Challenges for Parenting Programs in Closing the Parenting Divide

POSTED BY: MARILEE COMFORT ON FRI, JUL 11, 2014

In the US we have been fighting to close the achievement gap of children living in disadvantaged circumstances since Lyndon Johnson declared the War on Poverty 50 years ago.  Efforts to close the gap have advanced from many angles – economic, housing, nutrition, crime prevention and education.  Research on early intervention programs, such as the Perry Preschool and the Chicago Child-Parent Center, have proven the long-term benefits of comprehensive services to young children (birth to 5 years), their families and communities.  Yet, we still haven’t solved the problem.  

Call for Renewed Efforts and Innovation in Parenting Interventions

The importance of early intervention to address the achievement gap has become widely accepted.  More recently, supporting parenting within early intervention is becoming widely touted as a key to success.  High profile researchers are calling for renewed efforts and innovation in parenting interventions to address the wide disparities in children’s success among families at opposite ends of the income and educational spectrums.  

  • James Heckman, Nobel Prize Winning economist claims, “The proper measure of disadvantage is not necessarily family poverty or parental education. The available evidence suggests that the quality of parenting is the important scarce resource.” – Giving Kids a Fair Chance, 2013, page 35 

  • Isabell Sawhill and her colleagues at the Brookings Institution assert, “Families and the parents that shape them are equally important incubators of opportunity. If we want more equality—of opportunity, of income, of wealth, of occupation—we’ll have to tackle the parenting gap, too.” – Parenting, Politics and Social Mobility, 2013, last paragraph 

  • Jack Shonkoff at the Center on the Developing Child at Harvard declares, “Protecting Children from the Impacts of Toxic Stress Requires Selective Skill Building—Not Simply the Provision of Information and Support—for the Adults Who Care for Them.…Central to this hypothesis is the required capacity of adult caregivers to provide that buffering protection through their own well-developed skills in problem solving, planning, monitoring, and self-regulation.” – Leveraging the Biology of Adversity,  PNAS, page 4  

As you may recall from last week’s post about the Brookings Institution proposal, Ariel Kalil, Professor at the University of Chicago, has joined the call to close what she refers to as the “Parenting Divide”.  She claims that many of our well-reputed programs serving young children and families need smarter, more effective, lower cost parenting interventions.  In her policy proposal, Addressing the Parenting Divide to Promote Early Childhood Development for Disadvantaged Children, she cites the few statistically significant improvements in parenting practices and home environment of low-income families in leading widespread home visiting programs designed to improve parenting.  Let’s look at the challenges Kalil identifies in this post, and her recommended solutions in next week’s post.  

Challenges in Closing the Parenting Divide

Kalil identifies three challenges that limit the effects of large-scale parenting interventions:

  • High attrition rates
  • Lack of family engagement
  • Resistance to changing parenting habits

The first challenge, high attrition rates, is corroborated by a new 2014 implementation evaluation from Mathematica Policy Research and Chapin Hall on 5 major home visiting models, Making Replication Work: Building Infrastructure to Implement, Scale-up, and Sustain Evidence-Based Early Childhood Home Visiting Programs with Fidelity.  For example, across the 3 longer-term service models (Healthy Families America, Nurse Family Partnership, Parents as Teachers), programs reported an average of 90% of families enrolled for 3 months, 79% for 6 months and only 64% of families remained enrolled for 12 months (page 38). These are disappointing numbers, considering that these 3 models aspire to enroll families during pregnancy and serve them until children are at least 2 years old.

Kalil suggests that the two challenges of attrition and family engagement could be related to daily financial, domestic and emotional stressors in high risk families that supersede children’s concerns.  She also suggests that programs are not meeting parents’ needs for relevant and accessible tools and technology to develop optimal parent-child interactions.

The third challenge, resistance to changing parenting habits, is a complicated issue related to family culture and privacy, motivation to change, and capabilities for self control, flexibility, reflection and planning ahead.   Beyond the family values, many of these are executive functions that require skill development.

I would like to offer a fourth challenge programs face in addressing the parenting divide. Parenting intervention programs often do not employ adequate parenting assessment measures.  I am surprised by the number of programs aimed at improving parenting that do not use any parenting assessment instruments.  The programs that do use assessments most commonly employ surveys completed by parents.  A survey can assess what someone knows, believes or feels, but doesn’t get at what ultimately matters to children.  Observational assessment tools measure what a parent actually does with his/her child.  It is what a parent does that matters most to young children.  Some programs have adopted global measures of the home environment or health literacy to measure parenting outcomes.  While these are useful in assessing families’ needs, they are inadequate in guiding improvement or documenting outcomes in specific parenting behaviors.

The Nurse Family Partnership’s New Parenting Assessment Tool

The most widely recognized and well-researched home visiting program is the Nurse Family Partnership (NFP).  The NFP is credited with leading the home visiting field.  In recognition of their great need for a practical observational parenting assessment, the NFP has developed its own parent-child interaction measure, the Dyadic Assessment of Naturalistic Caregiver-child Experiences (DANCE).  The DANCE was developed because researchers noted that nurses in replicated NFP programs in the community spent less time on building parenting competence than nurses in the initial experimental studies of NFP programs.  We all know that what gets measured gets attention, and so the NFP aims to increase its focus on parenting behavior by employing its new observational parenting measure.  We were pleased that the NFP chose to use KIPS to validate their own parenting assessment tool. To my knowledge, the development results are not yet published, but the NFP has obtained generous funding to train its nurse home visitors to use the tool in supporting the families they serve.

Using an observational parenting assessment can improve service planning, monitor parent progress, enhance staff development, promote reflective supervision, and inform continuous quality improvement efforts.   Also, using a validated parenting assessment tool helps programs document that the work they do with parents is making a difference that truly matters to children, which always pleases funders.