Www.learningbenefits.net Leon Feinstein 18-July-2006 Targeted and universal intervention.

www.learningbenefits.net

Leon Feinstein

18-July-2006

Targeted and universal intervention


Five questions

How well can we identify those children at risk of adult social exclusion?

Which measures are most predictive? What difference does it make? What are the implications for the delivery of

services? What are the implications for the targeting of

interventions?


E.g. Relationship of G1 maternal interest at G2 age 7 and G2-G3 parenting at G2 age 33

Home_Cog Home_Em

Low interest 0 0

Medium interest 4.7 *** 2.5 ***

High interest 7.2 *** 2.7 ***

Over-concern 8.7 *** 1.0

N 3873 3697


Relative cognitive shifts, 7 -11, by SES, 1958 Cohort

Source: Feinstein, L. ‘Schools and Educational Attainment’, Oxford Review of Economic Policy, (in press)

65.0

57.0

22.6

34.7

55.7

74.3

54.2

34.8

30.3

54.3

28.8

20.4

0

10

20

30

40

50

60

70

80

1 2 3nm 3m 4 5

SES

Pro

b.

(%)

Probability of escaping low quartile

Probability of falling from top quartile


Predicted changes in probability of not obtaining Level 4; by age 10 capabilities, men

-0.1

-0.08

-0.06

-0.04

-0.02

0

0.02

0.04

0.06

0.08

Maths Reading Self-esteem Loc. of Control Externalising Internalising Peer relations

Error bars indicate 95% confidence


Skills and capabilities; Probability of being in workless household with children at age 30

-0.030

-0.020

-0.010

0.000

0.010

0.020

0.030

0.040

Maths Reading Self Esteem Locus ofcontrol

Externalisingbehaviour

Internalisingbehaviour

Good peerrelations

Marg

inal eff

ect

(ch

an

ge in

pro

b.)

Source: Feinstein, L. and Bynner, J. (Dec 2003), ‘The benefits of assets in childhood as protection against adult social exclusion: the relative effects of financial, human, social and psychological assets’, Note to HM Treasury.


Predicted changes in probability of offending; by age 10 capabilities, men

-0.05

-0.04

-0.03

-0.02

-0.01

0

0.01

0.02

0.03

0.04

0.05

Maths Reading Self-esteem Loc. of Control Externalising Internalising Peer relations

Error bars indicate 95% confidence


Conceptual model for family influences on child development


Some cost-benefit notation

C(T+) = The social cost of the outcome (T=truth) P(T+) = The unconditional probability of the

outcome P(D+)= The level of targeting of the intervention C(D+)= The cost of the intervention f= the effectiveness of the intervention; 0 ≤ f ≤ 1.


True and false positives

Truth

Positive Negative

Decision (Predicted outcome)

Positive True positive

A

False positive

B

Negative False negative

C

True negative

D

P(TP) = P(D+ | T+) = A / (A+C)

P(FP) = P(D+ | T-) = B / (B+D)


Costs and benefits

C(T-, D+) = The cost of a positive decision and hence intervention for those who would not experience the outcome (deadweight +stigmatisation costs)

C(T+, D-) = The cost of a negative decision and hence failure to intervene for those who would experience the outcome

B(T+, D+) = The net benefit of a positive decision and intervention for those who would experience the outcome (net of intervention and stigmatisation costs)

B(T-, D-) = The net benefit of a negative decision and absence of intervention for those who would not experience the outcome.


B(T+, D+) =

P(D+, T+) * f * C(T+) – P(D+, T+) * C(D+)

=

P(TP) * P(T+) {f * C(T+) –C(D+) }


C(T-, D+) = P(D-, T+) * C(D+)

= P(FP) * P(T-) * C(D+)

Hence cost effectiveness requires:

P(TP) > P(T-) * C(D+)

P(FP) P(T+) { f * C(T+) –C(D+) }


ROC Curves: Allowing the allocation threshold to vary

0.0

00.2

50.5

00.7

51.0

0S

ensitiv

ity

0.00 0.25 0.50 0.75 1.001 - Specificity

Area under ROC curve = 0.9521


Optimal point on the ROC curve

S* = P(T-) * B(T-, D-) + C(T-, D+)

P(T+) B(T+, D+) + C(T+, D-)


2. Estimating P(TP) and P(FP)


Predicting teenage parenthood, by age

1958 Cohort 1970 Cohort

P(TP) P(FP) P(TP) P(FP)

Birth 22.0 5.7 23.8 4.0

22 months 26.8 3.9

42 months 29.2 3.7

5/7 years 28.5 4.2 29.2 3.8

10/11 years 30.7 4.3 60.0 1.4

16 years 45.2 3.6 32.4 3.1


Predicting adult depression, by age



Birth 34.2 17.3 32.3 17.4

5/7 years 38.3 15.8 34.4 17.1

10/11 years 34.6 16.8 46.7 11.0

16 years 45.8 12.4 34.5 16.7


Predicting teenage parenthood, by domain



Distal family background 31.1 2.1 52.6 1.3

Proximal family process 21.3 2.1 19.6 4.2

Neighbourhood 16.0 5.4 11.2 3.0

School 25.6 2.7 23.8 4.3

Child cognitive achievement 25.5 2.4 20.9 4.2

Behavioural and affective 34.0 2.0 35.5 2.8

Health and growth 19.0 2.8 15.9 4.4


Predicting adult depression, by domain



Distal family background 35.7 15.8 40.1 14.6

Proximal family process 35.0 15.5 32.5 17.1

Neighbourhood 29.9 19.3 6.0 2.8

School 36.4 16.5 33.3 17.2

Child cognitive achievement 32.9 16.5 32.1 17.5

Behavioural and affective 37.7 16.5 34.3 15.9

Health and growth 31.8 18.1 30.0 17.0


Predicting other outcomes from age 10 measures, 1970 Cohort

P(TP) P(FP)

Workless household with children 50.0 1.3

Mental health problem 45.3 16.3

Serious addiction to drugs or alcohol 52.2 1.1

Long periods of NEET (16-30) 51.6 2.5


On benefits at 30 41.6 3.6

Multiple offending 51.6 1.3


Predicting other outcomes, P(TP), 1970

Distal Behav.

Workless household with children 44.9 26.3

Mental health problem 42.0 37.5

Serious addiction to drugs or alcohol 42.5 29.4



On benefits at 30 33.9 29.2

Multiple offending 53.5 39.6


3. Preliminary discussion

Targeting depends on identification Identification capabilities are very strong So targeted intervention is possible, but:

Ethical issues Stigmatisation Need effective and appropriate intervention Facilitated community engagement crucial People move in and out of risk Progressive universalism is essential Role of schools and GPs?

Www.learningbenefits.net Leon Feinstein 18-July-2006 Targeted and universal intervention.

Documents

d slide

d ct

d ct

pfp slide

press slide

n38733697 slide

b b d slide

universal intervention