Parents as First Teachers (PAFT) is a home visiting intervention for disadvantaged families with a child aged 3 and younger. It is delivered by practitioners to individual families in their home on a weekly, fortnightly, or monthly basis depending on the family’s level of need. The intervention typically begins during the child’s first year and then continues until the child’s third birthday. During the visits, parents learn strategies for supporting their child’s early development and school readiness.
The information above is as offered/supported by the intervention provider.
0 to 3 years old
Home visiting
Child outcomes:
UK available
UK tested
Parents as First Teachers (PAFT – also referred to as Parents as Teachers) is a home visiting intervention for disadvantaged families with a child between 0 and 3 years old.
PAFT is delivered by a practitioner who visits the parent and child in their home on a weekly, fortnightly or monthly basis, depending upon the family’s needs. PAFT typically begins during the child’s first year and then continues until the child’s third birthday. Home visits are often augmented by group sessions involving other families enrolled in the intervention, as well as support for parents in networking and signposting to other services.
During the initial home visits, practitioners form a partnership with the parent to support them in their role as their child’s first teacher. During subsequent sessions, practitioners share age-appropriate information about the child’s development and are encouraged to recognise their child’s developmental milestones. The practitioner also carries out a general health and development screening at least annually.
Practitioners also facilitate parent–child interaction through age-appropriate talk, play and reading activities. Additionally, practitioners work with parents to develop strategies to address developmental and behavioural concerns, as well as concerns about family wellbeing. An ultimate intervention aim is to develop family resilience and promote positive parenting behaviours which will persist after the family’s engagement with the intervention has ended, along with improving the home learning environment.
Children aged 3 years old and younger
Families living in disadvantaged communities.
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
School readiness skills (including vocabulary and early self-regulation) during the preschool years are strongly associated with children’s later success in primary and secondary school.
Science-based assumption
An enriching home learning environment during the early years is known to support young children’s school readiness.
Science-based assumption
Low family income negatively impacts parents’ ability to provide an enriching home learning environment.
Intervention
Parents with a child between 0 and 3 years receive home visits from an early years practitioner
Books, toys, and learning activities are used to support parents’ role as their child’s first teacher
Advice is tailored to parents’ specific concerns about their child’s needs and development
Families are signposted to community resources as needed.
Short-term
Parents are better able to support their child’s school readiness
Parents are better able to understand their child’s early developmental and learning needs.
Medium-term
Improved parent–child interaction
Improved school readiness.
Long-term
Improved school achievement in secondary and primary school
Reduced income-related learning gaps
Reduced risk of behavioural and mental health problems as children develop.
PAFT is for economically disadvantaged families eligible for income or housing benefits.
The practitioner who delivers this intervention is a practitioner with experience in the early years trained in the PAFT model.
The practitioner receives 35 hours of intervention training. Booster training of practitioners is recommended.
It is recommended that practitioners are supervised by one host-agency supervisor with 35 hours of intervention training.
Organisation: PAFT UK
Email address: info@parentsasfirstteachers.org.uk
*Please note that this information may not be up to date. In this case, please visit the listed intervention website for up to date contact details.
PAFT’s most rigorous evidence comes from one RCT conducted in Switzerland consistent with Foundations’ Level 3 evidence strength criteria. Evidence from at least one Level 3 study, along with evidence from other studies rated 2 or better qualifies PAFT for a 3+ rating.
This study observed statistically significant improvements in PAFT children’s early language development, behaviour, and developmental milestones in comparison to children not receiving the intervention.
PAFT also has evidence from an RCT conducted in the United States, consistent with Foundations’ L2+ evidence strength criteria. This study observed statistically significant improvements in PAFT children’s mastery motivation relative to children not exposed to the intervention.
PAFT additionally has evidence from a QED conducted in the United States consistent with Foundations’ Level 2 criteria. This study observed a reduction in the number of substantiated cases of child maltreatment amongst PAFT families compared to a similar group of families who did not.
PAFT can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome.
