The Incredible Years® Blog


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The Incredible Years® in Pediatric Settings

Evaluation of a parenting program for treating children’s early disruptive behavior problems delivered in a pediatric setting. 

In well child visits pediatricians frequently see parents who are asking about their children’s hyperactivity, aggression and defiant behaviors. Such behaviors are a developmentally normal phase for toddlers because they lack the language and self-regulation skills to control their impulses.  However, toddlers and preschoolers who exhibit these behaviors at high intensity and frequency are at risk for continuing this disruptive behavior pattern in later childhood and many parents and caregivers do not have the parenting tools to respond effectively.  These early onset behavior problems are associated with academic underachievement, and confer risk for later life psychopathology including criminality and substance abuse (Tremblay, Nagin, & Seguin, 2004).  Effective early intervention is crucial.

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Unfortunately even though numerous clinical trials, meta-analyses, and consensus guidelines recommend that psychosocial interventions should constitute the first-line approach for treatment of early disruptive behavior problems, the proportion of children receiving evidence-based programs is decreasing (Comer, Chow, Chan, Cooper-Vince, & Wilson, 2013). Children are more likely to receive psychotropic medications, even though controlled trials of the efficacy of this approach for this age group have not been conducted.

Primary care physicians, who see families frequently during a child’s early years, are strategically placed to help parents prevent the development of serious disruptive behavior problems and to expand the availability and accessibility of services by offering evidence-based parent training programs.

A newly published randomized control group trial has tested the efficacy of using the Incredible Years® (IY) toddler parent program in 11 diverse primary care rural and urban pediatric practices (Perrin, Sheldrick, McMenamy, Henson, & Carter, 2014).

Ellen PerrinThis study was conducted by Dr. Ellen Perrin, a developmental-behavioral pediatrician who is Director of Research at the Center for Children with Special Needs and  Professor at Tufts University School of Medicine in Boston Massachusetts.

This particular evidence-based program was chosen because of its extensive research and ease of delivery. A recent meta-analyses of  50 studies utilizing the IY program reported its success in improving child behavior in a diverse range of families (Menting, Orobio de Castro, & Matthys, 2013).

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Study Method

Parents were selected for this program based on behavioral screening above the 80th percentile on the Infant-Toddler Social-Emotional Assessment Scale. The study sample is characterized as high risk or borderline clinical because children were selected based on elevated symptoms of behavior problems.  A total of 150 parents were randomly assigned to either the IY 10-week, 2-hour parent program or a waiting list control group.  An additional 123 parents were assigned to the parent intervention without a randomly selected comparison group. The parent program was offered primarily by psychologists or social workers in conjunction with a member of the pediatric office staff.  Among the 3 study groups, 54% to 73% completed at least  7 group sessions.

Positive results

Results showed that parents who participated in the IY program reported more change in self-reported parent and toddler outcomes at post treatment than did parents in the waiting list control condition. Analyses of independent videotaped observations of parent-toddler interactions showed that negative parenting, child disruptive behaviors and negative child-parent interactions were lower at post treatment and at 12-month follow-up compared with baseline observations for parents who received the program.  No differences were found for the waiting list control parents at post condition compared with baseline.

The findings are very promising and suggest that offering the IY program as a group model in pediatric settings is a cost effective way of reducing children’s behavior problems and providing secondary preventive intervention (Stein, 2014). (Stein, 2014). The next step is to convince practitioners, who typically see these families in individual treatment sessions, of the value of the group learning model for providing behavioral training for parents of young children and building support networks for their families.

Please don’t hesitate to contact us for more information about the Incredible Years® Programs and/or this recent research!

Click this link to read the full article!

If you are interested in learning more about The Incredible Years programs, click this link to go to our website.

References:

Comer, J. S., Chow, C., Chan, P. T., Cooper-Vince, C., & Wilson, L. A. (2013). Psychosocial treament efficacy for disruptive behavior problems in very young children: A meta-analytic examination Journal of American Academy of Child and Adolescent Psychiatry, 52(1), 26-36.

Menting, A. T. A., Orobio de Castro, B., & Matthys, W. (2013). Effectiveness of the Incredible Years Parent Training to Modify Disruptive and Prosocial Child Behavior:A Meta-Analytic Review. Clinical Psychology Review, 33, 901-913.

