Implementing Parents as Teachers (PAT)® Meets HHS Criteria

Model implementation summary last updated: 2019

The information in this implementation report reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the manuscripts 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. Please see the Effectiveness button on the left for more information about any research on the effectiveness of the model, including any version(s) of the model with effectiveness research. Versions of the model that are described in the Adaptations and enhancements section of this implementation report may include (1) versions that were identified by the model’s developer and (2) versions that have been implemented by researchers and have manuscripts that HomVEE rated high or moderate, but that are not supported by the model’s developer.

Materials and forms to support implementation

Service delivery forms

The Parents as Teachers National Center requires that affiliates document key components of service delivery using the Parents as Teachers records. These include information on enrollment; assessments, screenings, and information on child and adult health; family goals; exits and transitions out of Parents as Teachers; and records of personal visits, group connections, and resource and referral connections. In addition, affiliates should maintain a waiting list of families trying to access services. Service documentation forms are available through the Parents as Teachers National Center.

The Parents as Teachers National Center provides a web-based data collection and service documentation system. If affiliates choose not to use the Parents as Teachers system, Parents as Teachers recommends that affiliates record information in a computerized or web-based system that contains the approved Parents as Teachers records.

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Assessment tools

The Parents as Teachers model requires that affiliates implement a family-centered needs assessment. Parents as Teachers recommends using one of three tools that address all required areas: (1) the Life Skills Progression, (2) the Family Map, and (3) the Massachusetts Family Self-Sufficiency Scales and LADDERS Assessment.

In addition, affiliates are required to select from instruments that measure parenting skills, practices, capacity, or stress: Health Families Parenting Inventory, Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO), the Keys to Interactive Parenting Scale (KIPS), Adult Adolescent Parenting Inventory (AAPI-2), Home Observation for Measurement of the Environment (HOME), Parenting Stress Index, Parenting Stress Scale, and Parents Assessment of Protective Factors. Affiliates can, however, choose to implement other tools.

The Parents as Teachers model also requires parent educators to conduct at least annual child developmental screening and review of health, vision, and hearing statuses, as well as safety, for early identification of children’s potential developmental delays and/or health, vision, and hearing problems. The first screening is required within 90 days of enrollment. The Parents as Teachers National Center provides affiliates with a list of approved developmental and safety screening tools.

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The Parents as Teachers Foundational Curricula are designed to provide a framework for Parents as Teachers services. The curricula include:

  • Research-based resources and handouts
  • Evidence-informed practices
  • Personal visit plans
  • Guided planning tools

These web-based materials help parent educators individualize services for each family and maintain consistency across families. The curricula also include Parents as Teachers Toolkit Cards to help parent educators organize discussions with families, implement strategies to strengthen the parent educator–family relationship, and facilitate the Parents as Teachers approach to working with families.

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Available languages

Parents as Teachers Foundational Curricula are available in English, Spanish, and German. Certain parent handouts are also available in Arabic, Burmese, Chinese, French, Nepali, Greek, Korean, Portuguese, and Turkish.
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Fidelity measurement

To help achieve fidelity to the Parents as Teachers model, the Parents as Teachers National Center requires that affiliates provide annual data on their fidelity to the model through an Affiliate Performance Report. In addition, affiliates are expected to participate in the affiliate quality endorsement and improvement process in their fourth year of implementation and every fifth year thereafter. The quality endorsement and improvement process consists of three main steps: (1) a review of the Parents as Teachers Essential Requirements (see next section), (2) an affiliate self-study, and (3) an in-depth review of the self-study by the Parents as Teachers National Center. The affiliate assessment process emphasizes both quality assurance and continuous quality improvement.
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Fidelity standards

The Parents as Teachers Foundational Curricula and Model Implementation Library provide information to support implementation. The Supervisors Handbook provides resources for the supervisor to support a quality Parents as Teachers affiliate. The curricula have online components that parent educators and supervisors can access electronically.

