Parents as Teachers (PAT)

Evidence Rating  
Evidence rating: Some Evidence

Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.

Health Factors  
Date last updated

Parents as Teachers (PAT) is a voluntary early childhood parent education and family support program that begins at or before birth and continues until kindergarten. Educators visit parents’ homes to teach them about early childhood development and promote effective parenting strategies. The program also includes developmental screenings of children, parent group meetings, and a resource network that links families with community resources1.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Improved cognitive skills

  • Increased school readiness

  • Improved child development

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Improved parenting

  • Increased health literacy

What does the research say about effectiveness?

There is some evidence that Parents as Teachers (PAT) improves cognitive skills and school readiness among children from families with low incomes2, 3, 4. PAT can also have positive effects on child development5. Additional evidence is needed to confirm effects.

PAT can increase children’s cognitive skills in some circumstances, especially among families with lower incomes4. For example, children from families with low incomes who participate in PAT show higher cognitive development scores than non-participating peers at 24 months old. Some studies suggest significant gains in child development for children in certain groups, such as those in Latino families who primarily speak Spanish, or under specific circumstances, for example, families who receive intensive services3. PAT can also increase children’s school readiness4, both by improving parenting skills and helping parents enroll their children in preschool. By increasing school readiness for children in low income families, PAT can help reduce disparities in academic outcomes6.

Implementing PAT via parent educators who have received empowerment training can improve maternal health literacy7. Overall, however, PAT has not demonstrated effects on participants’ health care use or coverage5.

Training for PAT parent educators costs $700 to $8008. Overall costs may vary by program intensity.

How could this strategy impact health disparities? This strategy is rated likely to decrease disparities.
Implementation Examples

There are Parents as Teachers (PAT) affiliates in all 50 states and Washington, D.C., as well as Australia, Canada, Germany, New Zealand, Switzerland, and the United Kingdom8. PAT has offices in 24 states and offers training around the nation9.

PAT is an approved model for federal home visiting programs. Funds from the federal Maternal, Infant, and Early Childhood Home Visiting Program are being used in 29 states to implement or expand use of the PAT model10.

Implementation Resources

PAT - Parents as Teachers (PAT).


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1 RAND-Karoly 2005 - Karoly LA, Kilburn MR, Cannon JS. Early childhood interventions: Proven results, future promise. Santa Monica: RAND Corporation; 2005: Monograph Report 341.

2 YG-PAT - (YG), Interagency Working Group on Youth Programs (IWGYP). Parents as Teachers (PAT).

3 Welsh 2014 - Welsh JA, Bierman KL, Mathis ET. Parenting programs that promote school readiness. In Boivin M, Bierman KL, eds. Promoting School Readiness and Early Learning: The Implications of Developmental Research for Practice. New York: Guilford Press; 2014:253-278.

4 PPN - Promising Practices Network (PPN). On children, families and communities.

5 Avellar 2013 - Avellar SA, Supplee LH. Effectiveness of home visiting in improving child health and reducing child maltreatment. Pediatrics. 2013;132(Suppl 2):S90–S99.

6 Zigler 2008 - Zigler E, Pfannenstiel JC, Seitz V. The Parents as Teachers program and school success: A replication and extension. Journal of Primary Prevention. 2008;29(2):103-20.

7 Carroll 2015 - Carroll LN, Smith SA, Thomson NR. Parents as Teachers Health Literacy Demonstration project: Integrating an empowerment model of health literacy promotion into home-based parent education. Health Promotion Practice. 2015;16(2):282–290.

8 PAT - Parents as Teachers (PAT).

9 US DHHS ACF-PAT - U.S. Department of Health and Human Services (U.S. DHHS), Administration for Children and Families (ACF). Home visiting evidence of effectiveness: Implementing Parents as Teachers (PAT) program model overview.

10 OPRE-Michalopoulos 2015 - Michalopoulos C, Lee H, Duggan A, et al. The Mother and Infant Home Visiting Program Evaluation: Early findings on the Maternal, Infant, and Early Childhood Home Visiting Program: A report to Congress. Washington, D.C.: U.S. Department of Health and Human Services (U.S. DHHS), Office of Planning, Research and Evaluation (OPRE), Administration for Children and Families (ACF); 2015.