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ParentChild+

Evidence rating
3
Cost rating
4
Reviews: January 2019; November 2019

ParentChild+ – formerly known as Parent Child Home Programme (or PCHP) – is a home-visiting programme. It is a targeted-selective programme primarily targeted at low-income families with children between the ages of 2 and 3 years. It is delivered in the family home by home visitors. It aims to improve the home learning environment, the parent–child relationship and the language, literacy, cognitive skills and social-emotional development critical to school success.

The ParentChild+ model is based on twice-weekly home visits by trained home visitors (Early Learning Specialists). By delivering in the family home, ParentChild+ is able to reach families who are reluctant to access other services. The curriculum is designed on two cycles: each cycle involves a minimum of 23 weeks of visits (46 visits), so every family will receive at least 92 home visits over the course of the programme.

ParentChild+ Early Learning Specialists model positive parent–child interaction utilising age-appropriate books and educational toys, which remain with the family, aiming to transform the home learning environment and giving the parents tools to continue positive interaction with their children.

EIF Programme Assessment

Evidence rating
3

ParentChild+ has evidence of a short-term positive impact on child outcomes from at least one rigorous evaluation.

What does the evidence rating mean?

Level 3 indicates evidence of efficacy. This means the programme 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.

This programme does not receive a rating of 4 as it has not yet replicated its results in another rigorously conducted study, where at least one study indicates long-term impacts, and at least one uses measures independent of study participants. 

What does the plus mean?

The plus rating indicates that this programme has evidence from at least one level 3 study, along with evidence from other studies rated 2 or better.

Cost rating
4

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:

Supporting children's mental health and wellbeing

based on
Increase in turn-taking ability (measured using the Tower Task)
Improvement index: +18
This means we would expect the average participant in the comparison group who did not receive the intervention (ie, someone for whom 50% of their peers have better outcomes and 50% have worse outcomes), to improve to the point where they would have better outcomes than 68% and worse outcomes than 32% of their peers, if they had received the intervention.
Immediately after the intervention

Enhancing school achievement & employment

based on
5.3-point improvement on the Stanford-Binet Intelligence Scale
Immediately after the intervention
based on
4.53-point improvement on the Preschool Language Scale Fourth Edition
Improvement index: +14
This means we would expect the average participant in the comparison group who did not receive the intervention (ie, someone for whom 50% of their peers have better outcomes and 50% have worse outcomes), to improve to the point where they would have better outcomes than 64% and worse outcomes than 36% of their peers, if they had received the intervention.
Immediately after the intervention

Preventing crime, violence and antisocial behaviour

based on
66.4% decrease in likelihood of falling into the range for possible problem behaviours (measured using the Ages & Stages Questionnaires: Social-Emotional subscale)
Improvement index: +24
This means we would expect the average participant in the comparison group who did not receive the intervention (ie, someone for whom 50% of their peers have better outcomes and 50% have worse outcomes), to improve to the point where they would have better outcomes than 74% and worse outcomes than 26% of their peers, if they had received the intervention.
Immediately after the intervention
ParentChild+

Key programme characteristics

Who is it for?

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

  • 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

How is it targeted?

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

  • Targeted selective

Where has it been implemented?

Canada, Chile, England, Ireland, 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.

Spotlight sets

EIF does not currently include this programme within any Spotlight set.

ParentChild+

About the programme

What happens during delivery?

How is it delivered?
  • ParentChild+ is delivered in 92 sessions of half-an-hour duration each by one practitioner to individual families.
What happens during the intervention?
  • Each week home visitors provide the family with a high-quality book or educational toy that is a gift to the family and are often the first such items in the home.
  • Using the book or toy, the home visitor models reading, conversation, and play activities designed to stimulate parent–child interaction, develop language and literacy skills, and build school-readiness.

What are the implementation requirements?

Who can deliver it?
  • The practitioner who delivers this programme is an Early Learning Specialist (or Home Visitor) with QCF-3 level qualifications. 
What are the training requirements?
  • Practitioners have at least 16 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), with 19.5 hours of programme training. 

What are the systems for maintaining fidelity?

Programme fidelity is maintained through the following processes:

  • Training manual
  • Other printed material
  • Other online material
  • Video or DVD training
  • Fidelity monitoring
  • National centre implementation support and recertification process.
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?
  • Rich, robust, positive, and consistent parent-child interaction strengthens the parent–child bond and develops the language and social-emotional skills children need to succeed in school and life.
  • The programme aims to encourage and strengthen positive parent–child interaction through play, conversation and reading together, using developmentally appropriate books and toys supported by trained home visitors during the regular home visits.
  • In the short term, parents discover the value and joy of regular reading, conversation and play with their children, and engage in more frequent positive interaction with their children, supporting their children’s language acquisition and social-emotional development.
  • In the longer term, children will have the language, early literacy and social-emotional skills to enter school ready to succeed and go on to be successful students.
Intended outcomes

Enhancing school achievement & employment

ParentChild+

About the evidence

ParentChild+’s most rigorous evidence comes three RCTs that were conducted in the United States.

