Standard Stepping Stones Triple P is a parenting intervention for families with a child aged between 0 and 12 years old with a developmental disability as well as moderate or severe behavioural problems. It is delivered by a parenting practitioner to individual parents through 10 one-hour sessions. During the sessions, parents learn strategies for managing their child’s behaviour in a variety of different contexts.
The information above is as offered/supported by the intervention provider.
0 to 6 years old
Individual
Standard Stepping Stones Triple P is part of the Triple P multilevel system of family support, developed specifically for parents of children aged 0 to 12 with a developmental disability. This includes families with a child who has Down’s syndrome or Autistic Spectrum Disorder, as well as moderate or severe behavioural problems.
Standard Stepping Stones Triple P is delivered by a Triple P parenting practitioner to individual parents over 10 weekly, one-hour sessions.
The intervention begins with a comprehensive interview where parents complete a series of questionnaires and provide detailed information about their child’s disability and behavioural challenges. Parents are also provided with a workbook and introduced to a variety of techniques for recording and monitoring their child’s behaviour.
The second session begins with an observation of parent–child interaction. The practitioner then provides the parent with feedback from the assessment and the observation and the two work together to identify specific goals for improvement.
During sessions 3 and 4, parents learn strategies for encouraging positive child behaviour, methods for sanctioning negative child behaviour, and ways in which to implement family routines.
Sessions 5 through 7 provide parents with opportunities for practice and feedback. This can include observation of parent-child interaction during the session, as well as homework assignments and shared problem solving. The practitioner and parent also review the goals set at the beginning of the intervention and consider ways in which they can be refined.
Sessions 8 and 9 are dedicated to developing strategies for avoiding child behavioural problems through planning ahead. During session 8, the parent identifies high risk home and community activities (for example, shopping, getting ready for school) and the practitioner suggests strategies for avoiding them. The parent then implements the strategies at home and discusses them with the practitioner at Session 9. The practitioner also observes the parent getting the child ready to go out and provides feedback before ending the session.
Session 10 is devoted to a progress review and the practitioner suggests further strategies for maintaining and continuing the progress in the future.
0 to 12 years old
Families with children aged between 0 and 12 with a developmental disability as well as moderate or severe behavioural problems.
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
Children with ASD and Down’s Syndrome typically have more difficulty regulating their emotions and behaviour.
Science-based assumption
Parents are influential in supporting the self-regulatory development of ASD, Down’s Syndrome, and other disorders associated with chid behavioural problems.
Science-based assumption
Parents with a child diagnosed with ASD, Down’s Syndrome, or serious behaviour problems.
Intervention
Parents learn strategies for:
Encouraging positive child behaviour
Discouraging problematic child behaviour
Supporting children’s communication skills
Encouraging emotional self-regulation
Increasing child independence.
Short-term
Reductions in parental stress
Improved parental confidence
Improved parenting behaviours.
Medium-term
Improved child behavioural regulation
Improved child emotion regulation
Improved child communication skills.
Long-term
Children are better able to self-regulate in contexts outside of the home, including school and other social situations.
Standard Stepping Stones Triple P is delivered in 10 sessions of one hours’ duration each by one practitioner, to individual families.
The practitioner who delivers this intervention typically has a qualification in a helping profession, such as school counsellor, nurse, psychologist, social worker, or as an allied health professional.
The practitioners have three days of intervention training, one day pre-accreditation workshop, and a half-day accreditation session. Booster training of practitioners is not required.
It is recommended that practitioners are supervised by one host-agency supervisor, who does not receive intervention training.
Intervention fidelity is maintained through the following processes:
A quality assurance checklist is available for organisations to use when planning for quality assurance of Triple P. There are three standard fidelity protocols built into the Triple P Implementation Framework: (1) Practitioner Accreditation, (2) Intervention Fidelity using Session Checklists, (3) Supervision and Practitioner Support Standards using the Peer Support Network. Triple P UK offers trainer-facilitated PASS sessions or a Flexibility & Fidelity workshop for professional development.
Organisation: Triple P UK
Email address: contact@triplep.uk.net
Website/s: www.triplep-parenting.net
www.triplep.net
https://pfsc-evidence.psy.uq.edu.au/
*Please note that this information may not be up to date. In this case, please visit the listed intervention website for up to date contact details.
