Evidence-Based Research


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Learn more about the evidence base for the Touchpoints Approach.

Evaluation of Touchpoints-Informed Practice: Findings from The Field

More than a decade of extensive and in-depth evaluation shows that Touchpoints-informed practice is proven effective in a variety of organizations and settings, including early care and education centers, pediatric healthcare, mental health, early intervention and home visitation, child welfare, public health, institutions of higher learning (i.e., pediatric residency programs, nursing sites, education sites, and early childhood education quality improvement programs) and Tribal communities. Touchpoints works and skills learned are maintained over time, with reflective practice.

An initial study of 459 diverse, interdisciplinary participants from 25 sites across the US who participated in Touchpoints training, demonstrated significant gains in developmental and family engagement knowledge from before to after participation in Touchpoints training (Touchpoints Professional Development report, 2011).

This section describes some of the evidence to date showing that Touchpoints-informed practice:

  • increases providers’ relational and developmental knowledge
  • improves providers’ attitudes about parents and families
  • sustains providers’ levels of developmental and relational knowledge
  • contributes to providers’ application of developmental and relational knowledge and skills in practice
  • improves providers’ perceptions of their own strengths-based practices with parents (parent empowerment)
  • improves providers’ perceptions of their own strengths-based practices with colleagues
  • improves providers’ perceptions of center climate
  • shifts organizational culture and practice
  • improves families’ perceptions of their relationships with providers
  • improves families’ perceptions of providers’ strengths-based practices (parent empowerment)
  • improves parental well-being (reduced parenting stress)
  • sustains improvements in the parent-provider relationship
  • sustains improvements in parent well-being
  • improves parent-child relationships
  • improves teacher-child relationships
  • improves children’s developmental outcomes
  • improves children’s school readiness
Touchpoints in Early Care and Education

Early care and education professionals trained in Touchpoints report:

  • Increased knowledge of child development and family engagement skills from before to after training 
  • Increased family engagement knowledge and skills up to 4-5 years following training; non-trained staff did not demonstrate such retention of knowledge and skill 
  • Improved retention

Families working with early care and education providers trained in Touchpoints report:

  • Their providers are more supportive of parent expertise than comparison providers.
  • They have better quality and more collaborative relationships with their providers.
  • They have increased confidence in their providers.
  • They show less stress in general, and more stable stress levels over time compared to families without trained providers.
  • They feel an increased sense of empowerment as caregivers.

Children working with early care providers trained in Touchpoints demonstrate:

  • Increased initiative to meet their needs compared to children without any exposure to a trained provider
  • Stronger and longer-lasting relationships with adults compared to children without any exposure to a trained provider
  • Increased number of protective factors compared to children without any exposure to a trained provider

These findings were further significant for children who worked with multiple Touchpoints trained providers compared to children working with one trained provider.

Publications and Reports

Easterbrooks, A.M., & Jacobs, F. (2007). Enhancing child care practice: Relationship-based interventions to support providers, parents, and children. Boston Institute for the Development of Infants and Parents BIDIP Newsletter, 22 (1), 1-4.

Swartz, M.I., & Easterbrooks, M.A. (Accepted for publication, 2008) Enhancing Parent-Provider Relationships and Communication in Infant and Toddler Classrooms. Journal of Early Childhood and Infant Psychology.

Easterbrooks, A.M., Copeman, A., Goldberg, J.L., Miranda-Julian, C., & Swartz, M. (2007). Supporting parent-provider relationships in early care and education. Paper presented at the Society for Research in Child Development Biennial Conference. Boston, MA.

Touchpoints in Infant Early Childhood Mental Health

Clinical diagnosticians in school settings trained in Touchpoints reported:  

  • Increased child development and family engagement knowledge from before to after training 
  • Retention of child development and family engagement knowledge for one year following training
  • Touchpoints reflective practice was useful for communicating with coworkers and other community service providers

Publications and Reports

Percy M. (2006) Using a Developmental-Relational Model in the School Setting. Journal for Specialists in Pediatric Nursing. School Health, 11 (3):207-210.

