been as effective as professionals (Hattie, Sharpley & Rogers,
1984).  Well-trained personnel are competent in the areas of
program focus and in interpersonal skills.  Paraprofessionals of
the same ethnic or racial group as parents may be more effective
in enrolling and retaining parents or in offering problem-solving
that is acceptable to clients (Barth, 1991).
The GREATEST BENEFITS APPEAR TO BE DERIVED BY FAMILIES IN THE
GREATEST NEED.  Parents of pre-term and low birthweight children,
young teen parents and poorly educated mothers (Olds et al.,
1986) show the greatest gains.  Low-income, unmarried adolescent
mothers are particularly responsive to home-visiting programs
(Olds & Kitzman, 1993).  Families receiving more of an
intervention demonstrate greater benefits (Powell & Grantham-
MacGregor, 1989).  As the needs of families increase, parent
education and support programs must be customized to address
specific needs.  For example, programs should provide parents of
a developmentally disabled child with generic parenting
education,  general information about parenting a child with a
disability, and information and support to deal with the child's
specific disability.  Likewise, home-visiting programs can be
customized in a similar way to meet families' needs.
Home visiting is NECESSARY, BUT NOT SUFFICIENT for parents facing
multiple risks (Weiss, 1993).  Home-visiting may be the most
cost-effective method of promoting healthy parent-child
interaction.  Home-visited teens appear to develop more realistic
expectations and more desirable child-rearing attitudes (Field,
Widmayer, Stringer & Ignatoff, 1980).  However, home-based
programs may be less successful than center-based programs in
affecting maternal outcomes such as educational and occupational
development (Clewell, Brooks-Gunn & Benasich, 1989; Field,
Widmayer, Greenberg & Stoller, 1982).
CENTER-BASED PROGRAMS FOR ADOLESCENT PARENTS APPEAR TO BE MORE
EFFECTIVE in promoting maternal education, employment and self-
sufficiency (Clewell et al., 1989).  Center-based programs
operating in schools, hospitals, universities, or agencies may
provide child care, supplemental classes in child development and
parenting, information and services related to sexuality, and job
training.  Adolescent mothers in center-based programs are more
likely to return to school or work and to have fewer subsequent
pregnancies (Clewell et al, 1989; Campbell, Breitmayer & Ramey,
1986).
Child care is a significant factor in adolescent mothers'
educational and employment outcomes (Campbell et al., 1986;
Roosa, 1984; Field et al., 1982).  Evaluation of services funded
by the Office of Adolescent Pregnancy Programs supports the
importance of child care in teen mothers' eventual self-
sufficiency (Burt, Kimmich, Goldmuntz & Sonenstein, 1984).
Evaluations of the pre-school components of center-based programs
have generally shown good outcomes for children. Programs that
are developmentally appropriate and emphasize consistent,
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