Evaluation of a Community based 12 week Basic Incredible Years: 2 year follow up

Deborah RobertsSpecialist Behaviour Practitioner

(5 – 11 years)January 2012

Why the evaluation took place

Working in Sure Start (England) evaluation was part of the culture

Local criticism that parents did not hold on to their strategies

Coalition government – a need for financial accountability and value for money

Pure curiosity

Aim of Evaluation To evaluate the effectiveness of a

community based 12 week Basic Incredible Years Parenting Programme, 2 years post completion

To share information and add to the evidence about the suitability of Incredible Years Programmes as a community intervention for mild to moderate behaviour difficulties in children up to 12.

How I went about it Registered with the audit department of BCUHB Sent out letters to previous participants

informing them of our intention Original questionnaires used (General Health

Questionnaire and Eyberg Behaviour Checklist) Structured / semi-structured questionnaire to

gather data on events over the previous 2 years Piloted on handful of participants Carried out by the support worker in post, in the

participants home

Quantitative Results (or the number crunching exercise)

First step was to digest ‘SPSS for Dummies’

As majority of data did not show normal distribution – most were skewed to the left – the non-parametric Wilcoxon signed rank test was performed

Interesting data 12 groups were targeted Sample of 57 out of original 90

participants (63%) Age range 0 – 12 years, mean average age

5.7 years (5.6 yrs boys, 5.9 yrs girls) Total boys 31 (54%) and girls 26 (46%) Average sessions attended 9.1 Age breakdown

0-4yrs 24 5-7yrs 15 8-12yrs 18

Source of referrals Self 22 Sure Start 14 CAMHS 9 School Nurses 6 Social Services 2 Community Paed 1 School 1 Family member 1 Voluntary org 1

General Health Questionnaire

General Health Questionnaire(Black line = clinical cut-off)

0

1

2

3

4

5

6

7

8

Pre-group

Post-group

2 years

Mean Average

Eyberg Child Behaviour Inventory – Intensity Score

Eyberg Behaviour Intensity Score(Black line = clinical cut-off)

0

20

40

60

80

100

120

140

Pre-group

Post-group

2 years

Mean Average

Eyberg Child Behaviour Inventory – Problem Score

Eyberg Behaviour Problem Score(Black line = clinical cut-off)

0

2

4

6

8

10

12

14

Pre-group

Post-group

2 years

Mean Average

ECBI Intensity Above the clinical cut-off

Pre group 28 (50%) Post group 6 (11%) 2 years 18 (31%)Of these 18 children, 12 had a ‘significant life

event’ in the past 2 years, 7 of which had gone on to be diagnosed with ADHD

Of these 18, 5 had shown no significant change post group

Of these 5 whose scores hadn’t changed post-group, only 2 were above the clinical cut-off

Significant Life Events Reported

ADHD Diagnosis 7Learning Disability 2Waiting for CAMHS assessment2Family relationship problems 2Referred to CAMHS but DNA 1Seen by CAMHS but NAD 1ASD Diagnosis 1

Qualitative data (or what they fed back) Participants comments themed:

Behaviour had remained better 24 Group was supportive 10 Enjoyed the group 9 Information and home practice 8 Group leaders supportive 6 Understood what to do/confident 4 Still struggling 4 Currently under assessment 4 Diagnosis was important 3 Problems with another child 3 Crèche facilities useful 2 Having further support 1

Participants comments Improved behaviour

“Things have been OK since doing the course. If I have a problem now, I go back to sticker charts”

“I found the group really useful, descriptive commenting was brilliant. The behaviour has been good since the group. Only 1 problem occurred when a little brother came along”

“It gave a good foundation on how to deal with issues. I still remember the principles, information got from the group was really good. I can see the benefits of structure, but not always able to keep this in place..”

Group Experience “I think this sort of parenting course is

invaluable to all mums and dads, whatever age their children. I also love the interaction with other parents, you do not feel alone with a problem. Keep the course going!!!”

Nothing bad. Good group, leaders were helpful and explanations were really good. Meeting other people and discussing issues, realising that I wasn’t the only person struggling”

What strategies were they predominately using? Prompt card and asked for examples

Rewards 27 Praise 26 Consequences 16 Ignoring 15 Play 14 Time out 14 Limit Setting 6 Controlling Upsetting Thoughts 3 Problem Solving 3

Summary of outcomes at 2 years

General Health Questionnaire - 79% remained below the clinical cut-off

Eyberg Child Behaviour Inventory - 69% below above the clinical cut-off for both intensity of the behaviour and problem score.

What has happened since ‘Top-up’ sessions have been offered due to

expressed need, but little success ‘Advanced IY’ offered as a result and huge demand.

Two groups run and waiting list! New Support worker recruited Oct 2011 after post

frozen for 12 months Sure Start project ended, Behaviour Practitioner (0-

4s) moved to Flying Start to run in-house – since retired

Run the new up-dated Basic Referral source shifted to CAMHS and School Nurses Maintained our universal approach to all parents in

Conwy county Findings been accepted for publication