Parents as Teachers
Parents as Teachers (PAT) is a home-visiting parent education program that teaches new and expectant parents skills intended to promote positive child development and prevent child maltreatment. PAT aims to increase parent knowledge of early childhood development, improve parenting practices, promote early detection of developmental delays and health issues, prevent child abuse and neglect, and increase school readiness and success. The PAT model includes four core components: personal home visits, supportive group connection events, child health and developmental screenings, and community resource networks. PAT is designed so that it can be delivered to diverse families with diverse needs, although PAT sites typically target families with specific risk factors. Families can begin the program prenatally and continue through when their child enters kindergarten. Services are offered on a biweekly or monthly basis, depending on family needs. Sessions are typically held for one hour in the family’s home, but can also be delivered in schools, child care centers, or other community spaces. Each participant is assigned a parent educator who must have a high school degree or GED with two or more years of experience working with children and parents. Parent educators must also attend five days of PAT training.
PAT is rated as a well-supported practice because at least two studies with non-overlapping samples carried out in usual care or practice settings achieved a rating of moderate or high on design and execution and demonstrated favorable effects in a target outcome domain. At least one of the studies demonstrated a sustained favorable effect of at least 12 months beyond the end of treatment on at least one target outcome.
Date Research Evidence Last Reviewed: Jun 2019
Sources
The program or service description, target population, and program or service delivery and implementation information was informed by the following sources: The California Evidence-based Clearinghouse for Child Welfare, the program or service developer’s website, the program or service manual, and the studies reviewed.
Program/Service Webpage Updated: Dec 2020
This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the download the Handbook of Standards and Procedures, Version 1.0
Target Population
PAT offers services to new and expectant parents, starting prenatally and continuing until their child reaches kindergarten. PAT is a home visiting model that is designed to be used in any community and with any family during early childhood. However, many PAT programs target families in possible high risk environments such as teen parents, low income, parental low educational attainment, history of substance abuse in the family, and chronic health conditions.
Dosage
Families can receive services prenatally until their child starts kindergarten. Parent educators meet with families for about an hour at a time. The frequency of meetings can range from biweekly to monthly, based on need.
Location/Delivery Setting
Recommended Locations/Delivery Settings
PAT is usually delivered in homes, but can also be delivered in schools, child care centers, or other community spaces.
Location/Delivery Settings Observed in the Research
- Home
- Community Center (e.g., religious or recreational facility)
Education, Certifications and Training
Parent educators must have a high school degree or GED with two or more years of experience working with children and parents. In order to receive their PAT certification, all parent educators must attend a three-day foundational training. They must also attend a two-day model implementation training that covers strategies used to implement PAT. The PAT National Center also offers technical assistance and certification renewal sessions.
Program or Service Documentation
Book/Manual/Available documentation used for review
Depending on the ages of children in the families served, the Foundational Curriculum is available to support families prenatal to age 3 and the Foundational 2 Curriculum is available to support families with children age 3 through kindergarten. The manuals may be used separately, concurrently, or sequentially.
Parents as Teachers National Center, Inc. (2016). Foundational curriculum.
Parents as Teachers National Center, Inc. (2014). Foundational 2 curriculum: 3 years through kindergarten.
Available languages
Materials for PAT have been translated into Spanish, French, Mandarin, and German.
Other supporting materials
For More Information
Website: https://parentsasteachers.org/
Phone: (314) 432-4330
Email: allison.kemner@parentsasteachers.org or kerry.caverly@parentsasteachers.org
Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.
