Signposts for Building Better Behaviour

About This Program

Target Population: Parents of children with an intellectual disability who display difficult behaviours

For parents/caregivers of children ages: 3 – 16

Program Overview

Signposts for Building Better Behaviour is a program that helps families prevent or manage the difficult behaviour of children aged 3-16 who have a developmental delay or an intellectual disability. Trained facilitators offer the program to families in groups, face-to-face with individuals, via telephone, or as a self-directed program.

The Signposts program involves the provision of written and videotaped materials to assist these families. Five parenting skills development areas are addressed:

  • Module 1 – Measuring your child's behaviour
  • Module 2 – Systematic use of daily interactions
  • Module 3 – Replacing difficult behaviour with useful behaviour
  • Module 4 – Planning for better behaviour
  • Module 5 – Developing more skills in your child

Three additional modules include:

  • Introduction
  • Your family as a team
  • Dealing with stress in the family

Program Goals

The goals of the Signposts for Building Better Behaviour are:

  • Increase ability to manage difficult behaviour before it escalates and needs additional resources
  • Increase the frequency of a specific identified positive behaviour that their child already did before the program
  • Decrease the frequency of a specific identified negative behaviour that their child already did before the program
  • Increase recognition of child’s strengths
  • Increase responsiveness
  • Increase understanding of underlying reasons for difficult behaviour
  • Increase family support network

Essential Components

The essential components of Signposts for Building Better Behaviour include:

  • Signposts is typically presented in a group format. However, the Signpost Facilitator’s manual provides guidelines for delivering the program with individual families with telephone support, without telephone support, or self-directed as well.
  • The Signposts practitioner facilitates an introduction session and then five group sessions of 2-hours per session delivered every two weeks. A sixth session for program review and postprogram assessment is held four weeks after Session 5.
  • During each session, participants are given a program module booklet, each corresponding to specific session content.
  • These modules and their content are:
    • An Introduction module to describe the program and its use
    • Module 1 – Measuring your Child's Behaviour
      • Reasons for difficult behaviour
      • Describing behaviour
      • Ways of measuring behaviour
      • Measuring behaviour
      • Recording behaviour
      • Graphing data
    • Module 2 – Systematic Use of Daily Interactions
      • Identifying strengths
      • Building on and consolidating skills
      • Triggers and consequences
      • Strengthening desirable behaviours
      • Weakening undesirable behaviours
      • Instruction giving and household rules
    • Module 3 – Replacing Difficult Behaviour with Useful Behaviour
      • Purposes of difficult behaviour
      • Selecting alternative behaviours
      • Using positive and negative consequences
      • Selecting strategies based on purpose of behaviour
    • Module 4 – Planning for Better Behaviour
      • Planning routines
      • Daily routines
      • Identifying high-risk situations
      • Developing planned activity routines
    • Module 5 – Developing More Skills in your Child
      • Selecting skills to teach your child
      • How to teach new skills effectively
      • Working with others (schools, etc.)
      • Pulling it all together: Developing action plans
    • Supplementary Modules are also given to the participants during the program.
      • They focus on:
        • Your Family as a Team
        • Dealing with Stress in the Family
      • These are given to the participants in the form of written advice to read at home.
  • During each session, the practitioner uses active teaching techniques such as modelling and role-play as well as verbal explanations to teach participants the skills associated with that session’s content.
  • Video examples are used throughout the session to demonstrate skills or as vignettes to guide participants thinking and review of skills.
  • The group participants, with the assistance of the practitioner, complete a range of activities and exercises detailed in the parent workbook. Participants are also encouraged to participate in large and small group discussions about the skills being introduced.

Program Delivery

Parent/Caregiver Services

Signposts for Building Better Behaviour directly provides services to parents/caregivers and addresses the following:

  • Parents of children with a disability or intellectual delay who are displaying difficult behaviours
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Signposts focuses on family strategies to deal with difficult behaviour. It also offers training to family groups.

Recommended Intensity:

An introduction session followed by 2- to 2.5-hour sessions every other week plus a review session and follow-up

Recommended Duration:

26-30 weeks

Delivery Settings

This program is typically conducted in a(n):

  • Birth Family Home
  • Community Agency

Homework

Signposts for Building Better Behaviour includes a homework component:

Homework tasks that help parent reinforce what is learned in the session are provided at the end of each module session plus two supplementary modules are intended to be done at home.

Resources Needed to Run Program

The typical resources for implementing the program are:

  • Overhead projector and screen
  • VHS or DVD video replay facility
  • Chairs and name tag (enough for number of participants)
  • Program materials including:
    • Facilitator’s manual
    • Overhead transparencies/slides
    • Signpost videos on VHS tape or DVD
    • Attendance record sheet
    • Program adherence checklist
    • Various scales and checklists specific (e.g., goal achievement scale forms, child behaviour record sheet)
  • Rooms should be large enough for role-plays to be completed in small groups
  • Various everyday items to be used in role-plays (e.g., bags, cups, kitchen timers)

Education and Training

Prerequisite/Minimum Provider Qualifications

Providers should have training and experience working with families, parents, and children (e.g., Psychologists, Social Workers, Teachers) before attending training on Signposts.

