Search

Background: Early language delay is exacerbated by social disadvantage. Factors such as parents' low levels of literacy, confidence and self‐perception can affect the capacity to act on advice received, critical to empowerment. Methods used to achieve successful health outcomes in socially disadvantaged clinical populations may need enhancing. Aims: To compare the impact of standard parent‐based intervention (PBI) to enhanced PBI for young children with speech, language and communication needs (SCLN) and their families living in more socially disadvantaged populations. Methods and Procedures: A multicentre clustered blind randomised controlled trial was used to compare the effect of parent‐based group interventions to improve early language development with children (mean age 27.5 months) from more socially disadvantaged populations with an expressive vocabulary of 40 or less single words. Intervention sessions were delivered by a speech and language therapist, over a 20‐week period. Participants received one of two interventions: (1) Standard Care – indirect group PBI – (PBI) (2) Enhanced Care: indirect group enhanced PBI – (EPBI). Both standardised and non‐standardised measures were used as outcomes. Parent engagement in the intervention was captured through analysis of attendance and the Parent Activation Measure – Speech & Language Therapy (PAM‐SLT) (Insignia Health, 2014). The PAM measures a person's knowledge, skills and confidence to manage their own health and well‐being (NHS England, 2018). In this study, activation referred to parents' knowledge, skills and confidence to manage their child's language development. Outcomes and Results: One hundred fifty‐five participants were randomised at baseline. Children in both groups made significant improvements in the outcome on MacArthur‐Bates Communicative Development Inventories Sentence Length, from pre‐intervention to post‐intervention and 6 months post‐intervention (p < 0.05). Changes in vocabulary and expressive language skills were more equivocal, showing wide variation in confidence intervals for both groups. Where parents attended at least one intervention session almost all effect sizes were in favour of the EPBI intervention. Parents' activation levels significantly increased for both groups (EPBI p < 0.001, PBI p = 0.003), with a moderate effect size in favour of EPBI (Hedges' G 0.37, confidence interval –0.02 to 0.76), although wide variation was found. Conclusions and Implications: This trial provides some evidence of facilitating the language development of children with SLCN from more socially disadvantaged areas through supporting caregivers. However, we found variation in outcomes; some children made excellent progress, whilst others did not. Further exploration of parent engagement and its relationship to child language outcomes will be valuable to understanding more about mechanisms of change in interventions that involve parents. WHAT THIS PAPER ADDS: What is already known on the subject: Speech, language and communication needs (SLCN) have a knock‐on effect on emotional well‐being, school readiness, literacy and school attainment, putting children at increased risk of long‐term consequences such as poor literacy, mental health problems and unemployment. In disadvantaged areas, the prevalence of language difficulties is higher than elsewhere. Factors such as parents' low levels of literacy, confidence and self‐perception can affect the capacity to act on advice received, critical to empowerment. What this paper adds to existing knowledge: Children with SLCN from more socially disadvantaged areas can make improvements in their language development through parent intervention, although wide individual variation was found. There was some evidence that children achieve better outcomes with EPBI, which employed an interagency collaborative approach. Parent's engagement (activation levels) increased significantly over time with intervention, with the increase twice as big for EPBI. What are the potential or actual clinical implications of this work?: This trial provides some evidence that it is possible to facilitate the language development of children from more socially disadvantaged areas through supporting their caregivers. Further research would be useful to determine whether increases in parent engagement are related to adherence to intervention and change in child outcomes. [ABSTRACT FROM AUTHOR]

