Coping with Crying Evidence, impact and evaluation
We've worked with Warwick Medical School and Great Ormond Street Hospital to develop Coping with Crying, a programme to protect babies from non-accidental head injuries. We've found promising evidence that the programme can contribute to reducing harm to babies.
How abuse in infancy affects children
Babies under one are particularly vulnerable to abuse and neglect. One third of serious case reviews in England relate to babies under the age of 1 year (Brandon et al, 2012). In England and Wales, babies are seven times more likely to be killed than older children (ONS, 2015).
Abuse has life-long impacts, and early adversity can cast a long shadow. Recent neurological and psychological research highlights more clearly than ever before how critical pregnancy and the first years are to a baby's development. They provide the essential foundations for all future learning, behaviour and health.
Read more about the importance of early intervention.
How Coping with Crying is helping prevent child abuse and neglect
It has been reported that infant crying is the most common reason why parents seek help when they have a small baby. As many as 1 in 6 new parents approach a medical professional for advice (Kaley, Reid and Flynn, 2011). In extreme cases crying can cause problems in parenting and even trigger abuse (Lester et al, 1990).
Brain damage caused by shaking is a major cause of death for abused children. Head injuries are the leading cause of death and long-term disability for babies who are harmed (Sidebotham and Fleming, 2007).
Research shows that educating parents about the risks of head injury, and providing them with practical advice about keeping their baby safe, can reduce the risk of babies suffering from non-accidental head injuries (Dias et al, 2005).
We learned from a similar programme in western New York State, USA, which reduced the number of shaken babies or non-accidental head injuries by 47% (Dias et al, 2005).
Research on preventing non-accidental head injury
Find more research on preventing non-accidental head injuries in babies by searching our library catalogue.
How we're evaluating this service
We evaluated Coping With Crying with 56 hospitals and agencies around the UK using information collected from over 41,000 parents, focus groups and a telephone survey of 2,324 parents.
We used 3 approaches:
- information from more than 41,000 parents who saw the film was collected and analysed to understand their characteristics
- focus groups with practitioners and parents were conducted to understand their experiences of the programme and gain insight into the practicalities of showing the film
- a telephone survey of over 2,324 parents was carried out to understand the impact of the film on parents' attitudes, knowledge and behaviour. Parents with babies aged 6-9 months-old were invited to participate in the survey.
Some of these parents had seen the film, and some had not, which allowed for comparison between the groups.
The aims of the evaluation were to:
- Understand differences in the reach of the programme (the proportion of mothers and fathers who had seen the film) between different models of delivery and approaches to implementation.
- Understand the relative impact of showing the film at different times and in different ways on parents' knowledge, attitudes and self-reported behaviours, and in comparison to not seeing the film at all.
- Understand the strengths and weaknesses of different delivery models.
Setting up focus groups with parents who had viewed the DVD was challenging. Parents consented to be contacted when they first viewed the DVD and came to the focus groups when their babies were 4-5 months-old. They had very little engagement with the NSPCC having only watched a 10 minute film and having babies made it difficult for them to travel. We ran focus groups in venues which were baby and child friendly and offered parents assistance with their travel. To try and engage dads we ran the groups at a range of times including in the evening.
It was also challenging surveying parents over the phone about how they were coping with their babies crying and their attitudes towards handling their babies. We went through a round of cognitive testing to get the survey questions right, making sure they were acceptable to parents and were measuring the correct concepts.
This evaluation was carried out internally by the NSPCC evaluation department. It didn't use any standardised measures. A bespoke survey was designed to measure parents knowledge, attitudes and behaviours.
Contact Denise Coster for more information.
What we've learnt so far
Our findings provide encouraging evidence that Coping with Crying may make babies safer by helping parents react in a positive way when their baby is crying.
Parents who watched the film reported improvements in their knowledge about infant crying, and coping strategies they could use to soothe their baby. They had more understanding about the impact of shaking their baby.
Evidence suggests that, during times of stress, parents who had watched the film were reacting in a positive way to their infant crying and were seeking help when it was necessary
Findings are published in our evaluation report Evaluation of Coping with Crying: final report (Denise Coster with Caroline Bryson and Susan Purdon, 2016).
What we're doing next
We would like Coping with Crying to be available to every parent of a newborn baby in the UK, and we're using what we have learnt from both phases of the pilot to plan the national roll out of the programme.
The service will be made available to relevant health, children's and social care organisations who wish to deliver the film in their area, and we will provide best practice guidance for showing the film.
Impact and evidence hub
Find out how we evaluate and research the impact we’re making in protecting children, get tips and tools for researchers and access resources.
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With your support, we help keep one million children safe from abuse and neglect – so they can look forward to a life of hope, and endless possibilities.
Brandon,M. et al (2012) New learning from serious case reviews: a two year report for 2009-2011 London: Department for Education.
Dias, M. S. et al (2005) Preventing abusive head trauma among infants and young children: a hospital-based, parent education program. Pediatrics, 15(4): e470-e477
Kaley, F, Reid, V & Flynn, E (2011) The psychology of infant colic: a review of current research. Infant Mental Health Journal 32(5): 526-541 [Freely view abstract or access full text by subscription: Infant Mental Health Journal 32(5): 526-541]
Lester, B. M., Boukydis, C. F., Garcia‐Coll, C. T., & Hole, W. T. (1990). Colic for developmentalists. Infant Mental Health Journal 11(4): 321-333 [Freely view abstract or access full text by subscription: Infant Mental Health Journal 11(4): 321-333]
Office for National Statistics (2015) Focus on violent crime and sexual offences, 2013/14. Newport: ONS
Sidebotham, P. and Fleming, P. (eds.) (2007) Unexpected death in childhood: a handbook for practitioners. Chichester: Wiley.