Perrin, E. C., Sheldrick, R. C., McMenamy, J. M., Henson, B. S., & Carter, A. S. (2014). Improving parenting skills for families of young children in pediatric settings: a randomized clinical trial. Journal of American Medical Association Pediatrics, 168(1), 16-24.

Stein, M. T. (2014). Group-Based Parenting-Skills training in primary care offices:Are we ready for the challenge? Journal of American Medical Association, 168(1), 7-9.

Tremblay, R., Nagin, D., & Seguin, J. (2004). Physical aggression during early childhood: trajectories and predictors. Pediatrics, 114, 43-50.


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“Anos Incríveis” – Portuguese researchers at the University of Coimbra share their findings delivering the Incredible Years Parent and Teacher Programs

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Full group at Conference

Carolyn Webster-Stratton recently attended and presented at a conference, held at the University of Coimbra in Portugal, “Prevention and early intervention for behavioral disorders in preschool children: the effectiveness of parenting programs and school-based evidence.” Portuguese researchers at the University shared their findings delivering the Incredible Years Parent and Teacher Programs.

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The University of Coimbra is a public university, established in 1290. It is one of the oldest universities in continuous operation in the world and currently has around 20,000 students and hosts many international students. While there, Dr. Webster-Stratton felt she had been transported to Hogwarts, especially when she viewed the students’ robes and the gorgeous location.

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Carolyn and one of the university students

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Prior to being a University, this building was the Royal Palace (for four centuries!). The first of all the royal residences in Portugal, the Palace was inhabited by monarchs between the 12th and 15th centuries. In 2013, UNESCO added the university as a World Heritage site based on its architectural and artistic heritage.

While at the conference, Dr. Webster-Stratton had a chance to find out what was happening in the Psychology and Education departments at the University. She met a dynamic team of people who are delivering the Incredible Years programs with different populations.  She was impressed with their commitment to quality delivery of the programs as prevention programs as well as treatment programs for children with ADHD and conduct problems, and with their dedication to evaluating their results.


TV local news interviews Carolyn and the two Portuguese researchers who brought the program to Portugal.
(some of this is in English and some in Portuguese language ~ take a look at the beautiful university)

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Carolyn with Maria João (L) and Maria Filomena (R)

Consultation Day:  Carolyn began her visit with a group leader consultation day that was co-led with  Maria Filomena and Maria João, two psychology professors completing their Incredible Years mentor training. There were 11 participants attending who showed 6 different DVDs of their parent group work.  These clinicians had previously delivered any where from 2 to 7, 14-week groups.  The day began with three psychiatrists presenting 2 DVDs of their work delivering the parent program in the psychiatry department at the Realidade Hospital in Porto. The next two psychologists presented their delivery of the IY parenting program with residential care workers. The remaining psychologists showed their group session DVDs with parents of children with ADHD and ODD. It was a packed agenda with participants having carefully determined their goals and segments of video they wanted to show for feedback. The group was very open to feedback and readily engaged in practices and shared ideas for helping support parents’ learning and confidence in their parenting approaches.

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Carolyn with two Doctoral students, Sara Leitao (left) and Mariana Pimente (right)

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Carolyn with Tatiana Homem (left) and Andreia Azevedo (right)

Conference Day: This was a truly amazing and packed day that started at 10 am and went overtime until 7:30 pm with most people staying until the conclusion.  There were approximately 180+ participants with 50 of these being parents who had participated in IY parent groups. Additionally there were at least as many teachers participating as well as psychologists. There was a great deal of excitement as people greeted each other.  In addition to Carolyn’s two presentations there were 8 other presentations of research that has been conducted with the Incredible Years parent and the teacher programs. All outcomes are looking very promising with improvements in parenting and teacher practices as well as reductions in children’s behavior problems.  Drop outs are low and satisfaction reports very positive.  Research with the families of children with ADHD has recently been accepted for publication.

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Carolyn with Vera Maria Silverio do Vale, who did her research with Teacher Classroom Management, and a teacher with a turtle shell

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Carolyn with two psychiatrists, João Guerra and Vânia Martins

It certainly appears that this very energetic and collaborative team have successfully transported the Incredible Years Programs to Portugal.  They have accomplished a great deal and even Wally Problem Solver and Dina Dinosaur have learned to speak Portuguese!

~Guest post written by Carolyn Webster-Stratton, Ph.D.


