Review

At the time of this review, no research studies that evaluate the curriculum's effect on child outcomes have been published in peer-reviewed journals. Although one program evaluation mentioned this curriculum, the study also mentioned the use of other home visiting curricula (Kirkland & Mitchell-Herzfeld, 2012). Outcomes from this evaluation are omitted in this review because the effects were not clearly linked to use of Partners for a Healthy Baby. Some evidence indicates that use of this curriculum was associated with a reduction in rates of low birth weight (e.g., Lee et al., 2009) and maternal depression (DuMont et al., 2008). However, more rigorous research is needed in order to establish evidence for positive effects of the Partners for a Healthy Baby curriculum on child outcomes.

For more information on Partners for a Healthy Baby as a parenting curriculum, see the Parenting Curricula for Home-Based Delivery Database.

References:

DuMont, K., Rodriguez, M., Mitchell-Herzfeld, S., Walden, N., Kirkland, K., Greene, R., & Lee, E. (2008). Effects of Healthy Families New York on maternal behaviors: Observational assessments of positive and negative parenting. Rensselaer, NY: New York State Office of Children and Family Services.

Kirkland, K., & Mitchell-Herzfeld, S. (2012). Final report: Evaluating the effectiveness of home visiting services in promoting children's adjustment in school. Washington, DC: Pew Center on the States.

Lee, E., Mitchell-Herzfeld, S., Lowenfels, A., Green, R., Dorabawila, V., & DuMont, K. (2009). Reducing low birth weight through home visitation: A randomized controlled trial. American Journal of Preventive Medicine, 36(2), 154–160.

At the time of this review, Baby TALK has been studied as part of the evaluation of the RefugeeOne program in Chicago, IL (Hilado, Leow, & Yang, 2019; Hilado, Leow, & Yang, 2018). 

For information on Baby TALK as a parenting curriculum, please see the Parenting Curricula for Home-Based Delivery Database. 

Rigorous Design: Baby TALK was evaluated in a randomized control trial.

Sample and Generalizability: The sample included 200 families with children between 3 and 36 months old. Families were referred by a refugee resettlement program in Chicago. About half of the sample was East Asian, with several African, Near Eastern, South Asian, Latin American, and Caribbean families. Families were predominantly low-income.

Training: Home visitors participated in a four-day core training and received supervision twice a month. Fidelity of implementation was assessed as part of supervision. It was also assessed by analyzing the documentation home visitors completed before and after each home visit. The study did not present an analysis of the home visitors' fidelity to the intervention.

Parenting Outcomes: Parents reported lower parental stress and trauma symptoms after one year of participating in Baby TALK. However, these outcomes were not significantly different from those of families who did not participate. In addition, home visitors reported observing more positive parenting practices after one year of participating in Baby TALK. The parenting practices of families in the control group were not assessed. 

Child Outcomes: The evaluation investigated the effect of one year of participation in a home visiting program using Baby TALK on children's language development and social and emotional development. Children who participated in the program had more gains in language development after one year than children who did not participate in home visiting. They also had higher scores on social and emotional development after one year. However, these gains in social and emotional development were not significantly different from the gains of children who did not participate in home visiting. 

References:

Hilado, A., Leow, C., & Yang, Y. The Baby TALK – RefugeeOne Study: A Randomized Controlled Trial Examining Home Visiting Services with Refugees and Immigrants. Report submitted to the U.S. Department of Health and Human Services, Home Visiting Evidence of Effectiveness (HomVEE) Review, January 2018.

Hilado, A., Leow, C., & Yang, Y. “Understanding Immigration Trauma and the Potential of Home Visiting Among Immigrant and Refugee Families.” Zero to Three Journal, 39(6), (July 2019): 44–53.
 

Parents as Teachers Foundational 2 Curriculum: Three Years Through Kindergarten has been revised several times since Parents as Teachers began in 1984. This review presents evidence from two studies on the effectiveness of the current version, which was introduced in 2010. The first study is a recent evaluation of the Parents as Teachers home-visiting intervention, including Parents as Teachers Foundational Curriculum 1 and 2 (Lahti, Evans, Goodman, Schmidt, & LeCroy, 2019). The second study uses a descriptive design to investigate the Parents as Teachers Foundational 2 Curriculum as part of the Parents Possible home visiting program (Lopez & Bernstein, 2016). More rigorous research investigating Parents as Teachers Foundational 2 Curriculum is needed in order to establish evidence for positive effects of this curriculum on child school readiness outcomes.

