Evaluation

Child First Impact: Highlights of Outcome Data Analysis
August 2010 through December 2016

Child First collects and analyzes implementation and outcome data on an ongoing basis with the support of the Child First Research and Evaluation Team at the University of Connecticut Health Center (UCHC). 

Child First children and families face many challenges.  In order to understand and measure both problems and strengths at baseline, assessment data is collected on all identified children and their primary caregivers. Outcome data is collected at 6 months and prior to discharge to assess progress and document change.

Baseline data of all children and families served:

  • Trauma: 98.2% of parents had a significant history of trauma (as measured by the Life Stressor Checklist - Revised-LSC-R) and 85.1% of children have experienced significant traumatic events (as measured by the Traumatic Event Screening Inventory - TESI-PRR).
  • Emotional/behavioral problems and social skills: 65.5% of children scored positive for behavior problems (as measured by the Brief Infant-Toddler Social-Emotional Assessment - BITSEA and the Preschool-Kindergarten Behavior Scale - PKBS-2).
  • Social skills/competence: 46% of children had impairment in social skills/competence (as measured by the Brief Infant-Toddler Social-Emotional Assessment - BITSEA and the Preschool-Kindergarten Behavior Scale - PKBS-2).
  • Child language delay: 23.9% of children had delays in their language development (as measured by the Ages and Stages Questionnaire-Language - ASQ).
  • Caregiver-child relationship: 79.4% of caregivers and children demonstrated significant disturbances in the caregiver-child relationship (as measured by the Caregiver-Child Interaction Scale - CCIS).
  • Depression: 40.4% of caregivers scored positive for depressive symptoms (as measured by the Center for Epidemiology-Depression Scale - CES-D).
  • Parent stress: 49.3% of parents/caregivers scored positive for parental stress (as measured by the Parenting Stress Index - PSI-3 or PSI-4).
     

Child First data analysis has continued to show strong outcomes:
 

Data from August 2010 through December 2016 was analyzed to determine if there was statistically significant and clinically meaningful change in functioning from baseline to discharge scores in those children or parents who presented with problems in each of the key areas targeted for improvement.
In summary, data has demonstrated:

  • Decrease in child behavioral problems
  • Improvement in child social skills
  • Improvement in child language development
  • Strengthening of the caregiver-child relationship
  • Decrease in maternal/caregiver depression
  • Decrease in parent stress

The data for the period August 2010 – December 2016 shows impressive results among children and families who had documented problems at baseline on a given assessment, as shown below:

Child First Evaluation Data

  • The p value or statistical significance of the finding, reflects the certainty that these are real, not chance results. A p<.05 is considered a “statistically significant” finding,  (e.g., p<.05 means that there is a 1 in 20 possibility that this finding was by chance). In most cases, our p values are p<.0001, meaning that there is only 1 in 10,000 that this finding was by chance.
  • A Cohen’s d or “effect size,” reflects the magnitude or importance of the effect that we have had on the outcome (0.2 is small, 0.5 is moderate, 0.8 is large, and 1.0 is very large). In most analyses, our effect size is large to very large.
     

An extremely high percentage of our children and families show improvement:

Further analysis was done to see what percentage of our children and families improved by at least 8% (representing a clinically significant change) in at least one important measure. All scores were converted to T scores for this analysis. 87% of children and families showed improvement in at least one area, 70% in at least two areas, and 53% in at least three areas.

Improvement by Domain:

Among children with problems at baseline:

  • Emotional/Behavioral Problems or Social Competence (measured by BITSEA or PKBS-2): 
    • Among those with emotional/behavioral problems only, 67% improved (p<.0001, Cohen’s d=0.6907)
    • Among those with Social skills/competence impairment only, 76% improved (p<.0001, Cohen’s d=0.9134)
  • Language Development (measured by ASQ):
    • 70% improved,   (p<.0001, Cohen’s d= 0.8303)

Among mothers with problems at baseline:

  • Maternal Depression or Stress:
    • 71% improved on maternal depression (measured by CES-D) (p<.0001, Cohen’s d=0.7944)
    • 70% improved parenting stress (measured by the PSI-4) (p<.0001, Cohen’s d=1.3607)

Among parent-child dyads with problems at baseline:

  • Caregiver-Child Relationship (measured by CCIS):
    • 73% improved (p<.0001, Cohen’s d=0.9533)