This study identified statistically significant positive impact on a child outcome.

This programme has evidence from at least one rigorously conducted RCT along with evidence from an additional comparison group study.  Consequently, the programme receives a 3+ rating overall.

Study 1

Citation: Madden et al., 1984 (1976 cohort)
Design: RCT
Country: United States
Sample: In the 1976 cohort there were 55 families, with children between 21 and 33 months old, where families qualified for low-income housing.
Timing: Post-test
Child outcomes: Improved cognitive ability
Other outcomes: None measured
Study rating: 3

Madden, J., O'Hara, J., & Levenstein, P. (1984). Home again: Effects of the Mother-Child Home Program on mother and child. Child Development, 636-647.

Available at
https://www.jstor.org/stable/1129975?seq=1#page_scan_tab_contents

Study design and sample

The first study is an RCT. 

This study involved random assignment of children to a ParentChild+ group and an Early Screen Programme group, which consisted of developmental screening.

This study was conducted in the United States with a sample of 55 children between the ages of 21 and 33 months old. Families were living in suburban areas surrounding New York City, and qualified for low-income housing. Parents' occupational level was semiskilled or lower, and did not have more than a 12th-grade education.

Measures

  • Mother-child interactions were measured using the Maternal Interactive Behavior Record (expert observation of behaviour).
  • Cognitive ability and intelligence was measured using the Stanford-Binet Intelligence Scale (direct assessment).

Findings

This study identified statistically significant positive impact on a child outcome. 

This includes cognitive ability and intelligence.

More Less about study 1

Study 2

Citation: Astuto & Allen, (submitted) - described as study 2 within this paper
Design: RCT
Country: United States
Sample: 166 families, with children between 2.4 and 3.8 years old, where families were recruited from low-income immigrant Spanish-speaking communities.
Timing: Post-test
Child outcomes: Improved child language
Improved social-emotional competence
Other outcomes: None measured
Study rating: 3

Astuto, J., & Allen, L. (submitted). “Improving School Readiness for Children Living in Urban Poverty Through Home-based Intervention”.

Study design and sample

The second study is an RCT. 

This study involved random assignment of children to a ParentChild+ group and an alternate treatment group – a programme called Raising Happy & Healthy Eaters (focused on healthy eating).

This study was conducted in the United States with a sample of children between the ages of 2.4 and 3.8 years old. Children were 46% male and 54% female. Participants described their ethnicity as Latino (100%), and Spanish was the primary language spoken in the home for all families. 45% of parents reported having less than a high school education, 32% obtained a GED or high school diploma, 10% indicated having some college/trade school experience, and 13% attended a four-year college or beyond. 100% of parents were born outside of the United States.

Measures

  • Social-emotional development was measured using the Brief Infant-Toddler Social Emotional Assessment (BITSEA) (direct assessment).
  • Social-emotional competence was measured using the Ages & Stages Questionnaires: Social-Emotional subscale (ASQ:SE) (direct assessment).
  • Language competence was measured using the Preschool Language Scale Fourth Edition (PLS-4) (direct assessment).
  • Self-regulation was measured using the Tower Task, Tower Clean-Up and Day-Night tasks (direct assessments).
  • Parents’ expectations of their children and attitudes about developmentally appropriate behaviour were measured using the Parent as a Teacher Inventory (PAAT) (parent report)

Findings

This study identified statistically significant positive impact on a number of child outcomes.

This includes improved child language and improved social-emotional competence. 

More Less about study 2

Study 3

Citation: Astuto & Allen, (submitted) - described as study 1 within this paper
Design: RCT
Country: United States
Sample: 336 families with 2-year-old children
Timing: Post-test
Child outcomes: Improved self-regulation
Other outcomes: None measured
Study rating: 3

Astuto, J., & Allen, L. (submitted). “Improving School Readiness for Children Living in Urban Poverty Through Home-based Intervention”.

Study design and sample

The third study is an RCT. 

This study involved random assignment of children to a ParentChild+ group and an alternate treatment group – a programme called Raising Happy & Healthy Eaters (focused on healthy eating).

This study was conducted in the United States with a sample of children with a mean age of 2.2 years old. Children were 45% male and 55% female. 

Participants described their ethnicity as Black (55%) and Latino (29%).  The primary language spoken in the home was English for 82% of families and Spanish for 18%.  30% of parents reported having less than a high school education, 31% obtained a GED or High School diploma, 22% indicated having some college/trade school experience, and 6% attended a four-year college or beyond. 

