The impact of a classroom management programme on children’s mental health

Tamsin Ford and colleagues evaluated the effectiveness of the Incredible Years Teacher Classroom Management (IYTCM) programme. The IYTCM programme aims to improve teachers’ classroom management skills and build strong relationships with students and their parents. Teachers are trained to ignore low-level bad behaviour that often disrupts classrooms and instead develop effective behaviour plans that encourage and promote emotional regulation skills.

The study, published in Psychological Medicine, used a cluster randomised controlled trial, in which children ages four to nine from schools across the southwest of England were randomly allocated to undertake the IYTCM programme or continue their usual practice over a 30-month period (with outcomes assessed at 9, 18, and 30 months). One class in each of 80 schools (40 IYTCM, 40 usual practice; 2,075 children in total) participated. Effects of the intervention on students’ mental health were assessed via the Total Difficulties score from the teacher-report version of the Strengths and Difficulties Questionnaire (SDQ). Data on a range of secondary outcomes (e.g., children’s disruptive behaviour, service use), was also collected in addition to detailing the costs of IYTCM compared to usual practice.

The report concludes that IYTCM may provide a small short-term improvement to children’s mental health, particularly for children who are already struggling. The results of the trial showed there was a small reduction in the SDQ Total Difficulties score at 9 months, but not at 18 or 30 months.

Source: The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: Results of the STARS cluster randomised controlled trial. Psychological Medicine, 1-15.

Interventions for four-year-olds help three-year-olds, too

A new report from MDRC presents the findings for three-year-old children from the Head Start CARES demonstration. This was a large randomised controlled trial in more than 100 Head Start centres across the US. It tested the effects of three different approaches for improving children’s social-emotional competencies: The Incredible Years, PATHS, and Tools of the Mind – Play. The main trial looked at the impact on four-year-old children and this further analysis examines the impact on three-year-olds who were in the same classes.

The results show:

  • Overall, the approaches increased teachers’ social-emotional instruction, but did not affect other aspects of practice or classroom climate in mixed-age classes. The approaches also improved teacher reports of three-year-olds’ social behaviours and closeness with teachers.
  • The Incredible Years did not produce a statistically significant improvement in teachers’ use of classroom and behaviour-management strategies, but it improved teacher reports of three-year-olds’ social behaviours and closeness with teachers.
  • PATHS improved teachers’ social-emotional instruction and Tools of the Mind – Play improved scaffolding of children’s play. However, there was little evidence that the approaches improved teacher reports of three-year-olds’ social-emotional outcomes.

The findings suggest that it is possible for the benefits of social-emotional interventions to extend to three-year-olds, even when the interventions are designed primarily for four-year-olds. In this study, these benefits were driven primarily by The Incredible Years.

Source: Impacts of Social-Emotional Curricula on Three-Year-Olds: Exploratory Findings from the Head Start CARES Demonstration (2014), MDRC.

Evidence on improving preschool children’s social and emotional competence

MRDC has released findings from the Head Start CARES demonstration, an evaluation of the effects of three classroom-based approaches to enhancing children’s social-emotional development on a large scale. These programmes were The Incredible Years Teacher Training Programme (which focuses on teachers’ management of the classroom and of children’s behaviour); Preschool PATHS (which uses structured lessons to help children learn about emotions and interact with peers appropriately); and Tools of the Mind–Play (a one-year version of the Tools of the Mind curriculum that promotes children’s learning through structured “make-believe” play).

The demonstration was conducted in the US with 17 Head Start providers (similar in some ways to the UK’s Sure Start programme) that varied by geographic location, organisational setting, and size. Centres operated by these providers were randomly assigned to one of the three interventions or to a “business-as-usual” control group. Key findings included:

  • PATHS showed small to moderate improvements in children’s knowledge and understanding of emotion (emotion knowledge), social problem-solving skills, and social behaviours.
  • The Incredible Years improved children’s emotion knowledge, social problem-solving skills, and social behaviours. It did not produce expected impacts on children’s problem behaviour and executive function (except for highest-risk children).
  • Tools of the Mind–Play did not demonstrate expected impacts on executive function or self-regulation; it produced only positive impacts on emotion knowledge.

The authors note that the estimated impacts should be interpreted as the effects of the interventions beyond any effects of the existing Head Start programme in these classrooms. Overall, findings showed that evidence-based approaches can improve preschool children’s social-emotional competence when implemented at scale with appropriate supports.

Source: Impact Findings from the Head Start CARES Demonstration (2014), MDRC.

Alleviating parental depression

A new article published in BMC Health Services Research looks at the impact of the Incredible Years (IY) parenting programmes on parental depression and service use. IY aims to reduce conduct disorder in children and depression in their parents, two issues that are often apparent in the same family. Recent trials in the UK and Ireland have focused on the effects of the programme on children, but less was known about the effects on parents.

The authors explored parental depression and service use (and the associated costs) after attending a 12-week, group-based IY Basic Parenting programme. They conducted a secondary analysis of data gathered in a randomised controlled trial (RCT) of the programme. The original RCT sample consisted of 153 (Intervention N=104, Control N=49) parents of children aged 3–4 years old (at baseline) living in 11 disadvantaged Sure Start areas in north and mid Wales.

Depression scores were compared over time for the intervention and control groups. The authors found that parental depression decreased at six months for both the intervention and control groups; however, this decrease was only significant for the intervention group. The differences between intervention and control groups were not significant.

The article also looked at service use costs (primary services such as GPs and health visitors; social services; and hospital services). The parents in the trial accessed a high number of services, particularly in primary health. Total mean costs of service use for the intervention group increased at six and eighteen months post-baseline; however, costs decreased at twelve months post-baseline. Parents who scored above the “clinical level” of self-reported depression in both the intervention and control groups accessed more health and social services than those who were below the clinical level for concern.

Source: Parental Depression and Child Conduct Problems: Evaluation of Parental Service Use and Associated Costs After Attending the Incredible Years Basic Parenting Programme (2014), BMC Health Services Research, 13.

Improving outcomes for children and their parents

A new article published in European Child Adolescent Psychiatry indicates that parent-focused interventions, implemented in the early years, can result in improvements in child and parent behaviour and well-being 12 months later, as well as a possible reduced reliance on formal services.

The article describes an evaluation of the effectiveness of the Incredible Years Basic parenting programme (IYBP) in reducing child conduct problems and improving parent competencies and mental health. A total of 103 families and their children (between ages 2 and 7), who previously participated in a randomised controlled trial of the IYBP, took part in a 12-month follow-up assessment. Child and parent behaviour and well-being were measured using psychometric and observational measures. Pre- to post-intervention service use and related costs were also analysed.

Results indicate that post-intervention improvements in child conduct problems, parenting behaviour, and parental mental health were maintained, while service use and associated costs continued to decline.

Source: Reducing Child Conduct Disordered Behaviour and Improving Parent Mental Health in Disadvantaged Families: A 12-month Follow-up and Cost Analysis of a Parenting Intervention (2014), European Child Adolescent Psychiatry.

Incredible Years achieves “proven” rating

Incredible Years is a suite of programmes that target children up to age 12 who are at risk of, or who are exhibiting, conduct problems. The series has been given an overall rating of “proven” in a new programme summary from the Promising Practices Network, the highest rating they apply. The summary notes that studies of Incredible Years have generally focused on short-term effects, but that the handful of longer-term studies reviewed did show some significant extended effects of the programme. You can find out more about Incredible Years at the IEE conference, when Tracey Bywater (IEE), and Kevin Lawrence (Children’s Services Manager, Barnardo’s Cymru) will be running a session on the programme.

Source: Programs that work, Promising Practices Network.