The Parents as Teachers National Center has established 20 Essential Requirements that are deemed fundamental to replicating and implementing the Parents as Teachers model with fidelity. They include the following:

  1. Affiliates provide at least two years of services to families with children from the prenatal period up to kindergarten entry.
  2. The minimum qualifications for parent educators are a high school diploma or GED and two years of previous supervised work experience with young children, parents, or both.
  3. Each affiliate has an advisory committee that meets at least every six months. The advisory committee can be part of a larger committee, community network, or coalition as long as the group includes a regular focus on the Parents as Teachers affiliate.
  4. Each month, parent educators working more than 0.5 full-time equivalent (FTE) participate in a minimum of two hours of individual reflective supervision and a minimum of two hours of staff meetings. Parent educators working 0.5 FTE or less participate in a minimum of one hour of reflective supervision and two hours of staff meetings.
  5. Each supervisor, mentor, or lead parent educator is assigned no more than 12 parent educators, regardless of whether the parent educators are full-time or part-time employees.
  6. All new parent educators in an organization who will deliver Parents as Teachers services to families attend foundational and model implementation trainings before delivering Parents as Teachers; new supervisors also attend the foundational and model implementation trainings.
  7. Parent educators receive competency-based professional development and training and renew certification with the Parents as Teachers National Center annually.
  8. Parent educators complete and document a family-centered assessment within 90 days of enrollment and then at least annually thereafter using an assessment that addresses the Parents as Teachers-required areas.
  9. Parent educators develop and document goals with each family they serve.
  10. Parent educators use the foundational visit plans and planning guide from the curricula to design and deliver personal visits to families.
  11. Families with one or no high-needs characteristics receive at least 12 personal visits annually, and families with two or more high-needs characteristics receive at least 24 personal visits annually.
  12. Full-time first-year parent educators complete no more than 48 visits per month during their first year, and full-time parent educators in their second year and beyond complete no more than 60 visits per month.
  13. Affiliates deliver at least 12 group connections across the program year (that is, they facilitate at least 12 groups, but individual family participation may vary).
  14. Parent educators conduct the child health screening by 7 months of age, or within 90 days of enrollment, and at least annually thereafter. The screening includes health, safety, vision, and hearing elements.
  15. Child development screening takes place for all children within 90 days of enrollment or birth and then at least annually thereafter. Screening includes the following developmental domains: language, cognition, social-emotional, and motor development.
  16. Parent educators conduct child developmental surveillance during each personal visit. The parent educator and the parent discuss their observations of the child’s developmental skills and behaviors. After each personal visit, the parent educator updates the Parents as Teachers Milestones record, which tracks the child’s development.
  17. Parent educators connect families to resources that help them reach their goals and address their needs.
  18. At least annually, the affiliate gathers and summarizes feedback from families about the services they have received, using the results for program improvement.
  19. The affiliate annually reports data on service delivery and program implementation through the Affiliate Performance Report; affiliates use data in an ongoing way for purposes of continuous quality improvement, including participating in the quality endorsement and improvement process every five years.
  20. Affiliate programs select two outcomes to measure with eligible families. The first outcome must be from a list of approved tools that measure parenting skills, practices, capacity, or stress. The second outcome is from an approved list of measures that align with program goals. On the Affiliate Performance Report, programs must indicate how they use the data.

There are 100 Parents as Teachers quality standards that provide additional indicators of quality. The Parents as Teachers standards are divided into three main areas and 10 sections. Each section contains the associated essential requirements and standards.

  1. Organizational supports and continuous quality improvement
    1. Infrastructure and leadership
    2. Evaluation and continuous quality improvement
  2. Staff competence
    1. Staff selection and new parent educator development
    2. Supervision and professional development
  3. Parents as Teachers services
    1. Service initiation and participation
    2. Assessment and goal setting
    3. Personal visits
    4. Group connections
    5. Screening
    6. Resource network
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Implementation notes

The information contained on this page was last updated in October 2019. Recommended further reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the Parents as Teachers National Center in May 2019. HomVEE reserves the right to edit the profile for clarity and consistency.

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