Background: When parents bring their child to appointments and then adhere to agreed speech and language therapy (SLT) recommendations, there is the potential to increase the intensity of the intervention, support generalization and improve outcomes. In SLT, however, little is known about factors that may promote attendance or adherence. Studies in other clinical areas such in medicine, psychology and physiotherapy have identified risk factors for non‐attendance or non‐adherence that are multifactorial and variable dependent on, for example, population and intervention. Aims: To identify rates of non‐attendance and non‐adherence, and to identify parent or child factors associated with parent involvement in intervention for children under 5 years of age receiving SLT. Methods: Parents completed questionnaires at two time points assessing the domains of parents' beliefs (problem perceptions, self‐efficacy), personal circumstances (socio‐demographics, family functioning), treatment experience and child factors. Predictors of parent attendance and adherence were identified through multiple regression analyses. Non‐attendance rates were identified via local health records and non‐adherence ascertained using a specific parent‐reported measure within the treatment experience domain. Results: Participants (N = 199) were predominantly mothers, and were ethnically and socio‐economically diverse, speaking a wide range of languages. Their children presented with a range of speech, language communication needs (SLCN). The rate of non‐attendance was 25% and the main predictors of non‐attendance were maternal age, education level and two factors within the parent beliefs domain. This model explained 40% of the variance in attendance. The rate of non‐adherence in this cohort was 26% with parental rating of the importance of a recommendation and self‐efficacy beliefs predicting adherence; this explained 56% of the variance in adherence to SLT recommendations at home. Conclusions & Implications: Our research has provided preliminary evidence of the influence of parents' beliefs, personal circumstances and treatment experiences on their involvement in their child's therapy. Speech and language therapists should consider factors impacting attendance and adherence to treatment and explore parental perceptions of their child's SLCN before embarking on an intervention, a foundation for collaborative practice. A possible limitation of this study is that the levels of attrition in our sample led to generally high measured rates of participation, which should be considered in future studies. Future research should explore adherence in treatments with varying doses, with different types of SLCN or interventions and in different settings. WHAT THIS PAPER ADDS: What is already known on the subject: It is acknowledged that parent involvement in their child's therapy, such as attending and adhering to recommendations, is important but little is known about the rates of involvement and what factors may be associated with attendance and adherence in SLT. Qualitative research has explored parental involvement suggesting that beliefs about an intervention may be pertinent. Extensive research in other clinical areas suggest multiple and varied factors are influential and further exploration of particular populations and interventions is necessary. What this paper adds to the existing knowledge: This study identified rates of parental non‐attendance and non‐adherence in a cohort of predominantly mothers of children under the age of 5 years. It is the first study to measure parent adherence in SLT and identify factors that are associated parental adherence to SLT recommendations. It adds to the small body of SLT specific research in understanding risk factors for non‐attendance. What are the potential or actual clinical implications of this work?: This study highlights the need for a speech and language therapist to consider and explore parents' perspectives of their child's SLCN as a part of achieving collaboration with a parent in order to achieve the best outcomes. It provides a foundation for further systematic research into parent involvement with the ultimate aim of enhancing outcomes for children with SLCN. [ABSTRACT FROM AUTHOR]

This paper examines the participation of children and young people within government consultation processes. It considers the recent Department for Education consultation on its statutory guidance for schools for Relationships and Sex Education in England. The paper is based on a Freedom of Information request for the consultation responses categorised as from 'young people'. We identify two issues in our interrogation of the data. First, there is evidence that a substantial proportion of responses were not submitted by young people. Second, the consultation approach did not include all the features necessary for meaningful consultation. We consider the implications for the youth consultation on policy matters that affect them. [ABSTRACT FROM AUTHOR]