Standard Stepping Stones Triple P’s most rigorous evidence comes from a single RCT conducted in Australia consistent with Foundations’ Level 3 evidence strength criteria.
This study identified statistically significant improvements in the problematic behaviour of children of parents who attended Standard Stepping Stones Triple P compared to parents who did not receive the intervention. These improvements were confirmed through expert observations and parent reports.
Standard Stepping Stones Triple P can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome.
| Identified in search | 5 |
| Studies reviewed | 5 |
| Meeting the L2 threshold | 1 |
| Meeting the L3 threshold | 1 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 3 |
| Study design | RCT |
| Country | Australia |
| Sample characteristics | 74 families with a preschool-aged child (<6 years) with a developmental disability |
| Race, ethnicities, and nationalities | Not reported |
| Population risk factors | 61% of families had an annual income of less than 50,000 AUD |
| Timing |
|
| Child outcomes |
|
| Other outcomes |
|
| Study rating | 3 |
| Citations | Plant, K. & Sanders, M. (2007) Reducing problem behavior during care-giving in families of preschool-aged children with developmental disabilities. Research in Developmental Disabilities. 28 (4), 362–385. |
The following studies were identified for this intervention but did not count towards the intervention’s overall evidence rating. An intervention receives the same rating as its most robust study or studies.
Hodgetts, S., Savage, A. & McConnell, D. (2013) Experience and outcomes of stepping stones triple P for families of children with autism. Research in Developmental Disabilities. 34 (9), 2572–2585. This reference refers to a multiple case-study design, conducted in Canada.
Kleefman, M., Jansen, D. & Reijneveld, S. (2011) The effectiveness of Stepping Stones Triple P: The design of a randomised controlled trial on a parenting programme regarding children with mild intellectual disability and psychosocial problems versus care as usual. BMC Public Health. 11 (1), 676. This reference refers to a randomised control trial, conducted in the Netherlands.
Kleefman, M., Jansen, D., Stewart, R. & Reijneveld, S. (2014) The effectiveness of Stepping Stones Triple P parenting support in parents of children with borderline to mild intellectual disability and psychosocial problems: A randomized controlled trial. BMC Medicine. 12 (191), 1–10. This reference refers to a randomised control trial, conducted in the Netherlands.
Reis, A. (2004) Behavioural family intervention for families with pre-school children with disabilities and challenging behaviours: Assessing effects on parent and child play interactions. (Unpublished Master’s Thesis, Curtin University of Technology, Perth, Australia).
Roberts, C., Mazzucchelli, T., Studman, L. & Sanders, M. (2006) Behavioral family intervention for children with developmental disabilities and behavioral problems. Journal of Clinical Child and Adolescent Psychology. 35 (2), 180–193. This reference refers to a randomised control trial, conducted in Australia.
Shapiro, C., Kilburn, J. & Hardin, J. (2014) Prevention of behavior problems in a selected population: Stepping StonesTriple P for parents of young children with disabilities. Research in Developmental Disabilities. 35, 2958–2975. This reference refers to a randomised control trial, conducted in the USA.
Whittingham, K., Sofronoff, K., Sheffield, J. & Sanders, M. (2009a) Do parental attributions affect treatment outcome in a parenting program? An exploration of the effects of parental attributions in an RCT of Stepping Stones Triple P for the ASD population. Research in Autism Spectrum Disorders. 3 (1), 129–144. This reference refers to a randomised control trial, conducted in Australia.
Whittingham, K., Sofronoff, K., Sheffield, J. & Sanders, M. (2009b) Stepping Stones Triple P: An RCT of a parenting program with parents of children diagnosed with autism spectrum disorder. Journal of Abnormal Child Psychology. 37, 469–480. This reference refers to a randomised control trial, conducted in Australia.
Note on provider involvement: This provider has agreed to Foundations’ terms of reference (or the Early Intervention Foundation's terms of reference), and the assessment has been conducted and published with the full cooperation of the intervention provider.
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing substance abuse: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing risky sexual behaviour & teen pregnancy: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
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Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
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