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Parents as First Teachers

Evidence rating
Cost rating
Review: Foundations for Life, July 2016

Parents as First Teachers (PAFT – also referred to as Parents as Teachers) is for parents with a child aged three or under, typically living in a disadvantaged community.

The aim is to develop family resilience and promote positive parenting behaviours that will persist after the family’s engagement in the programme has ended.

The frequency and duration of PAFT visits is determined by each family’s needs. During the visits, practitioners encourage parents to enhance their role as their child’s first teacher. Practitioners partner with families to share age-appropriate child development and neuroscience information, helping parents to observe their child’s developmental milestones.

Practitioners also facilitate parent-child interaction through age-appropriate talk, play and reading activities. They help parents reflect on their parenting, and jointly develop strategies for addressing developmental and behavioural concerns. Family wellbeing is also addressed during the visits.

EIF Programme Assessment

Evidence rating

Parents as First Teachers has preliminary evidence of improving a child outcome, but we cannot be confident that the programme caused the improvement.

What does the evidence rating mean?

Level 2 indicates that the programme has evidence of improving a child outcome from a study involving at least 20 participants, representing 60% of the sample, using validated instruments. 

This programme does not receive a rating of 3 as its best evidence is not from a rigorously conducted RCT or QED evaluation.

What does the plus mean?

The plus rating indicates that a programme’s best available evidence is based on an evaluation that is more rigorous than a level 2 standard but does not meet the criteria for level 3. 

Cost rating

A rating of 4 indicates that a programme has a medium-high cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of £1,000–£2,000.

Child outcomes

According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:

Enhancing school achievement & employment

Improved language - based on study 1

Preventing crime, violence and antisocial behaviour

Improved behaviour - based on study 1

Parents as First Teachers

Key programme characteristics

Who is it for?

The best available evidence for this programme relates to the following age-groups:

  • Infants
  • Toddlers

How is it delivered?

The best available evidence for this programme relates to implementation through these delivery models:

  • Home visiting

Where is it delivered?

The best available evidence for this programme relates to its implementation in these settings:

  • Home
  • Children's centre or early-years setting

How is it targeted?

The best available evidence for this programme relates to its implementation as:

  • Targeted selective

Where has it been implemented?

United Kingdom, United States

UK provision

This programme has been implemented in the UK.

UK evaluation

This programme’s best evidence does not include evaluation conducted in the UK.

Parents as First Teachers

About the programme

What happens during delivery?

How is it delivered?
  • PAFT is delivered to parents in their home on a weekly, fortnightly, or monthly basis depending on the family’s level of need.
  • The visits begin at the time of enrolment and then continue until the child’s third birthday.
  • The typical length of a visit is one hour, although it can last up to an hour-and-a-half if the parent has more than one child.
What happens during the intervention?
  • During the home visits, practitioners guide parents in being their child’s ‘first teacher’ by demonstrating strategies that promote children’s development (including language development, social-emotional development, sensory-motor development and intellectual development).
  • These strategies include shared reading activities and play sessions that encourage children’s intellectual development. Practitioners first model the activity and then provide feedback to parents as they practise it with their child.
  • Parents also learn strategies for discouraging unwanted child behaviour and promoting their children’s self regulation.

What are the implementation requirements?

Who can deliver it?
  • Parents as First Teachers is delivered by one practitioner, qualified to QCF-4/5 level.
What are the training requirements?
  • The practitioner receives 35 hours of programme training. Booster training of practitioners is recommended.
How are the practitioners supervised?
  • It is recommended that practitioners are supervised by one host-agency supervisor qualified to QCF-6 level, also with 35 hours of programme training.
What are the systems for maintaining fidelity?
  • Newly trained practitioners and their supervisors are invited to a follow-up training day after they have implemented the programme for six months.
  • Agencies delivering PAFT are also required to complete an annual report demonstrating that practitioners are delivering the programme with fidelity.
Is there a licensing requirement?

Yes, there is a licence required to run this programme.

How does it work? (Theory of Change)

How does it work?
  • PAFT assumes that a warm and trusting relationship with a supportive practitioner will help parents feel less isolated and increase their sense of confidence.
  • Within this relationship, parents are more able to understand and accept relevant child development knowledge.
  • More confident parents will, in turn, be more likely to access community resources and take an active role in their children’s education.
  • Confident parents will also be more willing to attend parenting groups where they will make friends with other parents and share effective parenting strategies.
  • In the short term, parents will have increased access to community resources and feel less isolated.
  • In the longer term, parents will be better able to support their children’s development.
  • Ultimately, children will have improved physical, emotional and intellectual development.

Contact details

Pam Holtom
Implementations contact

PAFT UK (General Enquiries)

Parents as First Teachers

About the evidence

  • PAFT’s most rigorous evaluation includes one RCT conducted in Switzerland.

Parents as First Teachers has evidence from several RCTs demonstrating mixed and sometimes contradictory findings. The extent to which evaluations of PAFT are identifying positive effects do however appear to be increasing over time, with a recent evaluation of a Swiss adaptation confirming consistent improvements in children's language development. Hence, 2+ rating is provided to acknowledge the success of the most recent adaptation. Two other evaluations demonstrating mixed findings (Wagner et al., 1999; Wager et al., 2002) are included in the list of ‘other references’.

Study 1

Citation: Neuhauser et al (2015)
Design: RCT
Country: Switzerland
Sample: 252 families with an infant child living in disadvantaged communities in Switzerland
Timing: -
Child outcomes: Improved language
Improved behaviour
Other outcomes: None measured

Neuhauser, A., Ramseier, E., Schaub, S., Burkhardt, S.C.A., Templer, F. and Lanfranchi, A. (2015). Hard to reach families – A methodological approach to early recognition, recruitment and randomization in an intervention study. Mental Health and Prevention,

Available at

Other studies

The following studies were identified for this programme but did not count towards the programme's overall evidence rating. A programme receives the same rating as its most robust study or studies.

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.

Drotar, D., Robins, 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, 643-649.

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.

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.

Published March 2017   |   Last updated April 2017