Touchpoints in Early Intervention and Home Visitation

Home visitors trained in Touchpoints reported:

  • Increased child development and family engagement knowledge from before to after training
  • Reduced tendency to pathologize infant behavior and instead reframed their perception of behaviors as preparation for developmental bursts

Mothers working with home visitors trained in Touchpoints demonstrate:

  • Improved interaction with their infant
  • Increased adherence for well-child care treatment 
  • Enhanced mental health indicators
  • Longer breastfeeding
  • Greater satisfaction with care by providers 6 months postpartum

Infants/Children working with home visitors trained in Touchpoints demonstrate:

  • Improved child developmental outcomes

Publications and Reports

Peifer, K., Gannon, G., Tober, D., Kitzman, H. (2001). Children in San Mateo County: Changing the System of Care- The Prenatal to Three Collaborative. Pre to Three Program Summary. www.prenatalto3.org

Gomes-Pedro, J., Patricio, M., Carvalho, A., Goldschmidt, T., Torgal-Garcia, F., & Monteiro, M.B. (1995). Early intervention with Portuguese mothers: A two year follow-up. Developmental & Behavioral Pediatrics, 16(1), 21-28.

Touchpoints in Child Welfare

Child welfare professionals trained in Touchpoints report:

  • Significant gains in child development and family engagement knowledge compared to professionals who did not participate in Touchpoints training
  • Child development and family engagement knowledge retention for 6 months after training and reflective coaching
Touchpoints in Tribal Communities

We recently explored the impact of Touchpoints training and reflective coaching as a framework for over 10 community organizations that serve families with children from birth to 8 years of age. We found that Touchpoints was embraced as a useful approach for providers working in early childhood, health services, school, and family support services in a Native community.

In an ongoing large-scale community assessment, 88% of providers reported using the Touchpoints approach in their practice; they felt that Touchpoints impacted their ability to promote learning or support those who promote learning (82%) and implement child guidance strategies (82%). 100% of these providers said that they would continue to use the approach because they felt it improved their relationships with other community providers (100%) and was helpful for children and families (88%). They also reported that Touchpoints improved their understanding of child development (94%), including children’s social-emotional development (94%), physical development (80%), and behavioral and emotional functioning (88%).

When asked how Touchpoints was most helpful, providers responded that it encourages:

  • Connection with parents and the opportunity to build relationships with families (88%)
  • A better clinic environment
  • Nonjudgmental practice and a strength-based perspective about challenging families
  • A framework for what a Native community should be and was before historical trauma
  • The ethics and practice of Native traditions

Touchpoints reinforced providers’ understanding of Ojibwe culture and language (66%) and helped providers support children and families from a variety of cultural backgrounds (93%).

Providers also felt better equipped to manage children with developmental and/or behavioral concerns. They felt prepared to ask for help (83%) and talk with families about concerns (94%).

A second study of a parenting intervention using Touchpoints principles with Early Head Start families yielded positive results regarding families’ knowledge of child development and Native culture and their sense of efficacy as caregivers. The intervention consisted of the following:

  • A 6-week parenting component focusing on specific topics of early childhood development.
  • A 4-week cultural component focusing on the circle of life of Ojibwa culture. The curriculum helps parents reflect on their own personal upbringing and family history for the purpose of recognizing their role in their child’s development. Parents reflect on their children and imagine their goals for their children.
  • In cultural activities, we offered parents an opportunity to build their relationships with their children and with each other by participating in various cultural events and activities together.

Families who participate in this intervention: 

  • Improve their knowledge of child development from baseline to post-intervention (p <0.05; Cohen’s d = 1.09)
  • Improve their knowledge of cultural teachings related to childrearing (p <0.05; Cohen’s d = 1.56)
  • Report fewer concerns about their child’s problem behaviors. (ASQ Questionnaire)

When families connect to their cultural identities and learn about their cultures’ childrearing traditions and practices, they discover their own sense of competence as caregivers.

Results suggest that Early Head Start programs can enhance parental factors associated with positive child development outcomes by incorporating cultural traditions and practices of the families served into parent engagement efforts.

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Babies and children, families and communities do the research on what it takes for them to flourish. Listen with us to what they’ve been learning. Watch a webinar. Check out the Indigenous Early Learning Collaborative. Join the Brazelton Touchpoints Center Learning Network. Join the conversation.

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