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Background: Group-based parent programmes demonstrate positive benefits for adult and child mental health, and child behaviour outcomes. Greater fidelity to the programme delivery model equates to better outcomes for families attending, however, fidelity is typically self-monitored using programme specific checklists. Self-completed measures are open to bias, and it is difficult to know if positive outcomes found from research studies will be maintained when delivered in regular services. Currently, ongoing objective monitoring of quality is not conducted during usual service delivery. This is odd given that quality of other services is assessed objectively, for example by the Office for Standards in Education, Children's Services and Skills (OFSTED). Independent observations of programme delivery are needed to assess fidelity and quality of delivery to ensure positive outcomes, and therefore justify the expense of programme delivery. Methods: This paper outlines the initial development and reliability of a tool, the Parent Programme Implementation Checklist (PPIC), which was originally developed as a simple, brief and generic observational tool for independent assessment of implementation fidelity of group-based parent programmes. PPIC does not require intensive observer training before application/use. This paper presents initial data obtained during delivery of the Incredible Years BASIC programme across nine localities in England and Wales, United Kingdom (UK). Results: Reasonable levels of inter-rater reliability were achieved across each of the three subscales (Adherence, Quality and Participant Responsiveness) and the overall total score when applying percentage agreements (>70%) and intra-class correlations (ICC) (ICC range between 0.404 and 0.730). Intra-rater reliability (n = 6) was acceptable at the subscale level. Conclusions: We conclude that the PPIC has promise, and with further development could be utilised to assess fidelity of parent group delivery during research trials and standard service delivery. Further development would need to include data from other parent programmes, and testing by non-research staff. The objective assessment of quality of delivery would inform services where improvements could be made.

Teachers frequently struggle to cope with conduct problems in the classroom. The aim of this study was to assess the effectiveness of the Incredible Years Teacher Classroom Management Training Programme for improving teacher competencies and child adjustment. The study involved a group randomised controlled trial which included 22 teachers and 217 children (102 boys and 115 girls). The average age of children included in the study was 5.3 years (standard deviation = 0.89). Teachers were randomly allocated to an intervention group (n = 11 teachers; 110 children) or a waiting-list control group (n = 11; 107 children). The sample also included 63 'high-risk' children (33 intervention; 30 control), who scored above the cut-off (>12) on the Strengths and Difficulties Questionnaire for abnormal socioemotional and behavioural difficulties. Teacher and child behaviours were assessed at baseline and 6 months later using psychometric and observational measures. Programme delivery costs were also analysed. Results showed positive changes in teachers' self-reported use of positive classroom management strategies (effect size = 0.56), as well as negative classroom management strategies (effect size = -0.43). Teacher reports also highlight improvements in the classroom behaviour of the high-risk group of children, while the estimated cost of delivering the Incredible Years Teacher Classroom Management Training Programme was modest. However, analyses of teacher and child observations were largely non-significant. A need for further research exploring the effectiveness and cost-effectiveness of the Incredible Years Teacher Classroom Management Training Programme is indicated.

The prognosis for children with early-onset conduct disorder is poor. Conduct disorder also has a social cost for families and communities, and an economic cost for society through the increased use of health, education, social, legal and detention services. In this study, the Incredible Years (IY) BASIC programme was delivered to parents of pre-school children at risk of developing a conduct disorder and evaluated by pragmatic randomised controlled trial. Participants were parents of 161 children (110 intervention, 51 control) aged between 36 and 59 months (mean age 44 months, 63% boys) and scoring over the clinical cut-off on the Strengths and Difficulties Questionnaire (SDQ). At follow-up (six months post-baseline), the intent-to-treat analysis showed a mean between group difference in favour of IY on the SDQ total difficulties score of 2.23 (p < 0.05, effect size: 0.50). IY was also superior to control on the Eyberg Child Behaviour Inventory (p < 0.05, effect size: 0.37) and on the Arnold and O'Leary parenting scale (p < 0.01, effect size: 0.43). This study confirms the effectiveness of IY in a public system delivered with fidelity by regular children's centre staff, supporting findings from a similar trial in Wales. These results support the wider roll-out of IY to similar children.

