This study, one of the first within a European context, focused on a high-risk sample recruited from real-world urban settings and showed significantly improved child and parent outcomes following a parenting intervention delivered by regular, communitybased service staff. The findings reported here support the importance of early childhood intervention and the utility of evidencebased parenting programs in community-based services in different cultural contexts and in settings characterized by high levels of social disadvantage. This work is an important step in the development, evaluation, and delivery of empirically validated interventions for vulnerable young children with conduct problems and their families. These findings should serve to guide future policy and practice decisions for governments and practitioners who are considering investing in and/or delivering the Incredible Years BASIC Parenting program for children with behavioral problems in disadvantaged communities across different geographical and cultural contexts.
Incredible Years: Independent Replication
School-based interventions involving teacher and/or child training have been shown to benefit teacher practices and to prevent conduct
problems and improve children?s social and emotional competence in developed countries; however, we are aware of no reports from a
developing country.We conducted a pilot study of the Incredible Years Teacher Training programme and a curriculum unit on social and
emotional skills based on concepts and activities drawn from the Incredible Years Dina Dinosaur Classroom Curriculum to determine if
this approach is appropriate for use with Jamaican pre-school teachers and children.
Low-income children often develop in environments that undermine adjustment and academic success. One key challenge facing schools serving children in poverty is that teachers lack the training and ongoing support needed to manage challenges these children present. The Incredible Years Classroom Management Teacher Training Program (IYS-TP) is one program that improves classroom atmosphere and teacher practices, encourages social-emotional development in the classroom, and ultimately reduces behavior problems and enhances school readiness skills among high risk, low-income children.
Children?s aggressive behavior and reading difficulties during early elementary school years are risk factors for adolescent problem behaviors such as delinquency, academic failure, and substance use. This study determined if a comprehensive intervention that was designed to address both of these risk factors could affect teacher, parent, and observer measures of internalizing and externalizing problems.
The impact of difficult child behaviour on family functioning has a compounding effect on the physical, emotional, and psychological welfare of the child, the family unit, and the wider community. Additionally, untreated behaviour problems increase the risk of negative outcomes in adulthood (Breen & Barkley, 1998; Reyno & McGrath, 2006).
Indeed, apart from the impact on the child, recent research has confirmed earlier findings that parents of children with ADHD experience elevated stress levels, and have fewer effective parenting practices compared to parents of children without this disorder (Treacy, Tripp, & Barid, 2005). To address parenting issues and these other factors, an effective, low cost intervention strategy would obviously be a useful addition to the range of services available in everyday settings.
Behaviour management problems (BMP) are common among children (4-12%) and the prevalence seems to be rising. Persistent antisocial behaviour often leads to poor long-term psychosocial adjustment. Structured parent-training programmes have proven to be the most effective way of treating BMP in young children. The Incredible Years Series (IYS), which is a manual-based programme, was introduced in Sweden in 2001. Its aim was to evaluate the effectiveness of IYS in diverse clinical settings in Sweden. Parents of 113 children (3-9 years), recruited through the IYS-trained group leaders? ordinary services, participated in the study. The parents answered various questionnaires regarding their children?s symptoms and their own psychological well-being before and after participating in the parent-training groups. The results are very encouraging; significant reduction of BMP in the children was found on all relevant measures. A significant increase in the self-rated well-being of the mothers was also found. The IYS seems to work in Sweden, even when used by group leaders who are in training. The importance of using a well-documented manualized method when implementing new models is accentuated.
Aims: To assess the effectiveness of a parenting programme, delivered by health visitors in primary care, in improving the mental health of children and their parents among a representative general practice population.
Methods: Parents of children aged 2-8 years who scored in the upper 50% on a behaviour inventory were randomised to the Webster-Stratton 10 week parenting programme delivered by trained health visitors, or no intervention. Main outcome measures were the Eyberg Child Behaviour Inventory and the Goodman Strengths and Difficulties Questionnaire to measure child behaviour, and the General Health Questionnaire, Abidin?s Parenting Stress Index, and Rosenberg?s Self Esteem Scale to measure parents? mental health. These outcomes were measured before and immediately after the intervention, and at six months follow up.
