Chapter 11. Parents as Teachers: Improving the Odds with Early Intervention

Early intervention programs launched in the 1960s were designed to respond to that hope. In the late 1960s and early 1970s, some school systems began to use federal Title I funds to help prepare disadvantaged 3- and 4-year-olds for school success. But in Missouri we found that intervention at that age was already late for many children. So in 1981, the Missouri Department of Elementary and Secondary Education decided that to reduce the number of children who enter kindergarten needing special help, educators should support and assist parents in their teaching role from the onset of learning. And thus, the Parents as Teachers (PAT) program was born. Research told us that early human development is a time of both great opportunity and great vulnerability. Investing in good beginnings for children diminishes the probability of having to invest later in social costs such as remedial education, juvenile detainment, welfare dependency, and child abuse and neglect.

Conceptual Framework

Families, schools, and communities share a common goal—to have children become all that they can be. With “beginning at the beginning” as its hallmark, Parents as Teachers was intended as a first step toward that end. The program was designed as a partnership with families, beginning prenatally and extending to age 5. It was based on these two simple truths:

• Babies are born learners.
• Parents play a critical role from the outset in determining what their child will become.

The program was designed for the voluntary participation of families of all configurations, cultural backgrounds, and life circumstances. Now, as then, the major goals are to

• Empower parents to give their children the best possible start in life.
• Provide for early detection of developmental problems.
• Help prepare children for school success.
• Increase parents' feelings of competence and confidence.
• Increase parents' knowledge of child development and appropriate ways to stimulate their child's language, intellectual, social, and motor development.
• Improve parent-child interactions and strengthen family relationships.
• Prevent child abuse and neglect.
• Develop strong home-school-community partnerships for children and families.

• Parents are the experts on their own children by virtue of their special insight that comes from everyday living with them. They need to be respected as such.
• Whether by accident or design, parents are continually teaching their children through their actions and words.
• Parent educators can work effectively in partnership with parents, offering research-based information on child development and ways to enhance learning.
• Parents do not seek to be “fixed,” but rather to learn how to build on their strengths and draw on outside help to benefit their children.

Program Description

The Parents as Teachers pilot project was launched in 1981 as a cooperative effort of the Missouri Department of Elementary and Secondary Education, four diverse school districts selected on the basis of competitive proposals, and the Danforth Foundation of St. Louis. A total of 380 families who were expecting their first child between December 1981 and September 1982 were enrolled. The families, who were representative of each school district's population, were provided services from the third trimester of pregnancy until the child reached her 3rd birthday. The results of the 1985 independent evaluation of the project's benefits to participating children and parents, as assessed at the children's 3rd birthdays (Pfannenstiel & Seltzer, 1985), led to state funding for implementation of the program in every Missouri school district in 1985–86. A write-up on the program's evaluation results in The New York Times in October 1985 led to widespread interest and inquiries from around the world.

Now, as in the pilot project phase, Parents as Teachers offers all families the following services:

• Personal Visits. PAT-certified educators, trained in child development and home visiting, help parents understand and develop appropriate expectations for each stage of their child's development. They involve parents in parent-child activities that foster all areas of development and build a strong parent-child relationship. Response to parents' questions and concerns is always a priority during the visits of approximately one hour. Needs of the family and the age of the child determine whether visits are weekly, biweekly, or monthly. Parent materials, written at two reading levels, reinforce and expand upon the information discussed during the visit. Visits are arranged at times convenient to both fathers and mothers so as to accommodate schedules of parents who work outside the home.
• Group Meetings. Parents meet to gain new insights and to share their experiences, common concerns, and successes. Group meetings also provide families the opportunity to participate in parent-child activities in a group setting and to build support networks with other families. Many programs also offer families informal drop-in and play times.
• Developmental Screenings. Parents as Teachers offers periodic screenings in the areas of development, health, hearing, and vision. The intent is to provide early detection of potential and emerging problems to prevent more serious difficulties later, as well as to reassure parents whose children's development is age-appropriate.
• Resource Network. Families are helped to access other needed community services that the program cannot provide. Parents as Teachers has never claimed to be all things to all families.

