Standard Stepping Stones Triple P
Stepping Stones Triple P has been developed for parents or caregivers of children aged 0-12 with a developmental disability, such as Down’s syndrome or Autistic Spectrum Disorder, as well as moderate or severe behavioural problems. Standard Stepping Stones Triple P is one mode of implementation of the Stepping Stones programmes.
It is designed as a one-to-one 10-session intervention, delivered over 10 consecutive weeks. The intervention begins with a thorough assessment of parent-child interaction. Through a range of learning methods, the intervention provides parents with comprehensive support in managing their child’s behaviour across settings. Parents set goals, practise strategies, complete an activity workbook and undertake homework tasks.
EIF Programme Assessment
Child outcomes
This programme can affect outcomes for children in Active and healthy, physical and mental wellbeing.
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
Decreased child negative behaviour
based on study 1
- Statement: 11.53-point reduction on the Family Observation Schedule (expert observation)
- Score: 26
- Timeframe: Immediately after the intervention
Decreased child problem behaviour
based on study 1
- Statement: 1.77-point reduction on the Developmental Behaviour Checklist (disruptive subscale – parent report)
- Score: 9
- Timeframe: Immediately after the intervention
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.
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:
- Individual
Where is it delivered?
The best available evidence for this programme relates to its implementation in these settings:
- Home
- Out-patient health setting
How is it targeted?
The best available evidence for this programme relates to its implementation as:
- Targeted indicated
Where has it been implemented?
- Australia
- Canada
- Denmark
- England
- Hong Kong
- Ireland
- Netherlands
- New Zealand
- Romania
- United States
Ireland provision
Ireland evaluation
About the programme
What happens during the delivery?
How is it delivered?
Standard Stepping Stones Triple P is delivered in 10 sessions of one-hour duration each by one practitioner to individual parents.
What happens during the intervention?
- The first two sessions are for assessment and include an initial interview, observation and assessment feedback.
- In general, parents will set their own goals and work out what changes they would like to see in their child’s behaviour.
- Sessions 3-4 cover positive parenting strategies, sessions 5-7 are for practice, sessions 8-9 are for planned activities training, and session 10 covers maintenance and closure.
- Practitioners use a range of learning methods with parents, including behavioural rehearsal to teach skills, guided participation to discuss assessment findings and active skills training methods to facilitate the acquisition of new parenting routines.
What are the implementation requirements?
Who can deliver it?
- The practitioner who delivers this programme typically has a background as a school counsellor, nurse, psychologist, social worker, or as an allied health professional. Practitioners have NFQ level 6.
What are the training requirements?
- Practitioners attend three days’ training (9.00am - 4.30pm), one day pre-accreditation workshop and a half-day accreditation session. It is recommended that they spend between four and six hours on individual preparation before accreditation.
- 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 NFQ level 9/10. The host agency supervisor does not receive programme training.
What are the systems for maintaining fidelity?
- Training manual
- Other printed material
- Other online material
- Video or DVD training
- Face-to-face training
- Fidelity monitoring
A quality assurance checklist is available for organisations to use when planning for quality assurance of Triple P. There are three standard fidelity protocols built into the Triple P Implementation Framework (1) Practitioner Accreditation, (2) Intervention Fidelity using Session Checklists, (3) Supervision and Practitioner Support Standards using the Peer Support Network. Triple P UK offers trainer facilitated PASS sessions or a Flexibility & Fidelity workshop for professional development.
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?
- Stepping Stones Triple P assumes that parents with a disabled child need help understanding and adapting to their child’s needs.
- Parents therefore learn positive strategies for managing their child’s behaviour and helping their child become more independent.
- Children, in turn, become more independent and learn how to better manage their own behaviour.
- Children ultimately become more independent of their parents and parents experience less stress and greater family harmony.
Intended outcomes
- Active and healthy, physical and mental wellbeing
- Safe and protected from harm
- Safe and protected from harm
Contact details
Matt Buttery
Triple P UK
matt.buttery@triplep.net
About the evidence
Standard Stepping Stones Triple P’s most rigorous evidence comes from an RCT which was conducted in Australia. This study identified statistically significant positive impact on a number of child and parent outcomes. This programme is underpinned by one rigorously conducted (level 3) study, hence the programme receives a Level 3 rating overall.
Study 1
| Citation: | Plant & Sanders (2007) |
| Design: | RCT |
| Country: | Australia |
| Sample: | 74 families with children under age 6, average age 4.5 years. |
| Timing: | Post test |
| Child outcomes: |
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| Other outcomes: |
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| Study rating: | 3 |
Plant, K., & Sanders, M. (2007). Reducing problem behavior during care-giving in families of preschool-aged children with developmental disabilities. Research in Developmental Disabilities, (28), 4, 362-385.
Available at:
http://www.sciencedirect.com/science/article/pii/S0891422206000515
Study design and sample
This study is a rigorously conducted RCT. This study involved random assignment of participants to three conditions: Standard Stepping Stones Triple P, Standard Stepping Stones Triple P-Enhanced, and a waitlist control group. The first two conditions are the focus of this summary because they relate to Standard Stepping Stones Triple P and its comparison with a control group. Standard Stepping Stones Triple P-Enhanced is treated as a separate programme, due to its increased duration (it has the 10 standard sessions plus 6 additional sessions) and therefore is not reported on.
This study was conducted in Australia, with a sample of 74 families (26 families allocated to Standard Stepping Stones Triple P-S, 24 families allocated to the waitlist control, and the remainder allocated to Standard Stepping Stones Triple P-Enhanced), with children under the age of 6. The average age was 4.5 years. All children had a developmental disability and all had behaviour in the elevated range on the Eyberg Child Behaviour Inventory. 39% of families had a combined income of more than AUS$ 50,000 per annum. No information regarding ethnicity is provided.
Measures
Child negative behaviour was measured using the Family Observation Schedule (expert observation of behaviour). Child problem behaviour was measured using the Developmental Behaviour Checklist – disruptive scale (parent report). Difficult child behaviour was measured using the Caregiving Problem Checklist - difficult child behaviour. Frequency of problematic care-giving tasks were measured using the Caregiving Problem Checklist –problematic care giving tasks (parent self-report). Dysfunctional discipline style was measured using the Parenting Scale, total score (parent self-report). Parents’ views on their competence was measured using the Parenting Sense of Competence Scale, total score (parent self-report). Negative parent behaviour was measured using the Family Observation Schedule – observed negative parent behaviour (expert observation of behaviour). Parental depression, anxiety and stress were measured using the Depression, Anxiety and Stress Scale, total score (parent self-report). The quality of dyadic couple relationship adjustment was measured using the Abbreviated Dyadic Adjustment Scale (parent self-report).
Findings
This study identified statistically significant positive impact on a number of child and parent outcomes. Identified child outcomes were: decreased child negative behaviour and decreased child problem behaviour. Identified parent outcomes were: decreased frequency of problematic care-giving tasks, decreased dysfunctional discipline style and increased parental perception of competence.