Research Insights from the Incredible Years Centre: Advancements in Child Development Programs

1. Incredible Years Research Update Incredible Years Centre WalesSchool of Psychology17th March, 2010Tracey Bywater

2. Today…. • What type of research do we do, why, & who with? • What research are we currently undertaking?

3. Type of research & why we do it • Translational Research: • Examines what has been learned from research studies in real life settings in order to apply in everyday life • We evaluate IY Programmes using RCTs with parents, children and teachers • Establishes the impact (and cost-effectiveness) of programmes and so inform decisions about whether and how to embed them within local services

4. …and who with? • Funders • Children/Family services • Heath Visitors • CAMHS • Schools & teachers • Facilitators • Parents • Creche workers • Research team • Education Services • Health economists • Programme managers/developers • Service Directors/managers • Intervention trainers/supervisors • Registered Trials Unit (NWORTH) • CRC Cymru • Children • Students

5. Flintshire County Council

6. General Research Questions • For which children and families are the interventions effective in the short- and long-term? • What are the environmental/contextual circumstances that improve the likelihood of success? • Are the programmes implemented efficiently and effectively with fidelity? • Does the duration of time participating in an intervention affect likelihood of success, that is, is there a dosage affect? • What are the costs of implementing the interventions? • What are the longer term costs and benefits of intervention?

7. Current Funded Research • Big Lottery, evaluation of Pull-out Dina (& IYC PhD) • WAG funded evaluation (& Mantais PhD) of the IY Toddler Programme in Flying Start areas in Wales • IY Cymru funded evaluation of IY Therapeutic Dina • NW NHS Trust, IY evaluation with Nursery workers • NWW NHS Trust, 4-yr follow-up of Sure Start sample • DSCF & LA Pathfinders evaluation • Birmingham Council, Brighter Futures Strategy, • Atlantic Philanthropies, Irish National Evaluation of IY

8. Postgraduate projects • ESRC & Gwynedd Education PhD evaluation of TCM • ESRC PhD exploring SS subsample with ADHD symptoms • Objective 1 & IYW PhD fidelity & outcomes • KESS funded PhD evaluating the Baby Programme • KESS funded MRes to compare developmental measures • 125 PhD to evaluate IY School Readiness (WORD?) • MSc Live versus video-recorded observations • CePHI, costing of IY Toddler Programme

9. The Incredible Years Programmes The Incredible Years Programmes The Incredible Years Programmes Teacher Programme 6 full day sessions held monthly Teacher Programme 6 full day sessions held monthly Teacher Programme 6 full day sessions held monthly Child Dinosaur Classroom Programme:3 year curriculum, 2 sessions per week, 30 weeks Child Dinosaur Classroom Programme:3 year curriculum, 2 sessions per week, 30 weeks Child Dinosaur treatment Programme: 6 children, 18 - 22 weekly sessions Child Dinosaur Classroom Programme:3 year curriculum, 2 sessions per week, 30 weeks Child Dinosaur treatment Programme: 6 children, 18 - 22 weekly sessions Child Dinosaur treatment Programme: 6 children, 18 - 22 weekly sessions Fully revised ADVANCED Programme: 9 sessions helping adults communicate & problem solve Fully revised ADVANCED Programme: 9 sessions helping adults communicate & problem solve ADVANCED Programme: 9 sessions helping adults communicate & problem solve Fully revised School Aged BASIC Parent Programme: 10 - 12 sessions, 6 - 12 years*** Fully revised School Aged BASIC Parent Programme: 10 - 12 sessions, 6 - 12 years*** School Aged BASIC Parent Programme: 12 sessions, 6 - 12 years*** (6 – 8, 9 – 12 yrs) Pre-School BASIC Parent Programme: 14 or 18 weekly sessions, 3 – 6 years Fully revised Pre-School BASIC Parent Programme: 18 weekly sessions, 3 – 6 years Fully revised Pre-School BASIC Parent Programme: 18 weekly sessions, 3 – 6 years Infant (eight sessions) 0 - 12 months toddler 1 - 2 year olds (13 sessions) programmes Infant (eight sessions) 0 - 12 months toddler 1 - 2 year olds (13 sessions) programmes Infant - 8 sessions 0 - 12 months Toddler 1 - 3 year olds (12/13 sessions) School Readiness Programme: 4 pre-school sessions 2 – 4 years School Readiness Programme: 4 pre-school sessions 2 – 4 years School Readiness Programme: 4 pre-school sessions 2 – 4 years ***The School aged programme also has an additional four session unit on helping your child to do their best in school ***The School aged programme also has an additional four session unit on helping your child to do their best in school *** the School Aged programme also has an additional four sessions on helping your child to do their best in school 9 9 9

10. Welsh Sure Start Trial • Children of 3-4 years ‘at risk’ of developing CD • Randomly allocated families to intervention or waiting list control using 2:1 ratio • Saw intervention families at baseline and 3 follow-ups, all 6 months apart • Saw control families at baseline and follow-up 1 then offered the intervention • Measures were administered at each time point – child behaviour, parent competencies, parental depression, amongst others

11. DPICS

12. Eyberg Figure 2. Eyberg Child Behaviour Problem Scores

13. Ireland Results (n= 103:46) 2009

14. longer term follow-up • Maintained 80% to 18 month follow-up and then trial was terminated -18 month F/U data (Bywater et al. 2009) all positive outcomes maintained • Managed to find some of sample at 3 and 4 years with very limited funding (£5k) • Families were very socially disadvantaged and children had high rates of behaviour problems at baseline

15. Long term Sure Start data

16. lessons learned to inform Policy & Practice Programmes can be effective (even in disadvantaged Sure/Flying Start areas) when core research principles are adhered to: • Know what outcomes/change are required • Select an evidence-based programme for the target population • Develop a strategy for recruiting the target population • Address relevant service access issues • Ensure implementation fidelity • Evaluate the programme delivery and outcomes

17. References • Hutchings, Bywater, Daley et al., (2007). A Pragmatic Randomised Controlled Trial of a Parenting Intervention in Sure Start Services for Children at Risk of Developing Conduct Disorder, BMJ. doi:10.1136/bmj.39126.620799.55 • Bywater, Hutchings, Daley et al., (2009). Long-Term Effectiveness of a Parenting Intervention in Sure Start Services in Wales for Children at Risk of Developing Conduct Disorder, BJP. Doi:10.1192/bjp.bp.108.056531 • Edwards, R.T., Ó Céilleachair, A., Bywater, T., Hughes, D.A., & Hutchings, J. (2007). Parenting Programme for Parents of Children at Risk of Developing Conduct Disorder: Cost-Effective Analysis. BMJ, doi:10.1136/bmj.39126.699421.55. • McGilloway, S., Bywater, T., et al. (2009). Summary Report of Short-term Findings: IY National Evaluation Ireland. Archways & NUIM.

18. Thank you