Parents as Teachers (PAT)®

Meets HHS Criteria Meets HHS Criteria

Model effectiveness research report last updated: 2019

Effectiveness

Evidence of model effectiveness

Title General population Tribal population Domains with favorable effects
Parents as Teachers (PAT)® Yes, Meets HHS Criteria Meets HHS criteria for an early childhood home visiting service delivery model Does not meet HHS criteria for tribal population because the model has not been evaluated with a tribal population.
  • Child development and school readiness,
  • Family economic self-sufficiency,
  • Positive parenting practices,
Baby FACE, an adaptation of Parents as Teachers Does not meet HHS criteria because the findings from high- or moderate-rated effectiveness studies of the model do not meet all required criteria. Does not meet HHS criteria for tribal population because the findings from high- or moderate-rated effectiveness studies of the model in tribal populations do not meet all required criteria.
  • Child development and school readiness,
  • Positive parenting practices,
Parents as First Teachers (New Zealand) Does not meet HHS criteria because the findings from high- or moderate-rated effectiveness studies of the model do not meet all required criteria. Does not meet HHS criteria for tribal population because the model has not been evaluated with a tribal population.
  • No favorable effects found,

Model description

The goal of the Parents as Teachers (PAT) model is to provide parents with child development knowledge and parenting support, provide early detection of developmental delays and health issues, prevent child abuse and neglect, and increase children’s school readiness. The Parents as Teachers model includes one-on-one home visits, monthly group meetings, developmental screenings, and linkages and connections for families to needed resources. Parent educators conduct the home visits using structured visit plans and guided planning tools. Local sites offer at least 12 hour-long home visits annually with more offered to higher-need families. Parents as Teachers serves families for at least two years between pregnancy and kindergarten. Parents as Teachers affiliate programs select the target population they plan to serve and the program duration. 

This report also includes a review of two adaptations to Parents as Teachers: (1) Parents as First Teachers (PAFT-New Zealand) and (2) Baby Family and Child Education (Baby FACE). The New Zealand Ministry of Social Development’s Family and Community Services created the PAFT adaptation of Parents as Teachers to specifically meet the needs of their indigenous populations. As of 2016, implementation support is no longer available for PAFT (New Zealand). Baby FACE is implemented in the continental United States and serves high-need American Indian families by integrating Native language and culture into the model.

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Extent of evidence

Parents as Teachers (PAT)®

30 Manuscripts

Eligible for review

5 Manuscripts

Rated high or
moderate

PAT - <p>Baby FACE, an adaptation of PAT</p>

3 Manuscripts

Eligible for review

1 Manuscript

Rated high or
moderate

PAT Parents as First Teachers (New Zealand)

5 Manuscripts

Eligible for review

2 Manuscripts

Rated high or
moderate

For more information, see the research database. For more information on the criteria used to rate research, please see details of HomVEE’s methods and standards.

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Summary of findings

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Criteria established by the U.S. Department of Health and Human Services

Information based on comprehensive review of all high- and moderate-rated manuscripts
Parents as Teachers (PAT)®
CriterionCriterion descriptionCriterion met?
1High- or moderate-quality impact study?Yes
2Across 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?Yes
3Favorable impacts on full sample?Yes
4Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?
Reported for all research but only required for RCTs.
Yes
5One or more favorable, statistically significant impact reported in a peer-reviewed journal?
Reported for all research but only required for RCTs.
Yes
PAT - <p>Baby FACE, an adaptation of PAT</p>
CriterionCriterion descriptionCriterion met?
1High- or moderate-quality impact study?Yes
2Across 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?Yes
3Favorable impacts on full sample?Yes
4Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?
Reported for all research but only required for RCTs.
Yes
5One or more favorable, statistically significant impact reported in a peer-reviewed journal?
Reported for all research but only required for RCTs.
No
PAT Parents as First Teachers (New Zealand)
CriterionCriterion descriptionCriterion met?
1High- or moderate-quality impact study?Yes
2Across 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?No
3Favorable impacts on full sample?No
4Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?
Reported for all research but only required for RCTs.
No
5One or more favorable, statistically significant impact reported in a peer-reviewed journal?
Reported for all research but only required for RCTs.
No
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Implementation

Model implementation profile last updated: 2019

Theoretical approach

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

The overall Parents as Teachers 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. Parents as Teachers is informed by additional theories including developmental parenting, attribution theory, and self-efficacy theory.

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Implementation support availability

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

Parents as Teachers state and country offices offer affiliates guidance, technical assistance, and implementation support. In addition, these offices provide oversight of the Parents as Teachers affiliates in their state or country.

Technical assistance and implementation support are available to Parents as Teachers affiliates through the Parents as Teachers National Center’s Expansion and Model Implementation department, which includes Parents as Teachers state offices and approved regional technical assistance specialists.

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Intended population

The Parents as Teachers model serves families with high-needs characteristics. Parents as Teachers affiliates select the specific characteristics and eligibility criteria of the population they plan to serve. Such eligibility criteria might include children with special needs, families at risk for child abuse, low-income families, teen parents, first-time parents, immigrant families, low-literate families, parents with mental health or substance use issues, or families experiencing homelessness or unstable housing.

The Parents as Teachers 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 chooses to do so.

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Targeted outcomes

The Parents as Teachers 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. View Revisions

Model services

The Parents as Teachers model has four components that all affiliates are required to provide.

(1) One-on-one home (or personal) visits, during which the home visitor (referred to as a parent educator) visits the family in its home or a mutually agreeable alternative location. The parent educator delivers the majority of visits in the home. The Parents as Teachers model refers to some visits as “personal” visits because they can take place in environments other than the home when it is unsafe or impossible to have visits in the home. For example, some families may be homeless or have unstable housing, may be experiencing intimate partner violence, or may have infants in the neonatal intensive care unit. To be receptive to these families’ needs, home visits can occur in transitional housing shelters, hospitals, or in a safe location outside of the home.

