Skip over navigation

Journal Issue: Home Visiting: Recent Program Evaluations Volume 9 Number 1 Spring/Summer 1999

The Parents as Teachers Program: Results from Two Demonstrations
Authors: Mary M. Wagner Serena L. Clayton

Endnotes

  1. Additional Parents as Teachers program goals, as stated in Appendix B in this journal issue, are to (1) empower parents to give children the best start in life, (2) develop home-school community partnerships on behalf of children, and (3) prevent and reduce child abuse.
  2. Parents as Teachers National Center. Parents as Teachers National Center receives grants to pilot Neuroscience Project with high needs families in Chicago. News release. St. Louis, MO: Parents as Teachers National Center, 1997.
  3. Winter, M., and Rouse, J.M. Parents as Teachers: Nurturing literacy in the very young. Zero to Three (September 1991) 12:80–83.
  4. Montgomery, D.L., and Duenas, I.E. Parents as Teachers cost analysis-Phase I report. Palo Alto, CA: American Institutes of Research, 1997. The David and Lucile Packard Foundation commissioned a cost study as part of the Northern California Parents as Teachers Demonstration. The average monthly cost of serving a family was determined to be $170 in 1996 dollars. Given the average participation length of 30.1 months, the average cost per family was determined to be $5,117. Those that persisted in the program through the children's third birthdays averaged 35.4 months of participation, for an average per-family cost of $6,018. Dropouts from the program averaged 17.8 months of participation, for an average per-family cost of $3,026.
  5. For example, the Prenatal/Early Infancy Project. See Olds, D.L., Henderson, C.R. Jr., Tatelbaum, R., and Chamberlin, R. Improving the life-course development of socially disadvantaged mothers: A randomized trial of nurse home visitation. American Journal of Public Health (1988) 11:1436–44. Costs in 1996 dollars for this program as it operated in Elmira, New York, were estimated to be approximately $6,000 to serve a family through the child's second birthday. See Karoly, L.A., Greenwood, P.W., Everingham, S.S., et al. Investing in our children. What we know and don't know about the costs and benefits of early childhood interventions. Santa Monica, CA: RAND Corporation, 1998.
  6. For example, in the Perry Preschool Program, which was estimated to cost $12,000 per child in 1996 dollars, children were provided center-based services when they were three or four years old, through kindergarten entry. Barnett, W.S. Benefit-cost analysis of preschool education: Findings from a 25-year follow-up. American Journal of Orthopsychiatry (1993) 63:500–08.
  7. In the legislation (AB 3646), funding for the PAT grant program was made contingent on the passage of and sufficient fiscal appropriations for a related piece of legislation. The contingencies were not met, no state funds were allocated for implementation of PAT in California, and the authorizing legislation expired in 1996.
  8. Because these two demonstrations focused entirely on Latino and teen-parented families, findings cannot be assumed to be representative of the typically more diverse families PAT usually serves.
  9. Developing a long-term evaluation strategy for the Parents as Teachers National Center and program: A report on an invitational meeting held at The Ewing Marion Kauffman Foundation in Kansas City, Missouri on April 4–5, 1994 and funded by The Ewing Marion Kauffman and David and Lucile Packard Foundations, The Pew Charitable Trusts, and The National Center. Unpublished.
  10. Miller, S. A select review of past and current evaluations of the Parents as Teachers program. St. Louis, MO: Parents as Teachers National Center, 1995.
  11. See, for example, Pfannenstiel, J.C., and Seltzer, D.A. New Parents as Teachers: Evaluation of an early parent education program. Early Childhood Research Quarterly (1989) 4:1–18; Pfannenstiel, J.C., Lambson, T., and Yarnell, V. The Parents as Teachers program: Longitudinal follow-up to the second wave study. Overland Park, KS: Research and Training Associates, 1995; Wagner, M. Evaluation of the National City Parents as Teachers program: Summary of findings. Unpublished, 1993; Coates, D. Early childhood evaluation. A report to the Parkway Board of Education. St. Louis, MO: Parkway School District, 1994; and Pfannenstiel, J.C. Kansas Parents as Teachers program. Overland Park, KS: Research and Training Associates, 1997. Appendix B in this journal issue contains additional descriptions of these studies and their findings.
  12. See, for example, Drazen, S.M., and Haust, M. Increasing children's readiness for school by a parental education program. Ithaca, NY: Cornell University, 1994; and Davis, J.E., Russell, R.L., and Ketchum, P. Evaluation report: Parents as Teachers program. Newark, DE: Parent Early Education Center, University of Delaware, 1991.
  13. Weiss, H. Home visits: Necessary but not sufficient. The Future of Children (Winter 1993) 3,3:113–28.
  14. See note no. 11, Pfannenstiel and Seltzer. See also Owen, M.T., and Mulvihill, B.A. Benefits of a parent education and support program in the first three years. Family Relations (1994) 43:206–12; and Wheeler, H. 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, 1994.