There are a growing number of school-based interventions designed to promote children's social and emotional learning. One such intervention, PATHS (Promoting Alternative Thinking Strategies), was evaluated in a randomised controlled trial involving 5074 pupils aged 4-6 years at baseline in 56 primary schools across a large city in the UK. The programme was implemented for two academic years. The primary outcome measure was the teacher-rated Strengths and Difficulties Questionnaire (SDQ). A secondary measure was the PATHS Teacher Rating Scale (PTRS). Observations of child and teacher behaviours were undertaken in a third of intervention and control schools using the Teacher-Pupil Observation Tool (T-POT). Regarding fidelity, dose and adherence were measured via weekly logs completed by teachers, and a semi-structured questionnaire completed by PATHS coaches was used as a global measure of fidelity (capturing adherence, dose and quality). A cost-consequence analysis examined programme costs from a multi-agency public sector perspective. At 1 year post-baseline, there were no statistically significant differences between the programme and control groups on the SDQ subscales or the SDQ total difficulties and impact scores. There were statistically significant differences favouring the programme group for six out of 11 subscales on the secondary outcome measure (PTRS). At 2 years post-baseline, there were no statistically significant differences between the groups on either measure. Fidelity, according to the global measure, was relatively strong, and there was no relationship between fidelity and treatment effects. The average cost of PATHS was £12,666 per school or £139 per child. The study, which was fully powered and independent of the programme developer, shows no statistically significant effect of the programme on child behaviour or emotional well-being. Trial registration site and number: www.controlled-trials.com: ISRCTN 32534848.

Inappropriate, aggressive and disruptive behaviour in the classroom can be detrimental to child and teacher well-being. This study involved a longer-term evaluation of the "Incredible Years Teacher [Classroom Management]" programme (IYTP) undertaken mainly within disadvantaged schools in south-west Ireland. The IYTP is designed to strengthen teacher classroom management competencies. Eleven teachers, who had previously participated in a group-randomised control trial (RCT), took part in a 12-month post-baseline follow-up assessment. Psychometric and observational measures were administered to assess teachers when interacting with children (n = 217) in their classes. Qualitative data were collected from a sub-sample of teachers to explore their perceptions of programme impact and utility. The quantitative results showed some significant improvements in teachers' classroom management, although few changes were recorded on teacher-child observation measures. Qualitative findings indicated continued implementation of proactive disciplining strategies and higher levels of teacher self-efficacy. These results suggest, albeit tentatively in view of the study limitations, that the IYTP can benefit teacher classroom management, as well as teacher well-being, particularly within disadvantaged schools where behavioural problems tend to be more prevalent. The IYTP could prove useful in improving teacher competencies and the classroom environment in the longer term, although a need for further research is indicated.

The Incredible Years (IY) universal child Classroom Dinosaur and Teacher Classroom Management programmes are delivered in all 102 primary schools in Gwynedd County, Wales. This article describes a pilot study of the IY Therapeutic (small group) Dinosaur School social and emotional coaching programme, developed as a treatment programme, in one such school. The aim was to assess the added benefit of this programme for young high-risk children in order to inform a larger randomized controlled trial. Twenty-four children, aged between 5- and 9-years-old, were identified as likely to benefit from the programme. Twelve children received ten two-hour sessions, the other 12 were wait-list control. The-programme was reduced to ten weeks to fit the school and research timetable. A full set of pre- and post-intervention data was collected for 19 children, using child and researcher completed measures. No significant differences between conditions were found post-intervention. Sub-sample analysis of 12 children rated by teachers as high-risk demonstrated significant benefits for the intervention children by comparison with control in terms of increases in problem-solving skills. These findings suggest an important role for psychologists in training and supporting schools in implementing the evidence-based IY interventions as is currently happening across Wales. The study also provided guidance on targeting and evaluation measures for a more rigorous study using the full programme. (Contains 1 table.)

