At the time of this review, Growing Great Kids™: Prenatal–36 Months (Growing Great Kids™) has been studied as part of an evaluation of two home visiting programs, both administered by the Children's Institute of Los Angeles (Children's Institute, 2012; Children's Institute, 2017). The first study evaluated the federal Abandoned Infant Assistance (AIA) program, while the more recent study evaluated the Institute's Early Head Start (EHS) program. Both of these studies found outcomes for children associated with their families' participation in a program that used the Growing Great Kids™: Prenatal–36 Months curriculum. However, these evaluation studies used descriptive methods and did not include comparison groups. 

Some evidence also indicates that use of this curriculum was associated with positive infant health outcomes (e.g., Williams, Cprek, Asaolu, English, Jewell, Smith, & Robl, 2017). More rigorous research is needed in order to establish evidence for positive effects of the Growing Great Kids™ curriculum on child outcomes in the school readiness domains.

For information on Growing Great Kids™ as a parenting curriculum, please see the Parenting Curricula for Home-Based Delivery Database.

Rigorous Design: The Children's Institute conducted pre-post descriptive studies that explored how child outcomes changed after families participated in their programs. There were no comparison groups.

Sample and Generalizability: Both Children's Institute studies had small sample sizes (under 100 families in the final samples) and primarily included families with incomes below the poverty line. The children in the EHS sample ranged in age from 1 month to 30 months old, with a mean age of 10 months old when they began the program. Most children were from Latino families. The AIA sample included women who were pregnant as well as children up to 3 years and 8 months old, with a mean age of 13 months. All families in the AIA sample had multiple risk factors.

Fidelity of Implementation: The reports did not provide information on fidelity of impleentation. Home visitors in both programs received a week-long training from an official Growing Great Kids™ trainer. In addition, the EHS evaluation reported that home visitors participated in individual supervision twice each month, group supervision monthly, and booster training sessions annually. The AIA evaluation reported weekly individual and group supervision. The EHS program included weekly 90-minute home visits. The AIA program included weekly 60–90 minute home visits, with weekly supplemental group sessions.

Parenting Outcomes: The EHS evaluation did not investigate effects on parenting outcomes. The AIA evaluation found that parents reported positive changes in their stress levels, attitudes, and beliefs after six months in the program.

Child Outcomes: Both evaluations investigated child outcomes in the domains of communication, fine and gross motor, problem-solving, and personal-social skills. The EHS evaluation compared children's development in these domains at intake and at 4, 8, and 12 months. They reported normative child development in these domains. In addition, children's gross motor skills developed, on average, at a faster pace than normative development. The AIA evaluation reported that, after six months, child outcomes in communication, problem-solving, personal-social skills, and total score were higher than developmental norms for the children's ages. The EHS evaluation also explored child outcomes in initiative/attachment relationships and self-regulation and found that children's skills corresponded to normative development.

References:

Children's Institute, Inc. Project Stable Home Abandoned Infants Assistance Grant Final Report (No.: 90-CB-0159). Los Angeles, CA: Author, 2012.

Children's Institute, Inc. Outcome Evaluation of the Growing Great Kids™ Developmental Curriculum with Early Head Start Families Served by Children's Institute, Inc. Los Angeles, CA: Research & Evaluation Center, Children's Institute, 2017.

Williams, C. M., Cprek, S., Asaolu, I., English, B., Jewell, T., Smith, K., & Robl, J. “Kentucky Health Access Nurturing Development Services: Home Visiting Program Improves Maternal and Child Health.” Maternal and Child Health Journal, 21(5), (2017): 1166–1174. 

Home Visiting Practices and Interactions: The curriculum consistently promotes home visiting practices and interactions that research has shown to be effective in engaging families. The curriculum supports home visitors to build trusting and positive relationships with families, particularly through the proposed structure of home visits.  For example, each home visit starts with "Making Connections," a time for home visitors and families to check in on how families are doing). The curriculum also encourages home visitors to use a strengths-based approach with families to build relationships and affirm parental competence (e.g., materials emphasize "accentuating the positives" while working with families). The curriculum also supports many adult learning strategies that allow for family engagement (e.g., meaningful activities build on families' existing skills, joint reflection). While the curriculum provides information on supporting a family's strengths, minimal guidance is offered for home visitors on how to follow the family's lead to jointly plan home visits.

Parenting Practices: Growing Great Kids™ consistently promotes parenting practices that research has shown to be effective in supporting children's development and learning. Guidance to promote responsive and sensitive parent-child interactions is embedded throughout the materials. For example, each home visit includes "Getting in Sync with My Baby," which provides reflective prompts for parents to think about ways they can tune in to their child as they learn to respond contingently. The curriculum also guides parents to support play and exploration throughout the day by using routines, space, and materials in the home environment as learning opportunities. For example, the module "Basic Care" discusses the use of daily routines to promote learning and provides activities for making toys at home using everyday materials. The curriculum also offers guidance for parents on how to model and support the development of children's social skills (e.g., suggestions for building empathy during interactions), emotional regulation, problem-solving, and physical skills. However, while the curriculum supports families to promote a language and literacy-rich environment, less consistent guidance is offered on the use of the child's home language throughout the curriculum.