Results: The intervention was more effective at improving some aspects of the children?s mental health, notably conduct problems, than the no intervention control condition. The Goodman conduct problem score was reduced at immediate and six month follow up, and the Eyberg Child Behaviour Inventory was reduced at six months. The intervention also had a short term impact on social dysfunction among parents. These benefits were seen among families with children scoring in the clinical range for behaviour problems and also among children scoring in the non-clinical (normal) range. Conclusion: This intervention could make a useful contribution to the prevention of child behaviour problems and to mental health promotion in primary care.
This interdisciplinary training program prepares 9 Michigan State University doctoral students from school psychology and special education-emotional impairment for leadership roles in the development, implementation, and evaluation of interventions and prevention programs for youth exhibiting disruptive behaviors within the school setting. The objectives of this project include: (a) recruit and admit qualified candidates using effective strategies to recruit students from underrepresented populations including individuals with disabilities, (b) advise, provide financial assistance, and provide graduated and sustained training in areas and contexts that match doctoral leadership training goals, (c) plan, manage, and evaluate the project via involvement of parents of children with disruptive behaviors, interdisciplinary faculty who specialize in this population, and through the involvement of school, community, and administrative personnel (d) evaluate the program repeatedly across time to assure successful student completion and validation of the training methods and procedures, (e) help students assume leadership roles at local, state, or national levels, (f) institutionalize and disseminate our training model to other institutions and constituents across the country.
Our 4 A?s (Affiliate, Apprentice, Active Learner, Action Researcher) training model provides the methodology by which we will prepare doctoral students in a carefully sequenced set of activities within their current doctoral programs in the areas of teaching, research, and service. Comprehensive activity logs, supervisor ratings, and research to practice projects will serve as a means of evaluating our student leaders. Moreover, variables related to leadership in our respective fields (e.g., conference presentations, teacher in-service activities, preservice teacher instruction, journal publications) will be examined. Our participation in the Teacher Training Workshop in Seattle, WA was one example of the types of activities that the students are working on during the second year of the training grant.
Stripped of its dependence on video technology and other resources to be found in most US and UK schools, the Incredible Years prevention program has shown that with expert modification it can still be effective even in difficult social conditions.
Dyed in the wool prevention scientists will tell you that for a program to be truly valuable it must have the potential to be effective anywhere and in any conditions ? even in a country sometimes portrayed as being among the most dangerous in the world.
The location here in question is Jamaica. In 2005 more than 1,600 people were murdered on the island and there is widespread concern about violence in schools. The program under scrutiny is the normally resource-intensive Incredible Years, successful in developed Western conditions and a key component of a recently-announced public health initiative in Ireland.
The Jamaican experiment was led by Helen Baker-Henningham of the University of West Indies against the troubling background of a survey of more than 3,000 Jamaican adolescents conducted in 2000 by colleagues Kola Soyibo and Michael Lee.
New IY programmes for parents of toddlers and babies were recently developed in Seattle by Carolyn Webster-Stratton, Ph.D. The 12-week toddler parenting programme has been the subject of a Welsh Government funded separate evaluation. The eight-week programme discusses appropriate stimulation and aims to increase parental sensitivity to their babies’ cues, encourage the development of parent support networks and highlight safety issues. Parents and their babies meet weekly with two trained leaders for twohour sessions. Updates on their infants’ activities and development are shared in a safe and supportive environment. Parents are encouraged to implement the programme strategies in their daily activities at home.
Assessed the effectiveness of ?The Incredible Years Parent Training Program? on the functioning of families of children with ADHD within a community clinic setting. A multiple baseline across participants design was employed with four research participants in a group of nine parents attending a 2-hour treatment session weekly for twenty weeks, with planned booster sessions at 2 and 4 months following treatment. Participants were all solo mothers with sons between 6 and 9 years of age who met the DSM IV criteria for ADHD. Family functioning was assessed from the pre-treatment interview schedule, measures of child behavior (Conners, Strengths and Difficulties Questionnaire, daily ratings of child behavior) and parental functioning (BDI-II, Parental Stress Index, weekly ratings on specific areas of family functioning, group goals). Participants also completed program satisfaction and evaluation measures. Results overall showed (a) some improvement in teacher and parent reports of child behavior, including targeted child behavior goals, (b) improved targeted family functioning problems, (c) increased parental confidence, (d) reduced stress and depression levels for most parent participants, and (e) reports of better parent-child relationships. Additionally, participants all reported being highly satisfied with the program. Findings support the use of the Incredible Years Parent Training Program and planned booster sessions as an effective low cost intervention to improve the functioning of solo mothers and of children with ADHD. Discussion considers the use of this intervention in an overall multiple gating, stepped care approach, particularly in light of a need for continuing services for one of the mothers.
