CEY1512

Written evidence submitted by Triple P

Introduction

Triple P UK is a social enterprise providing training, resources, and implementation support to organisations across the UK and Ireland, seeking to create healthier communities by improving children’s and parents’ mental health, cultivating stable home environments, reducing parental conflict, and reducing child abuse and neglect[1].

The Triple P – Positive Parenting Program® is designed to improve the health and wellbeing of communities by supporting the development of more resilient and nurturing families.1 It is one of the most extensively evaluated parenting interventions in the world. The Triple P evidence base has been growing for over 40 years, with more than 793 published studies across 41 countries, including 403 evaluation papers, 192 of which are randomised controlled trials (RCTs).

Triple P currently delivers cost-effective support on both a national scale, and to over 60% of local authorities across England - from Portsmouth to Gateshead, and Suffolk to Herefordshire - in turn working closely with several government departments and local authorities to deliver a range of programmes to early years practitioners and parents of young children.

We are submitting evidence to this important inquiry because we believe the UK government should take bolder steps to improve early years provision by implementing a comprehensive network of evidence-based parenting programmes and improved training for the early years workforce. We believe this additional support would benefit parents across the country and help prevent problems later in life for children.

Early years provision

What challenges do early years providers face in terms of workforce, including recruiting, and retaining qualified staff, and the barriers faced by individuals joining the profession? To what extent has the Covid-19 pandemic exacerbated workforce challenges?

The COVID-19 pandemic has emphasised the importance of the Early Learning and Care sector, in supporting the emotional wellbeing and social learning of young children. However, it is increasingly challenging to attract and retain early years staff, and to support them to function with a high level of competence and confidence. Research by the Early Years Alliance has found significant challenges facing the early years workforce, with 84% of early years setting respondents reporting they find it difficult to recruit suitable new early years staff.[2]

Professional development is recognized as a core element of a quality work environment, however a lack of flexible funding in the sector is a significant barrier to providing this. The challenges faced by the sector has reduced the opportunities for high quality training, with research by the Early Years Workforce Commission finding that 44 percent of early years workforce respondents feel their learning and development has been negatively impacted during the pandemic.[3] This continues to perpetuate the widely recognised crisis in recruitment and retention the sector faces.

PECE – Positive Early Childhood Education programme is an evidence-based intervention delivered to early years practitioners globally to support them to develop skills to enable emotional development of children and improve job satisfaction. The PECE programme aims to tackle the issue of inconsistent CPD through the delivery of a programme that builds staff confidence and their ability to deal with difficult situations, while helping to develop children's potential to the fullest.

PECE is primarily delivered through four online modules with video learning and interactive activities and can also be delivered in-person for a whole-workforce approach. Developed from the Triple P - Positive Parenting Program©, the PECE model provides concrete strategies that can be easily adopted, implemented, and adapted across diverse early learning professionals and settings, increasing educators’ confidence and satisfaction while improving outcomes for children.

The Nuffield Foundation is funding an evaluation of the PECE programme[4], led by the University of Sheffield in collaboration with the University of Leeds, looking at outcomes for staff and children (2- to 4-year-olds) in nurseries in the Yorkshire region. The main aim of the project is to establish the feasibility and acceptability of PECE in early years settings in the UK in advance of a larger-scale trial, as well as begin to explore how the programme supports the EYFS and Ofsted.

Professor Dame Cathy Nutbrown, Professor of Education at the University of Sheffield said:

“High-quality, effective initial training and continuing professional development must be at the heart of any strategy to recruit and retain early years staff, at all levels. Alongside parents and caregivers, early years practitioners play a crucial role in the early development of children, and it is important to ensure they have the skills and support to succeed.  The School of Education is collaborating with Triple P UK and early years settings across South and West Yorkshire on a randomised controlled trial to evaluate Positive Early Childhood Education (PECE).  This trial builds on evidence from an international Randomised Control Trial which indicates that professional development to support PECE can enhance the skills of early years staff, increase their positive and supportive engagement with children, and  as a result improve educators’ confidence and reduce workplace stress.” 

The PECE programme helps to reduce teacher work-related stress, making the development and maintenance of positive learning environments and successful behaviour guidance less challenging.[5], [6] Research examining the PECE programme shows increased educator confidence in guiding challenging child behaviour, as well as improved team communication and support, higher job satisfaction, and reduced workplace stress.5

A service evaluation revealed that educators believed PECE learning and assessment strategies could be easily combined with currently operating strategies in their centres[7] and revealed that staff felt PECE fostered better team working between new and experienced staff, thus providing further opportunity to build skill-sets. [8], [9]

Whether the Early Childhood Education and Care (ECEC) system is meeting the needs of pupils with Special Educational Needs or Disabilities (SEND), and the improvements that could be made to better support young children with SEND within early years provisions.

Practitioners across the ECEC system, alongside families, play a key role in supporting the development of children with SEND. A central part of the ECEC system is working in partnership with parents and caregivers of children with SEND to support child development and confidence, and are supported to use the program flexibly and effectively with children with disabilities.

