The Incredible Years Autistic Spectrum and Language Delay programme

1. The Incredible Years Autistic Spectrum and Language Delay programme Margiad Elen Williams

2. Background • Estimated UK prevalence 1.7% (Russell et al., 2014) • Associated behavioural challenges are common (National Autistic Society, 2015) • They cause more distress than core symptoms (Hastings et al., 2005)

3. Parent programmes • Recommended by National Institute for Health and Care Excellence (NICE, 2013) • Group-based programmes effective for range of outcomes (e.g. Whittingham et al., 2015) • Provide social support (Dababnah & Parish, 2014)

4. Incredible Years (IY) Basic Parent programme • Evidence-based, NICE-recommended intervention (e.g. Hutchings et al., 2007) • Delivered with adaptations for parents of children with ASD (Dababnah & Parish, 2014, 2015) • Decreased parental stress • High acceptability and satisfaction with content

5. IY Autistic Spectrum & Language Delays programme • New addition to IY suite • Uses same core delivery components • Targets parent-child relationship and broad developmental outcomes e.g. communication, social skills, other adaptive skills, and behaviour problems

6. Initial pilot study • Nine parents (8 mothers, 1 father) • Children had been, or being assessed, for ASD by local services

7. Measures • Strengths and Difficulties Questionnaire (SDQ) • Arnold-O’Leary Parenting Scale (PS) • DPICS observation • Satisfaction

8. Results • High rates of attendance • High levels of satisfaction

9. Results • Significant change in SDQ

10. Parental feedback • “Meeting the other parents was the number one thing. All the tips have been brilliant. Knowing what to focus on especially using positive suggestions rather than commands.” • “Has shown me how to change my behaviour which in turn has an effect on my child’s behaviour.”

11. Dissemination • Results published in Good Autism Practice (Hutchings et al., 2016) • DVD about parents’ experiences of the IY Autism programme

12. Parenting for Autism, Language, And CommunicationEvaluation Study (Williams et al., 2017) • Pilot randomised controlled trial • Explore feasibility and initial effectiveness • 4 centres (NW Wales, Central North Wales, Flintshire & Newtown, Powys)

13. Measures • Child behaviour (CBCL) • Parental mental health (PSI, BDI) • Parenting (PS) • Child adaptive skills (VABS) • Social communication (SCQ) • Sibling behaviour (SDQ) • Partner relationship (Family APGAR) • Parent-child observation (DPICS) • Cost data

14. Data collection • Baseline, 6-month follow-up for all families • Additional 12-month and 18-month follow-up for intervention families • 10-minute parent-child observation videotaped

15. Participants - Children

16. Participants - Parents

17. Child Behaviour Problems

18. Next steps • Programme delivery due to finish by Easter • Finish scoring, inputting baseline data • Code parent-child observations • 6-month follow-up due in June

19. Further follow-up • Jess Bibby funded by KESS and CEIT to undertake a PhD alongside the trial • Explore impact on other family members • Collect longer term follow-up data at 12 and 18 months for intervention families only

20. References • Dababnah, S., & Parish, S. L. (2014). Incredible Years program tailored to parents of preschoolers with autism: Pilot results. Research on Social Work Practice. Advance online publication. doi:10.1177/1049731514558004 • Dababnah, S., & Parish, S. L. (2015). Feasibility of an empirically based program for parents of preschoolers with autism spectrum disorder. Autism. Advance online publication. doi:10.1177/1362361314568900 • Hastings, R. P., Kovshoff, H., Ward, N. J., Espinosa, F. D., Brown, T., & Remington, B. (2005). Systems analysis of stress and positive perceptions in mothers and fathers of pre-school children with autism. Journal of Autism and Development Disorders, 35, 635-642. doi:10.1007/s10803-005-0007-8 • Hutchings, J., Bywater, T., Daley, D., Gardner, F., Whitaker, C. J., Jones, K., … Edwards, R. T. (2007). Parenting intervention in Sure Start services for children at risk of developing Conduct Disorder: Pragmatic randomised controlled trial. British Medical Journal, 334, 678-684. doi:10.1136/bmj. 39126.620799.55 • National Autistic Society (2015). Autism facts and history. Retrieved from http://www.autism.org.uk/aboutautism/myths-facts-and-statistics/statistics-how-many-people-have-autism-spectrum-disorders.aspx • National Institute for Health Care and Excellence [NICE] (2013). The management and support of children and young people on the Autism Spectrum. Retrieved from: www.nice.org.uk/guideance/cg170 • Russell, G., Rodgers, L. R., Ukoumunne, O. C., & Ford, T. (2014). Prevalence of parent-reported ASD and ADHD in the UK: findings from the Millennium Cohort Study. Journal of autism and developmental disorders, 44, 31-40. doi: 10.1007/s10803-013-1849-0 • Whittingham, K., Sofronoff, K., Sheffield, J., & Sanders, M. R. (2009). Stepping stones triple P: An RCT of a parenting program with parents of a child diagnosed with an autism spectrum disorder. Journal of Abnormal Child Psychology, 37, 469-480. doi:10.1007/s10802-008-9285-x • Williams, M.E., Hastings, R.P., Charles, J.M., Evans, S., & Hutchings, J. (2017). Parenting for Autism, Language, And Communication Evaluation Study (PALACES): protocol for a pilot randomised controlled trial. BMJ Open, e014524. doi:10.1136/bmjopen-2016-014524

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