Plain English Summary
Background and study aims?
A recent review commissioned by the Government (Fair Society Healthy Lives, 2010) recommended that every child should be given the best start in life and that more money should be spent on programmes that promote the development and well being of all children. In particular, schools should be helped in trying to improve childrens social and emotional development, physical and mental health and well-being. Previous research has shown that well designed programmes that are delivered in the school setting can have a positive and lasting impact on these outcomes in children. Roots of Empathy (ROE) is one such programme. This study aims to find out whether ROE improves children's helping behaviour (prosocial behaviour) and decreases their aggressive behaviour. The study will try to find out whether the programme increases children's understanding of infant crying; their ability to recognise emotions; their empathy; and their ability to control their own emotions. The study will look at whether there are also improvements in children's school performance and their general quality of life as well as whether the programme is good value for money (cost effective).
Who can participate?
70 primary schools from across Northern Ireland have agreed to take part in the evaluation. In participating schools, all children in Year 5 (aged 8-9 years), and their parents, will be invited to take part .
What does the study involve?
Half of the 70 schools will deliver the ROE programme to their Year 5 pupils between October 2011 and June 2012 (the intervention group) and the other half will not deliver the ROE programme between October 2011 and June 2012 (the control group). Children in Year 5 in the control group will continue with usual classroom activities and practice. All schools in Northern Ireland, as part of the statutory requirements of the Revised Curriculum, deliver Personal Development and Mutual Understanding (PDMU) which follows an issues-based approach and aims to explore pupils and societys attitudes and beliefs. This evaluation will therefore look at the effect of ROE above and beyond any effects of the PDMU part of the curriculum, which is also focused on the social and emotional development of the child.
Children in Year 5 in the intervention group will receive the ROE programme, which is a 27 lessons programme that runs for one school year and is based around a monthly classroom visit by a parent and their baby. The class 'adopts' the parent and baby at the start of the school year and during these monthly visits children learn about the babys growth and development through interacting with the baby and watching the baby and parent together. Each month a trained ROE instructor, who is not the class teacher, visits the classroom three times for a pre-family visit, the visit of the parent and baby; and a post-family visit. Each lesson allows children to talk and learn about the different aspects of empathy, such as: being able to name and describe different emotions; being able to take the view of another person; and being sensitive to other people's emotions. Participating children will complete carefully chosen measures of social, emotional and behavioural development before the programme starts in October 2011 and again at the end of the programme in May 2012. Teacher and parent ratings of childrens behaviour will also be collected. We will collect the same information from children, parents and teachers every June for another three years until children are aged 12. This will allow us to see if the programme has any lasting effects.
What are the potential benefits and risks of participating?
There are no anticipated risks associated with taking part. Participants in the control group are not at any educational disadvantage as the study will be an add-on to the existing Personal Development and Mutual Understanding (PDMU) curriculum that all children in Northern Ireland receive. Expected benefits of taking part are anticipated improvements in social and emotional well being.
Where is the study run from?
The study will take place in 70 schools across Northern Ireland and will be coordinated by the lead partners in the research team who are based in Queens University Belfast.
When is the study starting and how long is it expected to run for?
October 2011 to December 2015
Who is funding the study?
1. The National Institute for Health Research (NIHR)
2. The Health and Social Care Trusts and Public Health Agency in Northern Ireland are meeting the costs of delivering the ROE programme in schools
Who is the main contact?
Dr Sarah Miller
A cluster randomised controlled trial evaluation and cost-effectiveness analysis of the Roots of Empathy (ROE) schools-based programme for improving social and emotional wellbeing outcomes among 8-9 year olds in Northern Ireland
1. What is the impact of the programme at post-test and at one, two and three years following the end of the programme on a number of specific social and emotional wellbeing outcomes for participating children?
2. Is the programme having a differential impact on children depending on:
2.1. Their gender?
2.2. The number of siblings they have?
2.3. Their socio-economic status and/or the socio-economic profile of the school?
3. Does the impact of the programme vary significantly with any variations in implementation fidelity found?
4. What is the cost effectiveness of the programme in reducing cases of aggressive behaviour and increasing prosocial behaviour among school-aged children?