Studies of prior versions of the curriculum (e.g., Born to Learn) and the version used with younger children (e.g., Parents as Teachers Foundational Curriculum) also show evidence for positive child outcomes (e.g., Schaub, Ramseier, Neuhauser, Burkhardt, & Lanfranchi, 2019; Zigler, Pfannenstiel, & Seitz, 2008). They are not included here because this review includes only studies of the current version of Parents as Teachers Foundational 2 Curriculum: 3 Years Through Kindergarten.

While this report focuses on evidence for child outcomes in the school readiness domains, Parents as Teachers has also been associated with positive parenting outcomes. For more information, please see the Parenting Curricula for Home-Based Delivery Database. 

In addition, the Home Visiting Evidence of Effectiveness (HomVEE) review presents information on associations between Parents as Teachers and outcomes in maternal and child health and other domains.

Rigorous Research Design: The evaluation of the Parents as Teachers home visiting intervention used a quasi-experimental design. The Parents Possible study used a pre- and post-descriptive design without comparison groups.

Sample and Generalizability: The evaluation of the Parents as Teachers home visiting intervention included children who were enrolled in the Puma County, AZ public schools. The children were predominantly Hispanic, and most qualified for free and reduced lunch in the public schools. The Parents Possible program is located in Colorado. The sample included predominantly White parents, mostly low-income, with many reporting Hispanic ethnicity. The children were 3 to 6 years old.

Fidelity of Implementation: The studies did not report information about training or fidelity of implementation. 

Parenting Outcomes: The evaluation of the Parents as Teachers home visiting intervention analyzed parenting outcomes using a pre- and post-test design without a comparison group. It found positive parenting outcomes for caregiver interactions during play, as well as for a variety of protective factors (e.g., family functioning, social support, and concrete support). While scores on nurturing and attachment were slightly higher at post-test, the difference was not significant. The Parents Possible evaluation did not investigate effects on parenting outcomes.

Child Outcomes: The evaluation of the Parents as Teachers home-visiting intervention assessed children's elementary math achievement, elementary reading achievement (on two measures), and English language learner achievement (i.e., English reading and writing achievement for English language learners). It found a small-to-medium positive effect on children's elementary math achievement and a small positive effect on English language learner achievement. While there were also small positive effects on children's elementary reading achievement, the effect only reached significance for one of the measures. The Parents Possible evaluation used a school readiness assessment measure to investigate the program's effects on preschool children, including children's understanding of colors, letters, numbers/counting, sizes/comparison, and shapes. Children had a higher percentile rank in all domains after participating in the program than they did at program entry.

References: 

Lahti, M., Evans, C. B., Goodman, G., Schmidt, M. C., & LeCroy, C. W. (2019). Parents as Teachers (PAT) home-visiting intervention: A path to improved academic outcomes, school behavior, and parenting skills. Children and Youth Services Review, 99, 451–460.

Lopez, A., & Bernstein, J. Parent Possible: 2016 Parents as Teachers (PAT) Evaluation. (2016). OMNI Institute. http://media.wix.com/ugd/9c9066_b2b844df114646ee8d1b9404148fc5cb.pdf

Schaub, S., Ramseier, E., Neuhauser, A., Burkhardt, S. C. A., & Lanfranchi, A. (2019). Effects of home-based early Intervention on child outcomes: A randomized controlled trial of parents as teachers in Switzerland. Early Childhood Research Quarterly, 48, 173–185.

Zigler, E., Pfannenstiel, J. C., & Seitz, V. (2008). The Parents as Teachers program and school success: A replication and extension. Journal of Primary Prevention, 29(2), 103–120. https://link.springer.com/article/10.1007/s10935-008-0132-1

Parents as Teachers Foundational Curriculum: Prenatal to 3 (Parents as Teachers) has been evaluated in many studies since it began in 1984; and over the years, the curriculum has been revised several times. This review presents evidence from two studies on the effectiveness of the current version of the Parents as Teachers curriculum, which was introduced in 2010. The first study is a recent evaluation of Parents as Teachers (Lahti, Evans, Goodman, Schmidt & LeCroy, 2019). The second study investigates implementation of Parents as Teachers as part of the Zurich Equity Prevention Project with Parents' Participation and Integration (ZEPPELIN) intervention (Schaub, Ramseier, Neuhauser, Burkhardt, & Lanfranchi, 2019; Neuhauser, Ramseier, Shaub, Burkhardt, & Lanfranchi, 2018).

