Glasgow Parenting Support Framework
Evaluation: school readiness and
longitudinal trajectories using the
Strengths and Difficulties Questionnaire
(SDQ) and linked health data
Dr Lucy Thompson
NHS Greater Glasgow and Clyde
Glasgow Parenting Support
• Collaboration between NHS GGC, Glasgow
City Council Education Services and
University of Glasgow
• Funded by Scottish Government
• Involves whole population assessments of
social and emotional development at ages
30 months, 5 years, 7 years and 10 years
• Prime aim is service evaluation rather than
Key factors
• Collaborative project
– Local academic expertise
– NHS input from a range of levels
– Multidisciplinary / multiagency evaluation
steering group
• Evaluation administrative office
• Coordination and communication
– Regular meetings of admin staff
– Regular contact with parenting coordinators
Glasgow Evaluation Principles
– Focus on measurable child-centred
– Use standardised tools
– Data should be useful for 4 purposes:
• Professional decision making
• Needs assessment
• Performance management
• External evaluation
Research Questions (1)
• What is the reach of /engagement with the Triple P
programme (compared to projected population
• In those families engaging with Triple P interventions,
what is the short term impact in terms of reducing risk
factors and increasing protective factors associated
with poor or favourable developmental outcomes in
children and young people?
• Can we achieve our aim of 90% completion of pre- and
post-intervention evaluation measures?
Research Questions (2)
• What is the pattern of emotional and behavioural difficulties in
the population at 2.5, 5, 7 and 10 years?
• What is the pattern of emotional and behavioural difficulties in
a sample of the population at 12 to 16 years?
• How do these patterns compare with national and international
normative data?
• Does this overall pattern change over time?
• To what extent do difficulties experienced by individual
children persist or change over time?
• Do socio-demographic factors such as geographical area,
relative deprivation and school influence trajectories of
emotional and behavioural functioning?
Research Questions (3)
• To what extent are offers, uptake and completion of
Triple-P and other interventions matched to the level
of emotional and behavioural difficulties?
• Are offers, uptake and completion of interventions
influenced by socio-demographic factors, parents’
perceptions, belief systems, etc?
• To what extent do offers, uptake and completion of
interventions influence the persistence of difficulties?
• What are the predictors of resolution of difficulties
both among participants in parenting support
interventions and more broadly?
Research Questions (4)
• To what extent is the population of parents
aware of Triple P and other sources of
parenting support?
• What are the key lessons regarding the
implementation process?
• Do rates of child injury change over time?
• Do numbers of children subject to child
protection case conferences and looked after
away from home change over time?
Types of data
• Routinely-gathered data on all children in Glasgow through:
– the Child Health Surveillance System including data collected at the new
universal contact at 30 months;
– social work systems re. child protection, child placement, etc; and
– Scottish Morbidity Record (SMR) data on child injury held centrally by
NHS Scotland’s Information and Statistics Division (ISD)
• Recently-instigated routinely-gathered data on emotional and
behavioural wellbeing for children in the education system;
• Process data – referral, uptake, completion information, as well
as pre- and post-intervention questionnaire data and qualitative
feedback from practitioners, stakeholders and parents.
The Strengths and Difficulties
Questionnaire –
A brief behavioural screening questionnaire for 3-16
year olds.
3 versions – parent, teacher, self-complete
Originally developed as a screening tool for
psychological problems in children
 but can be used to assess change after
 and can be used to compare the wellbeing of
 25 questions used to measure five aspects of the child’s
• emotional symptoms
• conduct problems
• hyperactivity/inattention
• peer relationship problems
• pro-social behaviour
Responses: “Not True”, “Somewhat True”, “Certainly True”
Questions scores in each domain totalled and classified: unlikely
to have problems / possibly has problems / likely to have
Along with questions about impact of problems, if relevant
SDQ data collection
• At a new routine 30 month health check by
health visitors – SDQ (parent version) and
• Before school entry (completed by nursery
• At primary 3 (age 7) (teacher complete)
• At primary 6 (age 10) (self complete)
x – data collection point
Solid lines indicate cohorts within the life of this project
Dashed lines project to future data collection (beyond this project)
2010: SDQ data at school entry only (cross-sectional time-specific only).
2011: SDQ data at school entry PLUS at 2.5 years (as above PLUS crosssectional time-series).
2012: SDQ data at school entry PLUS at 2.5 years PLUS at 7 and 10 years (as
above PLUS longitudinal cohort).
Single child
trajectory –
potential data
Demographic info
routine records
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7 yrs
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10 yrs
Triple P interventions: offer  referral  uptake  completion Local admin systems…
Social work involvement
Social work data systems
SDQ at school entry
For all children entering primary school in Glasgow,
started in 2010
Completed by Child Development Officers as part
of routine Transition Documentation
Now available as a SEEMIS module
Data will be linkable to NHS and GROS data
A way to measure how all preschool services are
Response rates – 2010 “pilot phase”
• Nursery-based data only so far
• Data available for about 70% of Glasgow
school entrants – about 3,300 in total
• Good questionnaire completion rates
• Some nurseries did not return data
• Expect about 97% completion in 2011
SIMD09 using within-Glasgow ranks
Data source: Bruce Whyte at GCPH
Factors related to total SDQ
score at school entry
Scores adjusted for establishment and neighbourhood
SIMD = Scottish Index of Multiple Deprivation (1=most deprived, 5=most affluent)
Deprivation and SDQ subscales
Analysis – future plans
• Refining the maps – disentangling the impact of
neighbourhood, deprivation and service use
• Linkage of health and education data: plotting
trajectories from 2 to 10 years
• Identify effects of area, nursery, school, family on
these trajectories
• Design trials of interventions aiming to reduce
Further evaluation of SDQ use
• User perspectives
Child Development Officers
Heads of preschool establishments
P1 teachers
Primary head teachers
• Checking against parental scores
Interviews with nursery staff
• Preliminary findings:
– Helps to think about children’s social and
emotional readiness for school, rather than just
academic preparedness
– Consistent with Curriculum for Excellence –
looking at the ‘whole child’.
– Concerns about parental consent & informing
parents confidently
– Concerns about committing any negative
information about a child to ‘paper’
– Concerns the data wouldn’t be used
• Phil Wilson
• Carolyn Wilson and the SG Child and Maternal Health Division
• Amanda Kerr, John Butcher and Morag Gunion and City of
Glasgow Education Services
• Kim Jones & Kelly Chung
• Bruce Whyte at Glasgow Centre for Population Health
• Sarah Barry at Robertson Centre for Biostatistics
• Scottish Government produced the socio-economic data and
Scottish Neighbourhood Statistics provided the datazone
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