Within Primary Care, clients presenting with mental health problems are most likely to report the presence of an anxiety disorder. Referrals to mental health services can result in waiting lists due to the prevalence of individual models of intervention. A service delivery innovation to this organizational impasse has been White's group-based "Stresspac" approach. The current project attempted to increase the effectiveness of such service delivery via the application of practice-based evidence (PBE) guidelines. Clients completed a battery of psychometric tests prior to engaging in and on completion of a six-session group cognitivebehavioural intervention. A satisfaction survey was completed on termination of the group. Two groups were completed, the second of which was conducted using a PBE derived selection criterion. The application of the PBE selection criterion appeared to increase the effectiveness of the intervention provided, with clients in both groups being widely satisfied with the group approach. The active employment of PBE in the design and implementation of services appears to offer the opportunity for increasing the range, format and effectiveness of psychological interventions offered.

Children with disabilities experience significantly poorer socio-emotional outcomes than their peers without disabilities. However, research evidence is scarce about children with both disability and migration background, the group which this study aimed to investigate using data from a national longitudinal study. Secondary data analyses were conducted on a sample of 7290 children (weighted with missing values imputed). Significant differences in socio-emotional outcomes were found in relation to impairment status but not in relation to migration. Having an impairment and activity limitation significantly increased the likelihood of experiencing poorer socio-emotional outcomes over time. Our findings highlight a higher risk of socio-emotional problems among children with disabilities, especially among children from lower income backgrounds and with parents with lower educational attainment. These findings clearly require policy development on two fronts: to raise professional and community awareness on these issues and to strengthen the capacity of health, education and social care systems to support schools, families, and communities.

A small proportion of children experience social-emotional difficulties from early childhood onwards. Longitudinal studies with nationally representative samples are needed to identify the prevalence and the characteristics of children and families persistently experiencing these difficulties. Secondary analysis of data collected on over 7500 Irish children and with the Strengths and Difficulties Questionnaire as the primary indicator, found that 6% of children when they were five year olds and 8% when they were nine-years, had above threshold scores that warranted further investigation. A smaller proportion—2.9% had elevated scores at both ages. Logistic regression analyses found that children with one or more developmental disabilities were up to six times more likely to have sustained difficulties. There were also significant associations with the lower education attainment of primary caregivers and the socio-economic deprivation of families. Primary caregivers and teachers reported higher conflict in their relationships with these children. Although the number of Irish children presenting with continuing social-emotional difficulties is small, they can present an ongoing and future societal cost in terms of the impact on family relations and demands placed on educational, health and social services. This study identified the children and families who are at greatest risk and for whom targeted early intervention services could be provided.

In many countries, information on the prevalence of persistent speech and language disorders in early childhood is sparse due to the lack of nationally representative samples and longitudinal studies. Secondary analysis of data collected on over 7500 Irish children at ages 5 and 9 years, found that the prevalence of speech and language difficulties reported by the primary caregivers of Irish children decreased from one in six at age 5 to one in 12 at age 9. However, one in 20 children were reported to have difficulties at both ages. Regression analysis compared children with difficulties at both age 5 and age 9 to those who had been reported to have them at age 5 but no longer had such difficulties at age 9. Children with speech and language difficulties at both age 5 and age 9 were more likely to have two or more developmental impairments as well as current or past hearing impairments. Teachers and parents also reported a greater number of social-emotional difficulties. Family characteristics did not differ significantly across the two groupings. At best, up to one third of the children at ages 5 and 9 with speech and language difficulties had two or more contacts with a speech and language therapists in the preceding 12 month period. Increased support to these children, their parents and teachers would seem to be warranted.