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Incredible Years Toddler

Evidence rating
2
Cost rating
2
Review: Foundations for Life, July 2016

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.

The Incredible Years (IY) Toddler programme is for parents (typically living in disadvantaged communities) with a child between the ages of two and three.

Parents attend 14 weekly group sessions where they learn strategies for responding sensitively to their child and discouraging unwanted behaviour. Two facilitators (QCF-Level 7/8) lead parents in weekly two-hour group discussions of mediated video vignettes, problem-solving exercises and structured practise activities addressing parents’ personal goals.

EIF Programme Assessment

Evidence rating
2

Incredible Years Toddler 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.

What does the plus mean?

The plus rating indicates that a programme’s best available evidence is based on an evaluation that is more rigorous than a level 2 standard but does not meet the criteria for level 3. 

Cost rating
2

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:

Preventing crime, violence and antisocial behaviour

based on

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.

Incredible Years Toddler

Key programme characteristics

Who is it for?

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

  • Toddlers

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:

  • Out-patient health setting

The programme may also be delivered in these settings:

  • Home
  • Children's centre or early-years setting
  • Primary school
  • 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 includes this programme in the following Spotlight sets:

  • Parenting programmes with violence reduction outcomes
Incredible Years Toddler

About the programme

What happens during delivery?

How is it delivered?
  • Incredible Years Toddler is delivered by two co-leaders to groups of approximately 12 families in 14 sessions of approximately two hours each.
What happens during the intervention?
  • During the sessions, parents practise child-directed play skills that build positive relationships and attachment; strengthen more nurturing parenting using social and emotional coaching methods; encourage language development and early social skills; support early learning; establish predictable routines, rules and home-safety proofing; and reduce behaviour problems. Parental social support is strengthened by weekly facilitator calls, parent-buddy calls and group-process methods.
  • IY Toddler can be combined with Incredible Years Advanced for families with more complex issues. IY Advanced is a 10 to 12-week add-on component which covers self-management and mental-health issues.

What are the implementation requirements?

Who can deliver it?
  • The practitioners are two co-leaders with QCF-7/8 qualifications that could be psychologists, social workers, nurses or physicians.
What are the training requirements?
  • The practitioners have 24 hours of programme training. Booster training of practitioners is not required.
How are the practitioners supervised?
  • It is recommended that practitioners are supervised by one host-agency supervisor qualified to QCF 7/8  with four hours of training and one programme developer supervisor qualified with no required training.
What are the systems for maintaining fidelity?
  • Fidelity monitoring
  • Accreditation or certification process
  • Supervision
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?
  • The Incredible Years model assumes that some parenting behaviours inadvertently encourage unwanted child behaviour.
  • Parents will learn more effective strategies for dealing with unwanted child behaviour when they have opportunities to practise and perceive themselves as effective in using them.
  • Effective parenting strategies help the child learn how to better manage his or her emotions and behaviour.
  • In the longer term, the child will get along better with others and there will be a reduced likelihood of antisocial or criminal behaviour.
Intended outcomes

Preventing crime, violence and antisocial behaviour

Incredible Years Toddler

About the evidence

Incredible Years Toddler's most rigorous evidence comes from an RCT which was conducted in the US.   

This study identified statistically significant positive impact on a number of child and parent outcomes.

This programme is underpinned by one study with a Level 2+, hence the programme receives a Level 2+ rating overall.

Study 1

Citation: Perrin et al (2014)
Design: RCT
Country: United States
Sample: 273 families with a two-year-old child identified with behavioural problems
Timing: Post-test; six-month follow-up; 12-month follow-up
Child outcomes: Improved behaviour
Other outcomes: Improved parenting
Study rating: 2+

Perrin, E.C., Sheldrick, R.C., McMenamy, J.M., Henson, B.S., & Carter, A.S. (2014). Improving parenting skills for families of young children in pediatric settings: a randomized clinical trial. Journal of American Medical Association Pediatrics, 168, 16-24.

Available at
https://www.ncbi.nlm.nih.gov/pubmed/24190691

Study design and sample

The first study is an RCT.  

This study involved random assignment of parents and children to an IY Toddler treatment group and a waitlist group. 

This study was conducted in the US, with a sample of 273 parents of children between two and four years. 

Measures

Child disruptive behaviour and intensity were measured using the Eyberg Child Behavior Checklist (parent report). Parent-child interactions (child disruptive behaviour, negative parenting behaviour) were measured using the Dyadic Parent-Child Interactive Coding System-Revised (DPICS-R) (expert observation of behaviour).  Coercive parenting was measured using the Arnold Parenting Scale (parent report).

Findings

This study identified statistically significant positive impact on a number of child and parent outcomes.

Child outcomes include:

  • Improved behaviour
More Less about study 1

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.

Gross, D., Fogg, L., Webster-Stratton, C., Garvey, C., Julion, W., & Grady, J. (2003). Parent training of toddlers in daycare in low-income urban communities. Journal of Consulting and Clinical Psychology, 71, 261-278 - This reference refers to a randomised control trial, conducted in the USA.

Hutchings, J., Griffith, N., Bywater, T. and Williams, M. (2016). Evaluating the Incredible Years Toddler Parenting Programme with parents of toddlers in disadvantaged (Flying Start) areas of Wales. Child: Care, Health and Development, 43(1), pp.104-113 - This reference refers to a randomised control trial, conducted in the UK.

Published April 2024