School of Education Research Ethics Committee, Queens University Belfast, 02/09/2011
Cluster randomised controlled trial and cost effectiveness analysis
Primary study design
Secondary study design
Cluster randomised trial
Quality of life
Patient information sheet
Not available in web format, please use the contact details to request a patient information sheet
Social and emotional well being
Roots of Empathy (ROE) is a 27 lesson programme that runs over a school year and is based around a monthly classroom visit by an infant and parent, typically recruited from the local community, whom the class 'adopts' at the start of the school year. During these monthly visits children learn about the babys growth and development via interactions and observations with the baby. Each month a trained ROE instructor, who is not the class teacher, visits the classroom three times for:
1. A pre-family visit
2. The visit of the parent and infant
3. Post-family visit
Instructors undergo a total of four days intensive training that is delivered directly by a specialist ROE trainer from Canada. The specialist trainer also provides on-going mentoring support via regular telephone calls to all instructors. In addition, on-going support is also available to each instructor through each Health and Social Care Trusts lead ROE coordinator. Each ROE lesson provides opportunities to discuss and learn about the different dimensions of empathy, namely:
1. Emotion identification and explanation
3. Emotional sensitivity
The parent-infant visit serves as a springboard for discussions about understanding feelings, infant development and effective parenting practices. ROE seeks to develop childrens social and emotional understanding, promote prosocial behaviours and decrease aggressive behaviours, and increase childrens knowledge about infant development and effective parenting practices.
The control group will not receive the ROE programme between October 2011 and June 2012. Instead they will continue with usual classroom activities and practice. In this regard, all schools in Northern Ireland, as part of the statutory requirements of the Revised Curriculum, deliver Personal Development and Mutual Understanding (PDMU). The developers of the curriculum, CCEA (Council for the Curriculum, Examinations and Assessment), describe PDMU as: "Encouraging each child to become personally, emotionally, socially and physically effective to lead healthy, safe and fulfilled lives and to become confident, independent and responsible citizens, making informed and responsible choices and decisions throughout their lives". PDMU is delivered using active and participatory learning methods, follows an issues-based approach and aims to explore pupils and societys attitudes and beliefs.This evaluation will therefore examine the effect of Roots of Empathy above and beyond any effects of the PDMU part of the curriculum, which is also focused on the social and emotional development of the child.
Control schools will be offered the ROE programme the following year for their 8-9 year olds. The control schools will, however, be required not to deliver the programme to children participating in the trial, who move into Years 6 and 7, to avoid their exposure to the intervention.
Primary outcome measure
1. Prosocial behaviour and aggressive behaviour measured using the Strengths and Difficulties Questionnaire (SDQ). There are three versions of the SDQ: parent, teacher and child and all three versions will be used to triangulate the data. The teacher and parent versions will be administered to teachers and parents at every data collection sweep. The child version is only suitable for administration with children aged 11 and above and so this version will be used in the final two data sweeps (June 2014 and June 2015)
2. Child Behaviour Scale
3. Olweus bully/victim questionnaire
4. Class detention rates
Secondary outcome measures
1. Understanding of infant crying, measured using the Infant Facial Expression of Emotions Scale
2. Ability to recognise emotions, measured using the Emotional Recognition Questionnaire
3. Empathy, measured using the Interpersonal Reactivity Index
4. Ability to regulate emotions, measured using the Child Anger Management Scale
5. Quality of life, measured using CHU 9D
6. Educational attainment, measured using the InCAS standardised maths and English scores that all schools in Northern Ireland now collect
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
1. All primary schools located in the four participating Health and Social Care Trust areas (Belfast, South Eastern, Southern and Western)
2. All children who are entering Year 5 (aged 8-9) at baseline in the participating schools
Target number of participants
Participant exclusion criteria
1. Special Schools
2. Schools with Year 5 (aged 8-9) classes that have less that 10 children
3. Schools already implementing the ROE programme
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Queen's University Belfast
Queen's University Belfast (UK)
Public Health Research Programme ref: 10/3006
NIHR Public Health Research Programme, PHR
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Basic results (scientific)
2018 results in: https://www.ncbi.nlm.nih.gov/pubmed/29543419