Background: Developmental Language Disorder (DLD) impacts various aspects of children's language abilities, including the processing of inflectional morphology. Prior research suggests that children with DLD exhibit deficits in processing speed and sensitivity to grammatical inflections, yet the relationship between these deficits remains unclear. Aims: This study aimed to investigate the relationship between processing speed and sensitivity to inflectional morphology in children with DLD, focusing on their real‐time processing abilities in response to regular past tense, third person singular, and regular plural inflections at different rates of sentence articulation. Method: Eighteen children with DLD and 18 age‐matched controls underwent word monitoring tasks that assessed sensitivity to grammaticality of inflections in sentences presented at normal and slow rates of articulation. Results: At a normal rate of articulation, children with DLD demonstrated slower response times and reduced sensitivity to grammaticality across all inflections compared to controls. When the articulation rate was slowed, children with DLD showed improved sensitivity, particularly to regular plural and third person singular inflections, although deficits in processing the regular past tense persisted. Conclusions: The findings suggest a significant relationship between processing speed and inflectional morphology sensitivity in children with DLD. Slower articulation rates improved grammatical sensitivity for certain inflections, highlighting the potential of tailored interventions that consider processing speed limitations. Persistent difficulties with the regular past tense inflection indicate the need for targeted support for children with DLD in this area. WHAT THIS PAPER ADDS: What is already known on this subject: Children with Developmental Language Disorder (DLD) have a wide range of language difficulties, but deficits in inflectional morphology are regarded as a 'hallmark' of the disorder. Children with DLD are also very likely to show deficits in speed of processing, although it is not known if a 'slowness to process' can causally explain the language difficulties these children experience. What this study adds to existing knowledge: When grammatical sensitivity was measured using an online real‐time task, children with DLD showed widespread inflectional deficits when sentences were spoken at a normal conversational rate. When sentence articulation rate was slowed down, children with DLD were faster, more accurate and more sensitive to the grammaticality of constructions. However, deficits in the regular past tense remained persistent, even in this slow‐rate condition. What are the clinical implications of this work?: This study has implications for clinical and educational practices that work with children with DLD to improve their language skills. The findings of this study show that when children with DLD are given more time to process incoming information, their grammatical skills significantly improve. This study also shows that deficits in the regular past tense are persistent, and children are likely need extensive and intensive support with this particular grammatical feature. [ABSTRACT FROM AUTHOR]

This paper explores how relational approaches to well‐being could support young children's educational achievement in high‐poverty contexts. It draws on findings from a qualitative study involving mothers and early years educators living and/or working in a city characterised as one of the most disadvantaged in England. The findings suggest that children's well‐being, rather than being merely an individual characteristic or aspiration, is interdependent with their social and material environments, as are the institutions that support them. The paper concludes by calling for a recalibration of early childhood policies away from assessing individual children's 'school readiness' to encouraging society's readiness to support everyone's well‐being, and consequently that of young children too. [ABSTRACT FROM AUTHOR]

Background: Very young children from lower socioeconomic status (SES) backgrounds often show poorer language development. Whilst there have been attempts to provide early intervention programmes, these sometimes miss the most disadvantaged groups. Aims: This report presents preliminary feasibility and effectiveness data for a novel language intervention designed for parents of toddlers in the United Kingdom. Methods and Procedures: In total, 43 UK families of 2–4‐year‐olds were recruited to the study, half of whom completed an 8‐week course (Tots Talking) focussed on parent interaction, and half of whom acted as wait‐list controls. Results and Outcomes: Results suggest that such programmes are feasible for families with 86% staying in the intervention. In addition, greater changes in underlying communication skills such as joint attention and gesture were evident compared to wait‐list controls. Conclusions and Implications: We conclude that pre‐verbal skills may be more important to measure as initial outcomes than language or vocabulary change in this population. What This Paper Adds: What is already known on the subject: Children from lower socioeconomic status (SES) backgrounds are at higher risk of communication difficulties and there is a need for community intervention programmes for very young children. What this study adds: This study suggests that such programmes can be feasible and effective, but that very early/basic communicative skills (such as joint attention) may be boosted first rather than language or vocabulary. What are the clinical implications of this work?: Children's centres and other community services could feasibly run short parent facing courses emphasising contingent communication in low SES families and other diverse groups. These may be more successful run with younger preschoolers. Joint attention may be a better focus of intervention before expecting vocabulary or language change. Community health professionals may find this information useful in referring and supporting families in need. [ABSTRACT FROM AUTHOR]

This article reports findings from a study which sought to offer primacy to the voice of the child, using narrative approaches to encourage children and young people to share their lived experiences of neglect. Using a constructivist approach, this paper explores the relationship between the voice of the child and their narrative of neglect. Drawing on the notion of 'family narrative', the discussion examines how children's views are constructed and reconstructed through the process of telling. This research documents that whilst practitioners seek to present the authentic voice of the child, our understanding of 'voice' should be problematized to take account of the fact that it is mediated through a number of filters and lenses. By attending to the voice of the child in the context of their narrative, practitioners may move closer to understanding the lived experience of the individual by exploring feelings, motivations and the myriad of factors which may influence how and for what purpose voice is shared. Engagement with the voice of their child in the context of their narrative, facilitates the development of a social work meta‐narrative to inform effective intervention. [ABSTRACT FROM AUTHOR]

