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Parents as Teachers (PAT)

Health Factors: Education
Decision Makers: Community Members Local Government State Government Grantmakers Public Health Professionals & Advocates
Evidence Rating: Some Evidence
Population Reach: 1-9% of WI's population
Impact on Disparities: Likely to decrease disparities

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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 (RAND-Karoly 2005). Educators visit parents’ homes to teach them about early childhood development and promote effective parenting strategies (SAMHSA-NREPP). The program also includes developmental screenings of children, parent group meetings, and a resource network that links families with community resources (RAND-Karoly 2005).

Expected Beneficial Outcomes

Improved cognitive skills
Increased school readiness
Improved child development
Improved parenting
Increased health literacy

Evidence of Effectiveness

There is some evidence that Parents as Teachers (PAT) improves cognitive skills and school readiness among children from families with low incomes (PPNSAMHSA-NREPP, Welsh 2014, YG-PAT). PAT can also have positive effects on child development (Avellar 2013). Additional evidence is needed to confirm effects.

PAT can increase children’s cognitive skills in some circumstances, especially among families with lower incomes (PPN). 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 services (Welsh 2014). PAT can also increase children’s school readiness (SAMHSA-NREPPPPN), 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 outcomes (Zigler 2008).

Implementing PAT via parent educators who have received empowerment training can improve maternal health literacy (Carroll 2015). Overall, however, PAT has not demonstrated effects on participants’ health care use or coverage (Avellar 2013).

Training for PAT parent educators costs $700 to $800 (PAT). After start-up expenses, the PAT program cost approximately $2,500 per family served in 2010 for those receiving twice-monthly visits (SAMHSA-NREPP). Costs may vary by program intensity.


United States

There are Parents as Teachers (PAT) affiliates in all 50 states and Washington DC, as well as Australia, Canada, Germany, New Zealand, Switzerland, and the United Kingdom (PAT). PAT has offices in 24 states and offers training around the nation (US DHHS ACF-PAT).

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 model (OPRE-Michalopoulos 2015).


PAT is offered in 22 locations in Wisconsin (PAT).

Implementation Resources

PAT - Parents as Teachers (PAT). Accessed on June 6, 2016

Citations - Description

RAND-Karoly 2005 - Karoly LA, Kilburn MR, Cannon JS. Early childhood interventions: Proven results, future promise. Santa Monica: RAND Corporation; 2005: Monograph Report 341. Accessed on September 28, 2017
SAMHSA-NREPP - SAMHSA's National Registry of Evidence-based Programs and Practices (NREPP). Accessed on June 6, 2018

Citations - Evidence

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. Accessed on June 14, 2016
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. Accessed on June 14, 2016
PAT - Parents as Teachers (PAT). Accessed on June 6, 2016
PPN - Promising Practices Network (PPN). On children, families and communities. Accessed on October 17, 2018
SAMHSA-NREPP - SAMHSA's National Registry of Evidence-based Programs and Practices (NREPP). Accessed on June 6, 2018
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. Accessed on June 14, 2016
YG-PAT - (YG), Interagency Working Group on Youth Programs (IWGYP). Parents as Teachers (PAT). Accessed on June 6, 2016
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. Accessed on June 6, 2016

Citations - Implementation

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, DC: US Department of Health and Human Services (US DHHS), Office of Planning, Research and Evaluation (OPRE), Administration for Children and Families (ACF); 2015. Accessed on March 2, 2017
PAT - Parents as Teachers (PAT). Accessed on June 6, 2016
US DHHS ACF-PAT - US Department of Health & Human Services (US DHHS), Administration for Children & Families (ACF). Home visiting evidence of effectiveness: Implementing Parents as Teachers (PAT) program model overview. Accessed on March 3, 2017

Page Last Updated

June 14, 2016

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