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Young Children’s Vocabulary Skills Predicted by Economic Factors (Follow up)

Hello friends!

Earlier this week we shared a guest post from Peter Loft, Certified Incredible Years Trainer. Mr. Loft discussed his response to an article in the NY Times which asserted the value of early childhood education in connection to reducing economic inequality, poverty, and crime.

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For those interested in this topic, we would like to share some further reading. Motoko Rich wrote an article just a few days prior to Kristoff’s article, titled “Language-Gap Study Bolsters a Push for Pre-K.”

This article examines new research from Anne Fernald, who found that young children from affluent families had far more advanced vocabularies than those from economically disadvantaged families. This gap began in children as young as 18 months old.

These studies and recent articles highlight the importance of early education and verbal interaction with very young children. Next week, we will begin a series of three guest posts from Incredible Years developer Carolyn Webster-Stratton. This series will provide in depth discussion and tips for reading with young children at various developmental stages (babies, toddlers, and preschool).

Stay tuned!

~The Incredible Years Team

 

Reference

Fernald, A., Marchman, V. A. and Weisleder, A. (2013), SES differences in language processing skill and vocabulary are evident at 18 months. Developmental Science, 16: 234–248. doi: 10.1111/desc.12019


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Teacher Classroom Management – Research and New Videos

Hello and Happy October!

The Incredible Years® (IY) Teacher Classroom Management (TCM) Program is intended to help teachers (of children ages 3-8) strengthen their classroom management strategies. It helps teachers learn fun, new ways to promote children’s prosocial behavior, school readiness, and also reduce children’s classroom aggression and noncooperation. We have a few exciting things that we would like to share with you today about this program!

1. Important Research

2. New Videos

Research

A new article has recently been accepted for publication in the Journal of School Psychology about the IY TCM Program. Judy Hutchings, Ph.D. (in Wales) reported on a randomized control group trial (RCT) with 12 teachers and 107 students.  Her primary outcome measure was independent classroom observations that showed that there was a significant reduction in classroom off-task behavior and child negative behaviors toward the teacher as well as to teacher negative interactions with target students. The preliminary results suggest the potential impact of this program on both teacher and child behavior.

Read the article here!

A second report on the IY TCM Program came out of Ireland by Sinead McGilloway and her research team. Her randomized control group study included 24 teachers and 217 children and used independent observations as outcome measures. These results indicated that teachers who had taken part in the training were using significantly fewer negative classroom management strategies (e.g., fewer threats and less shouting) and they reported using more positive strategies.  Observations indicated  a significant decrease in emotional symptoms in the intervention group compared with the control students. Further sub-group analyses indicated those children most ‘at risk’ derived the most benefit from the program.  A recent follow-up study showed that one year later, teachers reported they continued to confidently use the positive management strategies and described the classroom as a calmer and more pleasant place to work. Satisfaction with the program was very high.

See the report here!

Several more RCTs are being conducted with the IY TCM Program at Duke University, University of Missouri, the United Kingdom and Norway. Stay tuned for more results regarding this program!

New Videos

Recently, we added a new video series to our website and YouTube channel that highlights the Teacher Classroom Management Program – have you seen it yet?! The series highlights participant reflections based on their experiences with the TCM Program. These videos are available on our website, on YouTube, and (very soon) in DVD format (contact us for a copy!)

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Schools can use these videos to encourage teacher participation in this program. Results from TCM program research show that teachers who participate in the program develop support networks with other teachers and parents, feel confident about their classroom management strategies, and report classrooms with fewer behavior problems. As a result, teachers are able to more academic teaching.

There are 8 total segments and each segment addresses a different topic…

  1. Overview of the TCM Program
  2. Foundation of the Incredible Years Teaching Pyramid
  3. Managing Classroom Misbehavior
  4. Teacher Experiences Learning the Program
  5. Trainer Experiences Working with Teachers
  6. The Bedrock of Children’s Academic Learning
  7. Research Regarding the Program
  8. Dissemination, Certification, and Need for Ongoing Support and Mentoring

Whew! That’s a lot of information to cover! Each segment is under 10 minutes, and we really hope you will take a look at these when you have some spare time. See below for the first segment, “Overview of the TCM Program” OR  click here to view all the video segments.

~The Incredible Years Team


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2013 Group Leader & Certified Leader Data

Hello!

