A review of the evidence on enhancing psychosocial skills development in children and young people

Abstract

Summary Background: This report synthesizes the findings from international evidence reviews on the effectiveness of psychosocial skills development programmes for children and young people. A rapid review of the effectiveness of interventions related to parenting, preschool, school and community-based programmes that aim to enhance social and emotional skills development was conducted. Methods: Searching a range of electronic databases, 30 reviews published in the last ten years were identified, which provided evidence on a range of programmes employing RCTs and quasi-experimental study designs. The search process produced over 5000 articles, 26 of which were included in the review. This included three reviews of reviews, five Cochrane reviews and 16 systematic reviews and meta-analyses. Findings: Of the 26 reviews that were included, 11 relate to parenting programmes, 3 to preschool interventions, 6 to school-based programmes and 6 out-of-school interventions. Collectively, the review findings show that there is good quality evidence that both universal and targeted social and emotional skills-based interventions can lead to a range of positive outcomes for young people across emotional, social, educational, health and behavioural domains and reduce the risk for mental health problems, violence and aggressive behaviour, risky health behaviours and substance misuse. Employing the typology of actions to reduce health inequalities proposed by 7(2005), the review findings support a number of well-evidenced interventions across different levels. These may be summarised as follows: Strengthening Individuals and Families: Parenting & Preschool Programmes  There is a robust base of international evidence from high quality studies that parenting interventions that incorporate social and emotional skills development lead to significant positive outcomes for both children and their parents, with those at most risk making the greatest gains.  Systematic reviews indicate strong evidence that preschool programmes that develop children s social and emotional skills can produce positive and 2 enduring benefits for children s development, including cognitive, emotional and social wellbeing, school readiness and educational success.  There is good evidence of the effectiveness of parenting and preschool programmes for children living in poverty, with programmes reducing inequities in children s health and development and educational outcomes.  Additional evidence is needed to confirm the most effective parenting intervention approaches for particular population groups, including families from different ethnic minority backgrounds, and the comparative effectiveness of different methods of implementation for particular outcomes.  Cost-benefit analyses confirm that high quality parenting and preschool programmes produce substantial societal returns on investment, confirming that investing in early childhood is a solid social investment that yields multiple returns, especially for disadvantaged families. Strengthening the Community: School and Out-of- School Interventions  A substantive body of evidence from high quality reviews indicate that social and emotional skills-based interventions, when implemented effectively in schools, produce significant positive effects on targeted social-emotional competencies, students attitudes to self, others and school, school commitment and academic performance.  Positive outcomes are reported for children from diverse backgrounds, however, the evidence with regard to the differential impact of programmes is inconclusive.  More robust evidence is needed concerning the level of sustained long-term benefits. However, the findings from a systematic health equity review indicates strong evidence that school programmes focusing on social-emotional skills training can improve school completion for students from disadvantaged backgrounds and potentially impact on social and health inequities.  The emerging economic evidence base supports the case for investing in social and emotional learning programmes in schools, with crime and health-related benefits, and improved earning power in adulthood, yielding economic returns. 3  Implementation quality is identified as a key factor in the effectiveness of social and emotional skills-based interventions, as is their implementation within a whole school approach where skills development programmes are integrated into the core mission and ecology of the school and community in which they are implemented.  There is a limited international evidence base concerning the effectiveness of out-of-school and community-based youth programmes.  Reviews of youth development programmes, including approaches such as participation in creative arts, physical activity and mentoring, show that these interventions can impact positively on young peoples emotional and social wellbeing, academic performance, and range of social and health outcomes.  The majority of out-of-school interventions are delivered to young people identified as being at risk or socially excluded, and as such they have the potential to impact on health and social inequities.  Reviewers have commented on the poor quality of evidence in this area due to the methodological weaknesses of the programme evaluations conducted to date. Improving Living and Working Conditions Much of the evidence in this review is focused on individual-level interventions with few studies examining the impact of integrated approaches operating at the community and policy level in promoting the social and emotional wellbeing of young people and their families. Extrapolating from the findings included in this review, the following more general recommendations can be made:  The review findings support the provision of high quality universal child and maternal health interventions where a focus on social and emotional skills is integrated into child and family services in the early years. Such interventions have a significant and sustained effect on children s social and emotional development and are cost-effective.  Provision of high quality preschool education, especially for vulnerable families and children at higher risk of adverse outcomes, can impact on positive development outcomes. 4  Health promoting schools that integrate social and emotional skills development for students and teachers, provide a foundation for academic learning, health promotion and positive life course development. Promoting healthy macro-policies Although policy impact was not examined directly in this review, the evidence from effective interventions lends support to the following policies:  Health policies which support the delivery of universal primary health and childcare services including the delivery of home visiting and parenting programmes with a focus on social and emotional skills development, especially for the most vulnerable families.  Family support policies that provide high quality preschool education and childcare support meeting the needs of children and families, including targeted support for those most at risk of negative life outcomes.  Educational policies that promote the emotional and social wellbeing of young people as a basis for academic success, incorporating students social and emotional development as a core component of school policy and practice.  Policy initiatives that address poverty and the wider structural determinants of child health and social inequities. Authors Conclusions: This rapid review of the evidence has identified a number of high quality interventions for young people that have produced consistent evidence of their effectiveness across multiple robust trials in a diverse range of settings and countries. The findings confirm that social and emotional skills-based interventions for young people, implemented across the health, education and community sectors, can contribute to achieving the goals of population health, social and economic wellbeing and reduced inequities. However, as relatively few of the interventions have been scaled up to meet the needs of regional or national populations, evidence for their feasibility, effectiveness and sustainability in the local regional context will need to be strengthened.