An exploratory case study was undertaken to investigate the perspectives and experiences of six early intervention providers as they adopted and implemented a collaborative consultation approach to home visiting in urban neighborhoods. Survey, semistructured interview, and focus group methods were used over a 2-year period to obtain data about provider perspectives about the home visiting approach and their experiences in implementing it with parents of infants and toddlers receiving Part C services. The intensity of provider concerns about the use of collaborative consultation and routines-based, family-centered home visiting practices improved at posttest. Providers attributed these changes in large part to the culture of the organization as a learning community and its ongoing administrative support for reflective practice and problem solving about implementation issues. Providers also identified specific factors, such as time and opportunity to practice and problem solving with feedback, as having an impact on their ability to move forward in adopting and using family-centered home visiting practices. Challenges were identified related to home visiting generally, and a consultative approach specifically, in complex urban family settings. Implications for research and practice are discussed.

An exploratory case study was undertaken to examine child and caregiver outcomes in a diverse sample of 21 infants/toddlers with severe disabilities who received services from an urban, Part C program where caregiver-focused intervention was emphasized. Purposive sampling and mixed methods were used to collect data on child developmental change, rate of progress, and caregiver self-efficacy. Analyses revealed that (a) child developmental gains were significant across all subscales of the Early Learning Accomplishment Profile–Revised (ELAP-R) with large effect sizes, (b) individual rates of progress were highly variable as measured by proportional change index (PCI) scores, (c) caregivers attributed improvement in self-efficacy and parenting competence to involvement in this program, (d) caregivers whose child received services at home reported slightly greater levels of self-efficacy than those whose child was seen in a center-based context, and (e) location of service produced equally significant, positive changes in child outcome. Implications for research and practice were discussed.