Incredible Years Research Update Incredible Years Centre Wales School of Psychology 17th March, 2010 Tracey Bywater

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