(2) Group connections, which are planned events, such as family activities, ongoing parenting groups, or presentations, facilitated by a parent educator to share information about parenting and child development. Group connections are also designed to encourage families to share common experiences and to foster peer learning.

(3) Health, hearing, vision, and developmental screenings for children.

(4) Linkages and connections for families to needed resources.

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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Model intensity and length

The Parents as Teachers model requires that affiliates offer a minimum of 12 home visits annually to families with one or no high-needs characteristics. Affiliates must offer a minimum of 24 home visits annually to families with two or more high-needs characteristics. Home visits last a minimum of 60 minutes.

The Parents as Teachers model requires that affiliates offer families at least 12 group connections (or meetings) annually.

Additionally, the affiliates are required to screen children for developmental, health, hearing, and vision problems each year.

Parents as Teachers affiliates must plan to 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 through age 3; others may offer services from pregnancy through kindergarten.

In some cases, visit frequency may be gradually decreased as the family transitions out of the Parents as Teachers program because of changing needs. For families transitioning out of Parents as Teachers, parent educators develop a transition plan to discuss the resources, supports, and services that are available to the family.

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Adaptations and enhancements

Parents as Teachers 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 Parents as Teachers 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:

  • Approaches that honor family and community values
  • People who are included in the visits
  • Addressing needs of low-literate or illiterate parents

Examples of model elements that can be adapted 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)
  • Pace of parenting education
  • Extent to which verbal and non-verbal communication strategies are used

In New Zealand, the Ministry of Social Development’s Family and Community Services adapted Parents as Teachers 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 Parents as Teachers National Center in the United States to adapt the Parents as Teachers model to meet the needs of New Zealand families, including Māori and Pasifika families, indigenous populations of New Zealand and the Pacific Island nations. Families with children from birth to age 3 who were at risk of poor educational outcomes were served by PAFT (New Zealand) through home visits, developmental screenings, linkages to other community services, and group meetings. PAFT (New Zealand) used two curricula: the Parents as Teachers’ Born to Learn curriculum and the Āhuru Mōwai curriculum. The latter was developed for PAFT (New Zealand) and was based on Māori traditional beliefs and child-rearing practices. PAFT (New Zealand) materials were available in English, Māori, and seven Pasifika languages.

Another adaptation of Parents as Teachers, called Baby Family and Child Education (Baby FACE), integrates Native language and culture into Parents as Teachers services for high-needs American Indian families from pregnancy through kindergarten. Baby FACE is the home visiting component of FACE, which is an early childhood family literacy model designed for American Indian families. In addition to home visits every one to two weeks, Baby FACE services include routine health and developmental screenings, monthly parent group meetings, and referrals to needed services. Baby FACE has been implemented in several reservations throughout the continental United States. Parent educators, typically members of the tribal community, must have a high school diploma or general equivalency degree (GED), and be actively working toward obtaining an associate’s degree in child development. Baby FACE uses the Parents as Teachers curriculum, adapted to each community’s culture.

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

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Organizational requirements

Parents as Teachers affiliates frequently are embedded within an existing organization or program, such as Title I school districts, county health departments, Family Resource Centers, and other state and nonprofit agencies.

The model requires affiliates to meet a set of ongoing fidelity guidelines. Please contact the model developer for additional information about these guidelines.

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Staffing requirements

Parents as Teachers model affiliates have two primary staff positions: (1) certified parent educators who provide home visiting services and (2) their affiliate supervisors.

Parents as Teachers prefers parent educators to have a four-year degree in early childhood education or a related field, or at least either a two-year degree or 60 college hours in early childhood education or a related field. At a minimum, parent educators must have a high school diploma or GED and at least two years of previous supervised work experience with young children, parents, or both. Supervisors are required to have at least a bachelor's degree in early childhood education, social work, health, psychology or a related field (or equivalent degree); at least five years of experience working with families and young children; strong interpersonal skills; and a commitment to reflective supervision, data collection, and continuous quality improvement.

The Parents as Teachers model requires that, each month, full-time parent educators participate in a minimum of two hours of individual reflective supervision and a minimum of two hours of staff meetings. Parent educators working half time or less are required to participate in a minimum of one hour of reflective supervision and two hours of staff meetings.

The model requires parent educators and supervisors to participate in pre-service training. The Parents as Teachers National Center requires all parent educators and supervisors implementing the Parents as Teachers model to attend and successfully complete a three-day foundational training (Foundational I) and a two-day model implementation training. Affiliates that offer services to families with children age 3 years through kindergarten entry must attend a second (Foundational II) training. Please contact the model developer for additional information about the pre-service training requirement

The Parents as Teachers National Center offers professional development opportunities for professionals who work with special populations. The trainings are one- or two-day sessions taught by instructors experienced with working with the special populations. Please contact the model developer for additional information about the ongoing professional development requirement.

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Where to find out more

Parents as Teachers National Center
2228 Ball Drive
St. Louis, MO 63146

Phone: (314) 432-4330, 1-866-728-4968 (toll-free)
Fax: (314) 432-8963
Email: info@parentsasteachers.org
Website: http://www.parentsasteachers.org

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HomVEE requests input and feedback from the model developers on their profiles. The information in this implementation profile reflects feedback, if provided, from this model’s developer as of the above date. HomVEE reserves the right to edit the profile for clarity and consistency. 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. Model developers are encouraged to notify HomVEE of any changes to their contact information on this page.