Recommended early intervention practices emphasize family-centered approaches provided within natural settings through interventionist interactions with caregivers. We defined this approach as participation-based and used the Home Visiting Observation Form (HVOF) and the Natural Environments Rating Scale (NERS) to describe 50 home visits and to examine the extent to which participation-based services could be identified and distinguished from traditional services. A minority of the sample visits were described as participation-based although participation-based services were clearly distinguishable from traditionally provided services. Interventionists using participation-based approaches interacted with the caregiver-child dyad and caregivers were actively involved with their children during the session. Results from the study suggest the NERS can be used to describe characteristics of participation-based services and holds promise as a measure that might be used by interventionists, their supervisors, or by researchers to measure intervention fidelity during home visits.
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