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Selected (Seminars) Stepping Stones Triple P

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Evidence rating: 3+
Cost rating: 1

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. Selected (Seminars) Stepping Stones Triple P is one mode of implementation of the Stepping Stones programmes.

Selected (Seminars) Stepping Stones Triple P is a low-intensity parenting support and education programme conducted in a seminar format. It is classified as a Level 2 Triple P programme. It is for parents who are interested in general information about promoting their child’s development. It is aimed at a diverse range of parents seeking support for a specific child behavioural or emotional problem or developmental issue, which is of mild to moderate severity.

It is typically delivered through three seminars which consist of presentations followed by time for questions. It teaches parents how to encourage their child’s social and communication skills, emotional self-regulation, independence and problem-solving ability. 

EIF Programme Assessment

Evidence rating: 3+
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.
Cost rating: 1
A rating of 1 indicates that a programme has a low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of less than €125. This figure is based on an analysis of UK costs and a conversion rate of 1.19.

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.

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

Improved child behaviour and adjustment

based on study 1

  • Statement: 2.73-point reduction on the Eyberg Child Behaviour Inventory (problem subscale – parent report)
  • Score: 14
  • 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:

  • 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
  • Primary school
  • Community centre

How is it targeted?

The best available evidence for this programme relates to its implementation as:

  • Targeted selective

Where has it been implemented?

  • Australia
  • Canada
  • Denmark
  • United States
  • Ireland

Ireland provision

This programme has been implemented in Ireland.

Ireland evaluation

This programme’s best evidence does not include evaluation conducted in Ireland.

About the programme

What happens during the delivery?

How is it delivered?

  • Selected (Seminars) Stepping Stones Triple P is delivered in three sessions of 1.5 hours’ duration each, by one practitioner to 20–200 parents.
  • Parents may attend one or more seminars.
  • In addition, parents may access a brief individual consultation (up to 20 minutes) following the seminar.

What happens during the intervention?

  • Seminar 1, Positive Parenting for Children with a Disability, provides the building blocks for the program as it introduces parents to Triple P’s seven core principles of positive parenting.
  • Seminar 2, Helping Your Child Reach Their Potential, shows parents how they can use positive parenting principles to help their child develop by teaching them new skills and behaviours. For example, breaking the skill into steps and choosing suitable rewards.
  • Seminar 3, Changing Problem Behaviour into Positive Behaviour, focuses on a process for understanding and managing problem behaviour. This includes understanding why the behaviour is occurring and encouraging alternative behaviour.
  • Providers use a range of learning methods with parents, including selecting examples to illustrate teaching points and using live demonstrations.
  • Parents receive a tip sheet covering the content of the seminar they attend. Parents can also access individual consultations with the presenter. 

What are the implementation requirements?

Who can deliver it?

The practitioner who delivers this programme is typically involved in education, disability services, health services, or voluntary organisations and has NFQ-6 level qualifications.


What are the training requirements?

Practitioners attend two days’ training, a one-day pre-accreditation workshop and a half-day accreditation session. It is recommended that they spend 4-6 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. Supervisors do not have 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 the parents experience less stress and greater family harmony. 

Intended outcomes

  • Active and healthy, physical and mental wellbeing
  • Safe and protected from harm

Contact details

Matt Buttery
Triple P UK
matt.buttery@triplep.net

http://www.triplep.net/ 


About the evidence

Selected (Seminars) Stepping Stones Triple P’s most rigorous evidence comes from an RCT conducted in Australia. This is a rigorously conducted (level 3) study, which identified a statistically significant positive impact on child and parent outcomes. 

A programme receives the same rating as its most robust study, and so receives a level 3 overall.

Study 1

Citation:Sofronoff, Jahnel, & Sanders, (2011)
Design:RCT
Country:
Sample:53 parents of a child with a disability, mean age of 6.15 years
Timing:Post test
Child outcomes:
  • Improved child behaviour and adjustment
Other outcomes:
  • Improved parenting style (over-reactivity)
  • Improved parenting style (verbosity)
  • Reduced interparental conflict over child-rearing
Study rating:3

Sofronoff, K., Jahnel, D., & Sanders, M. (2011). Stepping Stones Triple P seminars for parents of a child with a disability: A randomized controlled trial. Research in Developmental Disabilities, 32, 2253–2262.

Study design and sample 

This study is a rigorously conducted RCT. 

This study involved random assignment of children to a Seminars Stepping Stones Triple P group or a waitlist group that participated in the intervention six weeks later.

The study was conducted in Australia with a sample of 53 parents of a child with a disability. The children had a mean age of 6.15 years.  Over half of the children (54.75%) had multiple disabilities, with diagnoses including autistic spectrum disorder (45.3%) and intellectual disability (18.9%). Parents were mainly women (92.5%) and had a mean age of 38.64 years. Two thirds (67.9%) were in paid employment, working an average of 15.43 hours per week. No information regarding ethnicity or socio-economic status is provided.

Measures

The following outcomes were measured:

  • Child behaviour and adjustment was measured using the Eyberg Child Behaviour Inventory (parent-report).
  • Parenting style was measured using the Parenting Scale (self-report).
  • Interparental conflict over parenting was measured using the Parent Problem Checklist (self-report).
  • Parents’ views of their competence was measured using the Parenting Sense of Competence Scale (self-report).
  • Relationship quality and satisfaction was measured using the Relationship quality index (self-report).
  • Parental adjustment was measured using the Depression Anxiety Stress Scales (self-report).
  • Overall functioning of the family was measured using the Family Assessment Device-General Functioning Scale (self-report).

Findings 

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

  • Eyberg Child Behavior Inventory: problem scale
  • Parenting Scale: over-reactivity and verbosity scales
  • Parent Problem Checklist: problem scale
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