A feasibility trial of remotely-delivered Video Interaction Guidance [VIG] for families of children with a learning disability referred to specialist mental health services

Challenging behaviours and mental health problems are 3-4 times higher in children with a learning disability (LD) compared to typically developing children. They can lead to family breakdown and out of family placements. The National Institute for Health and Care Excellence (NICE) recommends that services support families to manage effectively at home. Children with LD and behaviour or mental health problems are referred to specialist child mental health services for support. These services are increasingly under strain, particularly during the COVID-19 pandemic. Remote therapy could increase the reach of therapies that can help these families. Video Interaction Guidance (VIG) is increasingly used in specialist mental health services to help families. VIG is a brief, personalised, strengths-based intervention: it uses video to identify successful moments of communication between a parent and a child as a tool to improve parent-child interaction and relationships. The quality of the parent-child relationship affects the risk for challenging behaviours and mental health problems in children with LD. VIG has been offered remotely since the start of the pandemic. However, to date, there has been no robust test of VIG or remote VIG. Parents may not want remote therapy or a therapy that focuses on the parent-child relationship. We also do not know what the main effects of VIG are for these families, and whether any gains made from the therapy are present six months later, a time when parenting intervention effects are expected to be present. To determine if VIG works well as a remote therapy, the first step is to determine if we can recruit parents to a study and if they like VIG. Working alongside parent advisors and the Challenging Behaviour Foundation, we will recruit 50 parents with a 6-12 year-old child with LD referred to specialist child mental health services. Parents will be allocated by chance (randomly) to receive VIG remotely alongside the usual service support or just the usual service support. We will follow families up to 6 months to measure: how many parents are recruited to the study; how many stay in the study at 6 months and complete the study questionnaires; how many families complete VIG, whether remote VIG is acceptable to families and services, and what factors make it easy or difficult to offer or take up remote VIG. At the end of the study, we will determine, using pre-specified criteria, if we can proceed with testing in a large multicentre trial whether VIG is an effective therapy delivered remotely within specialist mental health services. We will communicate findings to parents, specialist mental health services and researchers.