Global Benchmarking Analysis of the Now and Next Program

Our global data analysed to end 2022. For New Zealand results, please scroll down this page.

Murdoch Children's Research Institute Executive Summary [2018 Evaluation Report]

Background to the project

Now and Next is a group program developed by Plumtree that helps parents and carers of young children with a disability or developmental delay cultivate skills to achieve positive outcomes for their child, family and self. It teaches families about setting goals and provides them with opportunities to connect with other families to inform, support and motivate each other to aim high and see new opportunities for their child now and in the future.

Plumtree delivered the Now and Next program between January 2017 and June 2018 as part of the ‘Building Capacity in Families of Young Children with Disability: A Family Leadership Project’ which was funded by ADHC, Department of Family and Community Services and the NDIA for an Information, Linkages and Capacity Building (ILC) transition project.

Background and purpose of the evaluation

The Centre for Community Child Health (the Centre) at Murdoch Children’s Research Institute (MCRI) was commissioned by Plumtree to undertake a process and outcomes evaluation of the Now and Next program. The evaluation looked at data for the 15 Now and Next groups that were run between January 2017 to March 2018 and involved 154 families of young children birth to eight years old who have disabilities or a developmental delay.

The purpose of the evaluation was to examine the Now and Next program and identify participant outcomes to inform decision-making about the future strategic direction and implementation of the Now and Next program. The evaluation used a mix of qualitative and quantitative methods to undertake both a process and outcomes evaluation of the Now and Next program. The process evaluation looked at whether the Now and Next program had been delivered as intended, if it was reaching the target groups and how participants rated the program. The outcome evaluation looked at participant outcomes, in particular, if participants had achieved their short-term goals, whether participants had become empowered and if participant sense of hope or wellbeing had grown. Data was collected by the program through online surveys at the beginning and end of the program and during the program by the peer facilitators of the Now and Next program using a participatory action research approach.

An additional research project undertaken by the Centre for Disability Studies at Sydney University documented case studies of the peer workers. This research is reported separately to the present evaluation.

Findings

The process evaluation found that Now and Next program had been delivered to the target group of parents and carers of young children with a disability or developmental delay. The evaluation also found and that the program had been delivered as intended with comprehensive and systematic documentation of the sessions for use by peer facilitators and real-time monitoring of participant feedback incorporated into the program for continuing improvement. Due to the iterative nature of the program, new concepts were tested over the evaluation period. This included delivering the Pictability vision and planning session as a group rather than individually, and trialling new measures to monitor participant outcomes.

The program had high levels of attendance from participants with an average attendance rate across all 15 groups of 79.9% over the eight-week program. The groups had strong levels of participation from culturally and linguistically diverse families (who made up 59.1% of participants) as well as from fathers (who represented 20.8% of participants).

The evaluation found the program was highly successful in providing all parents with the experience of developing and achieving short-term goals. Data was collected on the goals participants chose to address during the program: A total of 134 child goals, 137 family goals and 117 personal goals were recorded. More than nine in ten participants achieved all three of the goals that they set. Of the thirteen parents that did not achieve all three of their goals, ten achieved two of their goals and three achieved one of their goals.

The evaluation also found that the program was successful in empowering parents and growing participants sense of wellbeing. Matched participant data that was available for a subset of participants showed statistically significant increases in participants’ empowerment, sense of hope and wellbeing at the end of the program relative to the start of the program. Other participant measures are indicating that the program is also increasing participants’ sense of agency.

Recommendations for further areas of research

Now and Next has a number of unique features that warrant further investigation. Possible research studies include:

·   Further trials of the outcomes of the Now and Next program in different sites and populations.

·   Tracking one or more cohorts of parents over time to see what the long-term effects are, and whether

the short-term gains found in the present evaluation are sustained.

·   Comparison with other programs and pathways. It would be valuable to compare outcomes for those who enter the NDIS after a Now and Next experience with those who go through the standard pathway.

·   Determining which of the key features of Now and Next are the key ingredients for the effectiveness of the program will require further experimentation and research.

·   Exploring the timing of program in relation when parents engage with professionals.

Implications for policy

In contrast to current early childhood intervention services, Now and Next focusses on building family capacity using new approaches that are peer-led, provide connection with other families, focus on empowerment, agency and wellbeing and emphasise a whole family approach.

The Now and Next program demonstrates the power of parent-to-parent support when properly structured and facilitated. For parents of young children with developmental disabilities, such support can be beneficial in a variety of ways: in helping them clarify their goals for their children, families and themselves; in promoting their personal capabilities to meet these needs; in fostering a positive and constructive approach to the challenges they face; and in contributing to their general well-being. These are goals that early childhood intervention services around the world aspire to, so the Now and Next program offers a program for achieving those goals with families who have young children with developmental disabilities or delays. The current evaluation has shown that the program is also effective with non-English speaking groups, suggesting that the program could have widespread potential.

Click here and scroll down to see Dr. Tim Moore's presentation of these results at the 2019 International Society for Early Intervention conference.

Critical Ingredients

In order to understand better what the critical ingredients of the program are, we ran a survey asking participants to rate how important each of the ‘active ingredients’ were for them. The Figure below describes how participants rated them out of a total of 3.0 points. The result of the survey shows that parents rated each of the ‘active ingredients’ of the program overall in the range of ‘Extremely Important’ [Extremely Important 2.5-3.0]. 

Contributing our data to the body of evidence

The above show 2 reports: the top report is our Global Benchmarking Report which includes all our data collected so far in 4 countries, the second report details the NZ data extracted from our Global report.

