Mr. Matt Buttery:

I want to mention one specific thing which is that the children's disability network web page has group parenting programmes and I have highlighted the word "Triple P" on that. The HSE is saying we provide this. I have already talked about reach and said that it is low. In terms of the ask one makes of the people who are following on etc., it should be an open door but the provision is not there.

The Senator asked some really important questions. A lovely, randomised control trial was done, I think in Germany, involving parents with intellectual disabilities who had children. What one finds is, in the context of manualised evidence-based programmes, it is important to deliver them in the right order and format because they have been tested and refined in that way. I also talked about the importance of improving the parent-child relationship before we get on to other strategies. However, there is flexibility within the fidelity of that model. What that trial eloquently gave example to was the need to slow down the delivery, take a little bit more time with the families, and give them more support in implementing their practices. The programme did not need to change; the implementation of the programme just adapted to their additional needs.

We also have elements at the very top of our system that are for adjunct issues in the parenting that are affecting the parenting task. We have programmes, such as enhanced Triple P and pathways Triple P, that deal with a person's coping skills and mental health, couple conflicts, and anger management issues that an adult may have. We have other modules that can be flexibly drawn in. The Senator made a very good point about financial hardship and access to these programmes, hence my point about having flexible delivery modes, thinking about providing the opportunity to do things online. In work we did in England, we saw that parents on very low incomes were more likely to attend a remote session because they did not have to organise transport or childcare, but they were as engaged as others. In fact, they were more engaged because there was a degree of "I'm hungry for this".

We as programme providers are working as hard as we can and we need to continue to think about how we can work harder. As a system, we know these programmes work but as for that thoughtful implementation, which I talked about earlier, there is a lot we must do to think about how we ensure equity of access.