| Results of Search and Review | Number of Studies Identified and Reviewed for Parents as Teachers |
|---|---|
| Identified in Search | 13 |
| Eligible for Review | 6 |
| Rated High | 2 |
| Rated Moderate | 1 |
| Rated Low | 3 |
| Reviewed Only for Risk of Harm | 0 |
| Outcome | Effect Size
 and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
|---|---|---|---|---|
| Child safety: Child welfare administrative reports |
-0.05
-1 |
1 (4) | 4560 |
Favorable:
2 No Effect: 2 Unfavorable: 0 |
| Child permanency: Out-of-home placement |
0.16
6 |
1 (1) | 4560 |
Favorable:
0 No Effect: 1 Unfavorable: 0 |
| Child well-being: Social functioning |
0.12
4 |
1 (6) | 375 |
Favorable:
3 No Effect: 2 Unfavorable: 1 |
| Child well-being: Cognitive functions and abilities |
0.13
5 |
2 (12) | 575 |
Favorable:
2 No Effect: 10 Unfavorable: 0 |
| Child well-being: Physical development and health |
0.08
3 |
1 (3) | 375 |
Favorable:
0 No Effect: 3 Unfavorable: 0 |
| Adult well-being: Positive parenting practices |
0.27
10 |
1 (1) | 203 |
Favorable:
0 No Effect: 1 Unfavorable: 0 |
| Adult well-being: Family functioning |
-0.03
-1 |
1 (9) | 375 |
Favorable:
0 No Effect: 8 Unfavorable: 1 |
| Adult well-being: Economic and housing stability |
-0.09
-3 |
1 (10) | 366 |
Favorable:
0 No Effect: 9 Unfavorable: 1 |
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group.
| Outcome | Effect Size
and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
Months after treatment when outcome measured
|
|---|---|---|---|---|---|
| Child safety: Child welfare administrative reports |
-0.05
-1 |
1 (4) | 4560 |
Favorable:
2 No Effect: 2 Unfavorable: 0 |
- |
| Study 10198 - Home Visiting (PAT) vs. Matched Comparison Group (Chaiyachati, 2018) | |||||
| Any CPS Investigated Maltreatment Report |
-0.03
-1 |
- | 4560 | - | 37 |
| CPS Substantiated Maltreatment Report |
0.13
*
5 |
- | 4560 | - | 37 |
| Substantiated Neglect |
0.15
*
5 |
- | 4560 | - | 37 |
| Substantiated Physical Abuse |
-0.45
-17 |
- | 4560 | - | 37 |
| Child permanency: Out-of-home placement |
0.16
6 |
1 (1) | 4560 |
Favorable:
0 No Effect: 1 Unfavorable: 0 |
- |
| Study 10198 - Home Visiting (PAT) vs. Matched Comparison Group (Chaiyachati, 2018) | |||||
| Out-of-home Placement |
0.16
6 |
- | 4560 | - | 37 |
| Child well-being: Social functioning |
0.12
4 |
1 (6) | 375 |
Favorable:
3 No Effect: 2 Unfavorable: 1 |
- |
| Study 10206 - PAT vs. Usual Services Comparison Group (Wagner, 1999) | |||||
| DPII: Self-Help Development Scale (Months Differential) |
-0.01
0 |
- | 375 | - | 0 |
| DPII: Self-Help Development Scale (Months Differential) |
0.26
*
10 |
- | 363 | - | 0 |
| DPII: Self-Help Development Scale (% Scoring At or Above Chronological Age) |
0.62
*
23 |
- | 375 | - | 0 |
| DPII: Social Development Scale (Months Differential) |
-0.24
*
-9 |
- | 375 | - | 0 |
| DPII: Social Development Development Scale (Months Differential) |
0.27
*
10 |
- | 363 | - | 0 |
| DPII: Social Development Development Scale (% Scoring At or Above Chronological Age) |
-0.20
-7 |
- | 375 | - | 0 |
| Child well-being: Cognitive functions and abilities |
0.13
5 |
2 (12) | 575 |
Favorable:
2 No Effect: 10 Unfavorable: 0 |
- |
| Study 10202 - PAT vs. Usual Care Comparison Group (Neuhauser, 2018) | |||||
| Bayley-III (German): Receptive Language |
0.20
7 |
- | 200 | - | 0 |
| Bayley-III (German): Expressive Language |
0.22
8 |
- | 200 | - | 0 |
| Bayley-III (German): Receptive Language |
0.08
3 |
