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
Evaluation
• 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
research
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
outcomes
– 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
figures)?
• 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 – www.sdqinfo.org



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
interventions
 and can be used to compare the wellbeing of
populations
The SDQ
 25 questions used to measure five aspects of the child’s



development:
• 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
problems
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
language
• Before school entry (completed by nursery
staff)
• 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
questionnaires
SIMD
routine records
GROS
CHS-PS
SEEMIS
SEEMIS?
SEEMIS?
SDQ@
30m
SDQ@
preschool
SDQ@
7 yrs
SDQ@
10 yrs
birth
teens
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
performing?
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
inequalities
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
Acknowledgements
• 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
information.
lucy.thompson@ggc.scot.nhs.uk