Dr. Tracey Bywater Dr. Judy Hutchings

The Incredible Years (IY) Programmes:Programmes for children, teachers & parents were developed by Professor Webster-Stratton, University of Washington.The Programmes have been identified as achieving exceptional, long-term, evidence for violence reduction & prevention.The parent programme was originally developed & researched as a treatment programme for diagnosed conduct disordered children & its effectiveness

has been demonstrated in the USA, Canada, Norway & the UK.Webster-Stratton has since established the parenting programme as an early intervention strategy with high-risk Head Start communities in Seattle.IY Programme training has been available in Wales for the last six years & many services have IY trained staff & have delivered the programmes.

The IY BASIC Parenting Programme:Focuses on strengthening parenting skills with the intention of preventing, reducing, & treating conduct problems, & increasing social competence among

children aged 2-8 years. Consists of 12 weekly sessions that emphasise the importance of play, relationship building, ways to help children learn, effective praise, use of incentives,

limit setting, & ways to deal effectively with misbehaviour. A collaborative approach is emphasised, with skills developed through group discussion, videotape modeling, rehearsal & home assignments.

Has been researched over the last 20 years using randomised controlled group studies with long-term positive results replicated by independent researchers in both academic & service settings.

The Need to Evaluate the IY BASIC Parenting Programme in Wales:As yet no UK evaluation of the programme in an early intervention/preventive setting.

•As yet no examination of the special challenges of programme implementation to a largely bi-lingual & rural based population such as that found in Wales.The majority of Sure Start services in North & Mid Wales were implementing the programme & required evidence of effectiveness.

Overview of the Project funded by The Health Foundation, October 2002 to 2007:Randomised controlled trial replication of Webster-Stratton’s (1998)1 successful implementation of the programme in Head Start Centres in Seattle.Families with a child (36-59 months) ‘at risk’ of developing conduct problems were approached by a local Health Visitor who administered the Eyberg Child

Behaviour Inventory. families were eligible if the child resided with the primary carer, scored above the clinical cut-off on the Eyberg and the primary carer was able to attend group times.•Recruitment: 153 families (104 intervention, 49 control). Drop-out rate was 13% at 6 months & 24% by the last, 18-month, follow-up .•Data collection: At baseline & 6 months for both the intervention & waiting list control, & again at 12 & 18 months for intervention families only.

Parenting programme was delivered by accredited group leaders - the staff of collaborating Sure Start Services. 12 intervention groups were run in total from 11 Sure Start areas across North & Mid Wales.Programme delivery was standardised across centres: centres provided transport, free crèche & meal, the project provided course materials, all parenting

sessions were videotaped, randomly selected tapes were monitored by an independent IY trainer for fidelity.

Outcome Measures - Interview/Self report:Demographic & family risk factorsParental competenciesParental satisfaction with parenting programmeChild social & verbal competence, & conduct problems

Outcome Measures: Observation of parent-child interaction:Dyadic Parent-Child Interactive Coding System 30 minute observations take place in family home, 4-7pm positive parenting, parent commands, affect,critical statementschild deviance, child affect, prosocial behaviour

1 Webster-Stratton, C. (1998). Preventing Conduct Problems in Head Start Children: Strengthening Parenting Competencies. Journal of Consulting and Clinical Psychology, 66(5), 715-730

The short-term findings are currently in press in the British Medical Journal 2007

Evaluation of the Webster-Stratton BASIC Parenting Programme with Parents of ‘at risk’ Pre-school Children in Sure Start Areas Across North &

Mid WalesThis research has been funded by The Health Foundation

Dr. Frances Gardner & Dr. Dave Daley

Short-term Results: baseline to follow-up 1

Summary of Findings

There are differences between the intervention & control groups at follow-up 1, showing statistically & clinically significant outcomes for the intervention group.

Observation data shows that:

Intervention parents practice more positive parenting at follow-up 1 (Figure 1).

Intervention children show less anti-social behaviour

Parent report data shows that:

Intervention parents perceive their child as having fewer & less intense problem behaviours at follow-up (Figures 2 & 3)

These improvements have been maintained up to the 18-month follow-up (Figure 4)

A cost-effectiveness analysis of the IY groups (Edwards et al., in press, BMJ) found that the programme improved children’s behaviour at a modest cost - even when taking into account set-up, leader training, group & supervision costs, travel, telephone calls, clerical support etcetera.

Conclusions

The intervention improved parenting skills, this had a positive effect on child behaviour in both the short and long term

Positive changes for high-risk Sure Start families were demonstrated when using an effective evidenced-based parent programme delivered with fidelity

Long-term Results

Clinical cut-off

Figure 4. Intervention Eyberg Child Problem Scores