Parents as Teachers

In-home Parent Skill-Based Well Supported

Parents as Teachers (PAT) is a home-visiting parent education program that teaches new and expectant parents skills intended to promote positive child development and prevent child maltreatment. PAT aims to increase parent knowledge of early childhood development, improve parenting practices, promote early detection of developmental delays and health issues, prevent child abuse and neglect, and increase school readiness and success. The PAT model includes four core components: personal home visits, supportive group connection events, child health and developmental screenings, and community resource networks. PAT is designed so that it can be delivered to diverse families with diverse needs, although PAT sites typically target families with specific risk factors. Families can begin the program prenatally and continue through when their child enters kindergarten. Services are offered on a biweekly or monthly basis, depending on family needs. Sessions are typically held for one hour in the family’s home, but can also be delivered in schools, child care centers, or other community spaces. Each participant is assigned a parent educator who must have a high school degree or GED with two or more years of experience working with children and parents. Parent educators must also attend five days of PAT training.


PAT is rated as a well-supported practice because at least two studies with non-overlapping samples carried out in usual care or practice settings achieved a rating of moderate or high on design and execution and demonstrated favorable effects in a target outcome domain. At least one of the studies demonstrated a sustained favorable effect of at least 12 months beyond the end of treatment on at least one target outcome.


Date Research Evidence Last Reviewed: Jun 2019


Sources

The program or service description, target population, and program or service delivery and implementation information was informed by the following sources: The California Evidence-based Clearinghouse for Child Welfare, the program or service developer’s website, the program or service manual, and the studies reviewed.


This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the Review Process page or download the Handbook.

Target Population

PAT offers services to new and expectant parents, starting prenatally and continuing until their child reaches kindergarten. PAT is a home visiting model that is designed to be used in any community and with any family during early childhood. However, many PAT programs target families in possible high risk environments such as teen parents, low income, parental low educational attainment, history of substance abuse in the family, and chronic health conditions.  

Dosage

Families can receive services prenatally until their child starts kindergarten. Parent educators meet with families for about an hour at a time. The frequency of meetings can range from biweekly to monthly, based on need.

Location/Delivery Setting
Recommended Locations/Delivery Settings

PAT is usually delivered in homes, but can also be delivered in schools, child care centers, or other community spaces.

Location/Delivery Settings Observed in the Research

  • Home
  • Community Center (e.g., religious or recreational facility)

Education, Certifications and Training

Parent educators must have a high school degree or GED with two or more years of experience working with children and parents. In order to receive their PAT certification, all parent educators must attend a three-day foundational training. They must also attend a two-day model implementation training that covers strategies used to implement PAT. The PAT National Center also offers technical assistance and certification renewal sessions.

Program or Service Documentation
Book/Manual/Available documentation used for review

PAT has a Model Implementation Library with resources available to those who receive PAT training related to supporting supervisors, implementation, data collection, ethical considerations, and technical assistance. Depending on the ages of the families served, the PAT Foundational Curriculum is available to support families prenatal to 3 and the PAT Foundational 2 Curriculum is available to support families 3 through Kindergarten. For more information, visit the PAT website.

https://parentsasteachers.org/resources-tools

Available languages

Materials for PAT have been translated into Spanish, French, Mandarin, and German.

Other supporting materials

Logic Model

Requirements for Affiliates

Training

Contact Information for Developers

Website: https://parentsasteachers.org/

Phone: (314) 432-4330

Email: allison.kemner@parentsasteachers.org or kerry.caverly@parentsasteachers.org

Results of Search and Review Number of Studies Identified and Reviewed for Parents as Teachers
Identified in Search 13
Eligible for Review 6
Rated High 2
Rated Moderate 2
Rated Low 2
Reviewed Only for Risk of Harm 0
Outcome Effect Size
and Implied Percentile Effect
N of Studies (Findings) N of Participants Summary of Findings
Child safety 0.11
4
2 (6) 4825 Favorable: 2
No Effect: 3
Unfavorable: 0
Child permanency 0.16
6
1 (1) 4560 Favorable: 0
No Effect: 1
Unfavorable: 0
Child well-being: Social functioning 0.12
4
1 (6) 375 Favorable: 3
No Effect: 2
Unfavorable: 1
Child well-being: Cognitive functions and abilities 0.13
5
2 (12) 575 Favorable: 2
No Effect: 10
Unfavorable: 0
Child well-being: Physical development and health 0.08
3
1 (3) 375 Favorable: 0
No Effect: 3
Unfavorable: 0
Adult well-being: Positive parenting practices 0.27
10
1 (1) 203 Favorable: 0
No Effect: 1
Unfavorable: 0
Adult well-being: Family functioning -0.07
-2
2 (11) 640 Favorable: 0
No Effect: 10
Unfavorable: 1
Adult well-being: Economic and housing stability -0.09
-3
1 (10) 366 Favorable: 0
No Effect: 9
Unfavorable: 1

Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group.

