EIF PROGRAMME REPORT THE NEW FOREST PARENTING PROGRAMME JULY 2016
2 How to read an EIF Programme Report This Programme Report should be read in conjunction with our guidance on How to read an EIF Programme Report, which provides an explanation of the contents of the summary material. This can be found on the EIF website. Scope This assessment is based on information gathered through the EIF s review of What Works to support parentchild interaction in the period from conception to age 5 years in order to improve child development. The child outcomes reviewed were limited to impacts on attachment and/or parent sensitivity; behaviour and social and emotional skills; and cognitive development, in particular early literacy and use of language. The rating included represents an assessment in relation to these outcomes only. Disclaimer The information in this report and the rating of impact is designed to provide information for those developing early intervention programmes and systems. The evidence can be used to inform and assist professional judgement, but it is not a substitute for it. This Report does not purport to contain all the information that may be required by third parties in order to exercise their judgement. Evidence about what has worked in the past offers no guarantee that an approach will work in all circumstances. Every effort has been made to ensure the accuracy of the information, but no legal responsibility is accepted for (i) any errors or omissions (negligent or otherwise); and (ii) any consequences resulting from the use of or reliance on this Report. The Report includes reference to research and publications of third parties: the Early Intervention Foundation is not responsible for, and does not guarantee the accuracy, completeness, timeliness or availability of, those third party materials or any related material. The Early Intervention Foundation does not perform an audit and undertakes no duty of due diligence or independent verification of any information (including, but expressly not limited to, information about costs of the programmes) it receives from third parties including the programme providers. The rating is an independent judgement based on the facts reported to EIF as of the date expressed. It is not a recommendation or a statement of fact. This Report is provided on an as is basis without warranty of any kind, either express or implied.
3 Summary: The New Forest Parenting Programme Programme Description Brief Description Based on the version of the programme evaluated in its best evidence. Primary Outcome Behaviour Delivery Model: Individual Domain: Child Age: Preschool Level of Need: Targeted Indicated Full Description Based on information agreed with the programme developer, this section describes the programme more generally in terms of recommended or typical implementation. The New Forest Parenting Programme (NFPP) is for parents with a child between the ages of three and 11 with moderate to severe symptoms of ADHD. A single practitioner with a minimum QCF-Level 5 (preferably a Level 6) in psychology or another relevant helping profession conducts home visits with individual families over a period of eight weeks. Each session lasts one to one-and-a-half hours. During the weekly visits, parents are made aware of symptoms and signs of ADHD and the ways in which they may affect their child s behaviour and their relationship with their child. Parents also learn strategies for managing their child s behaviour and attention difficulties. Some of these strategies are taught through games that engage children s attention, encourage their patience and increase their concentration. The practitioner observes the parent and child playing the game together and provides feedback on the quality of their interaction. Ratings Summary Strength of Evidence of Child Outcomes 3+ The New Forest Parenting Programme (NFPP) has evidence from at least one rigorously conducted comparison group study along with evidence from an additional comparison group study. These studies identified statistically significant positive impact on a number of child and parent outcomes. This programme does not receive a rating of 4 as it has not yet replicated its results in a high quality study suggesting long-term impact (and using assessment measures independent of study participants). Programme Costs On the basis of information about resource requirements submitted by the provider, EIF has estimated the relative cost of programmes per family or child. The specific resource requirements are described in the next pages of this report. The cost scale runs from 1 to 5, with 1 being the least costly to set up and deliver, and 5 being the most costly. The New Forest Parenting Programme (NFPP) has a cost score of 3, meaning that this programme is estimated to be medium cost to set up and deliver compared to other interventions reviewed by EIF. Impact The New Forest Parenting Programme (NFPP) has evidence demonstrating impact on a number of child and parent outcomes. Some key examples of statistically significant impacts include: Child behaviour outcomes. 3 Reduced ADHD ratings on the Conners Rating Scale Revised parent report d=1.01 Reduced ADHD ratings clinician assessment d=1.66 Reduced defiance scores on the New York Teacher and Parent Rating Scales parent report d=.59 The evidence for The New Forest Parenting Programme also demonstrates a range of impacts for the parent, including improved parenting strategies and improved parenting confidence.
