Extension of the impact of Early years Provision in Children’s Centres (EPICC) trial on child cognitive and socio-emotional development

Daisy Powell, Amanda Busby, David Wellsted, Peter Cooper, Lynne Murray

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A number of programmes have been developed to support parents’ use of ‘Dialogic Reading’, or ‘Dialogic Book-sharing’ (DBS) with their children. The DBS method is based on extensive observational research on the kinds of parent-child interactions that best promote child development, and particularly language. It refers to a particular way of using a book with a child that sensitively follows and supports the child’s interests, and engages them actively in a reciprocal interaction.
In 2017-2018, we conducted a cluster randomized controlled trial (the Early-years Provision In Children’s Centres (EPICC) trial) to determine whether, compared to normal Children’s Centre input, a DBS intervention delivered as an adjunct to normal Children’s Centre input, conducted with parents of children aged 2-4 years in Children’s Centres in Reading, UK, was associated with better child developmental outcome and parenting six months post intervention. At the six-month post intervention assessment, there were substantial improvements in parenting in the book-sharing context in the intervention group. Benefits to child development were more limited: consistent with other studies (Dowdall et al., 2020; Burgoyne et al. 2018), and in the range considered promising for educational outcomes, these comprised small to medium effects on measures of language and attention, and these were enhanced where parents engaged well with the intervention. By contrast, there were no benefits to other areas of child outcome (executive function, social development and behaviour). Notably, the difference in performance between intervention and control group children had widened over the period between an immediate post-intervention assessment and that conducted at six months follow up on all dimensions of child development, consistent with the intervention having placed children on a more positive developmental trajectory.

In an extension to the original trial, reported here, we assessed the children and the home learning environment after children had attended school for two terms, and we examined the possibility that the intervention had placed children on a more positive developmental trajectory, leading to a longer-term benefit of the intervention.

In the original EPICC trial, 110 participants were randomised to the DBS Intervention and 108 to the Control group. The intervention was delivered by research facilitators in Children’s Centres once a week for seven weeks. It was delivered to small groups of parents for 50 minutes; and after each group session individual parents received support for five-ten minutes. Researchers assessed children and parents at baseline, and then immediately and at six months post-intervention. In the current extension to the study researchers made assessments of child development (early literacy, reading motivation, language, school adjustment, socio-emotional development and Early Years attainment) and the home literacy environment, after the child had attended school for two terms. Assessments were conducted in two waves. The first took place in 2019 and the second in 2020. The second wave of assessments occurred after the onset of the covid 19 pandemic, and adjustments to data collection were made accordingly, with children being assessed on-line rather than in school and teachers providing retrospective assessments of child adjustment and behaviour.

The children’s performance on the study measures and the Home Literacy Environment data were analysed according to group (intervention or control), and took account of previous child performance and demographic and family variables. Analysis was also made, within the intervention population, of the subgroup who were judged to have engaged well. Finally, and with regard to the impact of the covid 19 pandemic, analyses were conducted according to the wave of data collection.

Of the 218 participants recruited into the original EPICC trial, 127 (58.3%) consented to be assessed in the extension study: 60 participants in the intervention group and 67 in the control group. A larger proportion of eligible participants took part in Wave 1 (i.e., 75/92 (81.5%)) than in Wave 2 (i.e. 52/108 (48.1%)).

Key findings:
- No differences between intervention and control groups overall, with both performing within expected range.
- No effect found for more engaged parents (effect not detectable due to sample size or not sustained).
- Baseline vocabulary is associated with later child cognitive outcomes.
- Earlier book sharing/home literacy environment is related to later book sharing/home literacy environment and child reading motivation, although this did not translate to child outcomes.
- Assessments normally administered directly to children were successfully adapted for online administration, but lack of availability of online resources meant fewer families could participate in them.
- Evidence that the pandemic negatively affected early reading, increased screen time, and reduced school adjustment.

Interpretation and Conclusion
Relatively low numbers participated in the extension (particularly for the second wave), there were differences in administration of assessments imposed by the covid 19 pandemic, and those retained in the study were, on average, more socio-economically advantaged compared to those who were not retained. So, caution is required when interpreting the results of this extension study. Nevertheless, it is notable that the performance of the two groups of children was very similar, and was in the average range across measures. The fact that there had been an initial large group difference in child language development at baseline favouring the control group, combined with the findings of similar, and average, performance of both groups at the time of the extension, suggests that, while there was no evidence of a statistically significant benefit of the intervention, it may nevertheless have had a ‘levelling up’ effect, with the initially poorer performance of children in the intervention group being brought into line with that of the control group. Finally, it is notable that child expressive language at baseline, at age two-three years, continued to exert a significant effect on a range of measures of child functioning after two terms in school, a finding that underlines the potential benefit of targeting child development for intervention before this age. There were problems recruiting and retaining more disadvantaged parents, and future interventions need to find ways to overcome these challenges if they are to be successful.
Original languageEnglish
Commissioning bodyThe Nuffield Foundation
Publication statusPublished - 9 Sept 2022


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