Individual work with parents at home is particularly helpful for parents lacking the confidence or inclination to join a group. Practitioners can tailor support to 'where parents are at' in terms of their existing knowledge, skills and confidence and make informed, responsive decisions about appropriate activities and pace.

Key factors for effectiveness

• Keep the child the focus of the visit – use the visit as a structured opportunity to model and share play and learning activities with the child and to discuss them afterwards.
• Visit over a long enough time period to allow the parent to integrate the learning and develop the confidence to play with child as a normal part of daily life.
• Encourage parents to keep a record their child's development and learning so that progress can be discussed during visits to provide motivation, positive feedback and further suggestions. Think about loaning parents a digital camcorder to record their child if they would be more comfortable with a visual rather than written record.
• Be flexible - if a parent is stressed or upset about something else going on in their life when the practitioner arrives, this may need to be tackled first.

Example from practice

K has seven children by three different fathers, but does not currently have a partner. Her Health Visitor maintained regular contact with the family and became concerned about the destructive behaviour of the three year old, who had a very short concentration span, and the fact that the baby was spending a great deal of time strapped in his pushchair. She referred the family to Parents as First Teachers (PAFT).

Parents as First Teachers (PAFT) is an outreach programme offering parent education and family support to families with children from before birth to five years. The core element of the work is a regular personal visit that lasts for an hour and is usually held in the home. Home visits are used as structured opportunities to share age-appropriate child development information and activities with parents and discuss any parenting concerns.

The PAFT worker introduced K to activities to help develop her three year old's fine motor skills and games to help encourage gross motor activity. K was worried that her son was walking on his toes and the PAFT worker arranged for her to see the Health Visitor for an assessment, as this may be an early sign of cerebral palsy.

The PAFT worker also encouraged K to take the baby out of his chair and lay him on his tummy on the floor. He was not able to sit up, probably because he had spent so much time in a chair. The worker explained that he should be able to sit up unaided and be making attempts to move about, so K dispensed with the chair and followed the worker's advice.

The worker also took books for both children and encouraged K to read and talk with both of them. Through reading, playing and talking with the children, K saw clearly how this helped their development and was motivated to continue.

Source: Early Learning Partnerships Project (ELPP) 2006 – 2008

Group sessions provide opportunities for parents to meet other parents and share experiences and ideas each other, as well as for children to play with other children. Within this opportunity to socialise, the sessions aim to introduce parents and children to play and learning activities they can do together at home, such as singing, reading books, messy play and number games.

Key factors for effectiveness

• Venues should be welcoming, convenient and accessible.

• Modelling is a core practitioner skill, to allow parents to get ideas from watching staff interact with their child and become more actively involved when they feel ready.
• Provide resources for parents to use at home with their child, for instance books, ideas for creative play etc. Bookstart is an example of a resource pack that is available to support early learning activities at home. (Link to resources and contacts list)
• Enable parents to set their own learning objectives.
• Provide sessions at different times of the day, including evenings and weekends to include working parents.
• Childcare may be needed for older or younger children, especially when running groups during evenings and weekends.

Example from practice

R has clinical depression and struggles to engage with her children. She had been attending a voluntary sector family service for nine months, when she joined a Family Action Newpin Play Programme with her three year old son.

Her son was a very angry child and was always telling people to "shut up" and "go away"; he struggled to mix with his peers and had limited concentration for activities, as he always wanted to be with R.

R had decided her goals were to gain confidence to play with her son, get some new ideas of things she could do with him and get help with boundaries.

Before they started the programme, all R did was push her son away and tell him to go and play. Initially she was very nervous but was encouraged by her son's pleasure that she was with him in the playroom, getting involved and giving him positive attention. She enjoyed messy, creative play sessions and helped her son to join in too. During a 'follow your child' activity, R was ill at ease to start with, but got on the floor with her son, doing everything he did and playing as he did.

As the programme continued, her son became more confident and better able to mix with his peers and other adults. He was also more able to separate from R and spend time in the playroom without her. R still struggles at times to play with her son due to her depression, but she now spends time in the playroom with him, is more confident playing with him, understands the importance of play and does more activities with both her children at home.

Source: Early Learning Partnerships Project (ELPP) 2006 – 2008

Key factors for effectiveness

• Keep groups small to allow time for individual attention.
• Recommended age for group classes is from birth to pre crawling.
• Emphasis should be on enjoying time with the baby and having fun with other parents, as well as learning new skills in a supportive environment.

Example from practice

Coram runs regular baby massage courses for parents and babies as part of its Parents' Centre programme. An instructor certified by the International Association of Infant Massage runs the sessions over four or five consecutive weeks.

