Evaluation of CHANGE books for parents with learning difficulties

1. Evaluation of CHANGE books for parents with learning difficulties People First (Scotland) Parents’ Group Create Consultancy Ltd NHS Health Scotland

2. The evaluation • NHS Health Scotland made 3 CHANGE books available. • Pregnant women and parents with learning difficulties were meant to get them as a free, easy read alternative to Ready Steady Baby! and Ready Steady Toddler! • NHS Health Scotland heard this was not happening.

3. The evaluation NHS Health Scotland wanted to find out: 1. If parents were getting the books. 2. What parents and professionals thought of the books. 3. What the barriers were to parents getting the books. 4. The best way of giving out the books.

4. The evaluation Two parts • Parents • Professionals

5. What we did - parents • Interviewed 11 parents • Focus group for 7 parents in Edinburgh • Parents we met lived in Edinburgh, Glasgow, Dundee, Falkirk, Kinross, West Lothian, Midlothian, Alloa and Bo’ness. • All parents had a child under 5 who had lived with them for some of the time since August 2009.

6. What we found Did parents get the books? • Only 5 out of 18 parents received one of the books. • Only 2 parents got the books at the right time • Only 3 parents got a book from health or social work • 3 parents got a book from advocacy projects • No-one had seen My Pregnancy My Choice • All parents had contact with a wide variety of professionals

7. What we found What did parents think of the books? • They really liked the books and thought they were much easier to understand than Ready Steady Baby! and Ready Steady Toddler! • Parents liked the pictures, layout, large print, short sentences and paragraphs, and easy words. • Parents wanted their own copy to use at home.

8. What we found What could be better? Parents wanted the books to include information about: • Children with behavioural difficulties • People coming into your home to provide support They wanted: • You and Your Baby to be colour coded • A DVD to go with each book • A book about looking after children aged over 5

9. What we found Support? • 8 parents said they would like professionals to offer support to use the books • Some parents had support from their partners or parents to read them • Only 1 parent had support from a professional to use the book • Parents said they would be unlikely to ask for help.

10. What we found How and when should parents get the books • They should be given out by the same people and in the same way as Ready Steady Baby! and Ready Steady Toddler! • All parents should be offered a choice • Parents are unlikely to say they have learning difficulties or ask for help.

11. 14 telephone interviews with strategic informants across Scotland 9 focus groups with 62 practitioners (midwifery/health visitors, adult LD teams, children and family SW teams, advocacy workers and voluntary organisations). Whole process supported by steering group with Health Scotland and People 1st Scotland What we did - professionals

12. Are professionals aware of the books? Lots of different professionals work with parents with learning disabilities. However, many had not heard of the CHANGE books therefore were not giving them out to parents. Fewer staff had heard about the ‘You & Your Little Child’ book. More had heard of ‘My Pregnancy My Choice’ and ‘You and Your Baby’ Whatwe found?

13. What prevented staff getting them?... Confusion about whether it cost money to buy the CHANGE books how many books organisations were allowed to order. Lack of information about the CHANGE books on the internet. Infrequent working with parents with a learning disability meant the CHANGE books were not obviously relevant to their work What we found ? How many? 6? 2? 4? Not my job?

14. What helped staff? Some staff heard about the CHANGE books when at conferences or meetings. Others heard about the CHANGE books from people they work with. Also… Google searches E-mails sent to them from managers Information on internet sites and newsletters – this was more common among health staff. What we found

15. There was disagreement who best to give out the CHANGE books to parents. Overall it was felt: Midwives should give out My Pregnancy My Choice early in the pregnancy. Health visitors should give out You and Your Baby Family centres or nursery staff should give out You and Your Little Child. Parents could also be supported to use the books by social workers or other professionals they work with. What we found

16. Most staff were very positive about them. They liked the: Pictures/Layout/Large print Short sentences and paragraphs Easy words What we found

17. But they did not like: The LARGE size of the books Incorrect and outdated information Lack of breastfeeding images and too much bottle feeding information Some staff also felt that some of the pictures were confusing and insensitive, and that the books were not so good for people that don’t read very well. What we found

18. Debate about who the books should be given to. There was disagreement about whether the books should be given to parents to keep or held by staff. At the moment most staff use the books by giving out sections of them rather than the whole book. This is because staff want to make sure that the information they give to parents is relevant to them. What we found

19. CHANGE books should be given out alongside wider practical support from professionals to parents. They should be seen as an alternative to Ready Steady Baby! And Ready Steady Toddler! Different colours for the different sections in You and Your Baby and insame layout as other bookswould make it easier A DVD to go with each book would also be useful. What we found

20. Recommendations • A number of recommendations came out of the evaluations with parents with learning difficulties and professionals.

21. Making sure professionals know about the resources • NHS Health Scotland should promote the books to all Early Years Professionals. Giving information on who should distribute them to parents and how they can order for free. • Information on the CHANGE website should tell people the resources are available free in Scotland.

22. How should the resources be given to parents • All parents should be offered a choice between Ready Steady Baby! and Ready Steady Toddler! and the CHANGE resources • Parents should be given their own copy to keep at home

23. How should the resources be given to parents (cont) • Midwives should offer My Pregnancy My Choice at the booking appointment. • Midwives should offer You and Your Baby at the 28 week check • Health Visitors should offer You and Your Little Child as an alternative to Ready Steady Toddler!

24. Changes to the resources • You and Your Baby should be revised with colour coded sections to follow My Pregnancy My Choice and You and Your Little Child. • CHANGE should explore the development of a DVD to go alongside each book . • You and Your Baby and You and Your Little Child should include additional information about parenting children with behavioural difficulties. • All 3 resources should be updated to fit with Scottish policy on looking after babies and children

25. Supporting parents to use the resources • Parents should be offered support to go through the resources • Parents should be offered the opportunity to inform who provides this support to them