What do we know about early prevention of learning disabilities in children of social disadvantaged families? Measures primarily focused on home visiting programs can have a clear impact on the cognitive and linguistic competence of the children and on their social emotional behavior – even if multimodal approaches, in which high quality support at educational centers is combined with an empowerment approach for the parents, are more successful (Blok, Fukkink, Gebhardt, & Leseman, 2005; Brooks-Gunn & Markman, 2005). Nevertheless, families who are psychosocially stressed benefit specifically from the support (Gomby, 2007; Siraj-Blatchford, 2004). For this reason, effects can be expected that will for the most part be slightly positive, as described in the overview of research on the efficacy of home visiting programs (US Department of Health and Human Services, 2017).  According to  standards of the Institute of Education Sciences (IES) (What Works Clearinghouse, 2014), effect sizes in excess of 0.25 are substantially important and are interpreted as “qualified positive (or negative) effect” (p. 21), even if they fail to attain any statistical significance in the respective study.

In the last few years, the effectiveness of early intervention in Europe has been analysed in several studies (Jungmann, Sierau, Dähe, Dugraviert, Serbati & Lanfranchi, submitted). ZEPPELIN is one of the largest intervention studies with a long-term design (Lanfranchi & Neuhauser, 2013; Neuhauser et al., 2015). ZEPPELIN evaluates effects of the Parent as Teachers program (PAT) in the canton of Zurich, Switzerland. A trained PAT-parent educator (i.e., pediatric nurses in this study) visits families at their homes approximately two times a month until the child is three years old. Additionally, the program offers monthly group meetings. In the long term, the program strives to enhance the educational opportunities of children who are jeopardised in their development for psychosocial reasons. For the early recognition and recruitment of at-risk families around birth, an interdisciplinary network was established at the three project sites. Professionals from the medical (e.g. pediatricians, gynecologists, midwives) and psychosocial field (e.g. parent and social counseling) assessed the risk constellation using a short screening form with important risk indicators and enrolled at-risk families to the study. If migrant families met these criteria, they were explicitly addressed with the help of intercultural interpreters and included in the study. In order to recruit the projected number of 252 families and randomly assign them to the intervention and control group, a stratified block randomisation was used. Only the intervention group received home visits and participated in the group meetings. Assessments were performed at the age of 3 months (baseline data) and around the first three birthdays of the children.

The research questions are: Does early support with the "PAT-Parents as Teachers" (PAT) program have effects on the cognitive, language and social development in children aged 0 to 3 from families with psychosocial risk, and on the parental quality of caregiving? Which factors in program, family and context are related to these effects? 

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