Parents are encouraged to come along and give massage a go – and are reassured that sessions are fun, informal and that it's okay for their baby to cry.

Participants massage their babies whilst being guided through a step-by-step routine using different massage techniques. Each parent receives individual attention for any special needs and guidance is provided on how massage ca be adapted to the growing child. The emphasis is on helping parents to see that they are the experts in their baby by helping them to observe their baby's reactions and what they enjoy and don't enjoy.

"It shows parents that they have the magic touch with their babies and are able to give them what they want. It's a great way for parents to really get to know their babies and follow their cues. Parents who don't feel very confident handling their babies, for instance if their baby was very premature or needed a lot of medical treatment, really benefit."

Coram practitioner

Key factors for effectiveness

• Offer different ways that parents can be involved in decisions about their child's learning, join in activities with their child and share child-related information.
• Take time to get to know individual parents and families so that parents feel they matter too and can share concerns and difficulties with staff they know and trust.
• Strong links between settings and parents are important during transitions into and out of pre-school settings, which can be stressful times for children. This is particularly so for children from minority backgrounds, who may also have to cope with a culture and language that is unfamiliar to them and are at greater risk of demonstrating poorer behaviour and adjustment on entry to pre-school.(Melhuish et al 2001, cited Coghlan et al., 2009)
• Settings that provide opportunities for parent contact, such as home visits, parent discussion groups, parent resource rooms and home lending libraries, notice increased levels of family participation.(Ramey et al., 2000)

Examples from practice

The Wakefield Families Enjoying Everything Together (FEET) project brings practitioners, children and their parents together on a ten week course of fun activities designed to enhance language skills during the term before a child enters either pre-school or school.

Getting Ready for Nursery (Nottingham City) is a three session course on transition issues delivered by children's centre practitioners to parents whose children will be moving to pre-school.

Dads ACE Project (Coventry) worked with fathers and their children to transform an allotment into an outdoor learning environment. The project focused on developing the dads' and the children's language, literacy, emotional literacy and community skills through growing produce, exploring the natural environment and child-led play activities.

Source: Parents as Partners in Early Learning (PPEL) Project 2006 - 2008

Some parents, however, may need more intensive help with parenting skills before they can interact positively and play with their children. More focused support for the development of parenting skills may be provided through one-to-one support inside or outside the home or through a group programme.

Key factors for effectiveness

• One size does not fit all. Informed decisions should be made about the specific parenting support needs of the target group and how best to meet these. There is questionable value in delivering programmes which have been designed to address severe behavioural problems to families who do not fall within this group.(Scott et al., 2006)
• Services that integrate parenting, early years and family support services, for instance addressing a child's behaviour and learning difficulties concurrently, result in better outcomes as well as being more cost-effective. (Sanders et al 2000, Egeland and Bosquet 2002, Hannon et al 2006)
• There is strong evidence to suggest that home visiting can produce positive effects on parenting and parent-child interactions, as well as intellectual development in children.(Bull et al. 2004)
• Disadvantaged families have been shown to be least likely to become, or remain, engaged in group-based parenting programmes.(Hallam, 2008, cited by Springate et al., 2008)
• A 'stepping stone' approach, combining parenting programmes with more flexible community-based parenting workshops and short courses has been shown to be more effective in reaching parents whose children are most at risk of poor outcomes and in increasing take-up of longer parenting programmes.
• Providing parents with information in the form of leaflets, DVDs and e-learning, has been found to have beneficial impact and may be one way to reach some parents, although literacy, language or other communication barriers need to be borne in mind.(Moran et al., 2004)

Example from practice

Family Nurse Partnership (FNP), developed in the US and now being trialled in the UK, involves intensive home visits for vulnerable, first time, young parents during pregnancy and continuing for the first two years after the child's birth.
The programme focuses on improved outcomes across three areas:

• health, well-being and improved parenting skills
• enhancing child development and school readiness
• linking the family to wider social networks and employment.

In the US, large-scale clinical trials have shown the programme to effect significant and consistent improvements in the health and well being of the most disadvantaged children and their families in both the short and long term. Benefits include: improved school readiness; fewer subsequent pregnancies; better prenatal health; reductions of between 50 and 70 per cent in child injuries, neglect and abuse; and increases in father's involvement, although studies include few measures of children's cognitive attainment.(Utting et al 2007)
There are also group-based programmes that focus on parenting issues in the early years such as Mellow Parenting and Mellow Babies, Parents Together and Incredible Years.