  15. Collaborating school districts included: Alisal Union Elementary, Chualar Elementary, Gonzalez Union Elementary, North Monterey County Unified, Salinas City Elementary, Salinas Union High School, Santa Rita Union Elementary, Soledad Union Elementary, and Spreckels Union Elementary.
  16. Wagner, M., and McElroy, M. Home, the first classroom: A pilot evaluation of the Northern California Parents as Teachers project. Menlo Park, CA: SRI International, 1992.
  17. Over the 10-year course of the pilot and demonstration phases, Salinas Valley PAT services and evaluation were supported by grants from The Cowell Foundation, The Monterey County Community Foundation, The Harden Foundation, The David and Lucile Packard Foundation, and The Ford Foundation, as well as by in-kind contributions from the participating school districts and the Monterey County Office of Education.
  18. Children Now. California county data book, 1995. Oakland, CA: Children Now, 1996.
  19. Wagner, M., Clayton, S., Gerlach-Downie, S., and McElroy, M. An evaluation of the Northern California Parents as Teachers Demonstration: Review draft. Menlo Park, CA: SRI International, 1997.
  20. Data regarding the length of home visits come from videotapes of a sample of 75 home visits to 21 families in the Salinas Valley PAT Demonstration. Visits were videotaped as part of a qualitative study funded by The Ford Foundation. Gerlach-Downie, S., and Hebbeler, K. Parent education: How does it work? Qualitative assessment of the Parents as Teachers model of parenting education. Menlo Park, CA: SRI International, 1997.
  21. The sample of children for whom BSID assessments were conducted was a volunteer sample. At the three-year-old assessment, 91 control group children and 131 participant group children were assessed. BSID-assessed children were more likely to be white and to have better educated mothers and fathers who were working than the full sample. Further, control group mothers of children with BSID assessments were significantly more likely than PAT group families to have some postsecondary education (35% versus 19%, p< .01). To the extent that maternal education influences child development, the higher maternal education of the control group may have given those children an advantage relative to participants. BSID sample characteristics are reported fully in note no. 19, Wagner, Clayton, Gerlach-Downie, and McElroy.
  22. Funders of the Teen PAT Demonstration included the California Office of Child Abuse Prevention within the California Department of Social Services, the California Department of Health Services' Maternal and Child Health Branch, The David and Lucile Packard Foundation, and the Stuart Foundations.
  23. Wagner, M., Cameto, R., and Gerlach-Downie, S. Intervention in support of adolescent parents and their children: A final report on the Teen Parents as Teachers Demonstration. Menlo Park, CA: SRI International, 1996.
  24. Although PAT services normally are extended to families through children's third birthdays, and case management services are offered to teens through age 18, the funding for the services component of the demonstration from the California Office of Child Abuse Prevention was sufficient to serve families only through children's second birthdays. Thus, the findings reported here may not reflect the impacts that the full-term services would have achieved for parents or children.
  25. In the Teen PAT study, changes in maternal life course also were assessed (for example, changes in maternal enrollment in school, welfare receipt, education, and marital status; and repeat pregnancies and births). These results are summarized in Appendix B in this journal issue but are not reported here because they are outcomes that were hypothesized to occur as a result of the case management services afforded the teen mothers, rather than the PAT home visiting services. Generally, the PAT, case management, and combined PAT-plus-case-management groups showed few significant benefits over the control group in terms of maternal life course outcome.
  26. MacPhee, D. Knowledge of Infant Development Inventory. Unpublished manuscript, University of North Carolina, Chapel Hill, 1989. Available from David L. MacPhee, Ph.D., Human Development and Family Studies, Colorado State University, Fort Collins, CO 80523.
  27. Gibaud-Wallston, J., and Wandersman, L.P. Development and utility of the Parenting Sense of Competence Scale. Paper presented at the meeting of the American Psychological Association. Toronto, Canada. 1978.
  28. Caldwell, B.M., and Bradley, R.H. Home Observation and Measurement of the Environment. Little Rock, AK: University of Arkansas at Little Rock, 1984.
  29. Alpern, G., Boll, T., and Shearer, M. Developmental Profile II. Los Angeles: Western Psychological Services, 1986.
  30. The Psychological Corporation. Bayley Scales of Infant Development. Second ed. San Antonio, TX: The Psychological Corporation, 1993.
  31. Dunn, L.M., and Dunn, L.M. Peabody Picture Vocabulary Test—Revised. Circle Pines, MN: American Guidance Service, 1981.
