Report by British Government Early Intervention Review Team Names Parent-Child Home Program to the Top Tier of “Most Effective Early Intervention Programs”
A recently published government-commissioned report, Early Intervention: The Next Steps, An Independent Report to Her Majesty’s Government by Graham Allen MP, places the Parent-Child Home Program in the top tier of evidence-based early intervention programs. Parent-Child Home Program is one of 19 programs selected as “the best targets for new investment” because of a “high degree of confidence over their expected returns.”
The report’s goals are to 1) Raise awareness of the impact Early Intervention can have on child and family outcomes; and 2) Establish a rigorous review process to identify “the most effective Early Intervention Programs.” For the purposes of the report, Early Intervention refers to the policies and programs that help give children age 0–3 the social and emotional bedrock they need to reach their full potential, and those that help older children become the good parents of tomorrow. Mr. Allen concludes that “what parents do is more important than who they are. Especially in a child’s earliest years, the right kind of parenting is a bigger influence on their future than wealth, class, education or any other common social factor.” This conclusion is consistent with the Parent-Child Home Program’s focus on increasing the quantity and quality of parent-child interaction and strengthening parents as their children’s first and most important teachers.
Following rigorous criteria, an expert review team of international early childhood experts rated programs according to the strength of their evidence. The ratings scale, prepared by the Social Research Unit at Dartington, in collaboration with early intervention experts at the Annie E. Casey Foundation, the Social Development Research Group at the University of Washington, the Blueprints for Violence Prevention Group at the University of Colorado, Johns Hopkins University, Child Trends, and the Institute for Effective Education at University of York, evaluated programs based on: 1) evaluation quality; 2) impact; 3) intervention specificity; and 4) system readiness. The review team favored programs that have been evaluated according to very high standards using the most robust evaluation methods, such as RCTs or quasi-experimental designs and published in peer-reviewed publications. The review team also looked for programs that demonstrated a positive impact on children’s health and development and particularly their social and emotional competencies. Three levels of evidence were established. We are pleased to report that out of the 72 programs listed, The Parent-Child Home Program was in the Level 1 category, as one of the 19 “most effective Early Intervention programs.”
The reviewers found that The Parent-Child Home Program met the following criteria:
1.One randomized controlled trial or two quasi-experimental evaluations (initial quasi-experimental evaluation and a replication) with the following characteristics:
1a.Assignment to the intervention is at a level appropriate to the intervention.1b.There is use of measurement instruments that are appropriate for the intervention population of focus and desired outcomes.1c.Analysis is based on ‘intent to treat’.1d.There are appropriate statistical analyses.1e.Analyses of baseline differences indicate equivalence between intervention and comparison groups.
2.There is a minimum of one long-term follow-up (at least six months following completion of the intervention) on at least one outcome measure indicating whether results are sustained over time.
3.There is a clear statement of the demographic characteristics of the population with whom the intervention was tested.
4.There is documentation regarding what participants received in the intervention and counterfactual conditions.
5.There is no evidence of significant differential attrition.
6.Outcome measures are not dependent on the unique content of the intervention.
7.Outcome measures reflect relevant outcomes.
8.Outcome measures are not rated solely by the person or people delivering the intervention.
9.There are two RCTs or one RCT and one QED evaluation (in which analysis and controls rule out plausible threats to internal validity).
10.Where possible or appropriate there is analysis of the impact on sub-groups (e.g. do the results hold up for different age groups, boys and girls, ethnic minority groups?).
1.There is a positive impact on a relevant outcome.
2.There is an absence of iatrogenic effects for intervention participants. (This includes all subgroups and important outcomes.)
3.If two or more RCTs or at least one RCT and one QED have been conducted, and they meet the methodological criteria stipulated in section A, there is evidence of a positive effect and an absence of iatrogenic effects from a majority of the studies.