Do you bury bad news?

I guess you do if you feel that the overall intended objectives were not worth scrutiny and proper reflection, as is the point of any randomised controlled trial (RCT). But, if you genuinely want to have a user focused approach you of course need to accept that many good intentions, hard work and excellent delivery may not always provide you with the outcomes that you both desire and unconsciously hoped for.

ParentChild+ is an intensive 15-month home visiting programme primarily for low-income families with a 2 – 3‑year-old child. The programme was originally developed in the US. During the twice weekly (30-minute) visits trained home visitors model reading, conversation and play activities to parents using books and educational toys that are gifted to the family as part of the programme. 

For this above RCT trial you would need to place it in the context of an unimaginable global pandemic with lockdowns and a heightened sense of anxiety, bouts of illness due to covid and the necessity to completely rethink through how we continue to support vulnerable 2–4-year-old children from in-person delivery to online. Add to that the memory of graded lockdowns for different parts of the country, and you have a scenario where our work was delivered to the most locked down part of the country experiencing the most restrictions.  

In addition, the digital divide and data disparity became even more articulated as the families that we worked with often could not afford the technology to be online all of the time, or had insufficient devices, there was a high demand on single devices needing to be shared by competing family members who needed to be home schooled online, and/or parents who needed to be logged into work.

We trialed the programme in a range of contexts and the feedback was always excellent, in so much as the parents and families with whom we engaged always expressed their appreciation and the behaviour within the home always changed for the better, the general communication between both the parent and the child(ren) benefited from new routines and structure, and an expectation of learning was created.

We were given the opportunity to undertake an RCT programme with the Education Endowment Foundation (EEF) where we worked with 160 families and trialed this work across South Yorkshire in four districts. We were both daunted and excited by this challenge to demonstrate the importance of addressing the attainment gap in communities where English was often the second language, poverty was high and the disadvantage to children beginning school behind the recommended measures was often the establishment that would remain with that child without their education and into their working life.  What we were not prepared for was a pandemic that fundamentally shifted the learning and the delivery methods for the programme. We would like to highlight some outcomes and learning below.

ParentChild+ has demonstrated on multiple occasions and through numerous evaluations and RCT’s in the United States the huge impact of early intervention and the impact of addressing the educational attainment gap. Family Lives was delighted to be involved in a programme that recognised the huge impact of not being school ready had on both educational development and life chances.

This trial looked at the impact of ParentChild+ on children’s understanding of vocabulary, as positive findings had been found around this in previous trials of the programme in the US. On reflection we consider the initial measure of receptive language was with hindsight in our view too narrow, as it did not take into account the wider issues of school readiness. In discussion with EEF it was accepted that in future – where appropriate – they will consider whether to broaden the scope of measurement to look for impacts on other areas of young children’s language and literacy, for example use of vocabulary and language.

The impact of moving an in-person programme to online was also problematic, the home visitor, the parent and the child all had to learn to engage differently and there is a vast difference between someone being physically in your home or on a small screen on your phone. It was accepted in our conversations with EEF that future trials will assess the quality of delivery by home visitors, as well as recording the quantity of delivery.

The qualitative data and feedback from participating parents and families remains almost unilaterally positive and supportive, with the vast majority of parents maintaining the learning interventions once the programme has finished.

The final point remains potentially the most important, as despite covid challenges, the fear, the disadvantage, Family Lives turned up and found a way to work with families who were frightened and isolated and needed to know that they still mattered. My huge admiration and respect to all of the individuals who looked beyond their own fear to be available for others, through learning new skills to communicate online, and where possible and appropriate turning up in person.

You don’t bury bad news because there is always something to learn, and we will review the lessons from the RCT with wider colleagues, and against our pre-existing extensive delivery practice of other programmes look to learn and engage.

We are disappointed by an outcome which is not what we expected, and we believe does not tell the whole story, but we are proud that we turned up and supported children and families at a time when they needed it the most.  

Our thanks to Sarah and her team from EEF for their help and support throughout this process.

Jez Todd, Chief Executive 

October 2022