Early Intervention Strategies for Success

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  • Smoking during EI Visits…What Do You Do?(current)

As a guest in Amelia’s family’s home, you do your best to be polite and respectful. You enjoy working with her grandparents, and No Smoking iconfeel that they are doing their best to encourage Amelia’s development. The only challenge you have is the fact that they smoke during the visit. You’re concerned about the fact that you leave the home smelling like cigarette smoke and have several other visits afterwards. You also don’t want to breathe in second hand smoke each week. You aren’t sure if it would be appropriate to ask them not to smoke while you are in their home, but you’re struggling during and after each visit.

What do you do?

Smoking During EI Visits

Family members smoking during EI visits is a pretty common occurrence. Spending an hour in a family’s home where there is second hand smoke can be challenging for many reasons, such as the strong odor, concerns about carrying the smell with you on your clothing, breathing concerns (especially for providers with asthma), and allergies. Often, providers are concerned about exposing other children and families (in visits later that day) to second hand smoke that absorbs into the provider’s clothing. Providers with allergies or asthma may be especially vulnerable to the effects of second hand smoke; even when the family member doesn’t actually smoke during the visit, the residue in the environment can be problematic for these providers. Some providers may also worry about the effects of second hand smoke on the infant or toddler who lives in the home. With worries about oneself and the child, it can be a real struggle to know what to do.

I think the biggest question here is…how do you balance your own personal preferences and values with the fact that you are a guest in the family’s home?

A Few Questions to Consider

I’m not sure that there is one right answer to this question. On one hand, you have a personal and professional responsibility to protect your own health and safety. On the other hand, being an early interventionist requires that you respect families’ preferences, meet them where they are, and join them in their natural everyday lives. Here are a few questions to consider the next time you find yourself in this situation:

Are there other natural environment options? – If possible, perhaps you could meet the family outdoors or in a public area where smoking is not allowed or is less likely. If the child attends child care, maybe you could alternate visits between the home and child care. The idea here is to seek other options that are already a part of the family’s everyday routine, not to create new ones to avoid the family home.

Is there another provider available who would be more comfortable in this environment? – Especially if you have a health condition, it may be appropriate to chose a different provider for the family. In some programs, though, you might be the only provider of your discipline and/or you are the person best suited to work with the family.

Can you change clothing after the visit? – This isn’t ideal, but it can be a good solution to make yourself more comfortable and to avoid taking the odor with you to the next visit.

Can you seek advice from your supervisor? – If being in the environment becomes too challenging, it’s always a good idea to talk with your supervisor. Hopefully you can problem-solve together and come up with an acceptable solution.

Can you add a request for “no smoking during visits” to orientation or intake paperwork? – Some programs provide families with guidance about what to expect during visits. Perhaps a statement could be added to ask parents to avoid smoking during visits for the health and safety of everyone. This could be discussed at intake and again on the first visit to try to set boundaries early on.

Can you share your concerns with the family? – This is a very delicate question. The answer depends on the relationship you have with the family. Asking the family not to smoke when you come could be very offensive, or it could be that they won’t mind at all. Sometimes, even with a good relationship, you won’t know until you ask. If you ask, it will be important to share your specific reason for asking (i.e., “I have severe allergies and would love to continue working with you. I wonder if you wouldn’t mind not smoking while I visit?”). Be sure to avoid imposing your own personal values and judgments. If the child has a respiratory condition, it may be that discussing smoking around the child could be part of the education you provide. A great way to start this conversation would be to ask an open-ended question like, “What can you tell me about Amelia’s respiratory condition?” and “What has the pediatrician/pulmonologist said about smoking around Amelia?” Tread lightly and respectfully, however you approach this situation.

I feel like, in the interest of full disclosure, I should tell you that I never asked a parent not to smoke around me. I do have allergies, and it was a huge challenge, but I felt uncomfortable asking a family to change their behavior because of me. I’d love to know how you’ve handled this situation.

What did you do?

Share your thoughts and experiences in the chat below!

4 comments on “Smoking during EI Visits…What Do You Do?

  • Kim Lephart says:

    Such a great topic! I’ve struggled with this situation. I think the only time I brought it up with a family was when I was pregnant. I thought it was obvious I was pregnant, looking back I think they thought I was just getting chubby. When I asked if they would mind smoking in another room because I was pregnant, they immediately put out the cigarettes. On my subsequent visits they would either smoke before I got there or as soon as I left.; and they smoked outside – which was better for their kiddo!
    When I wasn’t pregnant, I would try to plan my visits so that my ‘smoking during session’ families were the last visits of the day.

    • Great suggestions, Kim! I’m glad you shared both suggestions. I think most families are very accommodating during a provider’s pregnancy, and when we build a strong rapport, they are happy to work with us on things like this too. Flexibility and kindness really go both ways!

  • michelle says:

    I have asthma and cigarette smoke really affects my breathing. I visited a home that the parent smoke and after the first visit, I walked out of their home wheezing, in fact took time to go home for a quick shower and change of clothes. I then made an appt. with my supervise to let her know of the situation and asked for another case worker to be assigned to this family. If I know families are smokers I keep the visit very short and keep an extra change of clothes in the car. Once back to the office, I go into the bathroom do a quick wash of face and hands and change my clothing.

    • Yes, being around smoking and having asthma can be a huge challenge for home visitors. Talking with your supervisor and keeping a change of clothes are great strategies. I would imagine that keeping your visit short might be a challenge with families who need lots of support, but it could also be necessary to safeguard your health. Thanks for sharing your perspective!


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