We wanted to share with you some interesting data that we have recently compiled. Each year we analyze the number of group leaders in every country implementing Incredible Years®, as well as information on Certified Group Leaders, Peer Coaches, Mentors and Trainers.

For those of you who don’t know about our Certification Process, it is the process facilitators may apply for in order to become accredited in Incredible Years® programs. It is an extensive process that focuses on peer review and feedback as a means to assist group leaders with becoming more able to effectively use the Incredible Years® programs with fidelity. We strongly encourage facilitators to go through Certification because it allows them to become more comfortable using the programs and it provides such a strong focus on supporting them and celebrating their successes.

Take a look through the pie charts below to see statistics about where in the world people are being trained and becoming certified! (Click on the images to enlarge them.)

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Guest Blog: Incredible Years Delivered to Mothers Being Released from Incarceration (Written By: Carolyn Webster-Stratton)

Hi Friends!

An exciting new study has come out evaluating the effectiveness of the Incredible Years® Parenting Program delivered to mothers being released from incarceration. (Published Journal of Clinical Child and Adolescent Psychology, August 2013.)

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This is a study I’ve always wanted to do and now it has been done by a Dutch team at Utrecht University.  Mothers of 133 children (ages 2 to 10 years) were randomly assigned to either an Incredible Years® parent program or a no-intervention control group. Mothers in the intervention condition were offered the program in group format while in jails as well as by individual home visits to enable individual practice work after mothers were released.

The results showed significant effects on parenting and child behavior according to maternal reports.  Marginally significant effects were shown for child behavior according to teacher reports. The results show the short term effectiveness for this high-risk and hard-to-reach population. It is important because a recent meta-analysis indicated that children of incarcerated mothers had about a 10% chance of increased risk for antisocial behavior compared to peers.  This approach shows promise in disrupting the transmission of delinquency from delinquent mothers to their children.

Read the full article here!

Reference:

Menting, A.T.A., Orobio de Castro, B., Wijngaards-de Meij, L.D.N.V., Matthys, W. 2013. Journal of Clinical Child & Adolescent Psychology, x(x), 1-16. dx.doi.org/10.1080/15374416.2013.817310 The Netherlands

~Carolyn Webster-Stratton
(Guest Blogger and Incredible Years® Developer)


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Guest Post – New Meta-Analysis looks at Effectiveness of Incredible Years®!

We have some exciting news to share!

This marks our FIRST Guest Post, courtesy of Incredible Years® Developer, Carolyn Webster-Stratton! Dr. Webster-Stratton has taken the time to write a summary of a new meta-analysis that has just been published, examining the effectiveness of the Incredible Years® Parent program. The full paper can be purchased online, here.

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Summary of Meta-Analysis Examining the Incredible Years® Parent Programs

Written by Carolyn Webster-Stratton

A new meta-analysis paper has just been published by a Dutch team. This review examines the effectiveness of the Incredible Years® parent training to reduce disruptive behavior and promote social competence in children.  Fifty studies were conducted where the Incredible Years® parent program was compared with a comparison control group by various researchers. Findings indicate that the Incredible Years® program is successful in improving child behavior, particularly for the most severe cases, and with a diverse range of families in different contexts.  The parent program is considered by this review to be well-established. These positive findings which are comparable across a range of studies may be interesting for policymakers, agencies and practitioners.  
Take a look at this meta-analysis which separates prevention from treatment studies and assesses intervention, child and family characteristics, and effect sizes for different outcomes. Number of sessions attended by parents was positively related to intervention effects.
The authors write, “The Incredible Years® program might have capacity to be tailored to specific characteristics and needs of families in spite of being manualized group training. Group leaders can achieve flexible applications of the manual and help parents learn to use the parenting principles to achieve their own determined goals.”

Reference:

Ankie T.A. Menting, Bram Orobio de Castro, Walter Matthys, Effectiveness of the Incredible Years Parent Training to Modify Disruptive and Prosocial Child Behavior: A Meta-Analytic Review, Clinical Psychology Review, Available online 22 July 2013, ISSN 0272-7358, http://dx.doi.org/10.1016/j.cpr.2013.07.006. (http://www.sciencedirect.com/science/article/pii/S0272735813000949)

We are very excited about this review! We hope you will share this with others who may be interested in the research and/or the Incredible Years®.

~The Incredible Years® Team