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Implementing Parents as Teachers (PAT)®

Meets HHS criteria for an evidenced based model

Model Overview

Last Updated

April 2017


The information in this profile reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model here, including any adaptations, may differ from how it was implemented in the studies reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness.


Implementation Support

Parents as Teachers (PAT) National Center provides guidance, training, technical assistance, professional development opportunities, and a quality endorsement process for PAT affiliates. The PAT National Center also advocates at the state and national levels.

Twenty states and two countries have PAT offices. PAT state and country offices offer affiliates guidance, technical assistance, and implementation support. In addition, these offices provide oversight of the PAT affiliates in their state or country.


Theoretical Model

The theory of change for the PAT model is that affecting parenting knowledge, attitudes, behaviors and family well-being impacts the child’s developmental trajectory.

The overall PAT model is grounded in Urie Bronfenbrenner’s Human Ecology Theory and Family Systems Theory. The home visits focus on three areas of emphasis—parent-child interaction, development-centered parenting, and family well-being. PAT is informed by additional theories including developmental parenting, attribution theory, and self-efficacy theory.


Target Population

PAT affiliates select the specific characteristics and eligibility criteria of the target population they plan to serve. Such eligibility criteria might include children with special needs, families at risk for child abuse, income-based criteria, teen parents, first-time parents, immigrant families, low literate families, or parents with mental health or substance use issues.

The PAT model is designed to serve families throughout pregnancy through kindergarten entry. Families can enroll at any point along this continuum. Curriculum materials provide resources to continue services through the kindergarten year if an affiliate wants to do so.


Targeted Outcomes

The PAT model aims to (1) increase parent knowledge of early childhood development and improve parenting practices, (2) provide early detection of developmental delays and health issues, (3) prevent child abuse and neglect, and (4) increase children’s school readiness and school success.


Model Components

The PAT model has four components that all affiliates are required to provide: (1) one-on-one personal (or home) visits, (2) group connections (or meetings), (3) health and developmental screenings for children, and (4) linkages and connections for families to needed resources.


Model Intensity and Length

The PAT model requires that affiliates offer at least 12 home visits annually to families with one or no high-needs characteristics. Affiliates must offer at least 24 home visits annually to families with two or more high-needs characteristics. In some cases, visit frequency may be gradually decreased as the family transitions out and into other services. Home visits last approximately 60 minutes. The PAT model requires that affiliates offer at least 12 group connections (or meetings) annually and screen children for developmental, health, hearing, and vision problems each year.

PAT affiliates must offer services to enrolled families for at least two years. Affiliates may choose to focus services primarily on pregnant women and families with children from birth to age 3; others may offer services from pregnancy through kindergarten.



PAT affiliates are located in all 50 states and the District of Columbia, as well as six countries internationally.


Adaptations and Enhancements

PAT permits affiliates to offer additional strategies (beyond the four core model components) or to make model adaptations that may be needed to best address families’ needs at the local level. For example, implementation may be modified to be culturally responsive, directed to special populations, or offered in conjunction with other early childhood programs as determined by community need.

Adaptations of the PAT model are available for highly rural and/or indigenous populations such as aboriginal populations in Australia and Canada, and numerous American Indian tribes.

Examples of adaptations include:

  • Elements of training
  • Materials used during visits to encourage parent–child interactions (for example, use of materials in the home to create toys and games)
  • Approaches that honor family and community values
  • Who is included in the visits
  • Pace of parenting education
  • Extent to which verbal and non-verbal communication strategies are used
  • Addressing needs of low literate or illiterate parents

In New Zealand, the Ministry of Social Development’s Family and Community Services adapted PAT into a program known in New Zealand as Parents as First Teachers (PAFT)*. The ministry contracted with community organizations to implement PAFT and managed, coordinated, and monitored the program. When developing the model, PAFT New Zealand negotiated with the PAT national office in the United States to adapt the PAT program to meet the needs of New Zealand families, including Māori and Pasifika families, indigenous populations of New Zealand and the Pacific Island nations.

PAFT (New Zealand) served families with children from birth to age 3 who were at risk of poor educational outcomes through home visits, linkages to other community services, and group meetings. The PAFT curriculum had two components: the PAT program’s Born to Learn curriculum and Āhuru Mōwai. The latter was developed for the PAFT program and was based on Māori traditional beliefs and child-rearing practices. PAFT materials were available in English, Māori, and seven Pasifika languages.

*As of 2016, implementation support is no longer available for PAFT (New Zealand).



The information contained on this page was last updated in April 2017. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the PAT National Center on January 18, 2017. HomVEE reserves the right to edit the profile for clarity and consistency.