Outcome Effect Size
and Implied Percentile Effect
N of Studies (Findings) N of Participants Summary of Findings Months after treatment
when outcome measured
Child safety 0.11
4
2 (6) 4825 Favorable: 2
No Effect: 3
Unfavorable: 0
-
Chaiyachati, 2018
Any CPS Investigated Maltreatment Report -0.03
-1
- 4560 - 37
CPS Substantiated Maltreatment Report 0.13 *
5
- 4560 - 37
Substantiated Neglect 0.15 *
5
- 4560 - 37
Substantiated Physical Abuse -0.45
-17
- 4560 - 37
Wagner, 2001
Treated for Injury in Past Year 0.46 *
17
- 265 - 0
Went to Emergency Room in Past Year 0.30
11
- 265 - 0
Child permanency 0.16
6
1 (1) 4560 Favorable: 0
No Effect: 1
Unfavorable: 0
-
Chaiyachati, 2018
Out-of-home Placement 0.16
6
- 4560 - 37
Child well-being: Social functioning 0.12
4
1 (6) 375 Favorable: 3
No Effect: 2
Unfavorable: 1
-
Wagner, 1999
DPII: Self-Help Development Scale (Months Differential) -0.01
0
- 375 - 0
DPII: Self-Help Development Scale (Months Differential) 0.26 *
10
- 363 - 0
DPII: Self-Help Development Scale (% Scoring At or Above Chronological Age) 0.62 *
23
- 375 - 0
DPII: Social Development Scale (Months Differential) -0.24 *
-9
- 375 - 0
DPII: Social Development Development Scale (Months Differential) 0.27 *
10
- 363 - 0
DPII: Social Development Development Scale (% Scoring At or Above Chronological Age) -0.20
-7
- 375 - 0
Child well-being: Cognitive functions and abilities 0.13
5
2 (12) 575 Favorable: 2
No Effect: 10
Unfavorable: 0
-
Neuhauser, 2018
Bayley-III (German): Receptive Language 0.20
7
- 200 - 0
Bayley-III (German): Expressive Language 0.22
8
- 200 - 0
Bayley-III (German): Receptive Language 0.08
3
- 200 - 0
Bayley-III (German): Expressive Language 0.30 *
11
- 200 - 0
Wagner, 1999
DPII: Cognitive Development Scale (Mean Months Differential) 0.00
0
- 375 - 0
DPII: Cognitive Development Scale (Mean Months Differential) 0.25 *
9
- 363 - 0
DPII: Cognitive Development Scale (% Scoring At or Above Chronological Age) 0.03
1
- 375 - 0
DPII: Communication Development Scale (Mean Months Differential) -0.02
0
- 375 - 0
DPII: Communication Development Scale (Mean Months Differential) 0.13
5
- 363 - 0
DPII: Communication Development Scale (% Scoring At or Above Chronological Age) -0.06
-2
- 375 - 0
Peabody Picture Vocabulary Test (Months Differential) 0.19
7
- 320 - 0
Peabody Picture Vocabulary Test (% Scoring At or Above Chronological Age) 0.02
0
- 320 - 0
Child well-being: Physical development and health 0.08
3
1 (3) 375 Favorable: 0
No Effect: 3
Unfavorable: 0
-
Wagner, 1999
DPII: Physical Development Scale (Months Differential) 0.01
0
- 375 - 0
DPII: Physical Development Development Scale (Months Differential) 0.17
6
- 363 - 0
DPII: Physical Development Development Scale (% Scoring At or Above Chronological Age) 0.06
2
- 375 - 0
Adult well-being: Positive parenting practices 0.27
10
1 (1) 203 Favorable: 0
No Effect: 1
Unfavorable: 0
-
Neuhauser, 2018
CARE-Index: Maternal Sensitivity 0.27
10
- 203 - 0
Adult well-being: Family functioning -0.07
-2
2 (11) 640 Favorable: 0
No Effect: 10
Unfavorable: 1
-
Wagner, 1999
HOME: Total Score -0.09
-3
- 375 - 0
HOME: Total Score 0.09
3
- 363 - 0
HOME: Parental Responsivity 0.00
0
- 375 - 0
HOME: Acceptance of Child's Behavior -0.32 *
-12
- 375 - 0
HOME: Appropriate Play Materials 0.02
0
- 375 - 0
HOME: Organization of the Environment 0.05
1
- 375 - 0
HOME: Involvement with Child -0.02
0
- 375 - 0
HOME: Opportunities for Stimulation -0.13
-5
- 375 - 0
Child Was Fully Immunized for Age 0.15
6
- 219 - 0
Wagner, 2001
Well-child Visit in Past 6 Months -0.33
-12
- 265 - 0
Child Covered by Health Insurance -0.21
-8
- 265 - 0
Adult well-being: Economic and housing stability -0.09
-3
1 (10) 366 Favorable: 0
No Effect: 9
Unfavorable: 1
-
Wagner, 1999
Mother Working or In Job Training -0.05
-1
- 296 - 0
Mother Working or In Job Training -0.07
-2
- 366 - 0
Mother Working or In Job Training -0.07
-2
- 354 - 0
Household Received Medi-Cal 0.08
3
- 296 - 0
Household Received Medi-Cal -0.09
-3
- 366 - 0
Household Received Medi-Cal 0.04
1
- 354 - 0
Household Received AFDC -0.12
-4
- 366 - 0
Household Received AFDC -0.09
-3
- 354 - 0
Household Income $30,000 or Greater -0.21
-8
- 366 - 0
Household Income $30,000 or Greater -0.31 *
-12
- 354 - 0

*p <.05

Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Section 5.10.4 and may not align with effect sizes reported in individual publications.

Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.

Full citations for the studies shown in the table are available in the "Studies Reviewed" section.

Sometimes study results are reported in more than one document, or a single document reports results from multiple studies. Studies are identified below by their Prevention Services Clearinghouse study identification numbers.

Studies Rated High

Study 10202

Neuhauser, A., Ramseier, E., Schaub, S., Burkhardt, S. C. A., & Lanfranchi, A. (2018). Mediating role of maternal sensitivity: Enhancing language development in at?risk families. Infant Mental Health Journal, 39(5), 522-536. doi:http://dx.doi.org/10.1002/imhj.21738

Study 10206

Wagner, M., Clayton, S., Gerlach-Downie, S., & McElroy, M. (1999). An evaluation of the Northern California Parents as Teachers demonstration. SRI International Menlo Park, CA.

Wagner, M. M., & Clayton, S. L. (1999). The Parents as Teachers program: Results from two demonstrations. The Future of Children, 9(1), 91-115.


Studies Rated Moderate

Study 10198

Chaiyachati, B. H., Gaither, J. R., Hughes, M., Foley-Schain, K., & Leventhal, J. M. (2018). Preventing child maltreatment: Examination of an established statewide home-visiting program. Child Abuse & Neglect, 79, 476-484.

Study 10207

Wagner, M., Spiker, D., Gerlach-Downie, S., & Hernandez, F. (2000). Parental engagement in home visiting programs: Findings from the Parents as Teachers multisite evaluation.Menlo Park, CA: SRI International.

Wagner, M., Iida, E., Spiker, D., Hernandez, F., & Song, J. (2001). The multisite evaluation of the Parents as Teachers home visiting program: Three-year findings from one community. Menlo Park, CA: SRI International.

Wagner, M., Spiker, D., Hernandez, F., Song, J., & Gerlach-Downie (2001). Multisite Parents as Teachers evaluation: Experiences and outcomes for children and families. Menlo Park, CA: SRI International.

Wagner, M., Spiker, D., & Linn, M. I. (2002). The effectiveness of the Parents as Teachers program with low-income parents and children. Topics in Early Childhood Special Education, 22(2), 67-81. doi:http://dx.doi.org/10.1177/02711214020220020101


Studies Rated Low

Study 10205

Wagner, M., Cameto, R., & Gerlach-Downie, S. (1996). Intervention in support of adolescent parents and their children: A final report on the teen Parents as Teachers demonstration.

Wagner, M. M., & Clayton, S. L. (1999). The Parents as Teachers program: Results from two demonstrations. The Future of Children, 9(1), 91-115.

This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.
Study 10201

Matone, M., Kellom, K., Griffis, H., Quarshie, W., Faerber, J., Gierlach, P., . . . Cronholm, P. F. (2018). A mixed methods evaluation of early childhood abuse prevention within evidence-based home visiting programs. Maternal and Child Health Journal, 22(Supp 1), S79-S91. doi:http://dx.doi.org/10.1007/s10995-018-2530-1

This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.


Studies Not Eligible for Review

Study 10197

Cavkaytar, A. (2007). Turkish Parents as Teachers: Teaching parents how to teach self-care and domestic skills to their children with mental retardation. Education and Training in Developmental Disabilities, 42(1), 85-93.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 10199

Herrenkohl, R. C., & Russo, J. M. (2001). Abusive early child rearing and early childhood aggression. Child Maltreatment, 6(1), 3 to 16. doi:http://dx.doi.org/10.1177/1077559501006001001

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 10200

Kim-Spoon, J., Haskett, M. E., Longo, G. S., &  Nice, R. (2012). Longitudinal study of self-regulation, positive parenting, and adjustment problems among physically abused children. Child Abuse & Neglect, 36(2), 95-107. doi:http://dx.doi.org/10.1016/j.chiabu.2011.09.016.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 10203

Pfannenstiel, J. C., Seitz, V., & Zigler, E. (2003). Promoting school readiness: The role of the Parents as Teachers Program. NHSA Dialog: A Research-to-Practice Journal for the early Intervention Field, 6(1), 71-86.

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 10204

Praat, A. (2011). Parents as First Teachers evaluation: Phase II report. Wellington: Centre for Social Research and Evaluation.

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 10208

Wheeler, W. H. (1995). A study of the Missouri Parents as Teachers program and its effect on the readiness skills of children entering kindergarten in Southwest Missouri Public Schools.

This study is ineligible for review because it is not a publicly available report or journal article (Study Eligibility Criterion 4.1.2).

Study 10210

Zigler, E., Pfannenstiel, J. C., & Seitz, V. (2008). The Parents as Teachers program and school success: A replication and extension. The Journal Of Primary Prevention, 29(2), 103-120.

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).