Scope: Activities in the curriculum manuals are organized around the following six modules: Basic Care, Social and Emotional Development, Cues and Communication, Physical and Brain Development, Play and Stimulation, and Successes and Next Steps. Each activity identifies a few developmental skills or concepts (e.g., object permanence, use of tools, cause and effect). The activities implicitly support children's development and learning across modules in key domains of development, but there is no explicit correspondence between the activities and the domains. Moreover, the developmental domains are identified differently in other curriculum resources, such as the "Child Development Milestone Charts" (e.g., Language/Communication, Cognitive and Physical, and Social and Emotional), making it difficult to see a clear connection between the domains and the activities.

Sequence: The curriculum provides a sequence of learning experiences that supports children as they build knowledge and skills in each of the ELOF domains. The curriculum manuals are organized by age: birth–12 months, 13–24 months, and 25–36 months. Along with Growing Great Families: A Family Strengthening, Stress Management, and Life Skills Curriculum (Growing Great Families), they provide a variety of learning experiences that are based on children's developmental progressions with multiple, related opportunities for children to explore or learn concepts or skills in each domain. While the curriculum promotes using the modules in the order that suits the family, limited guidance is offered on how to individualize sequences of learning experiences based on children's interests, strengths, and needs.

Alignment with the ELOF: A thorough review of all of the curriculum materials in relation to the ELOF domains and sub-domains indicates that Growing Great Kids™: Prenatal–36 Months is fully aligned with the ELOF. The learning experiences described in the curricular manuals support children across the ELOF sub-domains.

Learning Goals: Each curriculum activity includes goals for facilitating children's learning and development and supports children in making progress toward the goals. Some activity goals are too broad to be observable (e.g., "To prepare children to play sports"), but most activities include some observable behaviors or skills. In addition, the curriculum provides age-based (birth–36 months) developmental indicators in the "Child Development Milestone Charts." The milestones describe behaviors and skills that parents might observe in the following areas: Social and Emotional; Language/Communication; Cognitive; and Physical. The learning experiences support children in reaching the milestones across domains, but the connection between the developmental indicators and the activities in other sections of the manuals is not always clear. The curriculum also provides strategies for home visitors to engage parents in identifying individual goals for their child's learning and development.

Ongoing Observation: The "Child Development Milestone Charts" provide some general guidance parents and home visitors can use to observe children's behaviors and skills in different domains (e.g., a home visitor is encouraged to prompt parents, "As we go through the list, you can tell me what she is already doing"). Additionally, some activities throughout the manuals offer conversational prompts that could guide home visitors and families to reflect on a child's development (e.g., an activity designed to support toddler independence starts with conversational prompts to reflect on a child's self-care skills). The curriculum does not provide specific guidance on how to use information from observation to plan future home visits.

Standardized and Structured Assessment Instruments: The curriculum does not provide guidance for how home visitors and families select and use standardized and structured child assessment instruments. The curriculum offers information on using developmental screening tools (e.g., Ages and Stages Questionnaire (ASQ), Devereux Early Childhood Assessment (DECA)) in Growing Great Families, but no information on assessment instruments.

Relationships with Parents and Families: Growing Great Kids™ offers specific guidance for building positive relationships with families that is integrated throughout the curriculum materials and structure of home visits. Each home visit starts with "Making Connections," a dedicated time for home visitors and families to talk through what the family is experiencing, as well as to recognize the efforts of families. The "Conversation Guides" provide home visitors with conversation scripts that could support home visitors' relationships with families (e.g., "This is a partnership, so I will be listening closely to what is going on with you and your child and where you want to go next in the curriculum."). The materials offer a strengths-based approach for home visitors to use with families (e.g., a focus on "accentuating the positives"). Moreover, "Home Time," the last part of home visits, is a time for home visitors to check in with families about taking concepts and activities into the week.

Responsive Interactions with Parents and Families: The curriculum provides some information for home visitors on how to be responsive to families (e.g., using a strengths-based approach with families, collaborating to develop "Individualized Family Support Plans"). It also provides a tool for family self-assessment ("GGK Tool"). However, it is not clear how the tool is used to support collaborative planning. Additionally, the "Conversation Guides," which are the foundation of all curriculum manuals, give scripted questions and responses for home visitors to use with families. In a description of the "Conversation Guides" during the first visit with families, the home visitor script reads, "You will notice that I am going to be reading from this manual. That is because it includes ‘Conversation Guides' for our visits." The scripted nature of the guides leaves little room for home visitors to adaptively respond to families. Additionally, while families can ask which module to progress to next, little guidance is provided to modify activities based on the family's interests, strengths, or needs.

