PIP UK and clinical evaluation.
PIP UK is committed to demonstrating outcomes for therapeutic intervention in the first 1001 critical days. The central team has developed a unique system for collecting and collating a wide range of data that together can be used to demonstrate the impact of a specialised therapeutic service addressing risks to the caregiving relationship in the early years. The outcomes for the intervention provided by a PIP service is being measured against the following targets; and together these provide essential data for making the case for new service set up.
1) The prevention of maltreatment in the early years.
Research based on longitudinal studies and neuroscience has shown how harmful all forms of maltreatment can be for long-term development. This includes physical and mental health and the capacity to emotionally regulate. A stressed and vulnerable family that is removed from, or does not get put on, the child protection register represents a potentially very large financial saving to other future services in the area.
2) Creating the best possible attachment relationship between infant and caregiver.
What is known as ‘disorganised attachment’ is the most harmful for the child’s long-term development, and other family issues than just obvious maltreatment may cause this. The relationship between baby and caregiver will be influenced by what both parties bring to it, and so there are as many ‘ports of entry’ here as there are risks. The PIP UK risk factor analysis is a means of demonstrating this both to partners and funders. Changes in the quality of the relationship may be gauged by using the Parent Infant Relationship Global Assessment Scale (PIR-GAS), which needs to be backed up by a structured observation to be less subjective. However, it is not a good tool for research as it cannot be reliably replicated.
3) Improving the capacity of the caregiver to interact with their infant in a way that will provide appropriate stimulation to promote positive development.
Many vulnerable parents have childhoods marked by neglect, misery and abuse, and so their caregiving software carries few examples of positive, loving and fun interactions. Everyone’s default setting for parenting is how he or she was parented. The main observable interactions that promote relationships, learning and confidence can be measured and compared using the Keys to Interactive Parenting Scale (KIPS). KIPS can give a score, and unlike PIR-GAS this can be validated by someone else viewing the video recording.
4) Enabling the small child to have a positive social and emotional development.
Although attachment is central it is only one aspect of development; and children whose social and emotional development is on track will have more positive experiences in nursery and show better school readiness than those who are struggling. This is measured (from 1 month on) using the recently updated Ages and Stages Questionnaire for Social and Emotional Development (ASQ:SE 2).