The Incredible Years

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The program representative did not provide information about a Logic Model for The Incredible Years (IY). This training will prepare group leaders to lead three different basic parenting programs: (1) Toddler Parenting Program (ages 1-3 years) which is 13 weekly sessions; (2) Preschool Parenting Program (ages 3-6 years) which is 18-20 sessions; and (3) School-Age Parenting Program (ages 6-8 years) which is 16 sessions (four additional sessions for the Supporting your Child’s Education component). Status — Participants were first-generation Korean American mothers of young children (3-8 years old). Beauchaine, T. P., & McNulty, T. (2013). Comorbidities and continuities as ontogenic processes: Toward a developmental spectrum model of externalizing psychopathology. Development and Psychopathology, 25(4), 1505–1528. Bywater, T., Hutchings, J., Daley, D., Whitaker, C., Yeo, S. T., Jones, K.,...Edwards, R. T. (2009).

The Incredible Years BASIC Parent Training Program targets parents of high-risk children and those displaying behavior problems. Highlighted parenting skills include: http://www.incredibleyears.com/wp-content/uploads/Reinke-IY-TCM-Program-Outcomes.pdf Study design and sample In addition, at 2.5-year follow-up, parents, teachers, and children reported on conduct problems using the Strengths and Difficulties Questionnaire (SDQ; Goodman 2001). The SDQ has shown good validity and test-retest reliability (Stone et al. 2015). The conduct scale consists of five items (e.g., “often loses temper”) that are answered on a 3-point scale (0 = not true to 2 = certainly true). Internal consistency in our sample was α parent = .63, α teacher = .68, and α child = .55, which is in line with other findings (e.g., Bourdon et al. 2005) and most probably a result from skewness and limited response categories rather than actual low reliability (Stone et al. 2015). Emotional Problems, Peer Problems, and ADHD SymptomsOur finding that there are no broader benefits of Incredible Years on children’s mental health problems shows that reducing coercive parent-child interactions reduces children’s conduct problems specifically. Although coercive interactions and conduct problems often co-occur with other mental health problems (Capaldi 1992; Beauchaine and McNulty 2013), changes in conduct problems do not automatically translate into changes in other mental health problems. Whereas one might suggest that such cascading effects need more time to evolve and become apparent later, studies following children 5 to 10-year post-intervention suggest that this is not the case (Scott et al. 2014; see Sandler et al. 2015 for a review on cascading effects for a broader range of interventions). In situations where the prevention aim is to target a range of mental health problems, transdiagnostic interventions focused on shared underlying mechanisms for different mental health problems may need to be designed (e.g., transdiagnostic interventions; Weisz et al. 2017). Families who displayed greater levels of distress and higher levels of problems, particularly higher child disruptive behaviour or parental depression found greater positive effect, with more improvement from this intervention. Webster-Stratton, C. (2009). Affirming diversity: Multi-cultural collaboration to deliver the Incredible Years parent programs. International Journal of Child Health and Human Development, 2, 17–32. There were 14 studies in this review, six studies were undertaken in England, two in Wales, two in the Netherlands and one trial each in Ireland, Norway, Sweden and Portugal.

Clinical issues such as promoting attendance, managing resistant parents or teachers, being culturally responsive, managing disruptive children, setting up practice role plays, tailoring programs for children with developmental issues, and getting accredited or certified in the program. Weekly phone calls to problem solve any concerns or celebrate your successes, additional home visits to help practice the skills, support you during meetings with other professionals and signpost you to other support services.The only longer-term randomized controlled trial of Incredible Years (> 1 year, including follow-up data of control group) included assessments 5 to 10-year post-intervention (Scott et al. 2014). Results suggested sustained improvements in conduct problems for children in a clinical setting, but not for children in a prevention setting. This might in part be because effect sizes tend to be smaller in prevention settings (Leijten et al. 2018). To be able to detect smaller effect sizes, larger sample sizes are needed. The sample size of 109 families in the prevention trial by Scott et al. ( 2014) may have been too small to detect such smaller prevention effects. Other follow-up studies have been reported, but due to waitlist control designs, follow-up data for control groups were not available. We conducted a longer-term (albeit shorter than Scott and colleagues) follow-up including the control group in a large randomized controlled trial ( N = 387), to ensure sufficient power to detect smaller effects on children’s conduct problems. Are there Broader Benefits of Incredible Years on Children’s Development? To test for sustained effects, we conducted two analyses. First, we estimated the longer-term effect of Incredible Years on conduct problems (using the ECBI and the SDQ) at the final measurement wave, using analysis of covariance (ANCOVA), controlled for baseline levels of conduct problems. Second, we used LCM piecewise function in Mplus to get a more in-depth view on changes in conduct problems during intervention and after intervention, by estimating the initial intervention effect and the putative sustained effect based on all five waves of ECBI data. This model has two slopes of development: one slope represents change in conduct problems during the intervention phase (i.e., pretest to immediate post-test), and one slope represents change in conduct problems during the follow-up phase (i.e., immediate post-test to 2.5-year follow-up). Model fit is considered good if the root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) are < .05 and confirmatory fit index (CFI) value is > .95 (Hu and Bentler 1999). Previous analyses on the ORCHIDS data indicated that clustering effects were negligible and that IY intervention effects across the different groups were not dependent on therapists or therapist characteristics. Who benefits and how does It work? Moderators and mediators of outcome in an effectiveness Trial of a Parenting Intervention. Journal of Clinical Child & Adolescent Psychology. 39(4), 568-580. Hutchings, J., Martin-Forbes, P., Daley, D., & Williams, M. E. (2013). A randomized controlled trial of the impact of a teacher classroom management program on the classroom behavior of children with and without behavior problems. Journal of School Psychology, 51(5), 571–585. Our study brings several implications for practice. First, Incredible Years is an effective parenting intervention to sustainably reduce parent-perceived conduct problems of children—on average about a third of a standard deviation on the ECBI. Because of the significant overlap between Incredible Years and other “brands” of parenting intervention programs such as Parent Management Training Oregon (PMTO), parent-child interaction therapy (PCIT), or Triple P, for instance, this implies that parenting interventions in general might have sustained effects. Indeed, this conclusion is corroborated by other research showing longer-term intervention effects across different parenting intervention programs (Lundahl et al. 2006; Sandler et al. 2015; Van Aar et al. 2017). Second, based on our finding that conduct problems reduce during the intervention, and not afterward, no further improvements in conduct problems should be expected after the intervention terminates. If conduct problems do not sufficiently reduce during the intervention, this could be a sign that other types of support are needed. Third, based on our findings (but please note the limitations regarding measurements, sample, and design used for this study), no broader longer-term benefits should be expected on social, emotional, and ADHD problems. We therefore suggest that Incredible Years as an indicated prevention should be offered for conduct problems specifically.

