IT Tallaght 11th March 2015
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Overview of establishment of CDI;
Overview of CDI programmes;
Programme evaluations and link to policy;
What works;
Challenges;
Questions.
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Consortium of 23 people established;
One of three Prevention and Early Intervention
Programmes funded by Government and The
Atlantic Philanthropies;
Needs Analysis “How Are Our Kids?” (2004);
15 million granted for the design, implementation
and evaluation of programmes;
“How Are Our Families”, 2012 indicates ongoing
disadvantage and social issues;
CDI now funded under the Government’s Area
Based Childhood Programme (ABC) – co-funded by
AP.
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Identifying need;
Developing a coherent, community informed,
integrated response;
Implementing and overseeing the quality delivery of
evidence-based programmes;
Supporting inter-agency collaboration and outcomes
focused approaches;
Evaluating evidence-informed programmes, to
identify what works and what doesn’t;
Sharing the learning regarding programmes and
processes in order to inform future policy and
practice.
CDI Governance Chart 2015:
The Atlantic
Philanthropies
(AP)
Pobal/CES
CDI Board
CDI
Implementatio
n Support
Group
(ISG)
Restorative
Practice
Management
Committee
(RPC)
Expert
Advisory
Committee
(EAC)
RP National
Strategic
Forum
Children’s
Services
Committee (CSC)
CDI Team
Finance and Risk
Sub-Committee
Department of
Children and
Youth Affairs
(DCYA)
Local
Community
Development
Committee
(LCDC)
Human Resources
Sub-Committee
Communications
Sub-Committee
Indicates an
advisory/supporti
ve relationship
Indicates lines of
accountability
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Early Years Service;
Speech and Language Service;
Doodle Den: Literacy;
Mate-Tricks: Pro-Social Behaviour;
Healthy Schools Programme;
Community Safety Initiative;
Restorative Practice Programme.
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Research design;
Logic modelling;
Manualised approach;
Delivery through local agencies;
Supporting quality.
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A logic model is a tool for programme planning,
implementation and evaluation;
It provides a rationale for delivering specific
programmes;
It clearly describes a programme’s goals, tasks,
activities and anticipated outcomes, and links to
evidence and best practice.
The current
situation i.e.
the situation
that needs
changing
Research
evidence i.e.
what the
research or
best practice
tells us
Inputs i.e. the
resources
required to
bring about
change
Activities i.e.
the activities
necessary to
effect change
Outputs i.e.
what is
expected to
occur or be
delivered
Outcomes i.e.
changes in
attitudes,
behaviour,
knowledge
and
perceptions
Why use a manualised approach?
To ensure the programme is:
 Delivered with consistency
 Delivered as intended
 Adheres to the Logic Model
Fidelity
(i.e. where practitioners use all the
core intervention components
skillfully)
The role of fidelity and dosage
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Evidence-based programmes are most effective when they
are implemented with fidelity;
Fidelity helps us to attribute positive outcomes to the
programme;
The greater the fidelity, the more likely positive outcomes will
be replicated;
Dosage – where participants receive the intended amount of
programme/ core intervention.
3 Randomised
Controlled Trials
Community Safety Initiative –
(NUIG)
Restorative Practice – (NUIG)
Early Years – (DIT)
Doodle Den – (QUB)
Mate Tricks – (QUB)
3 Process Evaluations
Overall Process Evaluation –
(NUIG)
Quasi-Experimental Study
Healthy School’s
Programme – (TCD)
Retrospective
Impact Study
Speech &
Language Therapy
Dedicated Quality Specialist role;
 Training;
 Communities of Practice (COP’s);
 Site / practice visits;
 Fidelity checks;
 Progress meetings;
 Programmatic / thematic steering
committees.
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2 year programme 2½-3 year olds;
HighScope Curriculum;
1:5 staff:child ratio;
Staff qualifications;
Key worker system;
Home visits;
Parent/Carer Facilitator (PCF);
Speech and Language Therapy (SLT);
Communities of Practice (CoP);
Manager meetings;
Onsite support.
Measures
Child cognitive
& language
scores:
Findings
Overall - no statistically significant difference.