Objective: A community-based randomized controlled trial (RCT) was conducted in urban areas characterized by high levels of disadvantage to test the effectiveness of the Incredible Years BASIC parent training program (IYBP) for children with behavioral problems. Potential moderators of intervention effects on child behavioral outcomes were also explored. Method: Families were included if the child (aged 32-88 months) scored above a clinical cutoff on the Eyberg Child Behavior Inventory (ECBI). Participants (n = 149) were randomly allocated on a 2:1 ratio to an intervention group (n = 103) or a waiting-list control group (n = 46). Child behavior, parenting skills, and parent well-being were assessed at baseline and 6 months later using parent-report and independent observations. An intention-to-treat analysis of covariance was used to examine postintervention differences between groups. Results: Statistically significant differences in child disordered behavior favored the intervention group on the ECBI Intensity (effect size = 0.7, p less than 0.001) and Problem subscales (effect size = 0.75, p less than 0.001). Intervention effects on child hyperactive-inattentive behaviors and social competence, as well as parent competencies and well-being, were also found. Moderator analyses showed that the effects of the IYBP intervention on the primary child outcomes were not moderated by child or family demographic characteristics or risk factors. Conclusion: The results demonstrate the effectiveness of the IYBP in alleviating problem behavior among children and in improving well-being among families living in disadvantaged areas. The findings also highlight the importance of parental intervention in early childhood for parents and children most in need of support. (Contains 3 tables and 1 figure.)

School-based programmes developed to promote social and emotional well-being aims to reduce the risk of academic failure and other negative outcomes, such as antisocial behaviour and mental health problems. This article maps the British political trajectory from understanding the importance of social and emotional well-being, to delivering programmes in schools that enhance it. It summarises the outcomes of a selective review of effective school-based interventions and draws out lessons for policy and practice regarding choice and implementation of programmes. Amongst universal and targeted evidence-based interventions, multi-modal/component approaches appear useful in promoting cross-context competence and well-being. However, the scaling up of effective programmes remains unsuccessful and there is a lack of cost-effectiveness or cost-benefit analyses surrounding effective programmes. Despite these drawbacks there is a greater understanding of what constitutes "evidence" and how it can facilitate policy-makers' selection process when identifying a promising or effective programmes. There is a need to address ongoing outcome and process evaluation, and delivery and resource factors in order to ensure fidelity in programme implementation, and replication of positive outcomes. (Contains 2 tables.)

Parenting programmes are effective interventions for preventing and treating conduct problems in young children. Up to 20% of children in disadvantaged areas have conduct disorder. Recent government initiatives such as targeting early years services to designated disadvantaged Flying Start areas in Wales have resulted in increased nursery-care provision for pre-schoolers, yet little has been done to equip nursery staff with effective child behaviour management strategies. The purpose of this non-randomised trial platform study was to establish the feasibility of delivery and the effectiveness of the new Incredible Years Toddler Parent Programme in supporting nursery staff in managing difficult behaviour in the nursery. The Parent Programme is a 12-session (a two-hour session/week) course for carers/parents of children aged one to three years old, which encourages carers to: establish positive relationships with children through play and child-centred activities; use praise, rewards and incentives to encourage appropriate behaviours; and use effective limit setting and clear instructions. Thirteen nursery workers were recruited from two Flying Start nurseries in Wales. Measures were completed on 28 nursery children by their parents and nursery workers, baseline and four months post-baseline, with the intervention delivered in the interim. Paired t-test analyses demonstrated statistically significant improvements (p less than 0.05) for child behaviour in the nursery and nursery staff's self-reported stress and sense of competence. No improvement in child behaviour was reported in the home. In conclusion, nursery worker training could incorporate the Incredible Years parent programme to support the staff in managing child behaviour in the nursery. The intervention should be delivered to both home and out-of-home carers to encourage consistency in child management strategies. (Contains 2 tables and 1 figure.)

We examined mediators and moderators of change in conduct problems, in a multiagency randomized trial of the Incredible Years parenting program. Preschoolers (n = 153) at risk for conduct problems were randomly assigned to intervention (n = 104) and wait-list (n = 49) groups. Boys and younger children, and those with more depressed mothers, tended to show greater improvement in conduct problems post-intervention. Other risk factors (i.e., teen or single parenthood, very low income, high initial levels of problem behavior) showed no predictive effects, implying intervention was at least as successful at helping the most disadvantaged families, compared to more advantaged. Mediator analyses found change in positive parenting skill predicted change in conduct problems. (Contains 5 tables and 5 figures.)