PARENTS AS TEACHERS (PAT)
OVERVIEW
Parents as Teachers (PAT) is an early childhood parent education and family support program for parents of young children (prenatal - age 5). Program components include parent educator-administered home visits, parent meetings, child health/development screenings, and a referral service for community resources. Experimental evaluations show that participation in PAT has small but positive impacts on parent and child outcomes. Compared to control groups, PAT parents have experienced more positive impacts in attitude, knowledge, and behavior outcomes, and their children have experienced more positive impacts in certain social, cognitive, and health outcomes. Impacts have been more positive for Spanish-speaking and low-income subgroups.
DESCRIPTION OF PROGRAM
Target population: At-risk families with children (prenatal through age
5)
Parents as Teachers (PAT)-originated in 1981-is a home visiting-based early
childhood parent education and family support program for parents of young
children. PAT is designed to educate parents about what to expect during their
child's development, to teach parents ways to encourage their child's learning,
and to foster strong parent-child relationships.
Individual programs have some flexibility in how they administer PAT, but each
program must include four components. The first component is personal visits-a
parent educator makes home visits to help parents understand and develop
appropriate expectations for children's development and to teach parents ways
to foster growth and learning. The second component is parent meetings, during
which parents meet to share their experiences and gain new knowledge. The third
component is screenings of children's development, health, hearing and vision.
The fourth component is referrals to community resources. It is also a program
requirement that parent educators attend training sessions administered by the
Parents as Teachers National Center in order to become certified.
Over the last decade, several significant changes have been made to the PAT
curriculum. These include: facilitating more frequent home visiting (from
monthly to more often); developing a special curriculum for teen parents that
has a strong emphasis on group meetings; translating program materials into
Spanish; and incorporating new findings about brain development into the PAT
curriculum, now trademarked as the "Born to Learn" curriculum for
ages 0 to 3 and 3 to kindergarten entry.
· Number of Children in Program: Over 3,400 programs serve over 300,000 children throughout the United States and other (mostly English-speaking) countries.
· Length: Ongoing-as long as parents want and need it-from the prenatal period through children's entry into kindergarten.
· Intensity: Home visits last for about an hour and are scheduled monthly, biweekly or weekly, depending on the needs of the family and the resources available in that program.
· Service Delivery Mode: Home visits, parent meetings, child screenings, and referrals to community resources.
EVALUATION(S) OF PROGRAM
Though several studies have been conducted of PAT, only a few have been
experimental in design.
Wagner, M. M. & Clayton, S. L. (1999). The Parents as Teachers Program:
Results from two demonstrations. The Future of Children, 9(1), 91-115.
Evaluated population and
Approach: In Northern California, an experimental group (n = 298) received
PAT services-an average of 20 visits over the first three years of the
children's lives-and a control group (n = 199) did not receive PAT services.
The majority of this study's population was Latino, the average age of mothers
in the experimental group was 25.3, and about half of the families were headed
by single mothers. Data were collected from these families until children were
3 years old. In the second evaluation, participants were teenage mothers in
Southern California (all were less than 19 years old, their average age was
16.6, and the majority were unmarried). About half were Latino, and the
remaining were split fairly equally between African-American and white. They
were randomized to receive one of four services: PAT (n = 177; an average of 10
visits over the first two years of life); case management (n =174; targeted to
achieve positive outcomes for teen mothers); PAT plus case management (n =
175); or no services (n = 178). These participants were studied through the
children's second birthdays.
Results: The two evaluations showed that PAT had little impact on
parenting knowledge, attitudes or behaviors. They also found that PAT only
produced small, mostly non-significant gains in child outcomes, except for a
Latino Spanish-speaking subsample, which showed significant gains in cognitive,
communication and self-help development as a result of PAT participation.
Overall, significant, though modest, impacts appeared when demographic and
other factors were controlled in multivariate analyses. The authors also
examined program exposure and expressed concern about the number of families
who dropped out of the program (43 percent in the first evaluation and 57
percent in the second). In the first evaluation, they found that maintaining
participation through the end of the three-year program resulted in significant
gains in children's cognitive, social and self-help skills compared to the
control group. However, in the second evaluation, only children who were in the
case management group or PAT-plus-case-management group-but not PAT alone-and
persisted to the end experienced significant gains in cognitive development.