Peer Support: Growing Great Kids™: Prenatal–36 Months includes a few short sections that discuss the importance of social support for families (e.g., "Growing Your Support Network ... Strengthening Protective Buffers" in Growing Great Families). However, no explicit guidance is offered on how home visitors can gather families together for group socializations within this curriculum. The publisher offers a separate curriculum, Growing Great Socializations, that programs can purchase to support group socializations.

Professional Development: The curriculum developers offer comprehensive standardized initial and ongoing training. Home visitors and supervisors are required to attend a 4.5-day in-person training to become certified to use the curriculum. A variety of follow-up training options are offered online through the GK Professional Development Academy and in person, such as a training on home visitor competencies, including cultural humility, "GGK Advanced Practice Integration," "Fidelity Implementation Training." The curriculum developers also offer consultation services for individual program needs.

Curriculum Materials to Support Implementation: Growing Great Kids™ includes comprehensive materials and guidance to facilitate understanding of the curriculum. The "Conversation Guides" in each manual provide home visitors with discussion questions for families. The "HV Notes" are call-out boxes embedded throughout the manuals that provide suggestions to home visitors to highlight certain aspects of activities or areas of development. Additionally, many of the materials provided in the mandatory trainings (e.g., the Staff Development and Certification Guide) support various aspects of implementation.

• Fidelity Tool: The curriculum offers three fidelity tools to support implementation—one for home visitors, one for supervisors, and one for trainers. The fidelity tool for home visitors, GGK Implementation Fidelity Best Practice—for Home Visits, is a yes/no checklist with the required components for every home visit: materials to bring, what to do, dosage of curriculum components, and Foundational Modules to be completed with all families.

Family-Child Relationship: The curriculum provides specific guidance that is integrated throughout curriculum materials for how home visitors can support and promote nurturing family-child relationships as the foundation for a child's learning and development. Many activities support parents to respond to a child's cues and follow the child's lead. For example, in the section of each home visit called "Getting in Sync with My Baby," home visitors support parents to reflect on their child's cues with a list of questions, such as, "What is my baby feeling or experiencing right now?"

Active Exploration and Play: Growing Great Kids™ provides specific guidance throughout the curriculum manuals on how parents engage children in ongoing active exploration and play. Opportunities for play, movement, and active exploration are integrated throughout most learning experiences in the curriculum (e.g., suggestions for parents to arrange furniture to support exploration of the home environment, opportunities to promote outdoor play).

Interactions that Extend Children's Learning: The curriculum provides minimal guidance on supporting interactions that extend children's exploration, thinking, and communication during activities. A few activities include suggestions for parents to describe children's explorations (e.g., an activity for young infants encourages parents to talk with babies, even if they are not showing understanding). In addition, a handout for parents, the "Daily Do's," provides some strategies to support children's learning (e.g., describing what the child is doing). However, the curriculum lacks specific guidance throughout the activities for how parents can extend children's exploration, thinking, and communication.

Individualization: The curriculum provides general guidance for how to collaborate with families to create learning experiences that are responsive to all children. Some of the curriculum's activities highlight how home visitors can collaborate with families to create learning experiences that build on the family's culture. For example, "Cultural Practices and Responding to Infant Cues" describes how the home visitor can explore and discuss with parents how culture influences the ways that they respond to their children. However, limited guidance is offered on how to collaborate with families to create learning experiences that are responsive to a child with a disability, suspected delay, or other special need.

Environment: The curriculum emphasizes use of the home as a learning environment to support children's development. Throughout the curriculum, the activities provide specific guidance for using space in the home to support exploration and development (e.g., "messy play at home for learning through touch," arranging furniture to support exploration, activities on assessing safety in the home). A limitation is that no specific guidance is provided about making a home learning environment accessible for a child with a disability, suspected delay, or other special need.

Learning Materials: The curriculum provides specific guidance embedded throughout curriculum materials on using learning materials from the home. The learning activities in each of the manuals emphasize finding and using materials that can be found in the home to support open-ended exploration (e.g., plastic bowls, metal spoons). For example, one activity proposes that families and home visitors find "three objects that have different textures, colors, and shapes" for the child to touch or mouth. However, no specific guidance is offered on how to incorporate learning materials in play that are accessible for a child with a disability, suspected delay, or other special need.

Routines: Growing Great Kids™: Prenatal–36 Months provides specific guidance on how to establish and support developmentally appropriate routines that are responsive to a child's needs. Guidance on routines is embedded throughout the activities, "Daily Do's" (handouts parents can use every day), and Growing Great Families materials, emphasizing how routines (e.g., bath time, mealtime, bedtime) provide natural contexts for children's learning and development (e.g., self-regulation, independence, fine motor skills).

