolescent well-being between 1999-2000 and 2008-        2009. Child    Abuse and Neglect, 38, 1683-1693. Retrieved from:          http://www.sciencedirect.com

Center on the Developing Child Harvard University.  (2011). Three core concepts in early           development. Retrieved from: https://developingchild.harvard.edu

Fowler, D. R., Cantos, A. L., & Miller, S. A. (2016). Exposure to violence, typology, and     recidivism in a probation sample of domestic violence perpetrators. Child Abuse &       Neglect, 59, 66-67. Retrieved from: http://www.sciencedirect.com

Johnson, S. B., Riley, A. W., Granger, D. A., & Riis, J. (2013). The science of early life      toxic stress for pediatric practice and advocacy. Pediatrics, 131,319-327. doi:     10.1542/peds.2012-0469

Katz, C. (2014). The dead end of domestic violence: Spotlight on children’s narrative        during           forensic investigations following domestic homicide. Child Abuse and          Neglect, 38, 1976-1984. Retrieved from: http://www.science direct.com

Kiesel, L. R., Pieschar, K. N., & Edleson, J. L. (2016). The relationship between child           maltreatment, intimate partner violence exposure, and academic performance.     Journal of Public Child Welfare, (10) 4, 434-456. doi:         10.1080/15548732.2016.1209150

Maneta, E. K., White, M., & Mezzacappa, E. (2017). Parent-child aggression, adult-partner           violence, and child outcomes: A prospective, population-based study. Child abuse & Neglect, 68, 1-10. Retrieved from: http://www.sciencedirect.com





As summer comes to an end, fall quickly approaches. Many people await the season with excitement as the leaves begin to change and the temperatures slowly drop. Despite the refreshing changes the season brings about, it also comes with lots of sneezing, sniffling, and coughing. Yes, the fall season is infamous for the flu. Though this virus  is well known, it is easy for caregivers to forget how dangerous it can be for infants and children. As yesterday marked the end of summer, our discussion today will focus on how to prepare for the arriving flu season.

Influenza, commonly known as the flu, can often be mistaken for the common cold, but usually strikes more suddenly and makes you feel much worse than a cold does (Canadian Pediatric Society, 2015). According to the Canadian Pediatric Society (CPS) (2015) and the Centers for Disease Control and Prevention (CDC) (2017), infants and children can experience a wide range of symptoms from the flu. These symptoms include:

• Fever or feeling feverish

• Dry cough and sore throat

• Headache

• Muscle/body aches

• Fatigue

• Runny or stuffy nose

• Vomiting and diarrhea, especially common in children

Most people recover quickly from the flu, but it is crucial for caregivers to understand that young children are at a high risk for developing complications (CPS, 2015). A bout of the flu can lead to pneumonia, bacterial infections, croup, and bronchiolitis in children. Unfortunately, the virus is highly contagious and spreads easily among groups of children -  particularly in childcare settings (AAP, 2016). Even though infants and children can easily catch the flu, there are several steps caregivers can take to keep their little ones protected.

The CPS (2015) and the CDC (2016) recommend the following precautions this flu season:

  •  If you have a child who is 6 months or older, speak with a healthcare provider about the flu vaccine
  •  Wash hands frequently, especially after coughing, sneezing, or wiping noses
  •  Avoid touching your nose, eyes, and mouth as these areas allow for spreading of germs
  •  Clean and disinfect areas that could be contaminated with flu germs
  •  Avoid letting your child share toys that other children have placed in their mouth
  •  Do not share cups, utensils, or towels
  •  When coughing or sneezing, use a tissue to cover your mouth or nose

There are no GGK modules that specifically discuss the dangers of the flu virus for infants and children, but there are various subsections that can support caregivers in keeping their little ones healthy and free of illness. When preparing for upcoming home visits, please keep the following sections in mind:

Growing Great Kids Birth to 12 Months Manual

0-3 Months: Basic Care - When Baby Is Sick or Needs Health Care

4-6 Months: Basic Care - Keeping Your Baby Healthy

4-6 Months: Basic Care - Body Builders Daily Do Introduction

10-12 Months: Basic Care - Keeping Your Baby Healthy

Growing Great Kids 13 to 24 Months Manual

13-15 Months: Basic Care - Body Builders Daily Do

13-15 Months: Basic Care - Routine and Responsive Health Care

As you enjoy the break that Fall brings, don’t forget to protect your family from illness! Remember, even though young children are susceptible to viruses, there are lots of things caregivers can do to keep kids healthy this upcoming flu season.



American Academy of Pediatrics. 2016. Preventing the flu: Resources for parents and child care     providers. Retrieved from: https://www.healthychildren.org

Canadian Pediatric Society. 2015. Influenza in children. Retrieved from:     http://www.caringforkids.cps.ca

Centers for Disease Control and Prevention. 2017. Flu symptoms & complications. Retrieved          from: https://www.cdc.gov

Centers for Disease Control and Prevention. 2016. Preventive steps. Retrieved from:         https://www.cdc.gov