In 2021, Birmingham County Football Association (BCFA) in partnership with Newman University carried out a quantitative online review to assess coaches, volunteers, parents and young people's understanding of safeguarding information, policies and procedures in relation to football. This paper examines the findings from the children (aged 5–11) and young people (aged 12–17) using the Six Principles of Safeguarding to assess the current safeguarding measures in place to protect children and young people (CYP) playing grassroots football. The review found that whilst most CYP felt safe when playing organised football, there were some concerns raised from the young people in relation to angry parents, abuse and racism. Most children in both groupings had heard of the term safeguarding, but fewer had heard of the term welfare, and struggled to explain what welfare meant. A key finding and concern is that many CYP are not aware of the role of the Club Welfare Officer at their football club or that this might be someone to whom they can disclose issues concerning them. Furthermore, it became evident that further research, awareness raising and implementation of listening to and acting on children's voices needs to be fully embedded into safeguarding practice in children and young people's organised football. [ABSTRACT FROM AUTHOR]

This paper reports upon the learning that emerged from a development project which aimed to facilitate improvements in multiagency work in domestic abuse and safeguarding children. The two-year project (2011-13), funded by the Department for Education and led by WomenCentre, a specialist voluntary sector organisation based in West Yorkshire, was undertaken in nine local authorities in the north of England. Activities undertaken during the project included case mapping, service user and professional engagement exercises, observation of local multiagency meetings and provision of training. An evaluative research study examined the work of the project and the learning that emerged. Drawing upon data from telephone interviews with project participants, analysis of case mapping and project reports, this paper discusses some critical issues which emerged from this project. The paper draws attention to the different understandings and priorities which shape interprofessional practice in relation to safeguarding children and domestic abuse, and the complexities of the wider interagency environment including coordination, resources and expertise. Recommendations for improving multiagency work to achieve better outcomes for women and children experiencing domestic abuse are discussed. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages Multiagency working in domestic abuse and safeguarding children is complex and could be improved., The impact of professional differences in how cases are understood and managed, particularly in relation to 'risk', as well as different professional priorities and approaches to working with families should be recognised and considered within the multiagency context., Practitioners may want to consider whether 'case mapping' is pertinent to their own safeguarding practices and processes. [ABSTRACT FROM AUTHOR]

This TACTYC funded research highlights the role that Maintained Nursery Schools (MNS) play in supporting families within areas of extreme social deprivation in the UK. Data collected through survey and interview demonstrated the positive impact that these schools have upon disadvantaged children and their families, providing a breadth and depth of ongoing care, against a backdrop of ongoing fiscal cuts and uncertainty. Often this provision was in lieu of the reported minimisation of other social services support for struggling families. We argue in this paper that the loss of these state institutions could be highly detrimental to the families that they currently support. [ABSTRACT FROM AUTHOR]

Background: The existing evidence is limited in terms of perspectives of preschool children with speech and language needs and their views on activities used to support their needs. This paper discusses a stream of work from the interdisciplinary research programme known as "Child Talk," based in England, UK. The overall purpose of this work stream was to gain the perspectives of preschool children aged 2 to 5 years and 11 months, with speech and language needs, to use in the development of an evidence‐based framework of activities. Methods: Twenty‐four preschool children with a variety of needs from diverse backgrounds took part. An observational methodology was used to capture children's experiences. Children were filmed during a series of sessions, with innovative head‐mounted cameras worn by the children and supported by researcher field notes. Framework analysis was used to analyse the data based on the body movement, vocalization, and visual attention of the children during these sessions. Results and Conclusions: Results included that children expressed enjoyment and engagement in the activities. The children expressed themselves and demonstrated their focus "multimodally" through combinations of body language, vocalization, and visual attention. These modalities were present across all contexts and children. It highlights the importance of encouraging participation in preschool children and consequently this innovative piece of work has national and international importance. [ABSTRACT FROM AUTHOR]

