Mental health assessment tools for perinatal and early childhood services and research

Research with MORS-Child

Study of Early Education and Development (SEED): Impact Study on Early Education Use and Child Outcomes up to age five years, Department for Education.

A large-scale study of 3,186 children and their families collected data when children were aged two, three, four and five years old, with additional data from the Early Years Foundation Stage Profile (EYFSP) for 4,942 children when they were in reception class. MORS-Child scores, included in the home environment measures, were found to have associations with cognitive and socio-emotional outcomes. Higher levels of MORS warmth were associated with better outcomes on all EYFSP measures and with better child verbal ability, and with better child outcomes on all socio-emotional measures. Higher levels of MORS invasion were associated with poorer outcomes for EYFSP communication and language.


Melhuish, E. and Gardiner, J. (2018) ‘Study of Early Education and Development (SEED): Impact study on early education use and child outcomes up to age four years’, Department for Education.

A large-scale study of 3,930 children and their families included MORS-Child in the home environment measures and found that it was the measure with the strongest associations with cognitive and socio-emotional outcomes at age 4 years.


Simkiss, D.E., Snooks, H.A., Stallard, N., et al. (2013) ‘Effectiveness and cost-effectiveness of a universal parenting skills programme in deprived communities: multicentre randomised controlled trial’, BMJ Open.


To evaluate the effectiveness and cost utility of a universally provided early years parenting programme.

Multicentre randomised controlled trial with cost-effectiveness analysis.

Early years centres in four deprived areas of South Wales.

Families with children aged between 2 and 4 years. 286 families were recruited and randomly allocated to the intervention or waiting list control.

The Family Links Nurturing Programme (FLNP), a 10-week course with weekly 2 h facilitated group sessions.

Main outcome measures
Negative and supportive parenting, child and parental well-being and costs assessed before the intervention, following the course (3 months) and at 9 months using standardised measures.

There were no significant differences in primary or secondary outcomes between trial arms at 3 or 9 months. With ‘+’ indicating improvement, difference in change in negative parenting score at 9 months was +0.90 (95%CI −1.90 to 3.69); in supportive parenting, +0.17 (95%CI −0.61 to 0.94); and 12 of the 17 secondary outcomes showed a non-significant positive effect in the FLNP arm. Based on changes in parental well-being (SF-12), the cost per quality-adjusted life year (QALY) gained was estimated to be £34 913 (range 21 485–46 578) over 5 years and £18 954 (range 11 664–25 287) over 10 years. Probability of cost per QALY gained below £30 000 was 47% at 5 years and 57% at 10 years. Attendance was low: 34% of intervention families attended no sessions (n=48); only 47% completed the course (n=68). Also, 19% of control families attended a parenting programme before 9-month follow-up.

Our trial has not found evidence of clinical or cost utility for the FLNP in a universal setting. However, low levels of exposure and contamination mean that uncertainty remains.

DOI: bmjopen-2013-002851