This page describes some of the research tools we use to measure impact of our programmes on parents raising children with disability. Amongst them is the Life Satisfaction Cantril Ladder tool, also used by the New Zealand government [REFS}.

New Zealand Now and Next Alumni - learning together

The media below details what the NZ Now and Next Alumni accomplished since their inception - their aim: share knowledge and learn together how to best support their children achieve their goals. Scroll down the below screen to follow their learning.

Critical ingredients - more details

Moore, Fong and Rushton’s evaluation (2018) recognised that Now and Next is effective in achieving a number of important outcomes for parents. The authors ask that further research investigate what the program’s active ingredients are, i.e. the key elements of the program that create its impact. These critical factors set it aside from existing parents support or advocacy processes. Below is a summary of our findings on the potential active ingredients, which builds on and refines those identified by Moore, Fong and Rushton. 

1. An Evidence-based Positive Psychology Framework 

• Focus on systematically building parental skills and confidence through a purposeful and planned training approach based on the scientific evidence from Positive Psychology (Janson and Mahmic, 2018). 

• Tools:​ ​Increase wellbeing through PERMA practices; Identify and use Signature Strengths; Make intentional choices about what can and cannot be controlled; Mindfulness exercises; and ‘Creating memories’ to focus on positive events. 

• Training implications: ​Trainees need to understand how to ​optimize the use of these tools​ to assist participants build on these documented Positive Psychology achievements. 

2. A structured learning curriculum 

• Focus on embedding this framework as participants’ blueprint to imagine possibilities for their family and child (Janson and Mahmic, in preparation). 

• Tools:​ ​Sessions are structured so that each participant uncovers their own learning pathway. Participants work on Family goals first to strengthen the foundation for collaborative change between parents or carers. 

• Training implications: ​Trainees need to ​master the Positive Psychology curriculum and how the tools contribute to enhancing success factors. 

3. Parents empowering other parents 

• The program group sessions set the stage for parents to meet and build supportive networks with other parents. Parents who graduate from the program may be selected to train as facilitators. Facilitators are from a wide range of backgrounds but also have had similar experiences to those of the participants. This helps them understand and respect the responses of participants and also helps them set more realistic goals (Heyworth, 2018). Global participants commented that the ​diverse background of facilitators​ makes them feel fully included in the group and how learning from their peers helped make their own changes possible. In the short movie created by program graduates, one mother said: ​I looked at my session facilitator and thought ‘if she could do it, so can I’​. 

• Tools:​ ​Growing Informal supports and Peer network [offline and online]; Alumni conferences and workshops and Leadership development through Peer Work.

• Training implications: ​Trainees need to understand how to capitalize on using themselves as role models as well as learn how to ​manage small group discussions so that participants can learn to start building these supportive relationships with other peers. 

4. Vision and Goals 

• Focus on parents’ ​long-term vision as well as short-term goals​. Acknowledging and respecting parent’s hopes creates an authentic strength-based from which sustainable action and gains can stem. Moore, Fong and Rushton’s research (2018) has outlined that early intervention in this domain is particularly powerful. 

• Focus on ​three sets of goals – for the child, the family as a whole, and the parents themselves​ – rather than focusing solely on goals for the child, this encourages parents to think in terms of outcomes rather than services or therapies. 

• Tool:​ Pictability provides a creative/experiential and engaging process to help parents to build on the empowering energy of establishing a powerful vision for their family and then proceed to set goals, which clearly link to this vision. 

• Training implications: ​Trainees get ​additional training​ as Pictability facilitators and master core program knowledge​ such as how to link long and short term goals to build on the powerful motivational power of this connection and ‘moving the goal post’ mechanisms and how to counter them. 

5. Action 

• Focus on ​achieving short-term goals through their own actions​, rather than automatically deferring to, or looking for help from professionals. Parents of young children with developmental problems may feel overwhelmed and unable to see what they can do to make improvements in their lives or that of their children. Helping them to look for what they might be able to do is vital in creating participatory commitment (Heyworth, 2017). 

• Tool:​ ​Goal to Action coaching builds parents’ understanding​ ​of their Agency​ ​to help redefine and re-balance parents’ relationship with practitioners from expert/patient role to full collaborator with specific responsibilities. Hence the program encourages families to build positive partnerships with professionals and reinforces the fact that important contributions are made on both sides through Parents-Professional Statements about responsibility and about leaning in. 

• Training implications: ​Trainees need to understand how to ​coach parents​ to act to achieve their goals through action within this newly redefined relationship. 

6. Ongoing improvement through real-time data collection and feedback 

• Focus on how participants are tracking outside of sessions, so that immediate and relevant information about progress improvement can be provided to participants if needed. Long-term approach building capacity and resilience (Janson, Mahmic, Benge and Herbert, 2018). 

• Tools:​ ​Partners in Change Outcome Measures​ ​provide ongoing session by session feedback from which facilitators can learn to gauge participants’ level of engagement, including early potential signs of disengagement so they can take immediate action; Mission Control​ ​provides a collaborative and sharable mechanism to track ongoing progress of all participants. 

• Training implications: ​Trainees need to ​master the use of technology​, including that of the Airtable platform where Mission Control is hosted. 

Our global research program investigates the impact of ​bespoke coaching tools​, which encourage parents’ participatory actions through which parents learn skills that are transferable into other areas of their life. Core to ongoing program success is that peer facilitators are trained in creating the results that participants want, through the aforementioned ‘critical ingredients’.