Research into parenting programmes: evidence-based policy or what?

980 views

Published on

Presentation by Stephen Scott, Professor of Child Health and Behaviour, King's College London, and Director of Research, National Academy for Parenting Practitioners

Published in: Education, Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
980
On SlideShare
0
From Embeds
0
Number of Embeds
14
Actions
Shares
0
Downloads
14
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • The Press certainly seem to think parents are a live issue. In September these headlines were in papers I saw myself,.without searching. DM “Brtiain is becoming the bad parent of the western world’
  • Can parenting make a difference to any of this? Generate emotional confidence and skills within the family: safe to care and have empathy, will be cherished and encouraged, limits set Buffer and build resilience against influences outside the family BUT NOT everything Physical environment eg diet, neighbourhood Changes in society eg availability drugs, video games Schooling and peer pressures about eg drinking Although not a panacea for all society’s ills – I think I can show you that parenting does have an important role to play
  • Interestingly, whiles about half of early starters will not go on to become criminal, there are very few who start becoming serious ie repeat 0ffeneder after childhood thus 90% of recidivist offenders began being serious antisocial before the age of 10
  • Another study was the ILS of CD Michael Rutter. Was able to work with a HE, MK who worked at the IoP to do a study of the costs of CD. Actual were 70k, but if added in expected from things we didn’t measure, more like £250k each, since confirmed by Freidl and Parsonsage Tantalising since if you could intervene effectively…. But raises what the mechanism is , and whether it can be changed? IS it in fact all due to factors present at birth or soon after poverty – after all CD rates are about 3 ot 5 times higher in the most disadvantaged as opposed to the better off, or being a male,
  • Can parenting make a difference to any of this? Generate emotional confidence and skills within the family: safe to care and have empathy, will be cherished and encouraged, limits set Buffer and build resilience against influences outside the family BUT NOT everything Physical environment eg diet, neighbourhood Changes in society eg availability drugs, video games Schooling and peer pressures about eg drinking Although not a panacea for all society’s ills – I think I can show you that parenting does have an important role to play
  • Policy in England –eg Ministry name, Every Parent Matters Graham Allen & Ian Duncan Smith: Early Intervention ‘Only parents can deliver’
  • HOW with either the parent or the chidl shd you startby address ing thou8ghts = arugfe with them “you’ll end oup inpriosn if you keep ding that” “if you don’t so youre hoemwork you’ll neve get any GCSEs and then you’sll stakc shelesce in Sainsbursy (if youa re luckly) Feelings “you shudl be ashmsaed of yourself” You make me feel terrible when you steal formt eh shops or hit me. It supsets me” or behaviour” if you so that again, yure getting a slap/ we wont get akitten for Chrsitmas” 70s and 80s Patterson – very exciign imeedite envt chidl alomsotseen as abblack box –no need to address thoughts or feelings
  • Research into parenting programmes: evidence-based policy or what?

