A comparison of the clinical effectiveness and cost of specialised individually delivered parent training for preschool attention-deficit/hyperactivity disorder and a generic, group-based programme: a multi-centre, randomised controlled trial of the New Forest Parenting Programme versus Incredible Years.
Sonuga-Barke, E. J., Barton, J., Daley, D., Hutchings, J., Maishman, T., Raftery, J., ... & Thompson, M. J. 2018

The objective of this study is to compare the efficacy and cost of specialised individually delivered parent training (PT) for preschool children with attention-deficit/hyperactivity disorder (ADHD) against generic group-based PT and treatment as usual (TAU). This is a multi-centre three-arm, parallel group randomised controlled trial conducted in National Health Service Trusts. The participants included in this study were preschool children (33–54 months) fulfilling ADHD research diagnostic criteria. New Forest Parenting Programme (NFPP)—12-week individual, home-delivered ADHD PT programme; Incredible Years (IY)—12-week group-based, PT programme initially designed for children with behaviour problems were the interventions. Primary outcome—Parent ratings of child’s ADHD symptoms (Swanson, Nolan & Pelham Questionnaire—SNAP-IV). Secondary outcomes—teacher ratings (SNAP-IV) and direct observations of ADHD symptoms and parent/teacher ratings of conduct problems. NFPP, IY and TAU outcomes were measured at baseline (T1) and post treatment (T2). NFPP and IY outcomes only were measured 6 months post treatment (T3). Researchers, but not therapists or parents, were blind to treatment allocation. Analysis employed mixed effect regression models (multiple imputations). Intervention and other costs were estimated using standardized approaches. NFPP and IT did not differ on parent-rated SNAP-IV, ADHD combined symptoms [mean difference − 0.009 95% CI (− 0.191, 0.173), p = 0.921] or any other measure. Small, non-significant, benefits of NFPP over TAU were seen for parent-rated SNAP-IV, ADHD combined symptoms [− 0.189 95% CI (− 0.380, 0.003), p = 0.053]. NFPP significantly reduced parent-rated conduct problems compared to TAU across scales (p values < 0.05). No significant benefits of IY over TAU were seen for parent-rated SNAP, ADHD symptoms [− 0.16 95% CI (− 0.37, 0.04), p = 0.121] or parent-rated conduct problems (p > 0.05). The cost per family of providing NFPP in the trial was significantly lower than IY (£1591 versus £2103). Although, there were no differences between NFPA and IY with regards clinical effectiveness, individually delivered NFPP cost less. However, this difference may be reduced when implemented in routine clinical practice. Clinical decisions should take into account parental preferences between delivery approaches.

Covid-19 and early intervention: evidence, challenges and risks relating to virtual and digital delivery
Martin, J., McBride, T., Masterman, T., Pote, I., Mokhtar, N., Oprea, E., & Sorgenfrei, M. 2020

This report sets out the evidence on virtual and digital delivery of interventions across a range of relevant domains, highlights the challenges and risks associated with remote delivery methods, and provides the findings from an EIF survey asking intervention developers and providers about their response to the Covid-19 crisis. It is intended to support the sector as it rapidly adapts to the constraints on delivery imposed by widespread social distancing and lockdown.Examples of remotely delivered interventions include one-to-one and group-based therapy or support provided by phone, messaging or videoconferencing, through to self-guided interventions such as online quizzes, apps and games.

Estimating Children’s Services spending on vulnerable children
The Children’s Commissioner Office 2019

This report provides new estimates of how much is spent on children in specific categories of need and vulnerability across a sample of local authority children’s services departments.The Children’s Commissioner’s Office visited over a dozen LAs between November 2018 and February 2019 to gather evidence from Directors of Children’s Services, elected council members, heads of finance and programme managers on local pressures on children’s services budgets, specifically budgets for high needs and early intervention. The Children’s Commissioner Office then worked closely with nine local authorities to develop a methodology to allocate financial data and produce a set of estimates.The work does not provide a nationally representative picture of demand and spend intended to benefit children in England. The aim was to get a better understanding of the current cost pressures facing councils and then work with local authority children’s services to co-create a common framework and methodology for mapping the level of support and spend on children and to work with a small sample of LAs to use this framework to obtain comparable data.In the absence of a full national dataset on where money goes this study provides an important contribution to the debate on the efficiency, effectiveness and fairness of current funding.