Adaptability is key to the success of Parents as Teachers. While it is an international model with a comprehensive curriculum and professional training program, it is truly a local program. It can be offered as a stand-alone program or as part of a comprehensive early education and family support system of services. It works well in Even Start and other Title I programs, Early Head Start, Head Start, and programs for teen parents. Although the majority of Parents as Teachers programs are sponsored by school districts, the program has been adapted successfully for child care centers, Bureau of Indian Affairs schools, military bases, and the workplace.

Born to Learn Curriculum

The wealth of information the scientific community is producing about the development of the brain and its link to behavior underscores the undeniable importance of children's earliest experiences for brain development. The human brain has a remarkable capacity to learn and change throughout the life span, but there are critical periods that represent unique opportunities to physically affect the brain. A number of these sensitive periods occur during the first three years of life. This knowledge prompted us at the Parents as Teachers National Center (PATNC), with a grant from the Charles A. Dana Foundation, to undertake the task of demystifying brain research findings for parents and other early educators. In 1996, PATNC initiated a collaboration with a team of neuroscientists from the Washington University School of Medicine in St. Louis, Missouri, to bridge the gap between neuroscience and education. Our neuroscience-infused Born to Learn Curriculum resulted, taking this frontier of science from the laboratory to the living room.

The Born to Learn Curriculum consists of written and audiovisual materials for parents and parent educators that translate brain research information into concrete “when,” “what,” “how,” and “why” advice for parents. The neuroscience information gives added credibility to child development and parenting information—it gives the “why” behind the suggestions provided by parent educators. The written materials, which were critiqued by the medical team, include detailed home visit plans, child development and neuroscience information for parents, suggested parent-child activities, and resource materials for parent educators. Personal visit plans are designed for weekly, biweekly, or monthly visits, depending on the needs of individuals and programs.

An international-award-winning video series, funded by the McCormick Tribune Foundation, is an integral part of the curriculum. The videos present neuroscience information keyed to topics parent educators will discuss with parents during personal visits. They feature short presentations by neuroscientists, physicians, and child development professionals using easy-to-understand language. All scripts were reviewed by the neuroscientists for scientific accuracy.

The Born to Learn Curriculum has been field tested with families for whom parenting is a special challenge in St. Louis and Chicago and on five Native American reservation sites. The response from parents and parent educators has been overwhelmingly positive. As of 1999, this curriculum became the standard prenatal-to-age-3 curriculum for PAT programs everywhere. The parent materials and the video series are available in English and Spanish, and translation of the entire curriculum into Spanish is in progress. In response to requests both from parents and parent educators, the addition of neuroscience information to the curriculum for Parents as Teachers for Ages Three to Five is underway.

Proven Effectiveness

True success is measured in terms of changed lives; hence, the challenge to continually evaluate the effectiveness of the Parents as Teachers program. Independent evaluation studies vary extensively in their sample sizes, types of outcome indicators, and use of comparison groups. Some have investigated Parents as Teachers as a stand-alone program, while others have looked at it as part of a more comprehensive initiative. Some of these investigations are described below.

An independent evaluation of the PAT pilot project showed that by age 3, participating children were significantly advanced over their peers in language, social development, problem solving, and other intellectual abilities. PAT parents were more knowledgeable about child rearing practices and child development (Pfannenstiel & Seltzer, 1985).

A follow-up study of the pilot project showed that PAT children scored significantly higher than comparison group children on standardized measures of reading and math achievement in 1st grade. A significantly higher proportion of PAT parents initiated contacts with teachers and took an active role in their child's schooling (Pfannenstiel, 1989).

