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Clinical and cost effectiveness of a parent mediated intervention to reduce challenging behaviour in pre-schoolers
Olayinka Farris1, Rachel Royston2, Michael Absoud3
1Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
Insights
This study evaluates the Stepping Stones Triple P (SSTP) intervention for challenging behaviour in preschool children with intellectual disabilities. Findings will guide UK policy on effective support for these children.
Area of Science:
- Child Psychology
- Developmental Disabilities
- Intervention Science
Background:
- Children with intellectual disabilities frequently exhibit challenging behaviours.
- Parent-mediated interventions show promise, but UK research is limited.
- National Institute for Health and Care Excellence (NICE) guidelines recommend Stepping Stones Triple P (SSTP).
Purpose of the Study:
- To assess the clinical and cost-effectiveness of SSTP.
- To evaluate SSTP for preschool children with moderate to severe intellectual disabilities.
- To inform UK policy on interventions for challenging behaviour.
Main Methods:
- A trial involving 258 children aged 30-59 months across four English sites.
- Intervention group received 9 weeks of SSTP plus Treatment as Usual (TAU).
- Control group received TAU only. Measurements taken at baseline, 4, and 12 months.
Main Results:
- Parent reports and structured observations of behaviour were primary outcomes.
- Service use and health-related quality of life data were collected.
- Cost-effectiveness and utility evaluations were conducted.
Conclusions:
- Study findings will inform policy on interventions for challenging behaviour in young children with intellectual disabilities.
- The trial provides crucial UK-based evidence on SSTP effectiveness.
- Results will guide future service provision and support strategies.
Background:
Children with intellectual disabilities are likely to present with challenging behaviour. Parent mediated interventions have shown utility in influencing child behaviour, although there is a paucity of UK research into challenging behaviour interventions in this population. NICE guidelines favour Stepping Stones Triple P (SSTP) as a challenging behaviour intervention and this trial aims to evaluate its clinical and cost effectiveness in preschool children with moderate to severe intellectual disabilities.
Methods:
This trial launched in 2017 at four sites across England, with the aim of recruiting 258 participants (aged 30-59 months). The Intervention Group receive nine weeks of SSTP parenting therapy (six group sessions and three individualised face to face or telephone sessions) in addition to Treatment as Usual, whilst the Treatment as Usual only group receive other available services in each location. Both study groups undergo the study measurements at baseline and at four and twelve months. Outcome measures include parent reports and structured observations of behaviour. Service use and health related quality of life data will also be collected to carry out a cost effectiveness and utility evaluation.
Discussion:
Findings from this study will inform policy regarding interventions for challenging behaviour in young children with moderate to severe intellectual disabilities.
Trial Registration Number:
Clinicaltrials.gov, NCT03086876. Registered 22nd March 2017, https://clinicaltrials.gov/ct2/show/NCT03086876.
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