Mapping the evidence about what works to safely reduce the entry of children and young people into statutory care: A systematic scoping review protocol
Brand, S. L., Morgan, F., Stabler, L., Weightman, A. L., Willis, S., Searchfield, L., ... & Evans, R. E. 2019

Introduction:The increasing number of children and young people entering statutory care in the UK is a significant social, health and educational priority. Development of effective approaches to safely reduce this number remains a complex but critical issue. Despite a proliferation in interventions, evidence summaries are limited. The present protocol outlines a scoping review of research evidence to identify what works in safely reducing the number of children and young people (aged ≤18 years) entering statutory social care. The mapping of evidence gaps, clusters and uncertainties will inform the research programme of the newly funded Department for Education’s What Works Centre for Children’s Social Care. Methods and analysis The review uses Arksey and O’Malley’s scoping review methodology. Electronic database and website searches will identify studies targeting reduction of care entry, reduction of care re-entry and increase in post-care reunification. Supplementary searching techniques will include international expert consultation. Abstracts and full-text studies will be independently screened by two reviewers. Ten percent of data abstraction will be independently conducted by two reviewers, with the remainder being extracted and then verified by a second reviewer. Descriptive numerical summaries and a thematic qualitative synthesis will be generated. Evidence will be synthesised according to primary outcome, intervention point (mapped across socio ecological domains) and the realist EMMIE categorisation of evidence type (Effectiveness; Mechanisms of change; Moderators; Implementation; Economic evaluation). Ethics and dissemination Outputs will be a conceptual evidence map, a descriptive table quantitatively summarising evidence and a qualitative narrative summary. Results will be disseminated through a peer- reviewed publication, conference presentations, the What Works Centre website, and knowledge translation events with policy-makers and practitioners. Findings will inform the primary research programme of the What Works Centre for Children’s Social Care and the subsequent suite

Mapping the evidence about what works to safely reduce the number of children and young people in statutory care: a systematic scoping review
Brand, S., Morgan, F., Stabler, L., Weightman, A. L., Willis, S., Searchfield, L., ... & Evans, R 2018

The increasing number of children and young people entering statutory care in the UK is a significant social, health and educational priority. Development of effective approaches to safely reduce this number remains a complex but critical issue. Despite an increase in interventions, evidence summaries are limited. This study is a scoping review; using systematic searching methods to map published evidence in the area of what works in safely reducing the number of children and young people, under the age of 18 years, entering statutory social care. Including exploring the clusters and gaps of research evidence in this area.

On Estimating the Fiscal Benefits of Early Intervention.
Feinstein, L., Chowdry, H., & Asmussen, K. 2020

In this paper we explain some of the difficulties of providing forecasts of the financial benefits of early intervention programmes, focussing on those delivered during the early childhood period. We highlight the diversity of early intervention, and the complexity and multiplicity of outcomes. We summarise recent work at the Early Intervention Foundation to assess the evidence on the impacts of early intervention, recognising the diversity of approaches to delivery and the importance of innovation and local practice as well as of rigorous approaches to evaluating causal effects. We also describe new ways of assessing accurately the local fiscal costs of late intervention and consider the implications of this for addressing the well-established barriers to investment in prevention. Our analysis brings to the fore gaps in the evidence from which even the most rigorous ‘gold-standard’ research is not immune. These limitations prevent the production of an accurate and realistic cost-benefit ratio or net present value for the majority of programmes as delivered in practice. We suggest some paths towards a firmer foundation of evidence and a better alignment of evidence and policy.

Promoting the retention,mental health and wellbeing of child and family social workers: a systematic review of workforce interventions
Turley, R., Roberts, S., Foster, C., Willis, S., Morgan, H., Warner, N., ... & Nurmatov, U. 2020

Mental health, wellbeing and retention are pressing concerns within children’s social care. This systematic review aims to summarise existing evidence on workforce interventions to improve mental health, wellbeing or retention of child and family social workers. Findings suggest a number of potentially promising interventions, particularly organisational level interventions. However, there is very little high quality or consistent evidence available, and more research is needed.

Research review: Economic evidence for interventions in children's social care: revisiting the what works for children project.
Stevens, M., Roberts, H., & Shiell, A 2010

Evidence about the cost-effectiveness of interventions in children’s services can help decision-makers make more efficient use of scarce resources. We returned to six somewhat disparate interventions on which we had collated research evidence identified by service planners and practitioners as relevant to the well-being of children in the course of the Economic and Social Research Council-funded What Works for Children project. These are home visiting, parenting, cognitive–behavioural therapy, mentoring, traffic calming and breakfast club interventions. We aimed to explore the nature and extent of evidence on cost-benefit and cost effectiveness for these measures. We conducted searches for studies that looked at the costs as well as the effectiveness of the six interventions and found 24 studies matching our inclusion criteria. The studies were diverse in terms of study design and economic methods (including economic modelling and willingness to pay). Studies relating to parenting programmes and traffic calming gave the most positive indication that the interventions may be cost-effective for the outcomes in question. The remainder of the studies did not give a clear picture, in large part because of a lack of demonstration that the intervention was effective.

What works to improve the lives of England's most vulnerable children's: a review of interventions for a local family help offer
Asmusen, K., Waddell, S., Molloy, D., & Moore, I. 2022

This report identifies over 50 interventions and activities with evidence of improving child and family outcomes within five categories of vulnerability: problematic child behaviour, family conflict, parental mental health, domestic abuse and parental substance misuse.