Background: Children and young people with learning disabilities experience poor health outcomes and lengthier hospital admissions than those without learning disabilities. No consistently applied, systematic approach exists across the NHS to identify and record this population. This paper describes practices in English hospitals to identify children and young people with learning disabilities. Method: Interviews: 65 NHS staff. Questionnaire: 2,261 NHS staff. Conducted across 24 NHS hospitals in England. Results: No standardized approach exists to identify children or young people with a learning disability or for this information to be consistently recorded, communicated to relevant parties within a hospital, Trust or across NHS services. Staff reported a reliance on parents to inform them about their child's needs but concerns about "flagging" patients might be a significant barrier. Discussion: Without an integrated systematic way across the NHS to identify children with learning disabilities, their individual needs will not be identified. [ABSTRACT FROM AUTHOR]

Multi-touch surfaces have the potential to change the nature of computer-supported collaborative learning, allowing more equitable access to shared digital content. In this paper, we explore how large multi-touch tables can be used by groups of students as an external representation of their group interaction processes. Video data from 24 groups of students working on a logic reasoning problem was examined to identify their levels of reasoning about the task, and how they used the table to support their reasoning. Results indicate that of the 13 groups who solved or nearly solved the problem, 12 used the table to represent their reasoning process, while only four groups who used the table to support their reasoning process did not solve the problem. Examples from three groups are used to explore the different ways the table was used as an external representation of the groups' processes. The findings indicate that the group problem-solving process can be enhanced with the use of multi-touch tables, although students may need support in using the technology effectively to support their collaborative reasoning. [ABSTRACT FROM AUTHOR]

In this paper, we present findings on lay constructions of racism from a focus group study (11 groups, n = 72) with a mixed sample of secondary-school students in England. We show that racism was, on the whole, 'othered': It was located in other times, places, and people or was denied altogether. We show that this way of talking about racism had different uses depending on the identity stakes involved in different interactional contexts. Even in the cases where racism was constructed as common, participants worked hard to make an 'irrefutable' argument, which suggests that they were anticipating reputational damage by making a claim for the persistence of racism. We discuss these findings with regard to the different levels of analysis involved in constructions of racism (micro-interactional, local and broader normative context) and with regard to an 'end of racism' discourse that appeared to provide the normative framework for participants' accounts. [ABSTRACT FROM AUTHOR]

Participation by children in child protection remains a complex area of practice. This paper presents findings from a qualitative study exploring the views of 26 children, aged 6–17 years, about their participation in the child protection system in England. All of the children were subject to a child protection plan and were living at home at the time of interview. The children's understanding of the child protection process was categorized, and the majority of children, including the youngest, were found be at least partially aware of the child protection process, often struggling to make sense of the professional intervention in their families on the basis of partial information. It is argued that decisions about children's involvement should take into account not only children's age and understanding, but be seen in the context of wider family dynamics. Participation in formal processes such as child protection conferences was experienced as difficult and emotive. The child's relationship with their social worker was central to meaningful participation. [ABSTRACT FROM AUTHOR]

This article highlights three dimensions to understanding children's well-being during and after parental imprisonment which have not been fully explored in current research. A consideration of 'time' reveals the importance of children's past experiences and their anticipated futures. A focus on 'space' highlights the impact of new or altered environmental dynamics. A study of 'agency' illuminates how children cope within structural, material and social confines which intensify vulnerability and dependency. This integrated perspective reveals important differences in individual children's experiences and commonalities in broader systemic and social constraints on prisoners' children. The paper analyses data from a prospective longitudinal study of 35 prisoners' children during and after their (step) father's imprisonment to illustrate the arguments. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To explore 40 years of Child Development Centre (CDC) activity and outcomes at Northampton General Hospital 1974–2014. Methods: The study comprises 3 data sets: a published report from 1974 to 1999, an internal audit from 2001 to 2004, and more recent data collected from 2005 to 2014. The medical notes of all children who were assessed by the CDC in 2014 were reviewed, along with referral data collected by the CDC manager from this year and the preceding 10 years. Results: From January 1, 1974 to December 31, 2014, 3,786 children were assessed. The male to female ratio is 2.8:1 from 2005 to 2014. Referrals for behavioural difficulties increased from 10% (10/100 referrals) in 1999–2004 to 17.8% (18/101 referrals) in 2014. Similarly, referrals for social and communication problems, “interaction” increased two and a half fold from 10% (10/100 referrals) in 1999–2004 to 26.7% (27/101 referrals) in 2014. Between 2004 and 2014, numbers of referrals for “developmental delay” halved (22.2% to 12%). Conclusion: We are aware of no other comparable extant UK CDC database. Services should plan for a referral rate of 6.5 per 1,000 preschool children. Between 1974 and 2014, there has clearly been a change in recorded assessment outcomes. From the mid‐1980s, this reflects the change to a preschool assessment role and a shift away from purely educational outcome to include medical conditions. Covering 1974–2014, we demonstrate a clear increase in the number of referrals together with an increasing demand for assessments for social interaction and behavioural difficulties. This reflects the increased awareness of these neurodevelopmental difficulties and the changing diagnostic criteria which will now more likely result in an Autistic Spectrum Disorder diagnosis than previously. Together, these two features are most likely to have considerable implications for service development within Child Development Centres (CDCs) and Child Development Teams (CDTs). [ABSTRACT FROM AUTHOR]