Improved child self-help skills
Immediately after intervention
Improvement index
Interpretation
Study
Improved developmental milestones
Immediately after intervention
Improvement index
Interpretation
Study
Improved receptive language
12-month follow-up during the intervention
Improvement index
Interpretation
Study
Improved expressive language
Immediately after intervention
Improvement index
Interpretation
Study
Improved vocabulary
Immediately after intervention
Improvement index
Interpretation
Study
Improved problem behaviour
Immediately after intervention
Improvement index
Interpretation
Study
| Identified in search | 8 |
| Studies reviewed | 3 |
| Meeting the L2 threshold | 2 |
| Meeting the L3 threshold | 1 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 5 |
| Study design | RCT |
| Country | Switzerland |
| Sample characteristics | 248 at-risk families with a 2-month infant living in Zurich |
| Race, ethnicities, and nationalities |
|
| Population risk factors |
|
| Timing |
|
| Child outcomes | 12-month follow-up
24-month follow-up
36-month follow-up
|
| Other outcomes | 12-month follow-up
24-month follow-up
|
| Study rating | 3 |
| Citations | Study 1a: Neuhauser, A., Ramseier, E., Schaub, S., Burkhardt, S. C., Templer, F. & Lanfranchi, A. (2015) Hard to reach families: A methodological approach to early recognition, recruitment, and randomization in an intervention study. Mental Health & Prevention. 3 (3), 79–88. Study 1b: Lanfranchi, A., Neuhauser, A., Schaub, S. & Burkhardt, A. (2015) Preliminary findings from the SNSF study using the ‘PAT – Parents as Teachers’ programme. Findings presented at the Interkantonale Hochschule für Heilpädagogik, Zurich Switzerland, 5 June 2015. Study 1c: Neuhauser, A., Ramseier, E., Schaub, S., Burkhardt, S. C. & Lanfranchi, A. (2018) Mediating role of maternal sensitivity: Enhancing language development in at‐risk families. Infant Mental Health Journal. 39 (5), 522–536. Study 1d: Lanfanchi, A., Neuhaser, A. & Schaub, S. (2019) Effective early intervention in high-risk families: Evidence from the RCT-Zeppelin 0-3 with intervention ‘Parents as Teachers’. Findings presented at the ISSA conference, Leiden, NL, 19 June 2019. Study 1e: 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. |
| Study design | RCT |
| Country | United States |
| Sample characteristics | 459 families with infants between 0 and 9 months of age, living in disadvantaged communities in the vicinity of Cleveland, Ohio |
| Race, ethnicities, and nationalities |
|
| Population risk factors | 29% had incomes below the poverty line and 65% were assessed as having low socioeconomic status |
| Timing |
|
| Child outcomes | Improved task persistence (researcher assessed) |
| Other outcomes | None |
| Study rating | 2+ |
| Citations | 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. |
| Study design | QED |
| Country | United States |
| Sample characteristics | 4,560 socially high-risk families with a child between 0 and 4 years old living in the US state of Connecticut, and eligible for state-funded home visiting |
| Race, ethnicities, and nationalities | Not reported |
| Population risk factors |
|
| Timing | Child protection records between 1 January 2008 to 31 December 2013 |
| Child outcomes |
|
| Other outcomes | None |
| Study rating | 2 |
| Citations | Chaiyachati, B. H., Gaither, J. R., Hughes, M., Foley-Schain, K. & Leventhal, J. M. (2018) Preventing child maltreatment: Examination of an established statewide home-visiting program. Child Abuse & Neglect. 79, 476–484. |
The following studies were identified for this intervention but did not count towards the intervention’s overall evidence rating. An intervention receives the same rating as its most robust study or studies.
Cahill, A. G., Haire‐Joshu, D., Cade, W. T., Stein, R. I., Woolfolk, C. L., Moley, K. … & Klein, S. (2018) Weight control program and gestational weight gain in disadvantaged women with overweight or obesity: A randomized clinical trial. Obesity. 26 (3), 485–491. This reference refers to a randomised control trial, conducted in the USA.
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. This reference refers to a quasi-experimental design, conducted in the USA.
Jonson-Reid, M., Drake, B., Constantino, J. N., Tandon, M., Pons, L., Kohl, P. … & Auslander, W. (2018) A randomized trial of home visitation for CPS-involved families: The moderating impact of maternal depression and CPS history. Child Maltreatment. 23 (3), 281–293. This reference refers to a randomised control trial, conducted in the USA.
Wagner, M. M. & Clayton, S. L. (1999) The parents as teachers program: Results from two demonstrations. The Future of Children (Home Visiting Program Evaluation). 9, 91–115. This reference refers to a randomised control trial, conducted in the USA.
Wagner, M. M., Spiker, D. & Linn, M.I. (2002) The effectiveness of the parents as teachers program with low-income parents and children. Topics in Early Childhood Special Education. 22, 67–81. This reference refers to a randomised control trial, conducted in the USA.
Note on provider involvement: This provider has agreed to Foundations’ terms of reference (or the Early Intervention Foundation’s terms of reference), and the assessment has been conducted and published with the full cooperation of the intervention provider.
Note on provider involvement: This provider has agreed to Foundations’ terms of reference (or the Early Intervention Foundation's terms of reference), and the assessment has been conducted and published with the full cooperation of the intervention provider.
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing substance abuse: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing risky sexual behaviour & teen pregnancy: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing obesity and promoting healthy physical development: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
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