In January 2006 a new validation of the Family Caring Trust ‘Noughts to Sixes Parenting Programme’ was begun by two Chartered Child Psychologists, Dr Ion Wyness (West Lothian Primary Care Trust) & Dr Elise Kearney (NHS Lothian), beginning with questionnaires administered six weeks before and then immediately before a course (to rule out the possibility of the changes happening before the course began), and again at the end of the course and three months after the courses finished. The three short questionnaires were the Child Behaviour Checklist for ages 18 months to 5 years; The Parent Stress Index; and HAD – Hospital Anxiety & Depression Score.

Eight 6-week courses were run by trained facilitators between March and November 2006 – 80% Mums (4% Ethnic Minority) and 20% Dads. The last follow-up questionnaires were administered in Feb. ‘07, with analysis then done by Dr Wyness and Dr Kearney.

The final draft report was submitted to the Childcare Health & Development Journal in January 2008. The report states that “the FCT ‘Pram to Primary School’ parenting programme significantly reduced parenting stress and child behavioural difficulties. These positive effects were shown to have been maintained at three-month follow-up, and child behaviour problems continued to decrease. These results have important implications for practice. They demonstrate that Health Visitors can have a significant impact on parenting practices and improving children’s behaviour in the pre-school years. This is extremely important given the rising levels of children’s behavioural problems. The ‘0-6’ programme is a short intervention, which is relatively inexpensive to purchase and implement. With time and resource at a premium in services, this is an encouraging outcome for those working with parents in primary care.” 

Caution naturally needs to be exercised in applying these results to the general population, and it would also be interesting to continue testing at six months and a year after completion of the courses, but it should be borne in mind that this course has already been popular for well over a decade throughout Britain and Ireland with parents from all socio-economic groups, and it is obvious from the research findings detailed above that the results of other evaluations confirm these findings. 

The report continues, “The current research is very promising in that it suggests that the 0-6 programme is a cost effective and easily implemented programme for primary care workers, with the potential to be an effective intervention for increasing parental well-being and decreasing children’s behavioural problems in the area of primary care health promotion. It has also demonstrated an ability to significantly reduce parenting stress for parents experiencing stress within the clinical range. 

Frances Byatt-Smyth, Parenting organiser with NHS Lothian co-ordinated the 2-year validation process. She comments “What was surprising was that nearly 50% of the parents in the study had parental stress even though the behaviours of their children would be classified as mild behavioural difficulties. The research confirms it is a great programme for prevention and reduction of mild child behavioural difficulties and parental stress. It is cost effective and shows that Health Visitors can have a significant impact on parenting practice and improved children's behaviour in the pre-school years.” 

The Pram to Primary Programme (also known as the ‘Noughts to Sixes’ Programme) and the Fives to Fifteens’ Programme have been graded by the researchers at the National Academy of Parenting Practitioners under four distinct categories:

1.)  Evidence-based. 
In the light of independent research both have been given a ‘2’ rating for their evidence base.  This is impressive by current UK standards – it is only given where positive change has been demonstrated through scientifically validated assessment methods collected at multiple points.  The only programmes that score higher tend to be the bigger (American or university-backed) bodies with the vast resources (usually hundreds of thousands of pounds) required to commission full randomised controlled research studies.  

2.)  Training 
‘Pram to Primary’ was awarded a ‘3’ rating for training and supervision, i.e., it has met almost all criteria for best practice.  Given our ethos of onlyworking through other bodies, this was the most we could have expected.  All of our programmes have the same level of training and supervision to level 3 OCN. 

3.)  Appropriate Targets &  4.) Content and Approach. 
In these two categories The Pram to Primary Programme and the ‘Fives to Fifteens’ Programme met all ‘best practice’ criteria and have been graded ‘4’ – the highest level possible.

Doing Your Own Evaluation
It is very important to do your own evaluation of a course – to ask parents to take a few moments to fill in a questionnaire/enrolment form when they apply for a course, and again at the end of the course. The pre-course form can give you a better idea of their needs (and help to exclude parents who need to be referred on to other services for more intensive work). It can also build their expectations and help them get in touch with specific areas that they would like to work on. The end-of-course questionnaire helps parents to look back at the end of a course and it provides them with a measure of their success. This can validate their efforts and even reinforce their learning, and it gives you concrete evidence of change. If you go to ‘Questionnaires’ on the menu of this website, you can download excellent short tick-box questionnaires that have been adapted with permission from those used by Barnardos South Lakeland. There is no suggestion that you have to use the questionnaires from our website, but if you do design your own, please make sure that there is a consistency between the pre-course form and the end-of-course form, so that you are measuring the same things. Some health professionals also use the Parent Health Questionnaire (PHQ-9) or the Eyberg Child Behaviour Inventory.