Parent Aide Services & Case Management

About the program

Parent Aide Services and Case Management aims to reduce the risk of physical abuse and/or neglect. It targets parenting behaviour and environmental challenges linked with child maltreatment risk.

Families must have at least one child 12 years of age or younger living in the home and be deemed at high risk of abuse and/or neglect. This is determined by a referral from child protective services or an initial case assessment that examines imminent risk of harm to the child, parental capacity and resources to cope with stress in the parenting role.

The program has two components: parental aide and case management.

Who does it work for?

Parent Aide Services and Case Management is designed for families with at least one child 12 years of age or younger deemed high risk of abuse or neglect.

The program has only been evaluated in the USA (Guterman et al. 2013).

A randomised control trial was conducted with 101 people (57 in the intervention group and 44 in the control group). On average mothers were 29 years old. Most of the mothers were Caucasian and from low income households.

The program has not been evaluated in Australia, or with Aboriginal Australians.

What outcomes does it contribute to?

Positive outcomes:

• General parenting behaviours: household adequacy such as furniture, overcrowding, sanitation, security, availability of services, or physical safety in the home is significantly improved by the program, compared to households who just received case management.

No effects:

• Harsh parenting: the program did not have a significant effect on psychological or physical aggression used by a mother towards their child.
• Neglectful parenting behaviours: the program did not have a significant effect on maternal neglect of their child.
• Parenting attitude: the program did not have significant effect on parents feeling a sense of control over life circumstances.
• Parenting stress: the program did not have a significant effect on mother’s perceived stress in the parenting role.
• Parent’s mental health: the program did not have a significant effect on maternal depression, anxiety, or hostility.
• Parent’s substance use: the program did not have a significant effect on mother and partner’s substance use.

Negative outcomes:

• No negative effects were found.

How effective is it?

Overall, Parent Aide Services and Case Management had a mixed effect on client outcomes.

How strong is the evidence?

Mixed research evidence (with no adverse effects)

• At least one high-quality randomised controlled trial (RCT) or quasi-experimental design (QED) study reports statistically significant positive effects for at least one outcome, AND
• An equal number or more RCT or QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT or QED studies show statistically significant adverse effects.

How is it implemented?

Parent Aide Services and Case Management is at-home intervention, which averages 1 year in length.

A case manager conducts an initial needs assessment. The parent aide then visits up to 2 times per week, depending upon assessed risk, need, and parents’ assigned level of service. Frequency of visits can range from a more intensive engagement phase focusing on immediate concerns, to a phase emphasising work on parent–child discipline and family communication, and later to a phase focusing on maintenance of gains and termination of the parent aide.

Case management: An initial needs assessment is conducted by a case manager to gather information about family history and risk for maltreatment (including psychosocial and environmental risk). They provide crisis intervention counseling whenever necessary, and organise referrals for substance abuse, childcare/respite, and other community resources as needed.

Parent aide: Parent aides engage in activities specifically targeting:

• child safety (e.g. addressing home hazards)
• parenting skill guidance (e.g. appropriate discipline)
• problem-solving support (e.g. thinking through how to address extended family conflicts or how to access local public services)
• improving parents’ social support (e.g. identifying and reaching out to supportive family or friends).

Parent aides’ work is structured by setting up goal plans with clients, which are reviewed quarterly.

How much does it cost?

An average cost of $2500 USD per case per year.

What else should I consider?

Parent aides and case workers should be intensely trained in the 27 different types of services or supports provided to the clients. The training covers such topics as identification of child maltreatment, communication skills, problem solving skills, and linkage to available community resources (Guterman et al. 2013).

Where does the evidence come from?

One RCT conducted in the USA, with 101 participants (Guterman et al. 2013).

Further resources

Guterman et al. (2013), Examining the effectiveness of home-based parent aide services to reduce risk for physical child abuse and neglect: Six-month findings from a randomized clinical trial. Child Abuse & Neglect, Vol. 37, No. 8, pp. 566-577.