Mr. Matt Buttery:

Questions were asked about the best way to deliver, evidencing and training. I will try to answer a few quickly. Regarding the question from Deputy Ellis, there is no one way or best way to deliver. We offer 60- to 90-minute seminars, which have asset-focused messaging and pose questions like what children with disabilities need to do well in life and how we can support them as their parents, through to one-to-one and one-to-four 15- to 30-minute sessions, through to that nine-week group programme, which, as I explained, involves two-hour sessions plus three phone calls, through to a ten-week one-to-one programme, and the effect sizes across all of them are good when it comes to evidencing. This goes back to giving the parents choice about the capacity they have to engage, but it also concerns professionals. We are talking about capacity issues. While I may not have the capacity to run a group, I could do a few one-to-one sessions with someone because I am there anyway doing something else, so why not also talk about this at the same time. There is no one best way, which is why we need a public health and mutli-level approach.

Regarding evidencing and other things we have talked about, the gold standard is a high-quality randomised control trial with effective management of control groups, where thought has been given about intention to treat. There is detail behind what that looks like. As Ms Tyner said very clearly, it is important we give agencies the tools to measure the effectiveness of the programme for themselves. More importantly, as I said in my answer to Deputy Cairns, we need to feed that information back to parents as well. In a similar way, we have an online system which practitioners can use and feed back those results to parents. It does all the maths for them in terms of computing.

Regarding training, something like Stepping Stones Triple P involves a three-day training programme. It is an active skills programme. We are about trying to give parents active skills they can try. About six weeks later, they come to a pre-accreditation workshop and then go through an accreditation session where they need to demonstrate their skills, in particular their ability to promote self-regulation in the parents they are working with. It is about not getting caught in a trap of giving answers or advice, but rather asking good questions and pointing back to the material because the material works. It is a question of how we can help parents access it and apply it in their families.

Concerning integration of that within the community, implementation of evidence-based programmes is as important as the strength of evidence of the programmes, by which I mean the fidelity with which these programmes are implemented and the contextual fit of these programmes. It can be thought of as a three-part sum: the strength of evidence of the programme multiplied by the fidelity of the implementation multiplied by the contextual fit equals the socially significant outcome you want to achieve. We use a science-based implementation framework. We work from a first inquiry of thinking about delivering a programme all the way through to commitment, contracting, thinking through, planning implementation, supervision supports, how outcomes are to be measured, where the books are going to be, how parents are going to get there, the venue and whether transport needs to be arranged. It is about ensuring that by the time practitioners get in the room, they know they are the right practitioners and, ideally, they have a date in the diary of when they are going to be delivering this programme to parents, because it makes that training experience a real situation of needing to know how to deliver it. Critically important is that we continue to support the sustainability and maintenance of the programme, which we do as a matter of course. We have a team of implementation consultants who do that. That is part of integrating this into the community.

The other part of integrating is what I talked about in terms of multi-agency working. I had a slightly different figure of 86 on a waiting list, but it is not very different from the one in Finglas where there is good multi-agency work between the children's disability network team, CDNT, social workers, Tusla prevention, partnership and family support, PPFS, within the family resource centre, the wider team within Barnardos and the other agencies within Better Finglas. I wanted to raise that today because it is a good example of a multi-agency team working together to promote outcomes for parents of children and children with disabilities.