The measures were selected in line with the research that was conducted by Kings College London as part of the randomised control trail. The measures are designed to assess the extent to which caregivers and looked after children can benefit from the programme. The domains that these measures are designed to tap into are: (a) changes in child behaviour (b) improvements in relationships between carer and child (c) increased caregiver confidence and (d) fidelity to model.
Parenting style is measured by the level of social and emotional adjustment of the child. For participants in the Intervention Group, information about their perceptions of how the course is run will also be considered as important.
Primary Outcome Measures:
- Child Behaviour Problems: The Carer-Defined Problems Scale measured at baseline interview directly before treatment (Time 1), and again three months post-randomisation (Time 2).
- Foster Child’s attachment relationship with caregiver: The Quality of Attachment Relationships Questionnaire (QUARQ) measured at baseline interview directly before treatment (Time 1), and again three months post-randomisation (Time2).
- Foster child’s social, emotional and behavioural adjustment: Strengths and Difficulties Questionnaire (SDQ) (Goodman 2001) measured at Time 1 and Time 2.
- Carer Satisfaction: Satisfaction Questionnaire (Intervention Group only) measured at the end of the training.
The primary outcomes are those considered to be central to the aims of the Fostering Changes training i.e. to improve relationships, decrease the incidence of difficult behaviour, enhance social and emotional adjustment, and to deliver a training which meets the needs of carers.
Secondary Outcome Measures:
- Caregiver’s sense of confidence: Carer Efficacy Questionnaire measured at Time 1 and Time 2
- Foster parent’s parenting style, relationship with child and coping strategies: The Alabama Parenting Questionnaire Short Form (Scott et al 2011), measured at Time 1 & Time 2
- Caregiver’s coping strategies: Carers’ Coping Strategies measured at Time 1 and Time 2
- Service Use and Demographics: Client Service Receipt Inventory measured at Time 1 and Time 2)
Measures in detail:
Child Behaviour Problems: The Carer-defined Problems Scale (Scott et al, 2001) asks carers to list their foster child’s three main problems, and then to indicate how severe the problems by placing a mark on a 10 cm line. Data from this measure has been shown to be a very useful indicator of pre-‐ and post-‐ intervention change.
The Quality of Attachment Relationship Questionnaire (QUARQ) is an assessment of the attachment relationship between carer and foster child. Derived from key concepts that define our understanding of attachment theory, it includes items which tap into the child’s ability to show or accept affection, to trust the carer, and whether the child seeks help from their carer under stressful conditions. It also asks about the carer’s understanding of the child’s feelings.
The Alabama Parenting Questionnaire Short Form (APQ-‐SF) (Scott et al, 2011) is a measure of empirically identified aspects of positive and negative parenting styles which relate to conduct problems in children. The questions are divided into four domains of parenting practice: Positive parenting (e.g. praising your child for good behaviour); Inconsistent Discipline (e.g. saying that you will punish bad behaviour and then not doing it); Poor Supervision (e.g. not knowing who your child is out with); and Involvement (e.g. helping your child with their homework).
The Strengths and Difficulties Questionnaire It consists of 25 traits, comprising five sub-‐ scales: Emotional Symptoms, Conduct Problems, Hyperactivity-‐Inattention, Peer Problems, and Pro-‐social Behaviour. It has been widely used as a research screening tool and its validity has been confirmed in analyses of many different populations.
The Carer Efficacy Questionnaire (CEQ) (“How it feels to be a Caregiver”) was designed by the clinical team at the Institute of Psychiatry and used as part of the RCT. The questionnaire assesses the extent to which carers feel able to cope with and make positive changes to the lives of their foster children. It taps into domains related to knowledge (e.g.” I don’t know what I can do to control my foster child”), ability (e.g. “The things I do make a difference to my foster child’s behaviour”) and the possibility of change (e.g. “I can make an important difference to my foster child”). It also assesses the confidence of carers to facilitate education by, for example, feeling able to contact their foster child’s school if they have concerns. Three final questions relate to stress and quality of life e.g. “I feel confident about the future”.
Carer’s Coping Strategies (CCS) Assesses whether carers have absorbed and put into practice the principles introduced on the course such as praise and consistent discipline.
Other domains include giving clear instructions, attending, and remaining calm in situations involving difficult behaviour.