The preliminary effect of a parenting program for Korean American mothers: A randomized controlled experimental study. International Journal of Nursing Studies, 45, 1261-1273. The role of mental health factors and program engagement in the effectiveness of a preventive parenting program for Head Start mothers. Child Development, 74(5), 1433-1453. McGilloway, S., Bywater, T., Mhaille, G. N., Furlong, M., O’Neill, D., Comiskey, C., … Donnelly, M. (n.d.). Proving the Power of Positive Parenting - This reference refers to a randomised control trial, conducted in Ireland. The authors highlight that given the extreme consequences and potential high public health and financial cost, there is a good rationale for early preventative parenting programmes for parents of children who display persistent disruptive behaviour. According to parents, 31% of the children in the intervention condition showed clinical levels of conduct problems before intervention (> 95th percentile on the ECBI; Weeland et al. 2018b) which reduced to 14% at immediate post-test and to 9% at 2.5-year follow-up. In the control condition, this percentage of children with clinical-level conduct problems reduced from 25 to 18% at immediate post-test and to 10% at 2.5-year follow-up. The percentage of children showing clinical recovery was significantly higher in the intervention condition between pretest and post-test ( χ 2 = 3.88, p = .049), and not significantly different between post-test and follow-up ( χ 2 = 1.15, p = .283). According to teachers, equal percentages (7%) of children in the intervention and control condition showed clinical levels of conduct problems at follow-up (> 95th percentile on the SDQ; Meltzer et al. 2000). On the self-report measure, 12% of the children in the intervention condition, and 16% in the control condition, reported clinical levels of conduct problems at follow-up ( χ 2 = 0.98, p = .323).Kim, E., Cain, K. C., & Webster-Stratton, C. (2008). The preliminary effect of a parenting program for Korean American mothers: A randomized controlled experimental study. International Journal of Nursing Studies, 45(9), 1261–1273. Webster-Stratton, C., & Reid, J. (2010). Adapting the Incredible Years, an evidence-based parenting programme, for families involved in the child welfare system. Journal of Children’s Services, 5, 25–42. https://doi.org/10.5042/jcs.2010.0115. Cost-effectiveness analyses suggests that the Incredible Years intervention can provide savings to the public sector in the longer term.

De Los Reyes, A., Henry, D. B., Tolan, P. H., & Wakschlag, L. S. (2009). Linking informant discrepancies to observed variations in young children’s disruptive behavior. Journal of Abnormal Child Psychology, 37(5), 637–652. Graham, J. W., Olchowski, A. E., & Gilreath, T. D. (2007). How many imputations are really ` needed? Some practical clarifications of multiple imputation theory. Prevention Science, 8(3), 206–213. Status — Participants were self-referred or professionally referred parents of children with child misconduct problems lasting at least six months.Reid, M. J., Webster-Stratton, C., & Baydar, N. (2004). Halting the development of conduct problems in Head Start children: The effect of parent training. Journal of Clinical Child and Adolescent Psychology, 33(2), 279-291. Incredible Years tended to show a mixed effect on positive parenting. This is based on high strength evidence. The findings showed an increased use of positive praise. However parents did not report using more rewards or monitoring behaviours. The sustained effects of Incredible Years pertained to parent-reported conduct problems specifically; no effects were found using children’s self-reports or teacher reports. This may indicate that children’s conduct problems have changed in interaction with their parents specifically, and not in the school setting that is part of child and teacher report (De Los Reyes et al. 2009). An alternative explanation is that Incredible Years changed parents’ perception of their child’s behavior. A better understanding of their child’s behavior could, for example, lead to parents having more realistic, age-appropriate expectations, and reduced stress, relieving their potentially initial overestimation of their child’s behavior problems (Crnic et al. 2005; Moens et al. 2018). Yet another explanation might be that the questionnaire used by parents (i.e., the ECBI), detected changes in conduct problems that the questionnaire used by teachers and children (i.e., the SDQ), was unable to detect. Although well-established and validated (Bourdon et al. 2005; Stone et al. 2010), the SDQ conduct scale consists of only five items and has only three response options (i.e., not true, somewhat true, and certainly true). This makes the SDQ suitable for screening purposes but perhaps less suitable for assessing children’s behavior changes in the context of a parenting intervention. Moreover, given that the SDQ conduct problems scale also had a lower reliability, the power to detect the already subtle changes was further reduced. No Broader Benefits of Incredible Years on Children’s Development