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Parenting programmes: What works? Some UK evidence

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... all children Oppositional & Defiant Blamed by parents Disliked by siblings Gets into fights Rejected by peers Low sel-esteem Hard to control Poor ... – PowerPoint PPT presentation

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Title: Parenting programmes: What works? Some UK evidence


1
Parenting programmes What works? Some UK
evidence
  • April 2003
  • Stephen Scott
  • Reader in Child Health and Behaviour
  • Institute of Psychiatry, Kings College London

2
Continuity of Antisocial Behaviour from age 5 to
17
ESCAPE
of all children
1/5
1/5
1/5
1/5
4/5
4/5
Oppositional Defiant Blamed by
parents Disliked by siblings
4/5
Gets into fights Rejected by peers Low
sel-esteem
4/5
Hard to control Poor school achievements Blems
others
Stealing truanting Deviant peer
group Antisocial attitude
Career offender Unemployed Drug misuse
3
PREDICTION OF SOCIAL EXCLUSION
4
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5
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6
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7
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8
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9
SWITCH - REPEAT
RIGHT
LEFT
C gt CD
ACC
IPC
CD gt C
OFC/ IFC
OFC
PL
TL
PCu
10
What is Positive Parenting?
  • Encouraging desirable behaviour strengths
  • (rather than just stopping undesirable
    behaviour)
  • Sensitively responding to childs needs
  • (rather than ignoring their signals)
  • Setting firm limits consistently and calmly
  • (rather than exploding unpredictably and with
    venom)

11
What are the consequences of negative parenting ?
Immediate impact Long-term outcome
feel emotionally excluded low attachment to family, school
dont learn social skills No good friends, fail in love
feel stupid incompetent poor confidence, touchy
little persistence low qualifications, poor work
feel frustrated and angry antisocial, criminal, drug misuse
12
University centre vs Real-life clinic
13
Successful Programmes
  • Collaborate with parents involve vs tell
  • Provide practical assistance
  • Offer specific Skills AND Support
  • Last at least 20 hours
  • Catch children before adolescence
  • Supervise therapists, have a manual

14
Principles of Trial for Conduct Problems
  • CAMHS clinic ordinary referrals
  • Reasonably broad entry criteria
  • Multiple sites in regular NHS clinics
  • Local clinicians trained as therapists

15
Multicentre trial of positive parenting
  • 141 children age 3-7 referred to CAMHS
  • severe, persistent antisocial behaviour
  • Incredible Years parenting programme
  • videotapes shown in group, 3 wks each of
  • Play
  • praise rewards
  • setting limits
  • handling misbehaviour

16
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17
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18
Predictors of less child improvement
  • Child hyperactivity (?.19 p.03)
  • Younger child (?.17 p.04)

19
No Barrier to Change
20
Effect size by Centre
21
Attend Parenting Group
.53
.21
.43
Maternal depression change
Parenting skill change
Parental criticism change
.25
.05
.44
.08
Child less antisocial
22
DELIVERY IN EVERYDAY LIFE
  • the SPOKES Programme in schools
  • Address a whole population
  • Get them young
  • Engage the most deprived
  • Address child behaviour AND learning
  • Use the most effective interventions
  • Make it normal and fun

23
PROJECT PLAN
  • Design
  • Screen whole school
  • Take 1SD (16 national population/ 30
    Lambeth)
  • Screen positive randomise to
  • INTENSIVE PROGRAMME
  • CONSULTATION HELPLINE

OR
3
24
Child Antisocial Behaviour - PACS Interview
scores

25
Child Hyperactivity - PACS Interview Scores

26
Child Emotional problems - PACS Interview Scores

27
LITERACY PROGRAMME SKILLS
  • Orientation
  • PAUSE
  • PROMPT meaning picture cues
  • -own experience
  • read on to end of sentence
  • start sentence again
  • PRAISE
  • There should be less sounding out of letters

28
Child Reading BAS RA-CA

29
Child Reading BAS Percentile

30
Conclusions
  • Parenting programs can improve antisocial
    behaviour in the family by a substantial amount
  • Parents can be taught to enhance reading skills
  • It would be worth finding out the extent to which
    parents could enhance peer relationships

31
PREDICTION OF SOCIAL EXCLUSION
32
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33
Cognitions and beliefs
Emotions and motivation
Behaviour and skills
34
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35
Making your local parenting programme effective
for a whole population do you
  • Make it available, acceptable, accessible,
    affordable?
  • Use programmes independently shown to work?
  • Supervise workers regularly using a manual?
  • Have strong management to coordinate elements?
  • Define population, screen risk, pursue
    non-attenders?

36
Systematic, population-based services
  • Level 1 universal, media-based infotainment
  • Level 2 primary care 20 min specific consult
  • Level 3 primary care 4 X 20 min wider skills
  • Level 4 group parenting, say 8 sessions
  • Level 5 more intensive extra 10 sessions
  • Australian experience with Triple P (Sanders)
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