The mother and son are absorbed as they play with home-made playdough together. It’s an activity that they’ve never done at home before and the two-year-old, who is often hard to settle, has relaxed and his breathing has slowed down. A project worker quietly observes and comments on the way the mother is working with her child, accentuating positive behaviour and giving prompts when needed.
It is a low-key, inexpensive activity, but the payback for the mother and child is immediate. The mother is amazed by the simplicity and has gained so much from the experience that she later emails the Parents as First Teachers (PAFT) project worker to thank her and say that it has helped her to understand her son more.
PAFT is a parenting programme which recognises that parents are a child’s first and most influential teacher. Professionals are trained to work on a one-to-one basis with parents and their children from pre-birth to three years old, usually in their own home.
They aim to provide parents with the information, support and encouragement needed to help their child develop optimally during the crucial early years of life.
KEY ELEMENTS
The programme, which is based on current research into neuroscience and child development, has four key elements:
- Regular personal visits by a trained project worker who partners with the family to discuss their child’s development, facilitating activities that enhance the child’s language, problem-solving, social and physical skills, and encouraging parental reflection.
- Review of developmental milestones to help parents know what to expect and emphasise at each stage of the child’s development, and to detect and seek early intervention if any problems arise.
- Resource networking to put families in touch with other relevant support agencies or services.
- Group meetings that provide opportunities for parents to meet other local parents, to share experiences and to have contact with paediatric specialists to whom they would not otherwise have informal access.
A major feature of PAFT is that it is the parent, not the project worker, who works with their child to achieve the benefits of the programme.
‘It is about facilitation and reflection rather than top down, and the project worker works in partnership with the family,’ explains PAFT national trainer Janice Saunders.
‘A critical factor is that it’s predominantly delivered in the child’s home because it is where the child spends most of their time.’
BROAD AND FLEXIBLE
PAFT was developed in the US to be a broad and very flexible programme to develop school readiness in the widest sense: children ready socially, emotionally, in terms of language and communication, intellectually and health-wise. It has been operating in the UK for 25 years, usually run from children’s centres.
‘Children start school with a vast disparity – those who are well prepared to take full advantage of the classroom, and those who are not,’ says Ms Saunders. ‘This can be because parents, who love their children very much, have not recognised the everyday learning opportunities in the home learning environment, such as talking to children, playing, singing songs, reading books and playing with other children.’
The programme received a strength evidence rating of two-plus out of four in an Early Intervention Foundation report, showing preliminary evidence of improving child outcomes (see box, below left). It was also found to be medium to high cost to set up, with a cost intervention score of four out of five.
‘The project worker builds a relationship with the family which can last for months or years,’ says Ms Saunders. ‘How long it lasts is a programme decision. In Norfolk, visits can last up to three years, but in other areas it can be reviewed after six months.’ During the personal visits, which tend to last an hour and are fortnightly or monthly, the project worker:
- builds rapport with the family
- discusses and explains child development based on the latest neurological and sociological research
- acknowledges the positive strengths of the parent-child interaction
- models, explains and discusses parenting practices
- engages in parent-child activities, including book reading, related to the child’s developmental stage
- encourages observation of the child’s development
- builds parental confidence
- summarises new information and follows progress from previous visits to reinforce parent knowledge of parental strengths, newly achieved child development milestones, and activities to support further progress.
EMPOWERING PARENTS
PAFT has been delivered successfully in Monmouthshire, Wales, for the past three years by a team of eight family support workers who liaise with midwives to identify suitable mothers pre-birth. Positive outcomes include improvements in speech and language, an increase in breastfeeding, positive parenting, a better understanding of child development and post-natal depression.
‘We needed a focus for every visit and PAFT gives this. We are empowering the parents, not just acting as friendly visitors,’ says Flying Start manager for Monmouthshire County Council Beth Watkins.
‘When we began evaluating PAFT within our service, we found that the quantity of contacts reduced; however, the quality of these contacts increased greatly’.
Flying Start parenting co-ordinator Zoe Wildy has found that the PAFT resources enable her to have difficult and honest conversations with parents and give a focus for visits. ‘The advice is not coming from me but the programme and we are partners in learning,’ she says. ‘Through discussion and reflecting with the parents, we’re able to pre-empt the child’s next stage of development, such as looking at safety at the next visit if the child is starting to crawl. We can also help parents to recognise that what their child is doing is developmentally normal and not naughty.’
Ms Saunders believes that the programme works because it is non-threatening and non-invasive.
‘It’s about showing parents what they can do in their homes on a daily basis,’ she says. ‘It’s not rocket science, but it is based on neuroscience and this is a way of getting the information from the ivory towers of universities into the tower blocks where the children are.’
FOUNDATIONS FOR LIFE
‘Foundations for Life: What Works to Support Parent Child Interaction in the Early Years’ by the Early Intervention Foundation assesses programmes to improve child outcomes through positive parent-child interaction.
The 75 programmes, all available to UK commissioners, were identified in the Best Start at Home review and are rated out of four according to an assessment of the evaluation evidence, with four being strong; and out of five for the relative input costs, with five being high cost. It focuses on programmes to promote attachment, behaviour and early cognitive and language development.
The report found that, if commissioned, targeted and implemented carefully, many of these programmes could boost development and tackle problems identified in the early years, such as behaviour, achievement and mental health.
LET’S PLAY IN TANDEM
Also focusing on school readiness is Let’s Play in Tandem, a programme for three-year-olds living in socially disadvantaged communities and with the aim of improving children’s cognitive development and self-regulation.
The programme runs for 12 months and is typically delivered through children’s centres.
Each family is assigned a project worker who conducts weekly home visits for up to two hours. They deliver a pack of three educational activities to develop pre-reading and numerical skills and promote vocabulary and general knowledge. The activities are demonstrated by the project worker to the family during visits and are designed to facilitate one-on-one verbal interaction and to teach parents key scaffolding skills, including how to prompt, provide instructions and encourage their child. The activities specifically focus on school readiness in terms of children’s knowledge (name, address, colours); numeracy; listening; and communication.
The programme has been found to have a statistically significant positive impact on a number of child outcomes and scored three out of four in the EIF report. It is estimated to be medium cost to set up and deliver compared to other interventions, scoring three out of five.
MORE INFORMATION
Early Intervention Foundation, www.eif.org.uk
Parents as First Teachers, www.parentsasfirstteachers.org.uk
Peeple, www.peeple.org.uk