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

1. Evaluation of a Community based 12 week Basic Incredible Years: 2 year follow up Deborah Roberts Specialist Behaviour Practitioner (5 – 11 years) January 2012

2. 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

3. 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.

4. 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

5. 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

6. 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

7. 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

8. General Health Questionnaire

9. Eyberg Child Behaviour Inventory – Intensity Score

10. Eyberg Child Behaviour Inventory – Problem Score

11. 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

12. Significant Life Events Reported ADHD Diagnosis 7 Learning Disability 2 Waiting for CAMHS assessment 2 Family relationship problems 2 Referred to CAMHS but DNA 1 Seen by CAMHS but NAD 1 ASD Diagnosis 1

13. 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

14. 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..”

15. 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”

16. 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

17. 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.

18. 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