Purpose: Myopia prevalence has increased in the UK at age 10‐16y, but little is known about younger children. We hypothesise that if the 'myopia epidemic' is affecting young children, then there will be increasing rates of bilateral reduced unaided vision (V) at vision screenings of children 4–5 years of age. Methods: Retrospective anonymised data from computerised vision screening at age 4–5 years were analysed from serial cross‐sectional data. Refractive error is not assessed in UK vision screening, so vision was investigated. Data were only included from schools that screened every year from 2015/16 to 2021/22. The criterion used was unaided monocular logMAR (automated letter‐by‐letter scoring) vision >0.20 in both the right and left eyes, so as to maximise the chances of detecting bilateral, moderate myopia rather than amblyopia. Results: Anonymised raw data were obtained for 359,634 screening episodes from 2075 schools. Once schools were excluded where data were not available for every year and data were cleaned, the final database comprised 110,076 episodes. The proportion (percentage and 95% CI) failing the criterion from 2015/16 to 2021/22 were 7.6 (7.2–8.0), 8.5 (8.1–8.9), 7.5 (7.1–7.9), 7.8 (7.4–8.2), 8.7 (8.1–9.2), 8.5 (7.9–9.0) and 9.3 (8.8–9.7), respectively. The slope of the regression line showed a trend for increasing rates of reduced bilateral unaided vision, consistent with increasing frequency of myopia (p = 0.06). A decreasing linear trendline was noted for children 'Under Professional Care'. Conclusions: For children 4–5 years of age, there were signs of reduced vision over the last 7 years in England. Consideration of the most likely causes support the hypothesis of increasing myopia. The increase in screening failures highlights the importance of eye care in this young population. [ABSTRACT FROM AUTHOR]

Background: Annually in England, over 1.5 million children and young people (CYP) are admitted to hospital. However, a proportion of these CYP will experience failure to rescue (FtR), a failure to recognize, respond and escalate clinical deterioration, which can result in significant harm or death. Aim: To identify and quantify FtR episodes from emergency events at a 110‐bedded tertiary children's hospital located within a University Teaching Hospital and evaluate the impact of targeted interventions on reducing FtR. Methods: A quality improvement approach was adopted. From 170 446 patients admitted between 2011 and 2019, all emergency event calls were systematically reviewed to identify FtR episodes. Root–cause analysis was performed to identify practice deficiencies. The Plan‐Do‐Study‐Act fundamentals were used. Results: A total of 520 emergency events were reviewed over the 9‐year period. One hundred and thirty‐two (n = 132; 25%) were cardiac arrest events, with the majority occurring within the PCCU setting. Three hundred and twelve (60%) of the events were in children who had been inpatient for more than 48 hours. FtR trend declined over the study period from 23.6% in 2011 when the project commenced to 2.5% or less over the following 8 years. Conclusions: Identifying rates of FtR events from routinely collected emergency events data can be used as a patient safety measure to identify emergency concerns. This enables dynamic problem solving through delivery of strategic and targeted interventions. The proposed interventions outlined in this quality improvement study have application to critical care nursing as mechanisms for reducing unplanned admissions to paediatric critical care unit (PCCU), patient mortality, and PCCU and non‐PCCU cardiac arrests. Relevance to Clinical Practice: This study emphasises the importance in understanding the antecedence of emergency events for paediatric inpatient populations. This intelligence can be used to direct targeted interventions to significantly reduce failure to rescue rates. [ABSTRACT FROM AUTHOR]

