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Enhancing Social-Emotional Health and Wellbeing in the Early Years: A Community-based Randomised Controlled Trial (and Economic) Evaluation of the Incredible Years Infant and Toddler (0-2) Parenting Programmes

Behavioural & mental health disorders have become a public health crisis. There is a strong causal link between parent & child wellbeing. We identified a parent programme to support young children, called Incredible Years®. We first conducted a large randomised pilot study involving two research sites, over 200 families, and parent advisory committees, which informed the design and implementation of this trial. We mostly wanted to see if Incredible Years®, which has versions for parents of babies, and for parents of toddlers could improve young children’s wellbeing, but we were also interested in family wellbeing and health, parent competence, use of community, or health, services, parent-child relationships. Robust evidence for Incredible Years®  (3+ years) demonstrates increased child social & emotional wellbeing, fewer behavioural difficulties, & importantly, a positive impact on parent wellbeing - a major risk factor for healthy child development. However, few programmes, & little evidence, exists for the 0-2 year age range.

Two newly developed Incredible Years® programmes for parents of 0-2 year-olds, Incredible Years® Infant and Toddler programmes, have not been rigorously evaluated. We aimed to deliver Incredible Years® as a proportionate universal intervention based on assessment of risk/need and answer the following research question:

  • Are the Incredible Years® Infant and Toddler programmes, when delivered in a dose proportionate to need, & when compared to services as usual, effective & cost-effective in enhancing child social & emotional wellbeing at 20 months of age?

What did we find?

From the 341 participants, 285 and 56 were randomised to E-SEE model and control respectively. We also had an additional 68 co-parents in the study at the start (reducing to 47 at the end) who completed questionnaires, and some attended Incredible Years® groups. Not all parents who were eligible and offered the group programmes accepted, or turned up for it – 101 families were offered the Incredible Years® Infant programme, but only 51 attended. 101 families were also eligible and offered the Toddler programme, but only 21 attended.

We found that E-SEE Steps did not impact on child wellbeing when comparing scores on the Ages and Stages Questionnaire, Social Emotional (ASQ:SE-2) to those who did not receive E-SEE Steps, i.e. there was no difference. This may have been influenced by the low take-up of the Incredible Years® group programmes, and we can also not be sure if parents read the Incredible Years® Baby book. In addition, no other measures showed a difference between those who received and didn’t receive E-SEE Steps, e.g. parent-child relationship, parent competence. However, E-SEE Steps was found to be on the border of being financially worthwhile, mostly because there were very small gains for parent mental health for those allocated to E-SEE Steps. E-SEE Steps was found to cost £621 per family more than usual, or typically offered, services, but this cost would reduce with future delivery as staff training costs would not need to be included in the future now that staff have been trained to deliver.


For more information on the study design see the study protocol:

For more information on the Incredible Years® please see the IY website:

The main findings of the study can be seen on Watch my Powtoon: E-SEE main findings

Public Health and Society Research in the Department of Health Sciences