Incredible Years Research Update Incredible Years Centre Wales

School of Psychology

17th March, 2010

Tracey Bywater

Today….

• What type of research do we do, why, & who with?

• What research are we currently undertaking?

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

…and who with?

Flintshire County Council

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?

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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

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

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Teacher Programme

6 full day sessions held monthly

Child Dinosaur treatment Programme: 6 children, 18 - 22 weekly sessions

Child Dinosaur Classroom Programme:3 year curriculum, 2 sessions per week, 30 weeks

Fully revised ADVANCED Programme: 9 sessions helping adults communicate & problem solve

The Incredible Years Programmes

*** the School Aged programme also has an additional four sessions on helping your child to do their best in school

Fully revised School Aged BASIC Parent Programme:

10 - 12 sessions, 6 - 12 years***

Fully revised Pre-School BASIC Parent Programme: 18 weekly sessions, 3 – 6 years

School ReadinessProgramme:4 pre-school sessions 2 – 4 years

Infant (eight sessions) 0 - 12 months toddler 1 - 2 year olds (13 sessions) programmes

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Teacher Programme

6 full day sessions held monthly

Child Dinosaur treatment Programme: 6 children, 18 - 22 weekly sessions

Child Dinosaur Classroom Programme:3 year curriculum, 2 sessions per week, 30 weeks

Fully revised ADVANCED Programme: 9 sessions helping adults communicate & problem solve

The Incredible Years Programmes

***The School aged programme also has an additional four session unit on helping your child to do their best in school

Fully revised School Aged BASIC Parent Programme:

10 - 12 sessions, 6 - 12 years***

Fully revised Pre-School BASIC Parent Programme: 18 weekly sessions, 3 – 6 years

School ReadinessProgramme:4 pre-school sessions 2 – 4 years

Infant (eight sessions) 0 - 12 months toddler 1 - 2 year olds (13 sessions) programmes

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Teacher Programme

6 full day sessions held monthly

Child Dinosaur treatment Programme: 6 children, 18 - 22 weekly sessions

Child Dinosaur Classroom Programme:3 year curriculum, 2 sessions per week, 30 weeks

ADVANCED Programme: 9 sessions helping adults communicate & problem solve

The Incredible Years Programmes

***The School aged programme also has an additional four session unit on helping your child to do their best in school

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

School ReadinessProgramme:4 pre-school sessions 2 – 4 years

Infant - 8 sessions 0 - 12 months Toddler 1 - 3 year olds (12/13 sessions)

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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

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DPICS

T i m e

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C o n d i t i o n

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c o n t r o l

Figure 1. Observed Positive Parenting in 30 minutes

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Eyberg

Figure 2. Eyberg Child Behaviour Problem Scores

Ireland Results (n= 103:46) 2009

Clinical Cutoff 11

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Baseline Follow-up

ECBI Problem Conduct Score

Control

Intervention

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

Long term Sure Start data

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lessons learned to inform Policy & PracticeProgrammes can be effective (even in disadvantaged Sure/Flying Start areas) when core research principles are adhered to:

1. Know what outcomes/change are required2. Select an evidence-based programme for the target

population3. Develop a strategy for recruiting the target

population4. Address relevant service access issues 5. Ensure implementation fidelity6. Evaluate the programme delivery and outcomes

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.

Thank you