Executive Summary – Aims of the Study?
In the present study we assess the preventive effects of the IY BASIC and ADVANCE parent programs in preschool children at risk for disruptive behavior disorders. We are studying the moderating effects of psychophysiological and neuropsychological variables on intervention outcome. We also study whether positive outcomes are caused by favorable changes in parenting skills. Finally, costs and cost-effectiveness are studied. One hundred and forty children, aged four and a half years are selected for the study on the basis of high aggression scores on the Child Behavior Checklist. The parents of half of these children are randomly assigned to the IY BASIC and ADVANCE programs; the other children serve as ‘care as usual’ controls. Assessments are conducted 00at pre-treatment, post-treatment, one year follow-up, and two year follow-up. Measures consist of parent questionnaires (e.g., Child Behavior Checklist, Eyberg Children?s Behavior Inventory), parent interviews (e.g., Daily Discipline Interview, NIMH Diagnostic Interview Schedule for Children IV), teacher questionnaires (e.g., Child Behavior Checklist – Teacher Rating Form, Parent-teacher Involvement Questionnaire), and observations of parent-child interactions at home (Dyadic Parent-Child Interaction Coding System). Detailed information on the costs of the intervention and on the costs generated by the conduct problems (e.g., medical consumption, education) are monitored.
Early-onset behavioural problems such as aggression and non-compliance are the best predictors of antisocial and criminal behaviour in adolescence and Randomised controlled trial of a parenting intervention. Untreated, up to 40% of children with early difficulties develop subsequent conduct disorder, including drug misuse, criminal and violent behaviour. Early behavioural difficulties predicting long-term problems are easily identifiable and effective interventions prevent progression into more severe difficulties. There are severe financial costs if conduct disorder is not prevented. Utilisation of health, social, education and legal services is ten times higher for this population, mostly borne by publicly funded services, especially in areas of social exclusion. Parenting behaviour contributes to the establishment of conduct disorder and many children learn, develop, or establish problem behaviours because parents lack, or inconsistently use, key parenting skills9. When ineffective parenting is the problem, cognitive-behaviourally based parenting programmes can provide an effective solution but are more effective with younger children. When both child problems and parenting patterns are less well-established parents can more easily influence their children?s behaviour. One UK government strategy is Sure Start early preventive parenting support for families of pre-school children living in identified high-risk, disadvantaged areas. Since its launch in 2001 ?3.1 billion has been invested in the scheme11. This funding was provided without direction from government about which services should be delivered. As a result, widely varying services were provided, many lacking evidence of effectiveness from randomised trials.
Also of related interest: The ?Spokes? Project: Supporting Parents On Kids Education
Department Of Health Project Funded By The Parenting Initiative?
Authors: Stephen Scott, Reader in Child Health and Behaviour, Institute of Psychiatry, King?s College London and the Maudsley Hospital, and Kathy Sylva, Professor of Educational Psychology, University of Oxford
The objective of supporting parents is to enable them to develop a nurturing, stimulating relationship with their child, so they develop the child’s emotional and intellectual well-being. The question arises how best to support parents. This project sought to implement and evaluate a programme to support directly improvement of the quality of the parent-child relationship, rather than address the indirect factors that can stress it.
The consequences of inadequate parenting often lead to child behavioural difficulties and school failure. Without effective intervention, the behaviour problems have a high degree of continuity and lead to behaviours such as theft, violence to persons and property, and use of illegal drugs; disorders such as alcoholism, drug dependence, and antisocial personality disorder. The school failure has a high continuity with unemployment and receipt of state benefits. The children grow up into adults with a high rate of marital violence, family break-up, and abuse of the next generation of children.
These difficulties contribute to a greatly increased economic cost – one recent UK study showed that by the time they are 28 years old, individuals who were antisocial as children cost society ten times more than children without it. There is therefore a need for effective intervention to prevent serious, lifetime social exclusion of children, and strain and distress of parents. To address the need for early intervention, this project operated early, when the children were 5 and 6 years old in primary school.
