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This study found the intervention was well received and concluded that a full trial would be feasible.

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Elinor Coulman 1, Nick Gore 2, Gwenllian Moody 1, Melissa Wright 1, Jeremy Segrott 1, David Gillespie 1, Stavros Petrou 3, Fiona Lugg-Widger 1, Sungwook Kim 3, Jill Bradshaw 2, Rachel McNamara 1, Andrew Jahoda 4, Geoff Lindsay 5, Jacqui Shurlock 6, Vaso Totsika 7, Catherine Stanford 5, Samantha Flynn 5, Annabel Carter 2, Christian Barlow 1, Richard Hastings 5,*

1 Centre for Trials Research, Cardiff University, Cardiff, UK
2 Tizard Centre, University of Kent, Canterbury, UK
3 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
4 Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
5 Centre for Educational Development Appraisal and Research, University of Warwick, Coventry, UK
6 Challenging Behaviour Foundation, Chatham, UK
7 Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
* Corresponding author Email: R.Hastings@warwick.ac.uk

Declared competing interests of authors: Nick Gore reports payment to train study site facilitators in the Early Positive Approaches to Support (E-PAtS) intervention from the Royal Mencap Society during the conduct of the study; and payments to the University of Kent (Canterbury, UK) for training facilitators in the delivery of the E-PAtS intervention at other sites not involved in this research from the Royal Mencap Society, Université du Québec à Montréal (Montreal, QC, Canada), Mencap Northern Ireland (Belfast, UK), Mencap Leeds (Leeds, UK), Mencap Wales (Aberaeron, UK), Child and Family Psychological Therapies Service (Newport, UK), Cerebra (Carmarthen, UK), Mencap Carlisle (Carlisle, UK) and the Norwegian Health Services (Stavanger, Norway) outside the submitted work. In addition, the intellectual property for the E-PAtS intervention is held by the University of Kent, deferred to Dr Nick Gore. The E-PAtS materials are copyrighted in this regard also. The E-PAtS intervention has been developed through leadership from Nick Gore. A non-commercial (free) licence to deliver E-PAtS is provided to organisations where facilitators have completed E-PAtS training licensed to University of Kent. Jill Bradshaw reports other from the Royal Mencap Society, during the conduct of the study; other from the Royal Mencap Society, Université du Québec à Montréal, Mencap Leeds, Mencap Wales and Cerebra, outside the submitted work; and personal fees from Child and Family Psychological Therapies Service, outside the submitted work. Jacqui Shurlock reports that the organisation in which she is employed, the Challenging Behaviour Foundation, was involved in the initial development of the E-PAtS intervention. Richard Hastings reports that he has collaborated with both Nick Gore (E-PAtS intervention developer) and the Challenging Behaviour Foundation (Chatham, UK; a charity that contributes to the development of E-PAtS) on other research.

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