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‘Wanting the best for my children.’
Lorraine Khan, Lead for Children and Young People
Parenting programmes: improving outcomes for children with early behavioural problems
The Centre’s research
Study of evidence-based parenting programmesParents access to programmesMulti sector awareness of significance of early behavioural difficultiesImplementation effectiveness
National SurveyDetailed analysis of pathways/experiences in four areas159 interviews with practitioners stakeholders44 interviews with parents (attenders and non attenders).Literature review
Why early starting behavioural problems matter
Behaviour is how children communicate distress, developmental difficulties or frustration
5% of children (<11 years) have severe and persistent behavioural problems meeting threshold for mental health diagnosis
15% have less severe (but still life-chance damaging) behavioural problems
These children face very poor outcomes
More likely to end up on child protection caseloads and in carelower life expectancyhigher risk of school exclusion Higher risk of suicide Higher risk of teenage parenthood Higher risk of drug dependency and smoking…20 times more likely to end up in prison
Well implemented parenting programmes can help; BUT a minority of children get early help they need.
What parents told us
Most common criticism – poor knowledge of what helps and how to find support
I’m a bit disappointed that it’s not more widely known about. (Mother, attender of parenting group).
There was no information at all about courses. Nothing at my school or nothing on […] the borough website. It was very difficult to find information about courses like this. (Mother, attender of parenting group).
It’s good, it’s just not widely known. […] When you go to baby groups and things I don’t think people really know about it, that’s my take. (Mother, attender of parenting group).
What parents told us about seeking help
Parents underestimated significance of early behavioural problems as gauge of child’s healthy development
Confusion: ‘naughty’ or in need of support?I actually thought he was just a generally naughty boy.
Stigma: parents felt they were ‘failing’You think your kids a right terror and you think it’s because of you - the way you’re doing stuff
Confusion and stigma delayed help-seeking and increased family stress - crisis
What parents told us
Knowledgeable & motivational referrers using the right language were critical to supporting attendance
Schools – important gateways to supportGPs Also Health Visitors, nursery staff, school nurses and social workers = important routes into programmes
Importance of word of mouth recommendation by other parents
What’s helps parents engage
Practical incentives are critical - crèches, transport, venue
Motivation Additional outreach support for cautious/sceptical parentsMotivational interviewing approaches
Understanding what the programme feels like Interactive, supportive, non patronising/judgementalProblem solvingSkills-building important for fathersUnderstanding parenting within community and cultural context important for BME – dedicated groups?
Success stories
What parents interviews revealed…
Parents with most complex needs waited longest for help…often over many years
e.g. case example
Some evidence of:Lack of join up between health, social and educational behavioural provision
Limited stepped system linking severity of need with appropriate care
Implications…
Programmes (and healthy child development) need better promotion
during pregnancy30 month checks and nursery contactin GP/dentist surgeriesin schools – most popular source of info for parentsamong those in contact with children in crisis or those working with higher risk parentsWord of mouth recommendation most powerful
Language and marketing - involve parents in campaigns
‘Behaviour should fall within healthy developmental ranges to help children make progress in life’
‘Some children are more challenging to parent; simple techniques can make a real difference to your child’s behaviour, to their well being…and to your confidence.’
Focus on strengths and benefits: ‘Get it right now and you improve your child’s chances in life - and your family’s quality of life’.
One system to improve mental health
Routine and systematic tracking of who needs additional support:
multi sector use of Strengths and Difficulties Questionnaire
Glasgow example
Market programmes to multi sector referrers Sell bespoke benefits for partners’ outcomes
Skill up referrersCoach in motivational language and brief intervention approaches
Engagement and fidelity
Track enrolment and drop-out rates – analyse and problem solve dips in performance
Don’t cut corners on practical incentives –it’s a false economy
Poorly skilled and supervised staff make children’s outcomes worse
Quality control is important – to guarantee results
Strategically
Develop simple referral process - single well-publicised gateway
Develop all-age integrated health, education, social care & justice pathway supporting children with behavioural problems
Needs Assessment:Using SDQ data - compare existing provision with needClose gap through local commissioning
Involve parents in strategic planning, campaigns and delivery
The costs
Children with early starting behavioural difficulties:
cost public purse ten times more by age 28 savings disperse across range of budgets affecting schools, Looked After Children costs, child hospital admissions, other health and mostly ‘anti social behaviour’/crime.Beneficiaries from early intervention don’t fund parenting programmes
Need pooled funding mechanisms involving multi sector key beneficiaries from early intervention