Control groups scored higher on a Rhyme & Lower case
recognition. Within intervention groups – between group
differences on: rhyme; block building and vocabulary.
Child
Attendance:
No great difference. However, Int. services had a better
minimum attendance rate = better at supporting children
prone to lower attendance.
ECCE
Environment:
Int. services engaged significantly more often in some
music/movement; nature/science and maths.
Int. services had better planning and curricular quality.
Int. services had a higher quality literacy environment.
Int. staff maintained similar levels of sensitivity throughout
evaluation.
Home learning
environment:
Int. parents had a an improved home learning environment.
Measures
Home
Int. parents
Learning
environment.
Environment:
Process:
had
Findings
a an improved
home
learning
HighScope training:“revolutionised their practice” e.g.
conflict resolution: end of year two, children were able to
solve problems and conflicts without adult intervention.
Speech and Language training: better understanding of
language development and how to support children with
SL needs, e.g. greater awareness of the print rich
environment.
Communities of Practice (CoP): opportunity to share
ideas, information and ideas - impacted on their daily
practice and would like to see them continued.
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High staff:child ratios – as evident in children’s behaviour;
Non–contact time to allow for planning and training – as
evident in improved curricular and planning quality;
Advisable to have training structures in place prior to
programme implementation;
Importance of a very specific and clear curriculum;
In light of bedding-down effects, a longitudinal study/followup of parents, children and preschools would help to
determine if these effects persist and strengthen over time;
Delivery of parent training as part of a pre-school programme.
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Collaboration with HSE;
2 therapists employed;
Three pronged approach;
Onsite delivery;
11 early years services & 5 primary schools;
Staff training – formal and informal.
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18% discharged within normal limits following
intervention – TW has an over-representation of
families at risk of experiencing multiple
disadvantages (CDI, 2004 and 2005);
55-66% not ‘picked up’ by HSE service – early
identification and intervention;
25% referred to other specialist services - promotion
of access to health services.
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Changes in practice related to the support of speech and
language development within the Early Years services and
schools;
Parents reported easier access and less stigmatisation highlights the need for other SLT and specialist services to
give consideration to location and accessibility issues;
Improved Therapists’ Wellbeing:
◦ Therapists fulfilled by working in an intensive manner with
children. Made possible by short waiting lists and on-site therapy
over the course of the school/Early Years service term;
◦ HSE counterparts reported frustration at having to deal with long
waiting lists and block therapy delivery.
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Manualised whole school approach – based on the WHO
model of health promotion;
Two Healthy Schools Coordinators (HSC) based in 5 schools;
Supported schools to implement health and well being
activities, both in and out of school;
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Supported schools to review and update school policies;
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Supported families to attend specialist appointments;
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Strengthened links with school and health services, through
establishment of Care Teams.
Intervention schools showed significant difference in overweight and
obesity: Increased from baseline.
Children (older cohort) in intervention schools self reported a reduction
in bullying from baseline.
Health and Wellbeing: Both intervention and comparison were on
average within international range from baseline through to final year.
Autonomy + parent relations improved into year 2 (both groups).
Child Depression: Intervention and comparison: baseline – within
international range, improvements in year 2.
However: schools have begun the process of change that is required to
become a WHO defined ‘health promoting school.
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BMI: Higher percentages of Control school children were
underweight, overweight and obese compared to Int. schools;
Int. schools showed significant improvement in social support
and peer relations compared to C schools;
No significant differences between I and C schools on
breakfast uptake, children’s perception of weight and
incidences of reported bullying;
No significant differences between I and C schools on
emotional and behavioural outcomes;
No significant differences between I and C schools on the
depression scale.
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An assessment of the readiness of a school or organisation
for an intervention needs to be undertaken prior to the
implementation;
An expansion of the culture of joint working and
collaboration is required from the Department of Education
and Skills and the Department of Health in order to continue
the development of children’s wellbeing in educational
settings;
A National Framework for Health Promoting Schools involving
the Departments of Education and Health should be
developed;
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The establishment of a Health Promoting Committee, with
health and local authority participation, building on local
inter-agency models of working;
Health promotion and mechanisms to support inter-agency
collaboration should be included in training for teachers and
related professionals, and as part of continuous professional
development;
CDI recommends that all Government Departments commit to
using evidence to inform planning and service delivery and
that the implications are taken on board.
