Study Detail | Home Visiting Evidence of Effectiveness

Landry, S. H., Smith, K. E., & Swank, P. R. (2006). Responsive parenting: Establishing early foundations for social, communication, and independent problem-solving skills. Developmental Psychology, 42(4), 627-42.

Model(s) Reviewed: Play and Learning Strategies (PALS) Infant

Additional Sources:

WWHV029409

Guttentag, C. L., Pedrosa-Josic, C., Landry, S. H., Smith, K. E., & Swank, P. R. (2006). Individual variability in parenting profiles and predictors of change: Effects of an intervention with disadvantaged mothers. Journal of Applied Developmental Psychology, 27, p. 349-369.

Study Screening Details
Screening Decision	Screening Conclusion
Study Passes Screens	Study Passes Screens

Study Design Details
Rating	Design	Attrition	Baseline Equivalence	Reassignment	Confounding Factors
High	Randomized controlled trial	Low	Established on race and socioeconomic status	None	None

Study Characteristics
Study Participants	Mother-infant pairs were recruited from hospitals serving families from lower-income backgrounds and assigned to one of two intervention groups: PALS I or a Developmental Assessment of Skills (DAS) comparison group. Initially 264 mother-infant pairs were randomly assigned, 131 to the treatment group and 133 to the comparison group. After attrition, 241 mother-infant pairs (121 PALS I and 120 DAS) remained in the study. Approximately one-third of each group was African American, Hispanic, or Caucasian. Most were poor and unmarried. Mothers were all 18 years old or older at intake, and averaged 27.8 years old in the treatment group and 27.0 years old in the comparison group. On average, mothers had 12.6 years of education in both groups. Participants were followed over the course of 10 visits.Guttentag et al. (2006) and Smith et al. (2006) used the same sample as this study and described an analytic sample of this size and composition. Although the two studies do not include outcomes that are eligible for the HomVEE review, their information about the analytical sample size and composition provide an additional source of information for evaluating the Landry et al. (2006) study.
Setting	The study was conducted in the Houston-Galveston (Texas) area.
Home Visiting Services	PALS I consists of a series of 10 home visits, each lasting 1.5 hours and occurring approximately weekly. The home visits are guided by a curriculum that included (1) asking mothers to review their experiences across the past week related to their efforts to try targeted behaviors, (2) describing the current visit’s targeted behavior, (3) watching and discussing with mothers the educational videotape of mothers from similar backgrounds, (4) videotaping mothers interacting with their infants in situations that the mothers selected with coaching, (5) supporting mothers to critique their behaviors and the infants’ responses during the videotaped practice, and (6) planning with mothers how to integrate responsive behaviors into their everyday activities with laminated cards. The facilitator coached the mothers to use the targeted behaviors, including commenting on the infants’ responses when the behaviors were used. Sessions were available in both English and Spanish.
Comparison Conditions	Comparison group members received the same number of home visits from facilitators, which included discussions about new infant skills during the previous week and infant development and assessment. Facilitators provided mothers with answers to and handouts about their questions on infant skill development.
Staff Characteristics and Training	Facilitators, who had bachelor’s or master’s degrees, were trained to use the curriculum in a flexible manner to meet the learning needs of individual families. Training included review of videotaped facilitated sessions and coaching by a supervisor.
Funding Sources	Department of Health and Human Services, National Institutes of Health, Grant HD36099.
Author Affiliation	Susan Landry, a study author, is a developer of this model.

Study Effects Details

Outcome domain: Child Development and School Readiness Outcome Effects
Rating	Outcome Measure	Effect	Sample	Timing of Follow-up	Sample Size	Program Group	Comparison Group	Group Difference	Effect size	Statistical significance	Outcome Type	Notes
High	Negative Affect (With Examiner)	FavorableUnfavorableNo Effect	PALS I vs. DAS	12 months	241 mother/child dyads	Coefficient = -0.07	Coefficient = 0.28	Not Reported	Study reported = 0.70	Statistically significant, p < 0.01	Primary	footnote142 Submitted by user on Fri, 03/15/2019 - 14:29 The <em>p</em>-values are study reported.
High	Social Skills: Cooperation	FavorableUnfavorableNo Effect	PALS I vs. DAS	12 months	241 mother/child dyads	Coefficient = 5.56	Coefficient = 5.16	Not Reported	Study reported = 0.39	Not statistically significant, p = 0.08	Primary	footnote142 Submitted by user on Fri, 03/15/2019 - 14:29 The <em>p</em>-values are study reported.