Education and Training Resources

There is a manual that describes how to implement this program , and there is training available for this program.

Training Contact:
Training is obtained:

Trainers can travel to specific agencies or organizations around the world to deliver training

Number of days/hours:

Pre-reading of all the program materials and completion of a quiz on the content, and two full days of training.

Below outlines the phases of training for Signposts:

  • Phase 1 (Read all the program materials sent before the training and completion of a quiz on the content)
  • Phase 2 (2-day training workshops - approximately 6 hours per day)
  • Phase 3 (Providers deliver the Signposts program with support and guidance from trainers)

Relevant Published, Peer-Reviewed Research

Hudson, A. M., Matthews, J. M., Gavidia‐Payne, S. T., Cameron, C. A., Mildon, R. L., Radler, G. A., & Nankervis, K. L. (2003). Evaluation of an intervention system for parents of children with intellectual disability and challenging behaviour. Journal of Intellectual Disability Research, 47(4‐5), 238-249. doi:10.1046/j.1365-2788.2003.00486.x

Type of Study: Pretest-posttest with control group
Number of Participants: 115 families (mother–child dyads)

Population:

  • Age — Adults: Not specified; Children: 4.6-19.4 years (Mean=10.11 years)
  • Race/Ethnicity — Not specified
  • Gender — Adults: 100% Female; Children: 81 Male and 34 Female Race/Ethnicity: Not specified
  • Status — Participants were caregivers of children with an intellectual disability.

Location/Institution: Victoria, Australia

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The primary intent of this study was to determine if the Signposts for Building Better Behaviours program would be effective at reducing challenging behaviour of children with intellectual disabilities and lead to an improvement in the adjustment of their mothers. Participants were allocated to four groups 1) group support, 2) telephone support, 3) self-directed, and 4) control group. Follow-up data were collected on as many families as possible 3-4 months after intervention. Measures utilized include the Parenting Sense of Competence Scale (PSOC), the Depression Anxiety and Stress Scale (DASS), the Parenting Hassles Scale (PHS), the Consumer Satisfaction Scale (CSS), and the Developmental Behaviour Checklist (DBC). Results indicate that following the use of the Signposts materials in parent training programmes, the subjects reported that they were less stressed, felt more efficacious about managing their children’s behaviour, were less hassled about meeting their own needs, and that their children’s behaviour had improved. Additionally, families generally reported high levels of satisfaction with the content and delivery of the materials. Limitations include lack of randomization, attrition, length of follow-up, and follow-up did not include the wait-list control group.

Length of postintervention follow-up: 4-6 months.

Hudson, A., Cameron, C., & Matthews, J. (2008). The wide‐scale implementation of a support program for parents of children with an intellectual disability and difficult behaviour. Journal of Intellectual and Developmental Disability, 33(2), 117-126. doi:10.1080/13668250802065885

Type of Study: Pretest-posttest with comparison group
Number of Participants: 2,119

Population:

  • Age — Not specified
  • Race/Ethnicity — Not specified
  • Gender — Not specified
  • Status — Participants were caregivers of children with an intellectual disability.

Location/Institution: Victoria, Australia

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The primary intent of this study was to evaluate the impact of outcomes of the Signposts for Building Better Behaviour for children with intellectual disabilities. Participants were allocated to four groups 1) group, 2) individual, 3) telephone, and 4) self-directed. Measures utilized include the Parenting Sense of Competence Scale (PSOC), the Depression Anxiety and Stress Scale (DASS), the Parenting Hassles Scale (PHS), the Difficult Behaviour Assessment Form (DBAF), the Consumer Satisfaction Scale (CSS) and the Developmental Behaviour Checklist (DBC). Results indicate that following the program, participants reported that they were less depressed, less anxious, and less stressed, were more confident and satisfied with managing their child, and were less hassled by their child’s behaviour. They also reported that their child exhibited fewer difficult behaviours. Limitations include lack of randomization, attrition, lack of control group, and length of follow-up.

Length of postintervention follow-up: 3 months.

Hudson, A., Reece, J., Cameron, C., & Matthews, J. (2009). Effects of child characteristics on the outcomes of a parent support program. Journal of Intellectual and Developmental Disability, 34(2), 123-132. doi:10.1080/13668250902850426

Type of Study: Pretest-posttest with comparison group
Number of Participants: 689

Population:

  • Age — Adults: Not specified; Children: 2-18 years
  • Race/Ethnicity — Not specified
  • Gender — Adults: Not specified; Children: 27.2% female
  • Status — Participants were caregivers of children with an intellectual disability.

