None listed
Conditions
Brief summary
Background: Increasing referrals and competing demands for limited resources are challenges faced by many government and non-government early intervention (EI) services. and the metropolitan Child Development Service (CDS) of Perth, Western Australia is no exception. CDS is a publically funded agency that forms part of Child and Adolescent Community Health and provides services for approximately 20,000 children with developmental delay and/or disability across the metropolitan region. In recent years referrals have increased significantly, and are expected to rise further due to migration and increased birth rates which can impact negatively on waiting lists. Operating with waiting lists is a problem many EI organisations face which has resulted in pressure to consider alternative models of delivering services to enable vulnerable children and families to access critical services in a timely way. Playgroups are used throughout the community to increase community engagement and parenting capacity whilst promoting children’s development through developmentally appropriate play. Therapeutic playgroups target families and children with specific risk factors or identified developmental delays/disabilities and aim to provide support and information specific to the child’s needs. They have been shown to have positive impacts on both caregiver and child outcomes. Objective: To evaluate a therapeutic playgroup protocol for children and families when first referred to CDS. Project Plan: This project will aim to develop, test and evaluate the playgroup protocol. This will include; focus groups and collection of demographic and descriptive data a playgroup working group, a pilot trial to assess feasibility and acceptability of the playgroup intervention and a randomised controlled trial to evaluate playgroup effectiveness compared to usual care. Prior to this a scoping review was conducted to identify key elements of playgroups from the literature.
Interventions
For children and families participating in the RCT they will be randomised into either the ‘Treatment as Usual’ group or the ‘Playgroup Intervention’ group.
Playgroup Intervention: Lean, Engage a Play (LEaP) Playgroup
The manualised playgroup intervention will be delivered in a group of 8 to 10 families with two allied health clinicians as facilitators. It will be run for 2 hourly sessions, once a week for 8 weeks at a community centre. The sessions will have a consistent routine including play
For children and families participating in the RCT they will be randomised into either the ‘Treatment as Usual’ group or the ‘Playgroup Intervention’ group. Playgroup Intervention: Lean, Engage a Play (LEaP) Playgroup The manualised playgroup intervention will be delivered in a group of 8 to 10 families with two allied health clinicians as facilitators. It will be run for 2 hourly sessions, once a week for 8 weeks at a community centre. The sessions will have a consistent routine including play-based indoor and outdoor activities, group music and singing, story time, snack time, free play and farewell activities. The playgroup intervention overarching frameworks are family centred practice, self-efficacy theory and peer support theory. Therapists will use a coaching based framework when facilitating the group and when working on strategies with families. Parents will be given information each week and expected to use strategies learnt in playgroup sessions at home between sessions. Strategies will aim to enhance parent-child interaction and children's communication. An example of strategies are; i) Be face to face and get down to your child’s level; ii) Pay attention to what your child is interested in and; iii) Show enjoyment and join in with what they are doing. Parents will not be prevented from accessing other therapies as part of their ‘treatment as usual’. We will also seek to quantify all contact with health professionals by asking parents to complete a monthly diary. We will also qualify the nature of this contact by directly contacting the health professional(s) involved.
Sponsors
Child Development Service, Western Australia
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Months to No maximum
Healthy volunteers
Yes
Inclusion criteria
Participants will be eligible if they meet the following inclusion criteria. i) Children aged 18 months to 42 months referred and accepted to the Child Development Service between February 2017 to December 2017 ii) Children with 2 or more domains as measured by the Ages and Stages Questionnaire (ASQ-3) as being ‘at risk.’
Exclusion criteria
Participants will be excluded from the study if they meet the following criteria: i) Established disability diagnosis such as Autism Spectrum Disorder or Cerebral Palsy
Outcome results
None listed