Outcome domain: Positive Parenting Practices Outcome Effects
Rating	Outcome Measure	Effect	Sample	Timing of Follow-up	Sample Size	Program Group	Comparison Group	Group Difference	Effect size	Statistical significance	Outcome Type	Notes
High	Contingent Responsiveness	FavorableUnfavorableNo Effect	PALS I vs. DAS	12 months	241 mother/child dyads	Coefficient = 0.77	Coefficient = 0.99	Not Reported	Study reported = 0.93	Statistically significant, p < 0.01	Primary	footnote141 Submitted by user on Fri, 03/15/2019 - 14:29 Lower parameter value indicates a better score. The <em>p</em>-values are study reported.
High	Harshness of Voice Tone	FavorableUnfavorableNo Effect	PALS I vs. DAS	12 months	241 mother/child dyads	Coefficient = 0.07	Coefficient = 0.12	Not Reported	Study reported = 0.28	Statistically significant, p = 0.02	Primary	footnote141 Submitted by user on Fri, 03/15/2019 - 14:29 Lower parameter value indicates a better score. The <em>p</em>-values are study reported.
High	Labeling Actions	FavorableUnfavorableNo Effect	PALS I vs. DAS	12 months	241 mother/child dyads	Coefficient = -8.94	Coefficient = -9.20	Not Reported	Study reported = 0.63	Statistically significant, p < 0.01	Primary	footnote141 Submitted by user on Fri, 03/15/2019 - 14:29 Lower parameter value indicates a better score. The <em>p</em>-values are study reported.
High	Labeling Objects	FavorableUnfavorableNo Effect	PALS I vs. DAS	12 months	241 mother/child dyads	Coefficient = -5.47	Coefficient = -5.86	Not Reported	Study reported = 0.71	Statistically significant, p < 0.01	Primary	footnote141 Submitted by user on Fri, 03/15/2019 - 14:29 Lower parameter value indicates a better score. The <em>p</em>-values are study reported.
High	Maintaining Infant Foci of Attention	FavorableUnfavorableNo Effect	PALS I vs. DAS	12 months	241 mother/child dyads	Coefficient = 13.21	Coefficient = 12.40	Not Reported	Study reported = 0.36	Not statistically significant, p = 0.08	Primary	footnote142 Submitted by user on Fri, 03/15/2019 - 14:29 The <em>p</em>-values are study reported.
High	Physical Intrusiveness	FavorableUnfavorableNo Effect	PALS I vs. DAS	12 months	241 mother/child dyads	Coefficient = 0.44	Coefficient = 0.51	Not Reported	Study reported = 0.50	Statistically significant, p = 0.01	Primary	footnote141 Submitted by user on Fri, 03/15/2019 - 14:29 Lower parameter value indicates a better score. The <em>p</em>-values are study reported.
High	Redirecting Infant Foci of Attention	FavorableUnfavorableNo Effect	PALS I vs. DAS	12 months	241 mother/child dyads	Coefficient = 1.14	Coefficient = 1.57	Not Reported	Study reported = 1.31	Statistically significant, p < 0.01	Primary	footnote141 Submitted by user on Fri, 03/15/2019 - 14:29 Lower parameter value indicates a better score. The <em>p</em>-values are study reported.
High	Verbal Encouragement	FavorableUnfavorableNo Effect	PALS I vs. DAS	12 months	241 mother/child dyads	Coefficient = 0.67	Coefficient = 0.24	Not Reported	Study reported = 0.71	Statistically significant, p < 0.01	Primary	footnote142 Submitted by user on Fri, 03/15/2019 - 14:29 The <em>p</em>-values are study reported.
High	Verbal Scaffolding	FavorableUnfavorableNo Effect	PALS I vs. DAS	12 months	241 mother/child dyads	Coefficient = 0.41	Coefficient = -0.08	Not Reported	Study reported = 0.79	Statistically significant, p < 0.01	Primary	footnote142 Submitted by user on Fri, 03/15/2019 - 14:29 The <em>p</em>-values are study reported.
High	Warm Sensitivity	FavorableUnfavorableNo Effect	PALS I vs. DAS	12 months	241 mother/child dyads	Coefficient = 0.74	Coefficient = 0.90	Not Reported	Study reported = 0.49	Statistically significant, p < 0.01	Primary	footnote141 Submitted by user on Fri, 03/15/2019 - 14:29 Lower parameter value indicates a better score. The <em>p</em>-values are study reported.

Study Outcome Measure Summary

Outcome Domain: Child Development and School Readiness Outcome Measures
Rating	Outcome Measure	Description of measure	Data collection method	Properties of measure	Outcome Type
High	Negative Affect (With Examiner)	The frequency with which an infant displayed signs of irritation such as whining, fussing, and crying when interacting with the examiner.	Videotaped observation	Interrater reliability = 0.76	Primary
High	Social Skills: Cooperation	The frequency with which an infant attempted to respond to his/her mother's request for an action or verbalization.	Videotaped observation	Interrater reliability = 0.62	Primary

Outcome Domain: Positive Parenting Practices Outcome Measures
Rating	Outcome Measure	Description of measure	Data collection method	Properties of measure	Outcome Type
High	Contingent Responsiveness	The degree to which a mother responded promptly and appropriately to her infant's cues was rated on a five-point scale.	Videotaped observation	Interrater reliability = 0.74	Primary
High	Harshness of Voice Tone	The degree to which the mother used a harsh and/or impatient tone with her infant, rated on a five-point scale.	Videotaped observation	Interrater reliability = 0.70	Primary
High	Labeling Actions	The frequency with which a mother provided the specific names of actions during the interaction.	Videotaped observation	Interrater reliability = 0.70 for the labeling one action and 0.75 for the labeling of more than one action	Primary
High	Labeling Objects	The frequency with which a mother provided the specific names of objects during the interaction.	Videotaped observation	Interrater reliability = 0.77 for both the labeling of one object and the labeling of more than one object	Primary
High	Maintaining Infant Foci of Attention	The frequency with which the mother's behavior helped to sustain her child's current activity.	Videotaped observation	Interrater reliability = 0.81	Primary
High	Physical Intrusiveness	The degree of abruptness in physical interactions such as moving the infant, and physical expressions of impatience.	Videotaped observation	Interrater reliability = 0.45	Primary
High	Redirecting Infant Foci of Attention	The frequency with which the mother's interaction was unrelated to her child's current activity in an attempt to redirect the child's attention.	Videotaped observation	Interrater reliability = 0.77	Primary
High	Verbal Encouragement	The frequency with which a mother praised her infant's efforts.	Videotaped observation	Interrater reliability = 0.78	Primary
High	Verbal Scaffolding	The frequency with which a mother provided verbal hints and prompts.	Videotaped observation	Interrater reliability = 0.64	Primary
High	Warm Sensitivity	The degree to which the mother was warm and sensitive in her interactions with her infant (e.g., accepting of the infant's needs and interests), rated on a five-point scale.	Videotaped observation	Interrater reliability = 0.74	Primary