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Play and Learning Strategies (PALS)

Yes (PALS Infant only)

In Brief

Last Updated

October 2012

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Evidence of Model Effectiveness

PALS Infant meets the criteria established by the Department of Health and Human Services (HHS) for an “evidence-based early childhood home visiting service delivery model” for the general population, but does not meet the criteria for tribal populations.

PALS Toddler and the combination of PALS Infant + Toddler do not meet the HHS criteria for the general population or for tribal populations.

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Model Description

Play and Learning Strategies (PALS) is designed to strengthen parent-child bonding and stimulate children’s early language, cognitive, and social development. There are two versions of the program: PALS I Infant curriculum for families with children 5 months to 1 year, which consists of 10 weekly sessions; and PALS II Toddler curriculum for children 18 months to 3 years, which consists of 12 weekly sessions. Both versions are offered through 90-minute home visits conducted by a parent educator. Parent educators are required to receive training and certification from the program developer, the Children’s Learning Institute at the University of Texas Health Science Center. The Children’s Learning Institute recommends that PALS be implemented by agencies with sustained funding mechanisms and organizational structures that can support program continuity, such as Head Start, Early Head Start, and not-for-profit early childhood agencies. For more information, please read the Model Overview.

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Extent of Evidence

Results of Search and ReviewNumber of Studies for PALS InfantNumber of Studies for PALS ToddlerNumber of Studies for PALS Infant + Toddler
Released from 1979 to 2011 622
Eligible for review 622
     Rated high 322
     Rated moderate 000
     Rated low 100
     Additional sourcesa 200

aAdditional sources overlap with another study and are not rated.

For more information, see the study database. For more information on the criteria used to determine the study ratings, please read Producing Study Ratings.

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Summary of Findings



Play and Learning Strategies (PALS) Infant
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 1
No effect: 15
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Child Health Not measured Not measured
Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health Not measured Not measured
Positive Parenting Practices

Favorable: 11
No effect: 12
Unfavorable or ambiguous: 1

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured

PALS Toddler
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 6
No effect: 7
Unfavorable or ambiguous: 1

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Child Health Not measured Not measured
Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health Not measured Not measured
Positive Parenting Practices

Favorable: 1
No effect: 13
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured

PALS Infant + Toddler
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 0
No effect: 14
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Child Health Not measured Not measured
Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health Not measured Not measured
Positive Parenting Practices

Favorable: 3
No effect: 11
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured
Table Help
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This table summarizes the effects found in research across outcome domains. Outcomes with a favorable impact are listed in green and outcomes with an unfavorable or ambiguous impact are listed in red. Outcomes that have high attrition or lack of baseline equivalence are excluded from this report.

Favorable Impact: A statistically significant impact on an outcome measure in a direction that is beneficial for children and parents. This impact could statistically be positive or negative, and is determined “favorable” based on the end result. For example, a favorable impact could be an increase in children’s vocabulary or daily reading to children by parents, or a reduction in harsh parenting practices or maternal depression.

Unfavorable or Ambiguous Impact: A statistically significant impact on an outcome measure in a direction that may indicate potential harm to children and/or parents. This impact could statistically be positive or negative, and is determined “unfavorable or ambiguous” based on the end result. NOTE: While some outcomes are clearly unfavorable, for other outcomes it is not as clear which direction is desirable. For example, an increase in children’s behavior problems is clearly unfavorable, while an increase in number of days mothers are hospitalized is more ambiguous. This may be viewed as an unfavorable impact because it indicates that mothers have more health problems, but it could also indicate that mothers have increased access to needed health care due to their participation in a home visiting program.

Primary Outcome Measure: For the HomVEE review, an outcome measured through direct observation, direct assessment, or administrative data; or self-reported data collected using a standardized (normed) instrument.

Secondary Outcome Measure: For the HomVEE review, most self-reported data, excluding self-reports based on a standardized (normed) instrument.

Please read Describing Effects for more information on these categories. Only results from studies that meet the standards for the high or moderate ratings are included above.

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Criteria Established by the Department of Health and Human Services

 PALS InfantPALS ToddlerPALS Infant + Toddler
Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model
High- or moderate-quality impact study? YesYesYes
Across high- or moderate-quality studies, favorable impacts in…
 
   at least two outcome domains within one sample
 
   OR
 
   the same domain for at least two non-overlapping samples?
YesYesNo
Favorable impacts on full sample? YesYesYes
Any favorable impacts on outcome measures sustained at least 12 months after program enrollment?a YesNoNo
One or more favorable, statistically significant impact reported in a peer-reviewed journal?a YesYesYes

aThis information is reported for all models, but the requirements for sustained findings and inclusion in a peer-reviewed journal only apply to models for which all findings are from randomized controlled trials.

Please read the HHS Criteria for Evidence-Based Programs for more information.

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