Measures

  • Social-emotional development was measured using the Brief Infant-Toddler Social Emotional Assessment (BITSEA) (direct assessment).
  • Social-emotional competence was measured using the Ages & Stages Questionnaires: Social-Emotional subscale (ASQ:SE) (direct assessment).
  • Language competence was measured using the Preschool Language Scale Fourth Edition (PLS-4) (direct assessment).
  • Self-regulation was measured using the Tower Task, Tower Clean-Up and Day-Night tasks (direct assessments).
  • Parents’ expectations of their children and attitudes about developmentally appropriate behaviour were measured using the Parent as a Teacher Inventory (PAAT) (parent report)

Findings

This study identified statistically significant positive impact on a number of child outcomes.

This includes improved self-regulation. 

More Less about study 3

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.

Allen, L., Sethi, A., & Astuto, J. (2007). An Evaluation of a Toddlerhood Home Visiting Program at Kindergarten Age. NHSA Dialog, 10(1), 36-57

DeVito, P.J. & Karon, J.P. (1984). Pittsfield Parent-Child Home Program, Chapter 1. Longitudinal Evaluation Pittsfield Public Schools. Final report.

Fagan, B. (2011). Parent Child Home Programme (PHCP). In: 'Childhood Unfolding', World Organisations for Early Childhood Education (OMEP) Ireland Annual Research Conference, 2nd April 2011 Cork.

Gfellner, B. M., McLaren, L., & Metcalfe, A. (2008). The Parent-Child Home Program in Western Manitoba: a 20-year evaluation. Child Welfare, 87(5): 49-67

Joint Dissemination Review Panel of U.S. Department of Education. (1978). Unanimous Approval of Research Findings, 1967-1978, Mother-Child Home Program of Verbal Interaction Project. Freeport, NY: Verbal Interaction Project.

Levenstein, P. (1970) Cognitive growth in Preschoolers through verbal interaction with mothers. American Journal of Orthopsychiatry, 40: 426-432

Levenstein, P. (1998). High School Graduation Effects of a Verbal Interaction Program for At-Risk Toddlers: A Study of Long-Term Outcomes in a Replication of the Mother-Child Home Program. Paper presented at the Head Start National Research Conference (4th, Washington, DC, July 9-12, 1998).

Levenstein, P., Levenstein, S. & Oliver, D. (2002). First grade school readiness of former child participants in a South Carolina replication of the Parent-Child Home Program. Applied Developmental Psychology, 23, 331–353.

Levenstein, P., Levenstein, S., Shiminski, J. A., Stolzberg, J. E. (1998). Long-term impact of a verbal interaction program for at-risk toddlers: an exploratory study of high school outcomes in a replication of the mother-child home program. Journal of Applied Developmental Psychology, 19(2): 267-285.

Mann, V., Sandoval, M., Garcia, L., Calderon, D. (2009). Using Spanish in the Home to Promote School Readiness in English. In A. E. Harrison (Ed.), Speech disorders: Causes, treatment and social effects (Chapter 4). Hauppauge, NY: Nova Science.

Manz, P. H., Bracaliello, C. B., Pressimone, V. J., Eisenberg, R. A., Gernhart, A. C., Fu, Q. & Zuniga, C. (2016). Toddlers' expressive vocabulary outcomes after one year of Parent-Child Home Program services. Early Child Development and Care, 186(2), 229-248.

ORS (2010). Evaluation of the Parent-Child Home Program/Play & Learn Group Demonstration Project 2005-2010: Final Report. Seattle: Business Partnership for Early Learning. ORS Evaluation.

ORS Impact. (2016). Long-Term Academic Outcomes of Participation in the Parent-Child Home Program in King County, WA. Seattle, WA.

Rafoth, M. & Knickelbein, B. (2005). Cohort One Final Report: Assessment Summary for the Parent Child Home Program. An evaluation of the Armstrong Indiana County Intermediate Unit PCHP program, Center for Educational and Program Evaluation located at Indiana University of Pennsylvania.

Scarr, S., & McCartney, K. (1988). Far from home: An experimental evaluation of the Mother-Child Home Program in Bermuda. Child Development, 59, 531-543.

Scarr, S., McCartney, K., Miller, S., Hauenstein, E., Ricciuti, A. (1994). Evaluation of an Islandwide Screening, Assessment and Treatment Program. Early Development and Parenting, 3(4), 199-210.

Share, M., Doyle, E., Callahan, A., Greene, S., Wachtler, M., & Boyd, E. (2011). Baseline Evaluation of the Dublin Docklands Parent Child Home Programme. Dublin, Children’s Research Centre, Trinity College.

Published February 2019   |   Last updated April 2021