Thus, the results about persistence in the program are mixed, as well.
Wagner,
M., Spiker, D., Gerlach-Downie, S., & Hernandez, F. (2000, February). Parental
engagement in home visiting programs: Findings from the Parents as Teachers
multisite evaluation.
Evaluated population: 667 families were recruited in three evaluation communities at the beginning of the study. Participant families had children in their first year of life. Mothers ranged in age from 21.5 to 25 years, and a majority of participants were African American.
Approach: Participants were randomly assigned to receive the PAT program or to a control group. Qualitative and quantitative data were collected for members of the treatment group from a variety of sources including the enrollment form, the home visit record, the parent engagement assessment, the Home Observation and Measurement of the Environment (HOME) Inventory, home visit observations, parent educator interviews, focus groups, and coordinator interviews. Data were collected on or around the children’s birthday. Of the three evaluation communities, only one was able to gather data from children at their third birthdays. However, this study focuses primarily on how descriptive statistics from baseline are related to persistence in the program.
At baseline there were no significant differences between participants in the control or experimental group. The researchers analyzed the data by comparing descriptive statistics to determine the engagement of parents in the program.
Results: Results of the experimental analyses indicated that enrollment data were related to whether a participant would persist with the program. Individuals who stayed in PAT were older than mothers who dropped out (25 years vs. 21 years). Also, those who persisted were more likely to be African American and less likely to be Hispanic or of high income. Further, persisters were better educated (12.3 years of school vs. 11.5 years of school). Intensity and consistency of the home visits was also related to persistence in PAT. The researchers further found that those parents who demonstrated that their children were their top priority also persisted. Those parents that persisted were more likely to look at and read books with their children and talk to their children while reading/looking at books.
Wagner, M., & Spiker, D. (2001). Multisite Parents as Teachers
Evaluation: Experiences and outcomes for children and families (SRI Project
P07283). Menlo Park, CA: SRI International.
Evaluated population and
Approach: A third experimental study was conducted by SRI International in
three different metropolitan areas. Across the three communities, 667 families
with children under 8 months old were randomly assigned to PAT services or no
services. Overall, the majority of families in this study were "at risk
due to low income, teen parents, single parents, and other factors"; the
racial/ethnic makeup was 58% African American, 29% white, 9% Hispanic, and 3%
other. However, the characteristics of the participants differed greatly
between the three cites.
Results: This evaluation revealed modest positive program impacts for
parents across the three sites. For PAT parents, small positive effects were
found for parenting knowledge, attitudes, and behaviors. PAT parents with very
low incomes had more significant positive impacts than their
"more-moderate-income" counterparts. Participation in PAT also had
small but significant impacts on a few child outcomes, such as higher ratings
of social adjustment, greater likelihood of full immunization, and the reduced
need for treatment for injury or for emergency room care. It should be noted,
however, that "a substantial proportion of participant group families
whose children were assessed did not actually receive home visits".
Wagner,
M., Iida, E., & Spiker, D. (2001, August). The multisite evaluation of the
Parents as Teachers home visiting program: Three-year findings from one community.
Evaluated
population: Because of the high attrition in the other two sites, the
three-year evaluation was only conducted in one site. 206
families were recruited to participate in the evaluation. Participant
mothers were on average 24 years old and the sample was mostly Caucasian. The
average educational attainment of mothers was 12th grade and most
participants were from low-income households.
Approach: Parents
with infants up to 8 months of age were randomly assigned to either a
participant or control group. Participants varied in the number of home visits
they received, with an average of 20 home visits.
Data were collected from participants using the family enrollment form, the Mothers’ Previous Experience with Infants questionnaire, a family survey, parenting knowledge items, Parenting Sense of Competence Scale, Maternal Social Support Index, Adult-Adolescent Parenting Inventory, Language- and literacy-promoting behavior items, Home Observation for Measurement of the Environment, Nursing Child Assessment Satellite Training, Developmental Profile II, Adaptive Social Behavior Inventory, Immunization Status, and program records. Assessments were conducted around the time of children’s birthdays and data were collected from participants in in-home assessments.
