Early Impact

Delivering impact through early intervention and sessional therapy in our Child and Family Therapy Services.

How we measure impact

Progress against specific goals

We set goals for each child, using either Goal Attainment Scaling or the Canadian Occupational Performance Measure and review progress over time.

Assessing families’ experience over time

We have created our own Parent & Child Experience (PACE) assessment, which qualitatively records each family’s experience over time.

Parents’ feedback

We conduct an annual survey to obtain direct feedback on our service from parents and carers.

Child and Family Theory of Change

Tracking specific goals

Tracking specific goals

When a baby, toddler or child arrives in our Child and Family services, we work closely with families to set goals.

For babies and toddlers, we typically measure progress towards goals using the Canadian Occupational Performance Measure (COPM). It covers all areas of life and is highly personalised to each child.

For school-age children, we typically measure progress using Goal Attainment Scaling (GAS). We use this in Pace School too. It’s a method of assessing each child as an individual, as they progress towards their own personal learning goals.

Both systems mean we not only track each child’s progress, we can also monitor the impact of Pace services in helping children meet their goals.

Families’ experiences

Families’ experiences

Our own Parent and Child Experience (PACE) assessment tool provides qualitative evidence about our impact.

Parents are interviewed at their first session with us – and we ask the same questions at six-monthly intervals to determine the difference we’ve made.

Impact Highlights

Measuring the impact our early intervention programme is typically harder than within Pace School, given the wider range of conditions we work with and the disparity of needs. A baby who has been red-flagged for potential developmental issues will have very different needs, and a very different Pace intervention, compared to a 4-year-old who has a confirmed diagnosis of cerebral palsy and complex developmental challenges.

Where a particular outcome is not specific to a child (e.g.“Has improved self-care/independence skills” for a 2-month-old baby), it seems that parents sometimes respond“Neither Agree nor Disagree” rather than “Not Applicable”, skewing the results for that outcome as a whole.

We plan to address this measurement challenge in further iterations of this survey, particularly by using interviews rather than questionnaires to ensure that responses are accurately recorded. We also intend to measure more frequently, so that we can capture feedback soon after a block of intervention.
Overall, parents continue to rate our early intervention service highly, with 82% rating it as “excellent” and 18% as “good”.
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This is a little lower than in 2020 and 2021, which we ascribe to two main factors: Staffing and communication: In 2022 we had a number of staffing changes, both in our therapy team and our administration function. We recognise that the quality and proactivity of our communication with families slipped during this period, which we are working hard to improve.
COVID: In 2020 and 2021, the COVID pandemic meant that for long periods, Pace was effectively the only available provision and that we were literally a lifeline for those families. We believe that parental perceptions of Pace in those years were positively skewed as a result.


For example, lower ratings for self care/independence, feeding & eating, and sleep are driven to a significant extent by the reality that these outcome areas are irrelevant to a meaningful number of children in the survey. We believe that parents often tend to mark these outcomes as “neither agree nor disagree” rather than “not applicable”.


Replacing questionnaires with interviews should, we believe, remove this measurement bias. As in previous years, the outcomes reported for families are more clear cut than those for children. We continue to score very highly in the areas under which we have most control ( i.e. our listening and support, the quality of our advice and the upskilling of our parents).

Impact on Our Children

Impact on Our Children

The service continues to score highly across the key outcomes that it targets, with some variability driven by the variety of
underlying conditions and needs of the children and families responding to the survey, as outlined above.
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Impact on our Families

Impact on our Families

However, we recognise that families are struggling more in areas where we have less direct control (i.e. more generalised well being, stress and strength of the family unit). This may represent a generalised worsening in mental health and wellbeing across the wider population, but it does demonstrate the need for us to keep working to support these critically important areas of family wellbeing.
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