The Changing Lives Initiative: An Early Intervention Approach to ADHD

The Changing Lives Initiative is a cross border community-based project in County Louth, Ireland, Colin/West Belfast, Northern Ireland, and the Argyll & Bute region of Scotland working to provide an early intervention parent program for families with children aged 3-7 experiencing behaviors consistent with ADHD. There are five partner organizations involved in The Changing Lives Initiative: Archways, Colin Neighbourhood Partnership, Dundalk Institute of Technology, The Genesis Programme (Louth Leader Partnership) and NHS Highland.

The Changing Lives Initiative has been implementing the Incredible Years® parenting program, specifically aimed at helping families and children with ADHD. When Covid hit, they were able to continue with remote online delivery with families.

They have recently shared their outcomes evaluation, finding that parents participating in the Incredible Years program had increased use of positive discipline strategies, decreased parental stress, and improved parent/child relationships. The parents reported reduction in child hyperactive/impulsive behaviors, improved concentration and attention, and reduction in social and emotional problems.

Incredible Years Mentor Sean McDonnell, PhD, was Principal Investigator in this study and one of the authors of the evaluation report. Sean is a Psychologist and Deputy CEO at Archways. Sean has shared his work with the Changing Lives Initiative, below:

The Changing Lives Initiative

• by Sean McDonnell, PhD, Deputy CEO Archways

In 2017 Archways was awarded a large scale European funding to establish a new community-led early intervention treatment model for Attention Deficit Hyperactivity Disorder (ADHD).  This model designated the ‘Changing Lives Initiative’ was ambitious. Designed to be implemented over a three-year period in cross-border areas in border communities in Northern Ireland, the Republic of Ireland and in Western Scotland (the Argyll & Bute region), the Initiative set out to create a better understanding of ADHD and to provide an intervention programme for families with children (aged 3-7) experiencing behaviours consistent with ADHD.  The project offers a tiered intervention for families starting with Information and Awareness Sessions, through to a Screening Programme and finally an intensive intervention in the form of an evidence based ADHD-focused Incredible Years® Parent Training Programme (22 sessions).  The intervention was primarily delivered to a pre-diagnosis population; with potential families being identified via a range of agencies including schools, preschools, GPs, family support hubs, and pediatric health services.  Importantly, the primary goal of the implementation was to provide an implementation template for the treatment of ADHD using the Incredible Years® parent treatment model which would allow the standardization of services to this cohort of families and children.

Uptake of the Changing lives suite of offerings was phenomenal. Our ADHD information workshops were made available to 1700 professionals and 2000 families, and the Incredible Years®parenting Programme was made available to over 350 families. We were aware that research was vital if we were to provide the information needed to transform the services in these communities and embed the initiative in what were traditionally hard to reach communities. Thankfully all of our Project Partners recognized the imperative of robust research and evidence. The use of evaluations allowed us to measure the impact of our work and understand better what worked well and what did not.  Our research findings shed light on unknowns, filled gaps in our knowledge, and has in many ways changed the way that healthcare professionals in these areas now work.

Our suite of evaluations included outcome, process, and cost evaluations and since much of our work was conducted under the Covid shadow, we also had an opportunity to test and compare the online Incredible Years® parent programme and face to face delivery modes. Thankfully all of the evaluation outcomes proved successful. Participating organizations are now fully committed to the delivery of our changing lives model. Professionals are better informed as to the subtle and not so subtle manifestations of ADHD. Parents are better informed as to the unique challenges and opportunities parenting a child with ADHD presents. Most importantly the power of the Incredible Years® programme to bring about lasting change was proven.

Post programme, those who attended the twenty-two week programme thrived and their children flourished. Parents of children with behaviours consistent with ADHD reported improved relationships practices, greater positivity within the home, parental strategies which scaffolded their child, held them securely, and replaced negative disciplinary strategies with loving and supportive inputs. Not surprisingly, the parents spoke of reductions in stress and the amazement they experienced as they saw reductions in their children’s hyperactivity. Impulsivity and compulsivity reduced to normative levels. Time together was cherished, ideas explored as the children’s concentration levels improved. Children’s behaviours improved as the opportunity to practice social engagement skills grew from the peer networks the children developed over time.

In many ways the Parenting programme once again underscored the truism that supported children and informed parents and teachers can overcome even the most embedded of problems. The Changing Lives Initiative will shortly be rolled out to two counties in the Republic of Ireland with the mainstreaming of the service to be conducted over the coming years. We are thankful to the parents, families and practitioners, grateful to the children and as always indebted to the programme, we have started a conversation, made the first step in a journey, hopefully there is more to come.

In March 2020 the COVID -19 pandemic brought changes to how The Changing Lives Initiative continued to support families.  Along with other projects throughout the world, The Changing Lives Initiative had to adapt to the changing circumstances and restrictions arising from the pandemic. The added strain on families, who had lost support structures and routines due to the restrictions, made it even more important that the project continue its work.  The Changing Lives Initiative adapted quickly and completed some of the programmes underway through remote delivery methods.  Over the summer months, the project then went on to pilot the first ever fully remotely delivered ADHD IY Parent Programme.  From August 2020, Information and Awareness workshops for both practitioners and parents/caregivers were moved online and extended, with more emphasis on effective strategies to support children’s behaviour.  The Screening Programme was also then successfully adapted to remote delivery via telephone.   A full cohort of remotely delivered ADHD IY Parent Programmes were then delivered from September 2020 through to late January 2021. 

Although the project evaluations were mostly complete at this stage, it was felt important to gather feedback from parents in relation to the remotely delivered programmes and so a piece of qualitative research was added to the evaluations in order to explore the acceptability of the remotely delivered ADHD IY Parent Programme, a summary of the findings included in this report.

Read the report: The Changing Lives Initiative: Summary report on Outcomes, Process and Economic Evaluations