Location/Institution: Victoria, Australia

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study utilized a subsample of the sample in Hudson et al. (2008). The primary intent of this study was to determine if the child characteristics of gender, age, or associated disability impacted on outcomes of the Signposts for Building Better Behaviours for children with intellectual disabilities. Participants were separated into three groups according to age band: 2–6 years, 7–12 years, and 13–18 years. Measures utilized include the Parenting Sense of Competence Scale (PSOC), the Depression Anxiety and Stress Scale (DASS), the Parenting Hassles Scale (PHS), the Difficult Behaviour Assessment Form (DBAF), the Consumer Satisfaction Scale (CSS) and the Developmental Behaviour Checklist (DBC). Results indicate that gender is clearly not a moderating variable for the effects of the Signposts program. With regard to the age analyses, it was found that the effect sizes were somewhat smaller for children in the age range of 13–18 years than they were for young children. For the older group, the mean effect size was 0.30, whereas for the other two groups it was 0.42 for the middle groups, and 0.39 for the younger children; however, these results are purely descriptive and no statistically significant evidence for moderation was found. Limitations include lack of randomization, attrition, and length of follow-up.

Length of postintervention follow-up: 3 months.

May, F., Mclean, L., Anderson, A., Hudson, A., Cameron, C., & Matthews, J. (2013). Father participation with mothers in the Signposts program: An initial investigation. Journal of Intellectual and Developmental Disability, 38(1), 39-47. doi:10.3109/13668250.2012.748184

Type of Study: Pretest-posttest with comparison group
Number of Participants: 1,046

Population:

  • Age — Adults: Not specified, Children: 1-18 years
  • Race/Ethnicity — Not specified
  • Gender — Adults: Not specified, Children: 27.5% Female
  • Status — Participants were parents of children with developmental delay or intellectual disability enrolled in the Signposts Statewide project.

Location/Institution: Singapore, Australia.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study utilized a subsample of the sample in Hudson et al. (2008). The current study aimed to investigate outcomes for mothers associated with father participation in Signposts program. Participants were separated into two groups: 1) group-delivered mode of the Signposts program 2) and mothers who participated without fathers or others. Measures utilized The Parenting Sense of Competence Scale (PSOC), the Depression, Anxiety and Stress Scale (DASS), the Parenting Hassles Scale (PHS), the Developmental Behaviour Checklist (DBC), and the Difficult Behaviour Assessment Form (DBAF). Results indicate that both mothers who participate in the program with fathers and those who participate independently experience benefits from Signposts, as evidenced by preprogram to postprogram improvements across all measures for mothers in both groups. Mothers who participate in Signposts generally experience decreased stress, increased confidence and efficacy in the parenting role, and reductions in ratings of their child’s problem behaviours regardless of whether they participate in the program with or without their partner. Limitations include lack of randomization, generalizability of findings due to ethnicity, and length of follow-up.

Length of postintervention follow-up: 3 months.

Yap, D., Lau, L., Nasir, N., Cameron, C., Matthews, J., Tang, H. N., & Moore, D.W. (2014). Evaluation of a parenting program for children with behavioural problems: Signposts in Singapore. Journal of Intellectual and Developmental Disability, 39(2), 214-221. doi:10.3109/13668250.2014.899567

Type of Study: One group pretest-posttest study
Number of Participants: 1,021

Population:

  • Age — Adults: Not specified, Children: 1-12 years (Mean=3.65 years)
  • Race/Ethnicity — Not specified
  • Gender — Adults: 62.7% female; 36.5% male, Children: 80% Boys
  • Status — Participants were parents of children with developmental delays or intellectual disability enrolled in the Signposts Statewide project.

Location/Institution: Singapore, Australia

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The primary intent of this study was to evaluate the impact of Signposts for Building Better Behaviour. Measures utilized include the Parenting Sense of Competence Scale (PSOC), the Depression, Anxiety and Stress Scale (DASS), the Parenting Hassles Scale (PHS), the Developmental Behaviour Checklist (DBC), and the Difficult Behaviour Assessment Form (DBAF). Results indicate parents and caregivers reported being less hassled, stressed, depressed, and anxious after attending the program. They also reported being more confident and satisfied with managing their child, and less hassled by their child’s behaviour. With respect to child-related outcome, participants perceived their children’s behaviours as having improved. Limitations include lack of randomization, lack of comparison group, generalizability of findings due to ethnicity, and length of follow-up.

Length of postintervention follow-up: 3 months.

Additional References

No reference materials are currently available for Signposts for Building Better Behaviour.

Contact Information

Agency/Affiliation: Parenting Research Centre
Website: www.signposts.net.au
Email:
Phone: +613 8660 3500

Date Research Evidence Last Reviewed by CEBC: September 2017

Date Program Content Last Reviewed by Program Staff: October 2018

Date Program Originally Loaded onto CEBC: October 2018