Changing Lives Initiative
Note on provider involvement: This provider has agreed to EIF’s terms of reference, and the assessment has been conducted and published with the full cooperation of the programme provider.
Changing Lives Initiative (CLI) is a multicomponent intervention for children between ages of three to seven who are demonstrating behaviours that may be consistent with an ADHD diagnosis. It is delivered in community settings and aims to reduce ADHD symptoms and other emotional and conduct problems in children.
CLI aims to improve parents’ understanding of ADHD and reduce ADHD symptoms and emotional/conduct problems in children. It is aimed at children between the ages of three and seven who are demonstrating behaviours that may be consistent with an ADHD diagnosis. The programme is delivered over 26 weeks and includes: information and awareness workshops for parents and professionals; screening for families; and an ADHD-focused Incredible Years Parent Training programme.
EIF Programme Assessment
Changing Lives Initiative has preliminary evidence of improving a child outcome, but we cannot be confident that the programme caused the improvement.
What does the evidence rating mean?
Level 2 indicates that the programme has evidence of improving a child outcome from a study involving at least 20 participants, representing 60% of the sample, using validated instruments.
This programme does not receive a rating of 3 as its best evidence is not from a rigorously conducted RCT or QED evaluation.
A rating of 2 indicates that a programme has a medium-low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of £100–£499.
Child outcomes
According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:
Supporting children's mental health and wellbeing
Enhancing school achievement & employment
This programme also has evidence of supporting positive outcomes for couples, parents or families that may be relevant to a commissioning decision. Please see About the evidence for more detail.
Changing Lives Initiative
Key programme characteristics
Who is it for?
The best available evidence for this programme relates to the following age-groups:
- Preschool
- Primary school
How is it delivered?
The best available evidence for this programme relates to implementation through these delivery models:
- Group
Where is it delivered?
The best available evidence for this programme relates to its implementation in these settings:
- Children's centre or early-years setting
- Community centre
How is it targeted?
The best available evidence for this programme relates to its implementation as:
- Targeted indicated
Where has it been implemented?
United Kingdom, Ireland
UK provision
This programme has been implemented in the UK.
UK evaluation
This programme’s best evidence includes evaluation conducted in the UK.
Spotlight sets
EIF does not currently include this programme within any Spotlight set.
Changing Lives Initiative
About the programme
What happens during delivery?
How is it delivered?
- CLI is a multicomponent programme delivered over 65h in 26 weeks.
- Component 1 involves one information and awareness session of 2 hours duration delivered to groups of 20 parents.
- Component 2 is a one-session screening programme of 45 minutes duration delivered to groups of five parents.
- Component 3 is a 20-session ADHD-focused Incredible Years Parent Training Programme of 2.5 hours duration each, delivered to groups of 12 parents.
- Component 4 is a one information and awareness session of 2 hours duration delivered to groups of 20 practitioners.
What happens during the intervention?
- The Parenting Programme empowers parents to support children’s academic and social skills, emotional self-regulation, and to reduce conduct problems.
- The information sessions increase parents’ understanding of ADHD and how it impacts the development of children.
- Delivery methods for the programme include group discussion, role play, homework assignments, and use of video vignette.
What are the implementation requirements?
Who can deliver it?
- The intervention is delivered by 3 practitioners - 2 early years practitioners and a psychologist.
- The early years practitioners should have NFQ7/8 level qualifications and need to receive 35h of programme specific training.
- The psychologist should have NFQ 9 level qualifications and 7h of programme specific training
What are the training requirements?
- The practitioners have Incredible Years Group Leader training and ideally accreditation, alongside programme specific training.
- Booster training of practitioners is not required.
How are the practitioners supervised?
6h clinical supervision by an NFQ-9 level qualified practitioner
What are the systems for maintaining fidelity?
Programme fidelity is maintained through the following processes:
- Training manual
- Printed material
- Online material
- Video or DVD training
- Face-to-face training
- Fidelity monitoring
Is there a licensing requirement?
There is no licence required to run this programme.
How does it work? (Theory of Change)
How does it work?
- The programme focuses on increasing parents’ understanding of ADHD and uses positive parenting strategies and evidenced social cognitive behavioural therapy techniques to increase parent’s capacity to build positive social, emotional and behavioural skills in their children and strengthen parent child relationships.
- In the short term, the programme aims to achieve reductions in ADHD symptoms and other emotional and conduct problems in children, alongside improvements in parental knowledge of ADHD, reductions in parental stress and increase in parenting skills and competencies
- In the long term, the programme aims to enable children with ADHD to navigate school and society better and be less likely to suffer additional mental health difficulties, substance misuse and offending behaviours as adults
Intended outcomes
Supporting children's mental health and wellbeing
Preventing substance abuse
Preventing crime, violence and antisocial behaviour
Enhancing school achievement & employment
Contact details
Christina Riordan
Project Manager, Changing Lives Initiative
Archways
www.changinglivesinitiative.com and www.archways.ie
Changing Lives Initiative
About the evidence
CLI’s most rigorous evidence comes from a pre-post study, which was conducted in the Republic of Ireland and the UK.
This study identified statistically significant positive impact on a number of child outcomes.
This programme is underpinned by one study with a Level 2 rating, hence the programme receives a Level 2 rating overall.
Study 1
| Citation: | The Changing Lives Consortium, 2021 |
|---|---|
| Design: | Pre-post study |
| Country: | United Kingdom, Ireland |
| Sample: | 337 families, with children between 3 and 7 years old, experiencing behaviours consistently with ADHD, or with existing diagnosis, identified via schools, preschools, GPs, family support hubs,... Cross-border study – participants from Republic of Ireland, Scotland and Northern Ireland. |
| Timing: | Pre-test Post-test 6 months follow-up 1 year follow-up |
| Child outcomes: |
Improved social and emotional outcomes
Decreased ADHD symptoms Improved behaviour Improved academic performance |
| Other outcomes: | Improved parental disciplinary practices Reduced parenting stress level |
| Study rating: | 2 |
The Changing Lives Consortium (2021). Final report on Outcomes, Process and Economic Evaluations. Available at: https://changinglivesinitiative.com/about/project-report/
Study design and sample
The study was a one-group pre-post study. Outcomes were assessed before the intervention was delivered and immediately/6-months/ and 1-year after the intervention was delivered.
This study was conducted in the Republic of Ireland and the UK, with a sample of families with children (aged 3-7 years) who demonstrated behaviours consistent with ADHD.
Measures
- Child social and emotional issues were measured using the Strengths and difficulties questionnaire (parent-report)
- Child ADHD behaviours were measured using the Conners Parent Rating Scale Short Form (parent-report)
- Child ADHD symptoms and effects on behaviour and academic performance were measured using The Vanderbilt (parent-report)
- Parental disciplinary practices were measured using The Parenting Scale (parent-report)
- Parental stress level was measured using the Parenting Stress Index (parent-report)
Findings
This study identified statistically significant positive impact on a number of child and parent outcomes.
This includes:
- Improved social and emotional outcomes (specifically, on subscales that measure emotional problems, conduct problems, hyperactivity, prosocial behaviours, peer problems)
- Improved ADHD behaviours (specifically, on subscales that measure inattention, hyperactivity/impulsivity, learning problems, executive functioning, aggression/defiance)
- Decreased ADHD symptoms and effects on behaviour and academic performance
- Improved parental disciplinary practices
- Reduced parenting stress level
The conclusions that can be drawn from this study are limited by methodological issues pertaining to a lack of comparison group, hence why a higher rating is not achieved.
Published May 2024