Stepping Stones Triple P forms part of the Triple P – Positive Parenting Program® system of evidence-based programmes for parents and caregivers of children with additional needs or disabilities. Stepping Stones Triple P aims to increase parenting skills and confidence, by engaging, encouraging, and empowering families to address child social, emotional and behavioural problems, and develop effective strategies for dealing with a variety of childhood behaviour problems and developmental issues. The programme has consistently been demonstrated to be effective for children who have disruptive behaviour and a variety of developmental disabilities (including, intellectual, physical, and sensory disabilities).[10]

In England, various Triple P interventions, including Stepping Stones Triple P, have been implemented as part numerous major policy initiatives and manifesto commitments including: the Department of Work and Pensions’ Reducing Parental Conflict programme; Department for Education’s Home Learning Environment programme; Troubled Families & Supporting Families; and most recently through Family Hubs.

Stepping Stones Triple P programmes are recognised by various Government ‘What Works’ Centres. NICE guidelines recommend Stepping Stones Triple P as a parent-training programme for parents or carers of children (aged up to 12) with learning disabilities and risk of developing or emerging behaviour challenges[11]. Triple P is also recognised in numerous positive evaluations by the Early Intervention Foundation (EIF) for its strength of evidence base and improvements in parent and child outcomes. Group Stepping Stones Triple P, Standard Stepping Stones Triple P, Selected (Seminars) Stepping Stones, Family Transitions Triple P, Enhanced Triple P and Triple P Online have all been recognised as having robust evidence of positive effects from randomised controlled trials by the EIF.

Stepping Stones Triple P is delivered by a range of agencies including Early Help SEND Services, Schools, Voluntary & Community Sector, and CAMHS. Some examples include:

• Amaze, a parent-led community group, and Seaside View, the local Child Development Centre work together to deliver the programme in Brighton & Hove. The Council for Disabled Children (CDC) and Challenging Behaviour Foundation have case studied their approach of the ‘Paving the Way’ initiative. “A trained parent and a specialist make up the Stepping Stones team and work to engage parents with the programme, helping them overcome any initial doubt. Parents are referred by the social work team, parenting team or the Child Development Centre or can call the Amaze helpline to refer themselves. There is always a waiting list.” They report “challenges of insecure funding from year to year makes it hard to plan ahead, meet demand or offer early support to families”[12].
• Cambridgeshire, where the following video case studies highlight how Stepping Stones Triple P is delivered through schools, supporting inclusion:

• Video: Head Teacher in Cambridgeshire[13]
• Video: Parent testimony from parent of child with Asperger’s[14]

Commissioning interventions, such as Stepping Stones Triple P, to support parents of children with SEND needs would support the overall ECEC system. The opportunity to combine Stepping Stones Triple P with the PECE programme would support both parents and practitioners with tools to collaborate effectively to create a strong foundation of consistency and broader positive outcomes.

To what extent does the early years system adequately prepare young children for their transition into primary education, particularly children from disadvantaged backgrounds.

A key part of the early years system is partnership working with parents and caregivers to create a positive home learning environment, which in turn supports the transition into primary education.

To help increase knowledge about creating effective home learning environments, Triple P UK recently took part in a research project with the Education Endowment Foundation (EEF) and Shine[15], two organisations focussed on helping improve educational outcomes for children from disadvantaged backgrounds.

The project worked with Early Years settings in the North of England, giving parents new strategies to bolster the home learning environment. As part of the research, Level 4 Group Triple P was evaluated for its ability to help parents promote speech and language development of three- and four-year-olds, as well as their social, emotional, and behavioural well-being (all of which help improve school readiness and learning). Group Triple P is an 8-week programme covering a wide range of strategies helping encourage learning, supporting children’s emotional needs, encouraging more positive child behaviour and parental self-care. The EEF study of the Level 4 Triple P Positive Programme on children’s language development and social, emotional and behavioural wellbeing was disrupted by the COVID-19 pandemic and formal quantitative evaluation of language development was not possible. However, many parents and practitioners shared meaningful qualitative examples of improvements in children’s behaviour and communication. The majority of settings reported that they intend to continue delivering Triple P to families.

Triple P Online

Alongside the Group Triple P programme, Triple P has also developed and evidenced a parent self-directed format of Triple P – Triple P Online (TPOL). The online programme offers greater flexibility for parents and provided a useful platform during the COVID-19 pandemic when face-to-face delivery was not available. Research demonstrates TPOL produces comparable improvements for families as Triple P’s face-to-face Level 4 programme, and it has been awarded a coveted evidence rating of 3+ on the EIF guidebook.  TPOL costs significantly less to deliver, as well as allowing for greater flexibility for parent engagement. TPOL offers a significant increase in reach and access of evidence-based parenting support to help meet demand and support the needs of heightened stress in families juggling children, working, and schooling at home alongside other significant stressors (e.g., financial, relationship, personal, parenting). 