Interactions: Growing Great Families briefly mentions the importance of home visitors interacting with families from diverse backgrounds and cultures. In a unit called "Family Traditions and Cultural Practices," home visitors are provided with some scripted discussion questions to help families reflect on their traditions (e.g., religion, food, dress). Additionally, a few places in the curriculum prompt home visitors to ask families about cultural practices related to responding to children's cues. However, limited guidance is provided on how home visitors interact with families in a culturally responsive manner.

Learning Experiences: The curriculum provides some general principles for planning learning experiences based on a family's traditions, culture, and beliefs. The curriculum encourages families and home visitors to identify the family's values and traditions that are relevant to the child's daily life. For example, in a discussion on responding to infant cues, the curriculum prompts home visitors to inquire about how culture might influence the way a family responds to young children. A module from Growing Great Families called "Learning about Family Values and Strengths: Strengthening Family Foundations" describes how home visitors and families can discuss what values families want to pass on to their children. However, the curriculum does not give specific guidance that is embedded throughout the materials on how to collaborate with families to adapt learning experiences based on their culture.

Linguistic Responsiveness: The curriculum offers some general guidance on supporting the development and learning of children who are DLLs. For example, handouts such as "Two Languages Are Better Than One" and "Benefits of Being a Bilingual Child" list advantages of learning two languages and provide conversation prompts for home visitors to discuss bilingualism with parents. Limited specific guidance is provided on how home visitors can explicitly support parents' use of their home or tribal languages in learning experiences or routines.

Resources and Referrals: The curriculum offers minimal support for home visitors to connect families of a child with a disability, suspected delay, or other special need to resources in the community. In a few places in Growing Great Families, the curriculum mentions the importance of connecting families with resources in the community if needed (e.g., Advice for home visitors: "You can best support parents by ... partnering with community-based agencies/early intervention services."). However, it does not provide specific guidance for home visitors on how to identify resources or how to support families in a referral process.

Learning Environment: Growing Great Families very minimally addresses accessibility of the home environment or learning materials for a child with a disability, suspected delay, or other special need. The module "Unique Needs: Being a Parent of a Child with Special Needs" offers general suggestions for parents and mentions the importance of making a "home environment safe and developmentally rich" for children with unique needs.

Parenting Practices and Interventions: The curriculum offers minimal guidance in Growing Great Families on adapting routines and learning experiences for a child with a disability, suspected delay, or other special need. The module "Unique Needs: Being a Parent of a Child with Special Needs" includes a brief mention of the importance of adapting activities in the curriculum. The prompt says, "We can find and adapt activities that your child's care team feels are important," and provides one example. However, the information provided is vague and contained in the one section of the curriculum. Throughout the manuals, there is no information included on how specific activities can be adapted for a child with a disability, suspected delay, or other special need.

Individualization Based on Interests: Some activities in the curriculum manuals suggest ways to adapt activities based on children's interests, particularly around selecting materials for activities (e.g., an activity on naming objects encourages parents to use items that the child might be interested in). However, the curriculum provides minimal guidance throughout the materials on how to tailor home visits based on the interests of children.

Individualization Based on Strengths and Needs: The curriculum provides some suggestions for adapting activities in a home visit based on the strengths and needs of children. For example, the module "Unique Needs: Being a Parent of a Child with Special Needs" of Growing Great Families provides broad suggestions for modifying specific sections of the curriculum based on a child's development. For example, one suggestion for the "Play-by-Play" language development activities in the curriculum includes exploring and supporting different kinds of communication a child might use when the child does not use spoken words. However, the majority of activities described in the curriculum do not include guidance on how to tailor the home visit based on the strengths and needs of individual children.

Family Goals: The curriculum describes a specific process for how to engage parents in setting goals at the family level. Growing Great Families provides a unit on developing an Individual Family Support Plan (IFSP), which includes creating a set of family goals. It outlines a specific process for home visitors and families on how to select goals, plan action steps toward goals, and support goal success.

Ongoing Assessment of Progress Toward Family Goals: Growing Great Families includes a specific process for ongoing assessment of progress toward family goals. The "Supporting Goal Success with Families Blueprint" aids home visitors in engaging with families to check in on goal progress and revisit them when needed. The blueprint includes conversation starters and suggestions for specific steps to take daily, weekly, or monthly.

Resources and Referrals: The Growing Great Kids™ curriculum briefly describes the importance of connecting families to resources they might need in Growing Great Families (e.g., referring parents to a family counselor to address traumatic experiences). However, the curriculum lacks comprehensive guidance for referring families to resources in the community to make progress toward reaching their goals.