Implementing Parents as Teachers (PAT)® Meets HHS Criteria

Model implementation profile last updated: 2019

Theoretical approach

The theory of change for the Parents as Teachers model is that affecting parenting knowledge, attitudes, behaviors and family well-being impacts the child’s developmental trajectory.

The overall Parents as Teachers model is grounded in Urie Bronfenbrenner’s Human Ecology Theory and Family Systems Theory. The home visits focus on three areas of emphasis—parent-child interaction, development-centered parenting, and family well-being. Parents as Teachers is informed by additional theories including developmental parenting, attribution theory, and self-efficacy theory.

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Implementation support

The Parents as Teachers National Center provides guidance, training, technical assistance, professional development opportunities, and a quality endorsement process for Parents as Teachers affiliates. The Parents as Teachers National Center also advocates at the state and national levels.

Twenty-four states and two countries have Parents as Teachers offices. Parents as Teachers state and country offices offer affiliates guidance, technical assistance, and implementation support. In addition, these offices provide oversight of the Parents as Teachers affiliates in their state or country.

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Intended population

The Parents as Teachers model serves families with high-needs characteristics. Parents as Teachers affiliates select the specific characteristics and eligibility criteria of the target population they plan to serve. Such eligibility criteria might include children with special needs, families at risk for child abuse, low-income families, teen parents, first-time parents, immigrant families, low-literate families, parents with mental health or substance use issues, or families experiencing homelessness or unstable housing.

The Parents as Teachers model is designed to serve families throughout pregnancy through kindergarten entry. Families can enroll at any point along this continuum. Curriculum materials provide resources to continue services through the kindergarten year if an affiliate chooses to do so.

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Targeted outcomes

The Parents as Teachers model aims to (1) increase parent knowledge of early childhood development and improve parenting practices, (2) provide early detection of developmental delays and health issues, (3) prevent child abuse and neglect, and (4) increase children’s school readiness and school success.
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Model services

The Parents as Teachers model has four components that all affiliates are required to provide.

(1) One-on-one home (or personal) visits, during which the home visitor (referred to as a parent educator) visits the family in its home or a mutually agreeable alternative location. The parent educator delivers the majority of visits in the home. The Parents as Teachers model refers to some visits as “personal” visits because they can take place in environments other than the home when it is unsafe or impossible to have visits in the home. For example, some families may be homeless or have unstable housing, may be experiencing intimate partner violence, or may have infants in the neonatal intensive care unit. To be receptive to these families’ needs, home visits can occur in transitional housing shelters, hospitals, or in a safe location outside of the home.

(2) Group connections, which are planned events, such as family activities, ongoing parenting groups, or presentations, facilitated by a parent educator to share information about parenting and child development. Group connections are also designed to encourage families to share common experiences and to foster peer learning.

(3) Health, hearing, vision, and developmental screenings for children.

(4) Linkages and connections for families to needed resources.

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Model intensity and length

The Parents as Teachers model requires that affiliates offer a minimum of 12 home visits annually to families with one or no high-needs characteristics. Affiliates must offer a minimum of 24 home visits annually to families with two or more high-needs characteristics. Home visits last a minimum of 60 minutes.

The Parents as Teachers model requires that affiliates offer families at least 12 group connections (or meetings) annually.

Additionally, the affiliates are required to screen children for developmental, health, hearing, and vision problems each year.

Parents as Teachers affiliates must plan to offer services to enrolled families for at least two years. Affiliates may choose to focus services primarily on pregnant women and families with children from birth through age 3; others may offer services from pregnancy through kindergarten.

In some cases, visit frequency may be gradually decreased as the family transitions out of the Parents as Teachers program because of changing needs. For families transitioning out of Parents as Teachers, parent educators develop a transition plan to discuss the resources, supports, and services that are available to the family.

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Adaptations and enhancements

Parents as Teachers permits affiliates to offer additional strategies (beyond the four core model components) or to make model adaptations that may be needed to best address families’ needs at the local level. For example, implementation may be modified to be culturally responsive, directed to special populations, or offered in conjunction with other early childhood programs as determined by community need.

Adaptations of the Parents as Teachers model are available for highly rural and/or indigenous populations such as aboriginal populations in Australia and Canada, and numerous American Indian tribes.

Examples of adaptations include:

  • Approaches that honor family and community values
  • People who are included in the visits
  • Addressing needs of low-literate or illiterate parents

Examples of model elements that can be adapted include:

  • Elements of training
  • Materials used during visits to encourage parent–child interactions (for example, use of materials in the home to create toys and games)
  • Pace of parenting education
  • Extent to which verbal and non-verbal communication strategies are used

In New Zealand, the Ministry of Social Development’s Family and Community Services adapted Parents as Teachers into a program known in New Zealand as Parents as First Teachers (PAFT)*. The ministry contracted with community organizations to implement PAFT and managed, coordinated, and monitored the program. When developing the model, PAFT (New Zealand) negotiated with the Parents as Teachers National Center in the United States to adapt the Parents as Teachers model to meet the needs of New Zealand families, including Māori and Pasifika families, indigenous populations of New Zealand and the Pacific Island nations. Families with children from birth to age 3 who were at risk of poor educational outcomes were served by PAFT (New Zealand) through home visits, developmental screenings, linkages to other community services, and group meetings. PAFT (New Zealand) used two curricula: the Parents as Teachers’ Born to Learn curriculum and the Āhuru Mōwai curriculum. The latter was developed for PAFT (New Zealand) and was based on Māori traditional beliefs and child-rearing practices. PAFT (New Zealand) materials were available in English, Māori, and seven Pasifika languages.

Another adaptation of Parents as Teachers, called Baby Family and Child Education (Baby FACE), integrates Native language and culture into Parents as Teachers services for high-needs American Indian families from pregnancy through kindergarten. Baby FACE is the home visiting component of FACE, which is an early childhood family literacy model designed for American Indian families. In addition to home visits every one to two weeks, Baby FACE services include routine health and developmental screenings, monthly parent group meetings, and referrals to needed services. Baby FACE has been implemented in several reservations throughout the continental United States. Parent educators, typically members of the tribal community, must have a high school diploma or general equivalency degree (GED), and be actively working toward obtaining an associate’s degree in child development. Baby FACE uses the Parents as Teachers curriculum, adapted to each community’s culture.

*As of 2016, implementation support is no longer available for PAFT (New Zealand).

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Organizational requirements

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Staffing requirements

Parents as Teachers model affiliates have two primary staff positions: (1) certified parent educators who provide home visiting services and (2) their affiliate supervisors.

The Parents as Teachers model also recommends that the affiliate identify staff to serve as the data entry specialist and provide administrative support to the parent educators and supervisors.

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