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Currently submitted to: JMIR Pediatrics and Parenting

Date Submitted: Nov 12, 2020
Open Peer Review Period: Oct 16, 2020 - Dec 11, 2020
(currently open for review)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

The Sign 4 Big Feelings intervention to improve early years outcomes in preschool children: Outcome evaluation

  • Rosemary Davidson; 
  • Gurch Randhawa



Any delays in language development may affect learning, profoundly influencing personal, social, and professional trajectories. The effectiveness of the Sign 4 Big Feelings (S4BF) intervention was investigated by measuring change in early years outcomes after a three month period.


To determine whether Early Years Outcomes (EYOs) significantly improve (beyond typical expected development), if children’s wellbeing improves after the S4BF intervention period, and if there are differences between boys and girls in any progress made.


An evaluation of S4BF was conducted with 111 preschool age children in early years settings in Luton, United Kingdom. Listening, speaking, understanding, and managing feelings and behaviour, in addition to Leuven well-being scales were used in a quasi-experimental study design to measure outcomes pre- and postintervention.


Statistically and clinically significant differences were found for each of the seven pre- and post measures taken: words understood and spoken, well-being scores, and the four EYO domains. Gender differences were negligible in all analyses undertaken.


Children of all abilities may benefit considerably from S4BF, but a language-based intervention of this nature may be transformational for children who are behind developmentally, with EAL needs or of lower socio-economic status. Clinical Trial: ISRCTN42025531;


Please cite as:

Davidson R, Randhawa G

The Sign 4 Big Feelings intervention to improve early years outcomes in preschool children: Outcome evaluation

JMIR Preprints. 12/11/2020:25086

DOI: 10.2196/preprints.25086


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