In 1991, a “Second Wave” study was conducted to determine how well the model program would transfer statewide. Results of the Second Wave evaluation of the PAT program's effect on 400 randomly selected families in 37 diverse school districts across Missouri indicated that both children and parents benefitted. At age 3, PAT children performed significantly above the national norms on measures of intellectual and language abilities, despite the Second Wave sample being overrepresented on all traditional characteristics of risk. More than half the children with observed developmental delays overcame them by age 3. Parent knowledge of child development and appropriate parenting practices increased for all types of families. There were only two documented cases of child abuse in the 400 families during the three-year study period (Pfannenstiel, Lambson, and Yarnell (1991).

A 1993 study of 516 students entering kindergarten in 22 rural school districts in southwest Missouri showed that children who had participated in PAT scored significantly higher on the Kindergarten Inventory of Developmental Skills (KIDS) than those who did not participate. Of the sample, 224 came from economically disadvantaged families (Wheeler, 1994).

A series of studies in Binghamton, New York, beginning in 1992, showed that PAT graduates tested in prekindergarten and again in kindergarten had significantly higher cognitive, language, motor, and social skills than nonparticipants. These advanced skills led to higher grades in kindergarten and lower remedial and special education costs in 1st grade. PAT families also had substantially reduced welfare dependence and half the number of suspected child abuse and neglect cases compared with comparison group families. When assessed again in 2nd grade, PAT children continued to perform better on standardized tests and to require fewer remedial and special education placements (Drazen & Haust, 1995, 1996).

Results of a study in North Carolina of sustained educational effects of the Rutherford County Schools PAT program were reported in 1996. Twenty-one families participated fully in the program for three years; 22 received only a quarterly newsletter during the child's first three years; a third group of 22 families received no services from the school district. At kindergarten entry, the PAT children scored significantly higher than the comparison groups on measures of language and self-help/social skills (Coleman, Rowland, & Hutchins, 1997).

A longitudinal study by the Parkway School District, a large suburban district in St. Louis County, Missouri, reported that 3rd-graders who had been in the program with screening services from birth to age 3 scored significantly higher on the Stanford Achievement Test than nonparticipating counterparts. PAT graduates were less likely to receive remedial reading assistance or be retained in grade. The sample was followed-up in 4th grade, and the PAT graduates continued to significantly outperform non-PAT children on the Stanford Achievement Test (Coates, 1996). The district concluded the study at that point, feeling that the program had proven its worth.

Findings from a state school readiness assessment project conducted in Missouri in 1998 show that Parents as Teachers achieves its goal of preparing children for success in school. The study involved 3,500 kindergarteners from a stratified random sample of school districts and schools across Missouri. Kindergarten teachers in the more than 80 sample schools were trained to rate children's preparation for kindergarten using a 65-item School Entry Profile. Children were rated based on teacher observations after six weeks of school. Parents completed a survey on their child, on which they reported on health issues, the child's participation in child care or preschool, and the frequency and kinds of home literacy activities.

Among children whose care and education were solely home-based, those whose families participated in PAT scored significantly higher on the School Entry Profile. Among children who participated in PAT and attended preschool, both minority and nonminority children, as well as children who attended high-poverty and low-poverty schools, scored above average. Children in all categories who rated above average lived in homes where parents reported above-average frequency of home literacy activities, such as those emphasized in all PAT programs (Missouri Department of Elementary and Secondary Education, 1999).

A multisite study being conducted by SRI International with high-needs families in three metropolitan areas is an evaluation in progress. Families were randomly assigned to either a treatment group receiving PAT services or a no-treatment control group. The study is assessing children's development and parents' knowledge of child development, attitudes toward parenting, and use of appropriate support. Results will be available in the fall of 2001.

Cost-Effectiveness

The positive outcomes of numerous evaluations of Parents as Teachers underscore another important aspect of the program—its cost-effectiveness. A major source of savings to school districts is the elimination of special education services for many children who might otherwise have needed them were it not for their family's participation in PAT. The Parkway School District in St. Louis County, referenced earlier, reports a cost difference of $6,912 per child per year between regular and special education, or a cumulative savings per child for the K-12 years of $89,856. Studies also indicate that PAT children are less likely to be retained in grade.

