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Incredible Years Research Update Incredible Years Centre Wales School of Psychology 17th March, 2010 Tracey Bywater. Today…. What type of research do we do, why, & who with? What research are we currently undertaking?. Type of research & why we do it. Translational Research:

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Today

Incredible Years Research Update Incredible Years Centre WalesSchool of Psychology17th March, 2010Tracey Bywater


Today
Today….

  • What type of research do we do, why, & who with?

  • What research are we currently undertaking?


Type of research why we do it
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


And who with
…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



General research questions
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?


Current funded research
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


Postgraduate projects
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


Today

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


Welsh sure start trial
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



Eyberg
Eyberg

Figure 2. Eyberg Child Behaviour Problem Scores



Longer term follow up
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



Today

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


References
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.