- | 200 | - | 0 |
| Bayley-III (German): Expressive Language |
0.30
*
11 |
- | 200 | - | 0 |
| Study 10206 - PAT vs. Usual Services Comparison Group (Wagner, 1999) | |||||
| DPII: Cognitive Development Scale (Mean Months Differential) |
0.00
0 |
- | 375 | - | 0 |
| DPII: Cognitive Development Scale (Mean Months Differential) |
0.25
*
9 |
- | 363 | - | 0 |
| DPII: Cognitive Development Scale (% Scoring At or Above Chronological Age) |
0.03
1 |
- | 375 | - | 0 |
| DPII: Communication Development Scale (Mean Months Differential) |
-0.02
0 |
- | 375 | - | 0 |
| DPII: Communication Development Scale (Mean Months Differential) |
0.13
5 |
- | 363 | - | 0 |
| DPII: Communication Development Scale (% Scoring At or Above Chronological Age) |
-0.06
-2 |
- | 375 | - | 0 |
| Peabody Picture Vocabulary Test (Months Differential) |
0.19
7 |
- | 320 | - | 0 |
| Peabody Picture Vocabulary Test (% Scoring At or Above Chronological Age) |
0.02
0 |
- | 320 | - | 0 |
| Child well-being: Physical development and health |
0.08
3 |
1 (3) | 375 |
Favorable:
0 No Effect: 3 Unfavorable: 0 |
- |
| Study 10206 - PAT vs. Usual Services Comparison Group (Wagner, 1999) | |||||
| DPII: Physical Development Scale (Months Differential) |
0.01
0 |
- | 375 | - | 0 |
| DPII: Physical Development Development Scale (Months Differential) |
0.17
6 |
- | 363 | - | 0 |
| DPII: Physical Development Development Scale (% Scoring At or Above Chronological Age) |
0.06
2 |
- | 375 | - | 0 |
| Adult well-being: Positive parenting practices |
0.27
10 |
1 (1) | 203 |
Favorable:
0 No Effect: 1 Unfavorable: 0 |
- |
| Study 10202 - PAT vs. Usual Care Comparison Group (Neuhauser, 2018) | |||||
| CARE-Index: Maternal Sensitivity |
0.27
10 |
- | 203 | - | 0 |
| Adult well-being: Family functioning |
-0.03
-1 |
1 (9) | 375 |
Favorable:
0 No Effect: 8 Unfavorable: 1 |
- |
| Study 10206 - PAT vs. Usual Services Comparison Group (Wagner, 1999) | |||||
| HOME: Total Score |
-0.09
-3 |
- | 375 | - | 0 |
| HOME: Total Score |
0.09
3 |
- | 363 | - | 0 |
| HOME: Parental Responsivity |
0.00
0 |
- | 375 | - | 0 |
| HOME: Acceptance of Child's Behavior |
-0.32
*
-12 |
- | 375 | - | 0 |
| HOME: Appropriate Play Materials |
0.02
0 |
- | 375 | - | 0 |
| HOME: Organization of the Environment |
0.05
1 |
- | 375 | - | 0 |
| HOME: Involvement with Child |
-0.02
0 |
- | 375 | - | 0 |
| HOME: Opportunities for Stimulation |
-0.13
-5 |
- | 375 | - | 0 |
| Child Was Fully Immunized for Age |
0.15
6 |
- | 219 | - | 0 |
| Adult well-being: Economic and housing stability |
-0.09
-3 |
1 (10) | 366 |
Favorable:
0 No Effect: 9 Unfavorable: 1 |
- |
| Study 10206 - PAT vs. Usual Services Comparison Group (Wagner, 1999) | |||||
| Mother Working or In Job Training |
-0.05
-1 |
- | 296 | - | 0 |
| Mother Working or In Job Training |
-0.07
-2 |
- | 366 | - | 0 |
| Mother Working or In Job Training |
-0.07
-2 |
- | 354 | - | 0 |
| Household Received Medi-Cal |
0.08
3 |
- | 296 | - | 0 |
| Household Received Medi-Cal |
-0.09
-3 |
- | 366 | - | 0 |
| Household Received Medi-Cal |
0.04
1 |
- | 354 | - | 0 |
| Household Received AFDC |
-0.12
-4 |
- | 366 | - | 0 |
| Household Received AFDC |
-0.09
-3 |
- | 354 | - | 0 |
| Household Income $30,000 or Greater |
-0.21
-8 |
- | 366 | - | 0 |
| Household Income $30,000 or Greater |
-0.31
*
-12 |
- | 354 | - | 0 |
*p <.05
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Section 5.10.4 and may not align with effect sizes reported in individual publications.
Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.
Full citations for the studies shown in the table are available in the "Studies Reviewed" section.
The participant characteristics display is an initial version. We encourage those interested in providing feedback to send suggestions to preventionservices@abtglobal.com.
The table below displays locations, the year, and participant demographics for studies that received moderate or high ratings on design and execution and that reported the information. Participant characteristics for studies with more than one intervention versus comparison group pair that received moderate or high ratings are shown separately in the table. Please note, the information presented here uses terminology directly from the study documents, when available. Studies that received moderate or high ratings on design and execution that did not include relevant participant demographic information would not be represented in this table.
For more information on how Clearinghouse reviewers record the information in the table, please see our Resource Guide on Study Participant Characteristics and Settings.
| Characteristics of the Participants in the Studies with Moderate or High Ratings | ||||||
|---|---|---|---|---|---|---|
|
Study Location
|
Study Year
|
Age or Grade-level
|
Race, Ethnicity, Nationality
|
Gender
|
Populations of Interest*
|
Household Socioeconomic Status
|
| Study 10198 - Home Visiting (PAT) vs. Matched Comparison Group | ||||||
| Characteristics of the Adults, Parents, or Caregivers | ||||||
| Connecticut, USA | 2008 | Average age of mothers: 22 years | -- | -- |
100% Mothers; 89% Single mothers (single, separated, or divorced); 33% History of depression; 14% History of substance abuse; 10% Unstable housing |
-- |
| Study 10206 - PAT vs. Usual Services Comparison Group | ||||||
| Characteristics of the Adults, Parents, or Caregivers | ||||||
| Northern California, CA, USA; Southern California, CA, USA | -- | Average age of mothers: 26 years |
81% Latina 19% Caucasian (included all non-Latina mothers, the majority of whom were Caucasian) |
-- |
100% Parents/caregivers; 49% Enrolled while pregnant; 11% Only adult in household |
-- |
| Study 10202 - PAT vs. Usual Care Comparison Group | ||||||
| Characteristics of the Children and Youth | ||||||
| Zürich, Switzerland | 2011 | Average age at baseline: 92 days |
74% Foreigners (nationality) 25% Immigrant or descendant of immigrants from Balkan countries |
52% Female | -- | -- |
| Characteristics of the Adults, Parents, or Caregivers | ||||||
| Zürich, Switzerland | 2011 | Average age of the mother at birth of child: 30 years; Age range: 16-45 years |
32% Immigrant or descendant of immigrants from other countries 14% Swiss origin 11% Immigrant or descendant of immigrants from Turkey 9% Immigrant or descendant of immigrants from Portugal 9% Immigrant or descendant of immigrants from Central and East Asia |
-- |
100% Mothers; 14% Single parent |
-- |
“--” indicates information not reported in the study.
* The information about disabilities is based on initial coding. For more information on how the Clearinghouse recorded disability information for the initial release, please see our Resource Guide on Study Participant Characteristics and Settings. The Clearinghouse is currently seeking consultation from experts, including those with lived experience, and input from the public to enhance and improve the display.
Note: Citations for the documents associated with each 5-digit study number shown in the table can be found in the “Studies Reviewed” section below. Study settings and participant demographics are recorded for all studies that received moderate or high ratings on design and execution and that reported the information. Studies that did not report any information about setting or participant demographics are not displayed. For more information on how participant characteristics are recorded, please see our Resource Guide on Study Participant Characteristics and Settings.
Studies Rated High
Study 10202Neuhauser, A., Ramseier, E., Schaub, S., Burkhardt, S. C. A., & Lanfranchi, A. (2018). Mediating role of maternal sensitivity: Enhancing language development in at-risk families. Infant Mental Health Journal, 39(5), 522-536. doi:http://dx.doi.org/10.1002/imhj.21738
This study was conducted in a usual care or practice setting (Handbook Section 6.2.2)Study 10206
Wagner, M., Clayton, S., Gerlach-Downie, S., & McElroy, M. (1999). An evaluation of the Northern California Parents as Teachers demonstration. SRI International Menlo Park, CA.