Parents as Teachers is also effective in serving teen parents, helping them understand their child's development and the importance of their role—both prenatally and after the baby is born—and supporting them in their effort to continue their education and graduate from high school. These education efforts produce considerable savings to communities at large; teens' increased access to prenatal care leads to a reduction in the number of low-birth-weight babies, who are typically at risk for health problems and developmental delays. By staying in school, teenage mothers not only increase their own ability to stay off welfare and be gainfully employed, but they also increase their child's likelihood of success in school.

Part of the program's appeal is its low cost, the major expense being the salary and travel of parent educators, many of whom work on a part-time basis. This schedule provides added flexibility for personal visits on Saturdays, evenings, early mornings, and lunch times. At most sites, the program does not require extensive facilities or a large investment in materials. Parents are encouraged to take advantage of learning opportunities that occur in everyday living, using materials that are ordinarily found in the home. School districts and other sponsoring agencies commonly make in-kind contributions, such as office and group meeting space, clerical assistance, and program supervision. Annual reports submitted by PAT programs nationally indicate an average expenditure of $1,000–$1,500 per family per year. The frequency of personal visits provided obviously affects cost. One PAT benefit to schools, which has been widely documented but is difficult to translate into dollars, is the marked increase in parent support involvement in education.

Conclusion

Evidence of the effectiveness of Parents as Teachers and its affordability have been integral to the expansion of the program. As of the end of 2000, there were 2,655 PAT sites across the United States and in Australia, Canada, Great Britain, Japan, Malaysia, the Northern Mariana Islands, New Zealand, Puerto Rico, the South Pacific Islands, the Virgin Islands, and the West Indies.

It has been said that the first year last forever. Through the Parents as Teachers program, we are working to make them the best years for our children, particularly those who are most vulnerable to failure.

Further information on the Parents as Teachers program is available from:

Parents as Teachers National Center, Inc.

10176 Corporate Square Drive

St. Louis, Missouri, 63132

Telephone 314-432-4330; fax 314-432-8963; e-mail mwint@patnc.org; web http://www.patnc.org

References

Coates, D. (1996). Early childhood evaluation. A report to the Parkway School District Board of Education, Chesterfield, MO.

Coleman, M., Rowland, B., & Hutchins, B. (1997, November). Parents as teachers: Policy implications for early school intervention. Paper presented at the annual meeting of the National Council on Family Relations, Crystal City, VA.

Drazen, S., & Haust, M. (1995). The effects of the Parents and Children Together (PACT) program on school achievement. Binghamton, NY: Community Resource Center.

Drazen, S., & Haust, M. (1996). Lasting academic gains from an early home visitation program. Binghamton, NY: Community Resource Center.

Gopnik, A., Meltzoff, A., & Kuhl, P. (1999). The scientist in the crib. NY: William Morrow.

Missouri Department of Elementary and Secondary Education. (1999). School entry assessment project: Report of findings. Jefferson City, MO: Author.

Pfannenstiel, J. (1989). New Parents as Teachers project: A follow-up investigation. Overland Park, KS: Research & Training Associates.

Pfannenstiel, J., Lambson, T., & Yarnell, V. (1991). Second wave study of the Parents as Teachers program. Overland Park, KS: Research & Training Associates.

Pfannenstiel, J., & Seltzer, D. (1985). Evaluation report: New Parents as Teachers project. Overland Park, KS: Research & Training Associates.

Pfannenstiel, J., & Seltzer, D. (1989). New parents as teachers: Evaluation of an early parent education program. Early Childhood Research Quarterly, 4, 1–18.

Shore, R. (1997). Rethinking the brain: New insights into early development. New York: Families and Work Institute.

Wheeler, W. (1994). A study of the Missouri Parents as Teachers program and its effects on the readiness skills of children entering kindergarten in southwest Missouri public schools. Blue Eye, MO: Blue Eye School District.

Winter, M. (1995). Home visiting: Forging the home-school connection. Washington, DC: U.S. Department of Education.