  32. Results from the two evaluations were analyzed and reported in several ways. T tests were used to compare the experimental and control groups. Results are reported in Tables 2 and 3. The tables highlight findings in which the T tests suggested that true differences between the groups existed at a probability of p< .05. Because p values depend on sample size, small groups may make it hard to achieve significant p values, even when differences exist between experimental and control groups. Effect size is a statement of the magnitude of the difference between two groups and is not dependent upon group size. Effect sizes often are reported, therefore, when studies have small samples to help identify where meaningful effects may have occurred. These effects are reported in Tables 2, 3, 6, and 7. The following can serve as a gauge of the importance of any particular effect: For the parent outcomes and the child development outcomes, an effect size of 0.1 to 0.3 is considered small, 0.31 to 0.5 is considered moderate, and greater than 0.5 is considered large. For the child health and health care outcomes, an effect size of 0.2 to 0.49 is considered small, 0.5 to 1.0 is considered moderate, and greater than 1.0 is considered large. (The importance of the effects varies as a function of whether the factor being tested is a dichotomous, that is, a "yes" or "no" variable, or an ordinal variable, such as a test score from a scale of possible scores.) Multivariate analyses (ordinary least-squares regressions, or logistic regressions) were also used to control for individual, family, and household characteristic differences between the participant and control groups that might be related to observed outcomes, and to attempt to quantify the magnitude of change that a single unit of the intervention could be expected to produce. For example, analyses were conducted to suggest how many home visits would be needed to produce one month of developmental advantage for children.
  33. Multivariate analyses confirmed these effects, finding no significant relationship between interventions and parent outcomes, controlling for individual and household characteristics.
  34. An "opened case" of child abuse or neglect is a report of abuse or neglect for which there is enough confirming evidence to support an official case file and a complete investigation by child protective services. Not all opened cases are subsequently substantiated in the investigations. Given the considerable length of time that cases often remain open, it was not possible to determine substantiation during the demonstration period.
  35. A similar analysis of ethnic group differences was not conducted for the Teen PAT Demonstration because the ethnicity of mothers in that demonstration project was seriously confounded with the local programs that served them. For example, virtually all African-American teens were recruited from a single program; a majority of Caucasian teens were recruited from one other program. This made it impossible to distinguish the influence of individual site differences from that of ethnicity.
  36. A series of multivariate analyses were conducted that statistically controlled for the effects of the mother's education, age, primary language, and self-reported experience with infants at enrollment; household income; and the child's gender to determine whether the dissolution of marriage during the demonstration project had an effect on each of the outcomes for children. See note no. 32 for detailed descriptions of these analyses and results.
  37. Parents as Teachers National Center. Parents as Teachers birth to three. Program planning and implementation guide. Rev. ed. St. Louis, MO: PATNC, 1992. It is important to note that PATNC recommends that 17 specific lessons be delivered, not just that 17 nonspecific visits occur. However, these analyses did not take visit content into account, but rather focused solely on whether parents received 17 visits.
  38. In the Salinas Valley PAT Demonstration, these included the mother's ethnicity, primary language, education, age, and reported level of knowledge of infants; the child's gender and child care arrangement; household income; and whether the mother had been divorced since enrollment. In the Teen PAT Demonstration, control factors included the mother's ethnicity, age, high school completion status, and pregnancy status at enrollment; the program in which the family was enrolled; whether the mother was currently enrolled in school or job training or was working; and whether the mother had been pregnant again since enrollment.
  39. See, for example, Hauser-Cram, P., Pierson, D.E., Walker, D.K., and Tivnan, T. Early education in the public schools: Lessons from a comprehensive birth-to-kindergarten program. San Francisco: Jossey-Bass Publishers, 1991; Powell, C., and Grantham-McGregor, S. Home visiting of varying frequency and child development. Pediatrics (1989) 84:157–64. See also note no. 11, Pfannenstiel and Seltzer and Pfannenstiel, Lambson, and Yarnell.
  40. See, for example, Love, J.M., Nauta, M.J., Coelen, C.G., et al. National Home Start evaluation: Final report. Findings and implications. Report by High/Scope and Abt Associates to the Department of Health, Education, and Welfare. Washington, DC: U.S. Government Printing Office, 1976; Burkett, C.W. Effects of frequency of home visits on achievement of preschool students in a home-based early childhood education program. Journal of Educational Research (1982) 1:41–44; and Gray, S.W., Ramsey, B.K., and Klaus, R.A. The Early Training Project. In As the twig is bent . . . lasting effects of preschool programs. Consortium for Longitudinal Studies, ed. Hillsdale, NJ: Erlbaum, 1983.
  41. Gomby, D.S., Larner, M.B., Stevenson, C.S., et al. Long-term outcomes of early childhood programs: Analysis and recommendations. The Future of Children (Winter 1995) 5,3:6–24, p. 12.
  42. Olds, D.L., and Kitzman, H. Review of research on home visiting for pregnant women and parents of young children. The Future of Children (Winter 1993) 3,3:53–92.
  43. Barnes, H.V., Goodson, B.D., and Layzer, J.I. National evaluation of family support programs: Review of research on supportive interventions for children and families. Vol. 1. Cambridge, MA: Abt Associates, 1995, p. 3–17; see also Scarr, S., and McCartney, J. Far from home: An experimental evaluation of the Mother-Child Home Program in Bermuda. Child Development (1988) 59:248–53.
  44. The national multisite study is being funded by a public-private partnership that includes the Office of Educational Research and Improvement of the U.S. Department of Education, The Robert Wood Johnson Foundation, and The Smith Richardson Foundation. The Carnegie Corporation of New York provided funding for the study design. The evaluation is being conducted by SRI International in collaboration with the Parents as Teachers National Center.