Afterschool literacy
programme aimed at
children in Senior Infants
An evidence based
balanced literacy
framework
A manualised curriculum
that teaches literacy
through a variety of media
Child Component
Parent Component
Family Component
•32 weeks
•6 sessions – 2 per term
•3 per year
•3 sessions per week
•Supports work done in
Doodle Den session and
equips parents with
skills to support
children’s literacy
•Parent and child
working together
•90 minute duration
•Open door policy on all
sessions
•Variety of themes
7 percentile point gain in overall literacy
ability
Particular gains seen in: Word Recognition (7 percentile
point gain); Sentence Structure (12 percentile point gain);
and child’s word choice (10 percentile point gain)
Combined with teachers ratings, this
increased to an 11 percentile point gain
Teacher’s report indicate a 7 percentile
point decrease in negative behaviours
Parent’s report increase in child's
reading at home (10 percentile points)
Increase in family library activity (15
percentile points)
Improved school attendance
Parental reported child literacy activity
Parents were:
 Positive about library session;
 Feeling informed about what their
child was doing; and
 Had good relationships with everyone
involved.
Facilitators:
 Support from CDI and positive
communication;
 Improved relationships with schools
and parents;
 Improved parental involvement;
 Improved delivery over time, greater
confidence and knowledge of the manual.
Afterschool pro-social
behaviour programme
aimed at children in 4th
Class (9-10 year olds)
An evidence based
programme using the
Strengthening Families
and Coping Power
Programmes
A manualised afterschool
programme that
encourages children to
reflect on behaviour,
emotions and interactions
with peers
Child Component
Parent Component
Family Component
• 59 sessions over the
course of the year
• 6 sessions – 2 per
term
• 3 per year
• 2 sessions per week
• Supports work done
in Mate-Tricks
sessions
• 90 minute duration
• Parent and child
working together
• Opportunity to
develop and discuss
their ideas around
key family issues
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No change in majority of the 21 outcomes investigated -16 showed
no impact
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Two statistically significant adverse effects:
◦ Anti-social Behaviour (PSB Questionnaire)
◦ Authoritarian Parenting (APQ)
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Three effects approaching significance:
◦ Liberal parenting (adverse effect)
◦ Conflict tactics (positive effect)
◦ Improvement in relationships with mothers (positive effect)
ASB Scores**
Predicted Post Test
5
4
3
2
1.21
1.4
Control
Intervention
1
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Views and observations of the programme from the various
stakeholders were generally very positive;
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Combined findings from the process evaluation and the outcomes
data, provided by engaged parents and their children were more
favourable towards the Mate-Tricks programme than the findings
from the full sample of parents and children;
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The model of change or tools provided to facilitators (i.e. the
Mate-Tricks programme) was not effective.
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After-school programmes focused on behavioural change should be
rigorously piloted before roll out;
All services for children should be evaluated. Programmes which
have shown no demonstrable impact on outcomes should be
incrementally removed and replaced with EBPs;
All Government Departments commit to using evidence to inform
planning;
Serious consideration should be given to the implications of the MT
evaluation for professional training, service planning and
integration;
Managers in all state funded organisations working with children
receive training in logic modelling, utilising evidence to inform
planning and assessing outcomes;
Pre-service training involves mandatory modules on engaging
parents.
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Support for parents of young children;
On site, early intervention speech and language – 3
pronged approach;
Ongoing professional development, focus on reflective
practice, quality promotion;
Afterschool, literacy rich, high activity curriculum;
Collaboration to improve referrals and service
gateways;
Creating and supporting structures, systems and
relationships which promote collaboration.
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Impacting on children’s behaviour through
after school settings;
Evaluating programmes without a ‘bedding
down’ period;
Process driven programmes (i.e. cultural
change) is slow;
Unanticipated training and support needs
were identified, necessary for the delivery of
quality services with fidelity.
The tension between being “communityled” and “evidence-based”.
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