TPOL can be offered either as a parent self-directed online intervention and/or with additional practitioner support to provide an additional layer of guidance to parents, to answer their questions and support engagement. Practitioners help families to engage and work with them to apply the learnings from the programme to real life scenarios. This mixed approach ensures that harder to reach families can be supported.

There is no doubt that the education provided within an Early Years setting is paramount to the outcomes of young children; our young people spend an exhaustive amount of time in the care of their family, be it with parents, grandparents, siblings, or other relatives or friends.

It is therefore pivotal that parents are given the opportunity to learn about the most important job they will ever take on, beyond anti-natal classes during their pregnancy. Allowing parents and other family members the flexibility to complete an evidence-based intervention in their own time brings government support into the modern era, and gives parents the tools they need, to implement them in their own way, and at their own pace.

The extent to which the reduction of Sure Start Children’s Centres has affected children and families, particularly children from disadvantaged backgrounds, and the role of Family Hubs.

The impact of the reduction in Sure Start Children’s Centres has been profound. The Social Mobility Commission’s report Time for Change, said the Government should restore funding to evidence-based parenting programmes, while the recent Independent Review in Children’s’ Social Care echoed this, calling for a strengthening of family support and re-balancing of the system towards early intervention.[16] The Early Intervention Foundation (EIF) has also said “there is a need to go further in making evidence-based interventions the foundation of local approaches”, and ensure access to local family services which start in maternity and run throughout childhood[17].

The vision for Family Hubs is to provide a central base for families to go to get the support they need. As things stand, Family Hubs plan to bring together perinatal support, breastfeeding support, evidence-based parenting programmes and more. There is further opportunity to think more broadly – parenting programmes can provide significant outcomes for families, improving the life chances and health outcomes of babies and children, regardless of their age, stage, or location. For example, parenting programmes are core components of services such as Early Help, Best Start for Life, SEND services, the Home Learning Environment, Neurodevelopmental Pathways, Mental Health Support, Edge of Care/Reunification, Fostering & Adoption, Youth Offending Services, CSE / CE Services and more. Considering parenting programmes as the golden thread across all these services would further allow us to integrate support for families throughout their journey from conception to the teenage years and beyond.

Triple P for Baby

Triple P programmes focus on non-judgemental, positive, and evidence-based support, offered to parents at any stage in family life. This approach is hugely important. A Royal Foundation survey found that 70% of parents of under 5-year-olds reported feeling ‘judged’ in their parenting, so it’s no wonder parents may be reluctant to ask for support.[18] As a result, it is important that parenting programmes are positive, prevention-focussed, and ideally, universally available, to ensure the best outcomes for parents and children alike.

Normalising parenting support in the early days can help address this, making parenting education and support as readily accepted and available as ante-natal classes. Building on over a decade of international research Triple P has recently launched the Triple P for Baby programme.  This programme is currently being commissioned in many local authorities across the country, and is something we believe will help with the challenge around stigma.

Triple P for Baby helps parents at the transition to parenthood or with a baby up to 12 months of age, offering practical information through an interactive 8-session programme. The programme includes four (2-hour) group or 1:1 sessions where parents participate in a range of activities to learn about building the bond with their baby, encouraging healthy development, and positive strategies to teach their baby new skills as they get older. Parents also learn about coping with common emotional and relationship changes a baby’s arrival brings. The four sessions are followed by four individual consultations to help parents with independent problem solving as they practise their new skills at home.

The case for support in the early years

As part of Triple P’s ongoing evaluation programme, research is delivered in partnership with a range of academic organisations around the world.

Randomised Controlled Trials (RCTs) of Triple P for Baby (aka Baby Triple P in the literature) have been conducted in Germany, Scotland, Australia, and the UK. These include separate trials with fathers, couples, mothers, parents with multiple risk factors, mothers with post-natal depression, and parents of pre-term babies.

Overall, parents consistently reported being satisfied to very satisfied with the Triple P for Baby programme.19, 20, 21, 22 They said it gave the right amount of help, the right type of help, met their needs. Many also said it improved their relationship, was accessible and engaging, and gave them a sense of achievement when completing the programme.

Specific results from particular trials included:

• Babies around six-months of age were awake and content significantly more often, with significantly lower frequency and duration of inconsolable crying[19]
• At two years of age, pre-term children had significantly higher cognitive function and motor skills[20]
• First-time mothers report significantly lower levels of depression at post-intervention[21]
• First-time fathers report significantly lower levels of anxiety at post-intervention, 12- and 24-month follow-up21

These trials and others demonstrate Triple P for Baby’s ability to deliver outcomes both for universal and targeted samples of parents. Of particular note is the Randomised Control Trial (RCT) by the Glasgow Caledonian University, cited above, and another recently published trial from the University of Manchester[22].

Word count of response to questions: 2,968

Contact Details: Matt Buttery (CEO) |correspondence@triplep.net

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