    1. 1. Research into parenting programmes: evidence-based policy or what? Stephen Scott Professor of Child Health and Behaviour, King’s College London Director of Research, National Academy for Parenting Practitioners DCSF Research conference 9 February 2010
    2. 4. Good Childhood Findings <ul><li>Many positive aspects of child life today: </li></ul><ul><ul><li>Better physical health, better homes, more communication </li></ul></ul><ul><ul><li>More tolerant, more concerned environment </li></ul></ul><ul><li>BUT </li></ul><ul><ul><li>UNICEF on GB: more out of education 15-19, income inequality </li></ul></ul><ul><ul><li>Rise in emotional & behavioural problems in last 30 years </li></ul></ul>
    3. 5. Oppositional & defiant Blamed by parents Disliked by siblings Gets into fights Rejected by peers Low self esteem Hard to control Poor school achievements Blames others Stealing and truanting Deviant peer group Antisocial attitude Career offender Unemployed Drug misuse 0 5 10 15 5 years 8 years 11 years 14 years 17 years Escape 1/5 1/5 1/5 4/5 4/5 4/5 4/5 Continuity of anti-social behaviour from age 5 to 17. Source: Scott 2002 % of all children No past antisocial behaviour 1/5 1/5 10% 10% 10% 10%
    4. 8. Zone of impact of parenting programmes <ul><li>Abuse </li></ul><ul><ul><li>and it amelioration in Looked After Children </li></ul></ul><ul><li>Inequalities in attainment </li></ul><ul><li>Socialisation and Antisocial behaviour </li></ul>
    5. 9. Clinical trial (Scott, Spender et al 2001, BMJ) <ul><li>141 children age 3-7 referred to CAMHS </li></ul><ul><li>severe, persistent antisocial behaviour (worst 1%) </li></ul><ul><li>‘ Incredible Years’ parenting programme: </li></ul><ul><ul><li>videotapes shown in group, 3 wks each of </li></ul></ul><ul><ul><ul><li>Play </li></ul></ul></ul><ul><ul><ul><li>praise & rewards </li></ul></ul></ul><ul><ul><ul><li>setting limits </li></ul></ul></ul><ul><ul><ul><li>handling misbehaviour </li></ul></ul></ul>
    6. 11. Long-term follow up <ul><li>Follow up 2005-07 7-10 years later of 94 children now aged 10-17 (mean 13) </li></ul><ul><li>Intention to treat, 74 allocated to IY, 20 controls </li></ul>
    7. 12. Parent SDQ total (p<0.003)
    8. 13. Youth report home beh (p<0.038)
    9. 14. “ An ounce of action is worth a ton of theory” Friedrich Engels, 1860
    10. 17. TRAINER PARENTING PRACTITIONER PARENT CHILD Feedback loops of research contribution
    11. 18. The National Academy for Parenting Practitioners Page Training : over 4,000 practitioners trained in evidence-based programmes this year alone Research : extensive programme researching what we do and finding out what works and how Dissemination : events with stakeholders explaining what we are about, workshops for practitioners on new ways of working. Website with latest information on what works www.parentingacademy.org
    12. 19. Research <ul><li>Parenting Programme Evaluation Tool & </li></ul><ul><li>Training evaluation studies </li></ul><ul><li>2. Trials </li></ul><ul><ul><ul><ul><ul><li>FFT </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>SPOKES </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>High Need </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Fostered children </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Callous-unemotional children </li></ul></ul></ul></ul></ul><ul><li>3. Measures of Parenting & Cost-effectiveness </li></ul>Page
    13. 20. Example of Evaluation of a programme “Supporting Parents of children with autism” <ul><li>Element 1: Target population </li></ul><ul><li>Aims; Assist parents in managing children’s behaviour, increase parental knowledge about autism </li></ul><ul><li>Strengths : </li></ul><ul><li>Well described characteristics of the target population , fairly well specified expected outcomes, appropriate programme classification: targeted and specialist </li></ul><ul><li>Weaknesses </li></ul><ul><li>Lack of appropriate intake need assessment </li></ul><ul><li>Lack of appropriate measures of programme expected outcomes </li></ul><ul><li>Self-rating: 4 Academy Rating : 3 </li></ul><ul><li>Element 2:Content and Delivery </li></ul><ul><li>Strengths </li></ul><ul><li>Evidence of some theoretical framework </li></ul><ul><li>(behavioural, cognitive) </li></ul><ul><li>Flexibility in delivering sessions & wide range of attractive resources </li></ul><ul><li>Weaknesses </li></ul><ul><li>Lack of major key ‘autism specific’ theories (theory of mind, developmental milestones) </li></ul><ul><li>Poor content (lacks consideration of communication difficulties) </li></ul><ul><li>Poor balance between didactic component & active skill training, e.g. limited in role-plays and group exercises. </li></ul><ul><li>Self-rating: 3 Academy Rating : 1 </li></ul>
    14. 21. Implications for training & workforce development 1 st Training Offer: Parenting groups implemented
    15. 22. <ul><li>1 st Training offer: Implementation significantly correlated with practitioners’ level of qualification </li></ul>Implications for training & workforce development
    16. 23. Implications for training & workforce development * Does not include SF 1st Training Offer: Implementation significantly correlated with perceived relevance of the training
    17. 24. Implications for training & workforce development Stage 2: Parenting groups implemented * Phase 1 *
    18. 25. (1) Use evidence-based programmes <ul><li>Effect sizes av 0.6 with EB progs (Barlow et al 2002) Effects 0-0.2 otherwise </li></ul><ul><li>Eg Fort Bragg, Homestart, </li></ul><ul><li>Oxford Home Visiting (Weisz et al 1998) </li></ul>
    19. 26. (2) Target accurately Improvement in antisocial behaviour, according to initial severity level (Scott 2005) Clinical trial worst 2% SPOKES prevention trial targeting worst 20% PALS prevention targeting by geographical area
    20. 27. (3) Be engaging! <ul><li>Percent initial enrolment (prevention) depends on trust & liking, and: </li></ul><ul><li>Accessible </li></ul><ul><li>Available </li></ul><ul><li>Affordable </li></ul><ul><li>At convenient time </li></ul><ul><li>(after Pugh 1997) </li></ul>
    21. 28. (4) Keep attendance up Changes in Sensitive Responding according to number of sessions Attended in PALS trial (Scott, O’Connor & Futh in Press)
    22. 29. (5) Quality, quality, quality (Scott, Carby and Rendu 2007)
    23. 30. (6) Build in evaluation and review <ul><li>For some areas , do Randomized Controlled Trials to answer questions eg how many sessions are enough, which programmes have which effects, etc </li></ul><ul><ul><li>Not to do so is to set out to sea without a map </li></ul></ul><ul><ul><li>This is not a luxury, it is prudent and cost- saving </li></ul></ul><ul><li>For all areas , collect pre-post data on effectiveness, measure whole population – otherwise you don’t know who you are excluding (already done as SATS) </li></ul>
    24. 31. Think <ul><li>Feel Do </li></ul>

    ×