Tuesday September 10, 2002

Train the Politicians First

Last week we learned that compulsory parenting training is about as popular with parents as brussels sprouts are with children. Following a barrage of criticism, Children and Youth Affairs Minister Larry Anthony took less than a day to back off his proposal that parenting training be linked to welfare payments.

But the debate will not end there. Later this month, Mr Anthony is due to bring a proposal before Cabinet to put more resources into parenting training. And while most of the earlier furore concerned civil liberties, the basic questions remain: is parenting training likely to be effective, and when is it likely to work?

For researchers, the challenge in testing whether parenting interventions work is overcoming the “selection problem”. Just as ill people are more likely to receive medication than healthy people, attempts at parenting intervention have generally been targeted at families most in need. And just as a comparison of those who took medicine and those who did not might lead to the conclusion that medication make you sick, naïve comparisons of those who are selected for parenting help tell us little about the efficacy of the programs themselves. We might simply find out why some people received this help, rather than what this help achieves.

Medical researchers, of course, are no stranger to this problem, which is why they have long known the solution – randomised trials, in which some applicants are randomly assigned to receive treatment, while others do not.

While such trials are uncommon in social policy, particularly in Australia, they are incredibly useful, and American policy wonks have been particularly industrious on this front.

The leading study on the effectiveness of parenting training is a long-term study carried out in Elmira, a poor semi-rural community in the Appalachian region of New York state.

The Elmira trial followed 315 children born to first-time parents in the late-1970s. Parents in the treatment group received an average of 32 home visits from trained nurses before and after the birth of their child. Usually, each visit lasted for an hour and a half. In today’s money, the total cost for each family was around $12,000 Australian dollars. The control group received no home visits.

When they revisited the children 15 years later, the researchers found that the intervention had been successful. Those whose parents had received home visits had lower rates of substance abuse, fewer behavioural problems, and were less likely to have been in trouble with the law. Because the families also had lower rates of welfare usage, the researchers calculated that the program more than paid for itself.

So parenting programs work, right?

Not so fast. According to the Elmira research team, the reason that their intervention worked was threefold – it focused on extremely disadvantaged families; began during pregnancy; and used a comprehensive service strategy, including trained nurses. They point out that several piecemeal programs have failed over the past two decades, and these tend to be those that least resembled Elmira. A parent’s time is the main input to child-rearing, and programs need to complement a parent’s effort, not divert it into climbing bureaucratic barriers.

Which takes us back to the Coalition’s proposals. According to one report, Mr Anthony’s proposals for parenting intervention involve requiring parents to attend seminars and watch parenting videos in order to receive welfare. Such measures smack of short-term political gimmicks, and we know of no evidence in their favour.

Rather than toying with low-level, untargeted initiatives, the Federal Government would be better to heed the advice of the Elmira research team, who warn: “There is considerable enthusiasm these days about the promise of early preventive intervention programs that current evidence, unfortunately, cannot support. Public hope and confidence in the promise of such programs is a scarce commodity that we dare not squander on approaches that are not likely to work.”

Thanks to careful studies in the social sciences, we are beginning to understand what forms of assistance are likely to help at-risk families. If the Howard Government wants to get serious about parenting programs, it’s time it grew up and started looking at the research.

Andrew Leigh is a PhD student at the John F. Kennedy School of Government, Harvard University. Dr Justin Wolfers is an Assistant Professor at Stanford Business School.