Wagner, M. M., & Clayton, S. L. (1999). The Parents as Teachers program: Results from two demonstrations. The Future of Children, 9(1), 91-115.
This study was conducted in a usual care or practice setting (Handbook Section 6.2.2)Studies Rated Moderate
Study 10198Chaiyachati, B. H., Gaither, J. R., Hughes, M., Foley-Schain, K., & Leventhal, J. M. (2018). Preventing child maltreatment: Examination of an established statewide home-visiting program. Child Abuse & Neglect, 79, 476-484.
This study was not conducted in a usual care or practice setting (Handbook Section 6.2.2)Studies Rated Low
Study 10205Wagner, M., Cameto, R., & Gerlach-Downie, S. (1996). Intervention in support of adolescent parents and their children: A final report on the teen Parents as Teachers demonstration.
Wagner, M. M., & Clayton, S. L. (1999). The Parents as Teachers program: Results from two demonstrations. The Future of Children, 9(1), 91-115.
This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.Study 10201
Matone, M., Kellom, K., Griffis, H., Quarshie, W., Faerber, J., Gierlach, P., . . . Cronholm, P. F. (2018). A mixed methods evaluation of early childhood abuse prevention within evidence-based home visiting programs. Maternal and Child Health Journal, 22(Supp 1), S79-S91. doi:http://dx.doi.org/10.1007/s10995-018-2530-1
This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.Study 10207
Wagner, M., Spiker, D., Gerlach-Downie, S., & Hernandez, F. (2000). Parental engagement in home visiting programs: Findings from the Parents as Teachers multisite evaluation.Menlo Park, CA: SRI International.
Wagner, M., Iida, E., Spiker, D., Hernandez, F., & Song, J. (2001). The multisite evaluation of the Parents as Teachers home visiting program: Three-year findings from one community. Menlo Park, CA: SRI International.
Wagner, M., Spiker, D., Hernandez, F., Song, J., & Gerlach-Downie (2001). Multisite Parents as Teachers evaluation: Experiences and outcomes for children and families. Menlo Park, CA: SRI International.
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(2), 67-81. doi:http://dx.doi.org/10.1177/02711214020220020101
This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.Studies Not Eligible for Review
Study 10197
Cavkaytar, A. (2007). Turkish Parents as Teachers: Teaching parents how to teach self-care and domestic skills to their children with mental retardation. Education and Training in Developmental Disabilities, 42(1), 85-93.
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).
Study 10199
Herrenkohl, R. C., & Russo, J. M. (2001). Abusive early child rearing and early childhood aggression. Child Maltreatment, 6(1), 3 to 16. doi:http://dx.doi.org/10.1177/1077559501006001001
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).
Study 10200
Kim-Spoon, J., Haskett, M. E., Longo, G. S., & Nice, R. (2012). Longitudinal study of self-regulation, positive parenting, and adjustment problems among physically abused children. Child Abuse & Neglect, 36(2), 95-107. doi:http://dx.doi.org/10.1016/j.chiabu.2011.09.016.
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).
Study 10203
Pfannenstiel, J. C., Seitz, V., & Zigler, E. (2003). Promoting school readiness: The role of the Parents as Teachers Program. NHSA Dialog: A Research-to-Practice Journal for the early Intervention Field, 6(1), 71-86.
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).
Study 10204
Praat, A. (2011). Parents as First Teachers evaluation: Phase II report. Wellington: Centre for Social Research and Evaluation.
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).
Study 10208
Wheeler, W. H. (1995). A study of the Missouri Parents as Teachers program and its effect on the readiness skills of children entering kindergarten in Southwest Missouri Public Schools.
This study is ineligible for review because it is not a publicly available report or journal article (Study Eligibility Criterion 4.1.2).
Study 10210
Zigler, E., Pfannenstiel, J. C., & Seitz, V. (2008). The Parents as Teachers program and school success: A replication and extension. The Journal Of Primary Prevention, 29(2), 103-120.
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).