4 Implementation Summary Based on information provided by the programme developer, this section describes the programme more generally in terms of recommended or typical implementation. NFPP is delivered to individuals in eight sessions of between one and one-and-a-half hours duration. It is delivered by one practitioner with a QCF-4/5 qualification, who receives 24 hours of programme training. Booster training of practitioners is recommended. In addition, it is recommended that practitioners are supervised by one programme developer supervisor qualified to QCF-7/8 level. There is a licensing requirement to run this programme In Detail Level of need Low need X Moderate need High need Classification Universal X Targeted: Selective Programme requirements Targeted: Indicated Specialist Highly Specialist X X Format Sessions Number of practitioners required to deliver it Delivered to individuals 8 sessions of between 1 and 1.5 hours duration 1 Practitioner requirements Job Title or Profession of Practitioner 1st Senior family-support worker, psychologist, health visitor, nursery nurse Qualification Level 1st Recommended QCF 4/5 Hours of programme training 1st Accreditation/certificati on required? 24 hours Yes Booster training? Yes Supervision requirements Number of supervisors 1 Type of supervisor Programme developer supervisor providing clinical and skills supervision Qualification level Recommended QCF 7/8 Training - Host agency requirements
5 Licensing fee Yes Evidence Details NFPP has evidence from four RCTs. Three were conducted in the UK; one was conducted in the USA. Summary of impact evaluation informing the EIF evidence assessment Study Design Country of Origin Sample Child Outcomes Parent Outcomes 1. Sonuga- Burke et al. (2001). RCT UK 58 families with a child screened for symptoms of ADHD Reduced hyperactivity Improved behaviour Increased parenting satisfaction Increased sense of wellbeing Increased parenting efficacy 2. Sonuga- Burke et al. (2004). RCT UK 89 families with a child identified with behavioural difficulties None observed None observed 3. Thompson et al. (2009). RCT UK 41 families with a preschool child diagnosed with symptoms of ADHD Improved child behaviour None observed 4. Abikoff et al. (2015). RCT USA 164 families with a preschool child with symptoms of ADHD living in New York Reduced hyperactivity Improved behaviour Increased parenting satisfaction Improved parenting References References of main studies informing the EIF evidence assessment Sonuga-Barke, E.J.S., Daley, D., Thompson, M., Laver-Bradbury, C., & Weeks, A. (2001). Parent-based therapies for preschool attention-deficit/hyperactivity disorder: A randomized, controlled trial with a community sample. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 402-408. Sonuga-Barke, E.J.S., Thompson, M., Daley, D., & Laver-Bradbury, C. (2004). Parent training for attention deficit/hyperactivity disorder: Is it as effective when delivered as routine rather than as specialist care? British Journal of Clinical Psychology, 43, 449-457. Thompson, M.J.J., Laver-Bradbury, C., Ayres, M., le Poidevin, E., Mead, S., Dodds, C., Psychogiou, L., Bitsakou, P., Daley, D., Weeks, A., Miller Brotman, L., Abikoff, H., Thompason, P., & Sonuga-Barke, E.J.S. (2009). A small-scale randomized controlled trial of the revised new forest parenting programme for preschoolers with attention deficit hyperactivity disorder. European Journal of Adolescent Psychiatry, 18, 605-616.
6 Abikoff, H.B., Thompson, M., Laver-Bradbury, C., Long, N., Forehand, R.L., Miller Brotman, L., Klein, R.G., Reiss, P., Huo, L., & Sonuga-Barke, E. (2015). Parent training for preschool ADHD: a randomized controlled trial of specialized and generic programs. Journal of Child Psychology and Psychiatry, 56, 618-631.