Results: Results of the study showed parents in the PAT program increased their knowledge of child development and methods to stimulate children’s development. For overall parent knowledge, there were small to medium impacts (w2 ranging from .01 to .23). There were also significant differences on measures of attitudes towards parenting (effect size was .12 at year 3 assessment). Parents in PAT were also more likely to engage in reading activities with their children (effect size of .21 at 3 year assessment). Impacts were greater among teen parents.
With regard to child outcomes, children in the PAT program experienced several non-significant gains. Specifically, they showed gains in the self-help domain of child development at the 3-year assessment (effect size=.26). They also were more likely to be fully immunized (effect size=.81) and less likely to be treated for injury (effect size=.36) at the 3-year follow up.
The researchers concluded that PAT was effective in influencing outcomes but the effects were small. Also, since only one of the three sites participated, they caution about generalizing from these findings.
Wagner, M., Spiker, D., & Linn M. I. (2002). The effectiveness of the Parents as Teachers program with low-income parents and children. Topics in Early Childhood Special Education, 22, 67-81.
Evaluated
population: Parents of 665 young children from 8 months to 3 years of
age. 60% of families had incomes less than $15,000 per year and 18%
received Temporary Assistance for Needy Families incentives.
Approach: Families were selected only from PAT sites which had been running for at least two years, served at least 100 families, had high rates of low-income families, had monthly home visits, and agreed to participation in the study. Families were then randomly assigned to PAT and control group treatments. The control group received free annual assessments and free children’s books several times a year. Parents were assessed using measures designed to test parent knowledge of child-rearing/educating and parent reports of child behavior. In addition, children were assessed on their second birthdays on the Developmental Profile II (DPII) which is designed to collect data on child behavior and health.
Results: Researchers found that children in the PAT treatment groups performed only slightly better than the control group, and then only in a few areas. Treatment groups received higher parent ratings of happiness when caring for the child as well as acceptance of the child’s behavior. There were no differences between controls and treatment groups with respect to the DPII measure administered to children.
SOURCES FOR MORE INFORMATION
Web Site: www.patnc.org
Link to program curriculum: http://www.parentsasteachers.org/site/pp.asp?c=ekIRLcMZJxE&b=272091
References:
Missouri Department of Elementary and Secondary Education (1998). School
Entry Assessment Project: Report of findings.
Wagner, M. M. & Clayton, S. L. (1999). The Parents as Teachers Program:
Results from two demonstrations. The Future of Children, 9(1), 91-115.
Wagner, M.,
Iida, E., & Spiker, D. (2001, August). The multisite evaluation of the
Parents as Teachers home visiting program: Three-year findings from one
community.
Wagner, M., & Spiker, D. (2001). Multisite Parents as Teachers
Evaluation: Experiences and outcomes for children and families (SRI Project
P07283). Menlo Park, CA: SRI International. [Available at: http://www.sri.com/policy/cehs/early/pat.html]
Wagner, M., Spiker, D., Gerlach-Downie, S., & Hernandez,
F. (2000, February). Parental engagement in home visiting programs: Findings
from the Parents as Teachers multisite evaluation.
Wagner, M., Spiker, D., & Linn M. I. (2002). The effectiveness of the Parents as Teachers program with low-income parents and children. Topics in Early Childhood Special Education, 22, 67-81.
Program also discussed in the following Child Trends publication(s):
Child Trends. (2001). School readiness: Helping
communities get children ready for school and schools ready for children
(Research brief). Washington, DC: Child Trends.
Halle, T., Zaff, J., Calkins, J., & Margie, N. G.
(2000). Background for community-level work on school readiness: A review of
definitions, assessments, and investment strategies. Part II: Reviewing the
literature on contributing factors to school readiness. Washington, DC:
Child Trends, Inc.
SUMMARY & CATEGORIZATION
Program categorized in this guide according to the
following:
Evaluated participant ages: prenatal through age 5 / Program age ranges in the Guide: prenatal, 0-5
Program components: clinic/provider-based, home visiting, parent or family component
Measured outcomes: education/cognitive, social/emotional
Program information last updated 4/12/10
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© Child Trends 2003 |
