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The New Forest Parenting Programme

Evidence rating
3
Cost rating
3
Review: Foundations for Life, July 2016

The New Forest Parenting Programme (NFPP) is for parents with a child between the ages of three and 11 with moderate to severe symptoms of ADHD.

NFPP takes place in the family’s home through eight weekly visits. During these visits, parents are made aware of symptoms and signs of ADHD and the ways in which they may affect their child’s behaviour and their relationship with their child. Parents also learn strategies for managing their child’s behaviour and attention difficulties.

EIF Programme Assessment

Evidence rating
3

The New Forest Parenting Programme has evidence of a short-term positive impact on child outcomes from at least one rigorous evaluation.

What does the evidence rating mean?

Level 3 indicates evidence of efficacy. This means the programme can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome.

This programme does not receive a rating of 4 as it has not yet replicated its results in another rigorously conducted study, where at least one study indicates long-term impacts, and at least one uses measures independent of study participants. 

What does the plus mean?

The plus rating indicates that this programme has evidence from at least one level 3 study, along with evidence from other studies rated 2 or better.

Cost rating
3

A rating of 3 indicates that a programme has a medium cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of £500–£999.

Child outcomes

According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:

Preventing crime, violence and antisocial behaviour

Improved behaviour - based on study 1, study 2

Reduced hyperactivity - based on study 1, study 2

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.

The New Forest Parenting Programme

Key programme characteristics

Who is it for?

The best available evidence for this programme relates to the following age-groups:

  • Preschool

How is it delivered?

The best available evidence for this programme relates to implementation through these delivery models:

  • Individual

Where is it delivered?

The best available evidence for this programme relates to its implementation in these settings:

  • Home

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, United States

UK provision

This programme has been implemented in the UK.

UK evaluation

This programme’s best evidence includes evaluation conducted in the UK.

The New Forest Parenting Programme

About the programme

What happens during delivery?

How is it delivered?
  • The NFPP is delivered in eight sessions of between 1 and 1.5 hours duration each, by one senior family-support worker, psychologist, health visitor or nursery nurse to individual families.
What happens during the intervention?
  • During the weekly visits, parents are made aware of symptoms and signs of ADHD and the ways in which they may affect their child’s behaviour and their relationship with their child.
  • Parents also learn strategies for managing their child’s behaviour and attention difficulties. Some of these strategies are taught through games that engage children’s attention, encourage their patience and increase their concentration.
  • The practitioner observes the parent and child playing the game together and provides feedback on the quality of their interaction.

What are the implementation requirements?

Who can deliver it?
  • The practitioner who delivers this programme is a senior family-support worker, psychologist, health visitor or nursery nurse with QCF-4/5 level qualifications.
What are the training requirements?
  • The practitioner has 24 hours of programme training. Booster training of practitioners is recommended.
How are the practitioners supervised?
  • It is recommended that practitioners supervised by one programme developer supervisor (qualified to QCF-7/8 level), and one host-agency supervisor (qualified to QCF-7/8 level).
What are the systems for maintaining fidelity?
  • Training manual
  • Other printed material
  • Face-to-face training
  • Supervision
  • Accreditation or certification process
  • Booster training
  • Fidelity monitoring
Is there a licensing requirement?

Yes, there is a licence required to run this programme.

How does it work? (Theory of Change)

How does it work?
  • NFPP assumes that effective parenting skills help children with ADHD manage their behaviour and attention difficulties.
  • NFPP provides parents with strategies to help their children manage their attention, behaviours and impulses.
  • In the short term, the parent/child relationship improves. Children are better able to regulate their own behaviour and parents experience less stress.
  • In the longer term, children can concentrate for longer periods and their behaviour improves. Ultimately, children are expected to do better in school.
Intended outcomes

Supporting children's mental health and wellbeing

Contact details

Cathy Laver-Bradbury
CAMHS, The Orchard Centre
cathy.laver-bradbury@solent.nhs.uk

The New Forest Parenting Programme

About the evidence

NFPP’s most robust evidence comes from two RCTs. One was conducted in the UK and one was conducted in the USA.

Study 1

Citation: Sonuga-Burke et al (2001)
Design: RCT
Country: United Kingdom
Sample: 58 families with a child screened for symptoms of ADHD.
Timing: -
Child outcomes: Improved behaviour
Reduced hyperactivity
Other outcomes: Increased parenting satisfaction
Increased sense of well-being
Increased parenting efficacy

Sonuga-Barke, E.J.S., Daley, D., Thompson, M., Laver-Bradbury, C., & Weeks, A. (2001). Parent-based therapies for preschool attention-deficit/hyperactivity disorder:  A randomized, controlled trial with a community sample. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 402-408.

Available at
http://www.sciencedirect.com/science/article/pii/S0890856709603889

Study 2

Citation: Abikoff et al (2015)
Design: RCT
Country: United States
Sample: 164 families with a preschool child with symptoms of ADHD living in New York.
Timing: -
Child outcomes: Improved behaviour
Reduced hyperactivity
Other outcomes: Increased parenting satisfaction
Improved parenting

Abikoff, H.B., Thompson, M., Laver-Bradbury, C., Long, N., Forehand, R.L., Miller Brotman, L., Klein, R.G., Reiss, P., Huo, L., & Sonuga-Barke, E. (2015). Parent training for preschool ADHD: a randomized controlled trial of specialized and generic programs. Journal of Child Psychology and Psychiatry, 56, 618-631.

Available at
http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12346/full

Other studies

The following studies were identified for this programme but did not count towards the programme's overall evidence rating. A programme receives the same rating as its most robust study or studies.

Sonuga-Barke, E.J.S., Thompson, M., Daley, D., & Laver-Bradbury, C. (2004). Parent training for attention deficit/hyperactivity disorder: Is it as effective when delivered as routine rather than as specialist care? British Journal of Clinical Psychology, 43, 449-457.

Thompson, M.J.J., Laver-Bradbury, C., Ayres, M., le Poidevin, E., Mead, S., Dodds, C., Psychogiou, L., Bitsakou, P., Daley, D., Weeks, A., Miller Brotman, L., Abikoff, H., Thompason, P., & Sonuga-Barke, E.J.S. (2009). A small-scale randomized controlled trial of the revised new forest parenting programme for preschoolers with attention deficit hyperactivity disorder. European Journal of Adolescent Psychiatry, 18, 605-616.

Published March 2017   |   Last updated April 2017