While this report focuses on evidence for child outcomes in the school readiness domains, Parents as Teachers has also been associated with positive parenting outcomes. For more information on Parents as Teachers as a parenting curriculum, please see the Parenting Curricula for Home-Based Delivery Database. In addition, the Home Visiting Evidence of Effectiveness (HomVEE) review presents information on associations between Parents as Teachers and outcomes in maternal and child health and other domains.

Rigorous Research Design: The Parents as Teachers evaluation used a quasi-experimental design, and the ZEPPELIN study used an experimental design.

Sample and Generalizability: The Parents as Teachers evaluation included children who were enrolled in the Arizona public schools whose participated in Parents as Teachers as young children. The children were predominantly Hispanic, and most qualified for free and reduced lunch in the public schools. The ZEPPELIN study took place in Switzerland. The sample included families of children who were less than 4 months old when the study began. Families had psychosocial risk factors, and most were immigrants to Switzerland.

Fidelity of Implementation: The Parents as Teachers evaluation did not report training or fidelity information. The home visitors in the ZEPPELIN study were pediatric nurses who participated in training as parent educators and attained recertification. They had to meet fidelity requirements developed by their organization, including annual performance reports.

Parenting Outcomes: The Parents as Teachers evaluation analyzed parenting outcomes using a pre-test/post-test design without a comparison group. It found positive parenting outcomes for caregiver interactions during play, as well as for a variety of protective factors (i.e., family functioning, social support, and concrete support). While scores on nurturing and attachment were slightly higher at post-test, the difference was not significant. The ZEPPELIN study found a positive effect of Parents as Teachers on maternal sensitivity when children were 12 months old, though not when children were 24 or 36 months old.

Child Outcomes: The Parents as Teachers evaluation assessed children’s elementary math achievement, elementary reading achievement (on two measures), and English Language Learner Achievement (i.e., reading and writing in English). It found a small-medium positive effect on children’s elementary math achievement and a small positive effect on English Language Learner achievement. While there were also small positive effects on children’s elementary reading achievement, the effect only reached significance for one of the measures. The ZEPPELIN study analyzed children’s self-help skills, developmental milestones, developmental competence (in cognitive, language, and motor skills), vocabulary, nonverbal intelligence, developmental dysfunction (child behavior), and effortful control. Children who participated in Parents as Teachers had positive effects on self-help skills, developmental milestones, expressive language, vocabulary, and some aspects of developmental dysfunction and effortful control, when compared to children who did not participate in Parents as Teachers.

References: 

Drotar, D., Robinson, J., Jeavons, L., & Lester Kirchner, H. (2009). A randomized, controlled evaluation of early intervention: The Born to Learn curriculum. Child: Care, Health and Development, 35(5), 643–649. https://doi.org/10.1111/j.1365-2214.2008.00915.x

Lahti, M., Evans, C. B., Goodman, G., Schmidt, M. C., & LeCroy, C. W. (2019). Parents as Teachers (PAT) home-visiting intervention: A path to improved academic outcomes, school behavior, and parenting skills. Children and Youth Services Review, 99, 451–460.

Neuhauser, A., Ramseier, E., Shaub, 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), 532–536.

Parents as Teachers. (2016). Evaluating an Investing in Innovations project to improve education outcomes for American Indian children. St. Louis, MO. Retrieved from https://static1.squarespace.com/static/56be46a6b6aa60dbb45e41a5/t/57eea52515d5db8fe16501ab/1475257637451/babyface_report_pat_2016.pdf

Schaub, S., Ramseier, E., Neuhauser, A., Burkhardt, S. C., & Lanfranchi, A. (2019). Effects of home-based early intervention on child outcomes: A randomized controlled trial of Parents as Teachers in Switzerland. Early Childhood Research Quarterly, 48, 173–185.

Zigler, E., Pfannenstiel, J. C., & Seitz, V. (2008). The Parents as Teachers program and school success: A replication and extension. Journal of Primary Prevention, 29(2), 103–120. https://link.springer.com/article/10.1007/s10935-008-0132-1

At the time of this review, there are no available published research studies on Growing Great Kids™ for Preschoolers. However, there is some evidence that participation in programs using Growing Great Kids™: Prenatal–36 months is associated with positive child outcomes. Research investigating Growing Great Kids™ for Preschoolers is needed in order to establish evidence for positive effects on children's learning outcomes.

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

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.