Nature of Project
This project carried out an innovative community-based intervention to support parents in managing the two sets of child difficulties for which they most frequently seek help, namely behaviour and learning. Its aim was to see whether this parenting support package would improve the functioning of the children at risk for social exclusion, by looking at two crucial outcomes: reduction in antisocial behaviour; and their reading ability, a central skill for coping throughout life.
Implementation questions Question one: Could the groups easily be held in an everyday life venue – the local primary school, so that it could be widely replicated? Question two: Would a substantial proportion of parents with children at risk choose to enrol in the courses? Question three: Would the starting population taken as a whole show improvement? Even if there were useful improvements in those parents who attended most of the course, some would drop out.?
Parent support programme
The intervention package was delivered in 8 primary schools over three school terms. In term 1 there was a basic 12 week parenting course addressing the parent-child relationship and how to handle difficult child behaviour, in term 2 there was a 10 week reading programme, and in term 3 a 6 week combined course.
Term one: Personal development programme This was the basic ?Incredible Years? Webster-Stratton videotape parenting programme, backed up by home visits to maximise effectiveness. The scenes show parents and children in a variety of common situations, with the parents sometimes behaving in a way that leads to the child being calm and obedient, and sometimes in a way which leads the child to be miserable and have tantrums. Through careful observation and group discussion, the elements that led to successful child management were drawn out, and then parents role-played how they would apply these with their own children. They were then given homework to put this into practice during the following week.?
Term two: Intervention to support child literacy development. Professor Sylva and the team devised a new intervention with relatively intensive parental involvement and considerable specific instruction in technique. It centred around engaging maximal parental commitment and giving parents detailed training in how to encourage and shape reading skills in their child. The literacy intervention lasted 10 weeks. Term three: Combined programme This addressed communicating and problem solving with your child, and had a top-up element for literacy. It lasted six weeks.
Sample Strengths and Difficulties Questionnaires (SDQs) were completed on 733 reception and year one children by teachers, representing 99.5% of children in their classes. Parents of 433 children returned SDQs, a rate of 61%. 394 were correctly filled in and usable. A cutoff score was applied, giving 134 or 34% of the sample, who were deemed at risk of social exclusion through a high level of antisocial behaviour. 103 took part. The sample was a typical inner-city, multi-ethnic disadvantaged population. Half of the children were allocated to the parent support programme, the control half were offered an advice helpline. All 8 schools approached were extremely cooperative and welcomed the project.
Attendance by parents allocated to the intervention Personal development programme (term 1) mean attendance was 7 out of a maximum 12 sessions. Literacy programme (term 2) the mean was 6 out of a possible 10 sessions. Combined programme (term 3) the mean was 4 out of a possible 6 sessions?
Antisocial behaviour On the primary outcome, the PACS interview score, there was a significant effect in favour of the intervention group. The effect size was 0.51 standard deviations, substantial for a prevention trial. The reduction in antisocial behaviour corresponds to an improvement for the participants from being within the worst 15% of antisocial children to being outside the most antisocial 35%. The effect size for hyperactivity was also significant, 0.43. Hyperactivity is an important independent risk factor for social exclusion.?
Parent defined problems. Problems parents reported included arguing, disobedience, fighting, whining, spitefulness, jealousy etc. The intervention group showed a significant improvement compared to the controls, with an effect size of 0.64.?
Eyberg Child Behaviour Inventory.
The Intensity Score, which is a measure of the frequency of difficult behaviours, reduced significantly more in the intervention group, with an effect size of 0.28.?
Parent Satisfaction 93% of parents said they were well or extremely satisfied with the programme.
The intervention group gained seven months in reading skills, an effect size of 0.43. This result held up unchanged after multiple regression correction for age and gender. Race, parent education, parent income, and child age and gender did not affect degree of change in the intervention group compared to the control group, suggesting that the programme is robust and suited to disadvantaged populations.
This report has been prepared to provide an account of the Norwegian The Incredible Years programme, in accessible form. Beside a description of the programme, it concentrates on the results of clinical trials carried out in Trondheim and Troms? in 2001-2003, and presents material from a user evaluation carried out in 2003-2004. A brief examination of implementation issues is also included. Important project components in the programme seen as a whole have had to be omitted here, either because they are not yet complete or because space did not allow their inclusion. The treatment trial material presented here is based on work carried out by Bo Larsson, Willy-Tore M?rch, May Britt Drugli and Sturla Fossum. The user evaluation material is based on work carried out by Jim Lurie and the undersigned. Charlotte Reedtz, Jim Lurie and the undersigned have worked on collection of material to standardise instruments used in the research.
Background: Controlled evaluations of psychosocial interventions for young children with behavioural problems are sparse. However, in a series of experimental studies, professor Webster- Stratton and her collaborators in Seattle have examined the effects of various forms of parent and child therapy for 4-8 year-old children with aggressive and noncompliant behaviours. In the studies various forms of basic parent and child training have been compared to waiting-list controls, a more comprehensive parent training program, and in addition to a school-based (teacher) intervention. No previous replications have been made in Scandinavia, but two such studies have been conducted in Canada and one recently in England, both with positive outcomes.?
Aims and study design: To replicate one of Webster-Stratton’s studies comparing the basic training program for parents (12 sessions) with parent training and child therapy (“The Dinosaur School”)(18 sessions) and waiting-list controls in an experimental study including a total of 150 Norwegian children aged 4-8 years; 60 families will be randomized into each of the active treatment groups and 30 families to the waiting-list. To examine the maintenance of treatment effects one year after treatment, in addition to generalisation of treatment effects from home to school settings.?
Measures: After screening for children’ s noncompliant and aggressive behaviours as rated by parents and teachers (Eyberg Child Behavior Inventory-EBCI), parents of children with high scores are interviewed to obtain psychiatric diagnoses of either oppositional defiant disorder (ODD) or conduct disorder (CD). Parents rate their practices, involvement in child care and rearing disagreement, in addition to their own anger, depression and stress. Observations of child and parent interaction are made at home and in the clinic. In the school and preschool the children’s behavioural problems are observed and compared with children with no such problems. The child reports on its feelings of loneliness and takes a problem-solving test. School and day care teachers assess the children’ s behaviour and social competence, in addition to their own home involvement.?
Implementation and intervention: The planning of the project started 1998 and has been subjected to an evaluation by the Norwegian Research Council before implementation. Extensive contacts were established with professor Carolyn Webster-Stratton, who helped training of therapists and the mentor. Because no normative data existed for the screening measure (EBCI), it was first standardised in a survey including about 640 children aged 4-8 years from Trondheim and Troms?. Many of the assessment instruments and the video vignettes were translated into Norwegian.?
Since the fall of 200l recruitment of children and families has taken place. Today, about half of the final sample (N=78) has been recruited in the project, which will continue unti1 summer 2003. Treatment is administered to parents and children in groups over a 3-4 month period. Two therapists conduct the group treatment, which is highly structured and manual.?
For this paper the researcher took the unusual approach of interviewing the deliverers of the parent training programme in Tauranga, rather than the recipients. The perspective taken was that the programme facilitators are usually highly qualified psychologists and social workers who collectively have an enormous amount of knowledge, experience and insights. The Incredible Years parent training programme has been found to be highly successful in Tauranga as it provides a supportive group environment in which parents can share concerns and ideas, and it is adaptable to different cultural and individual needs.
Abstract – The efficacy of the Incredible Years parent training and child therapy programs was examined in a randomized controlled study including 127 Norwegian children aged 4?8 years. Children diagnosed with oppositional defiant disorder (ODD) or conduct disorder (CD) were randomized to parent training (PT), parent training combined with child therapy (PT + CT), or a waiting-list control condition (WLC). Assessments were carried out at baseline, posttreatment and at a one-year follow-up using standardized measures and a semi-structured interview. Both active treatment conditions reduced child conduct problems posttreatment as opposed to the WLC, while differences between the two treatment conditions were small and nonsignificant. About two thirds of the treated children functioned within normal variation after treatment, and the same proportion no longer received an ODD diagnosis at the one-year follow-up. Parental use of positive strategies increased after treatment, and the use of harsh and inconsistent discipline decreased as did mother experience of stress. The outcome of this study emphasizes the importance of offering parent training to young children with severe conduct problems exhibited at home. The findings and usefulness of the Incredible Years program in the present Norwegian replication study further support and extend positive outcomes of previous controlled trials conducted primarily in Anglo-Saxon ountries.