Introduction: In 2013, the United Kingdom began to roll‐out a universal annual influenza vaccination program for children. An important component of any new vaccination program is measuring its effectiveness. Live‐attenuated influenza vaccines (LAIVs) have since shown mixed results with vaccine effectiveness (VE) varying across seasons and countries elsewhere. This study aims to assess the effectiveness of influenza vaccination in children against severe disease during the first three seasons of the LAIV program in England. Methods: Using the screening method, LAIV vaccination coverage in children hospitalized with laboratory‐confirmed influenza infection was compared with vaccination coverage in 2–6‐year‐olds in the general population to estimate VE in 2013/14–2015/16. Results: The overall LAIV VE, adjusted for age group, week/month and geographical area, for all influenza types pooled over the three influenza seasons was 50.1% (95% confidence interval [CI] 31.2, 63.8). By age, there was evidence of protection against hospitalization from influenza vaccination in both the pre‐school (2–4‐year‐olds) (48.1%, 95% CI 27.2, 63.1) and school‐aged children (5–6‐year‐olds) (62.6%, 95% CI 2.6, 85.6) over the three seasons. Conclusion: LAIV vaccination in children provided moderate annual protection against laboratory‐confirmed influenza‐related hospitalization in England over the three influenza seasons. This study contributes further to the limited literature to date on influenza VE against severe disease in children. [ABSTRACT FROM AUTHOR]

Organisations funded by Sport England or UK Sport must work towards achieving standards for safeguarding and protecting children in sport as set by the National Society for the Prevention of Cruelty to Children's Child Protection in Sport Unit (CPSU) and encourage a culture of listening to children. The present research was commissioned by the NSPCC CPSU to understand the practices of UK sports clubs regarding this objective. An electronic questionnaire was distributed through the national governing bodies of sport working with the CPSU. Some 64 clubs/squads representing 6,000+ juniors (under 18 years) responded. Quantitative data were analysed using simple statistics and qualitative data were themed utilising Foucault's theory of power and following Braun and Clark's six‐phase guide. Discourse, hierarchical judgement and docility were considered with reference to formal management and cultural environments. Semantic and latent themes were explored. The themes identified were: expectation awareness, reframing voice and preserving discourse. Clubs recognise the value of listening to children. However, existing power relations valorise adult knowledge fields over the experiences of juniors. Technology could provide an effective solution as it is remote, potentially anonymous and culturally accessible. As power is a productive force, problematisation of organisational culture could centralise children's voices and limit/prevent abuse. [ABSTRACT FROM AUTHOR]

Objective: The study applies an adapted Family Stress Model (FSM) to analyze the relationship between child material deprivation and intra‐family conflict about money using a nationally representative survey of children in England in 2018. Background: The standard FSM holds that poverty is experienced by parents who, in turn, impact children. Drawing on new social studies of childhood, the authors posit that the model does not recognize children as social actors—with direct experiences of poverty—nor as social agents who co‐construct parent–child relationships in a context of poverty. Method: The authors use secondary survey data from Fair Shares and Families, which investigated children's and parents' experiences of, and involvement in, the sharing of family resources. The authors estimate linear structural equation models to test an adapted FSM, which includes separate pathways (for parents and children) from economic hardship to intra‐family conflict. Results: Both parent‐ and child‐reported economic pressure and psychological distress have significant direct and indirect associations with intra‐family conflict. The adapted model works the same way in lower and higher income households, as well as in lone parent and couple‐headed families. Conclusion: Children's experiences as social actors and influence as social agents are important in shaping parent–child relationships. This suggests that the standard FSM is limited in its insights about how economic hardship affects children and families and its policy applications for interventions to mitigate the impacts of child poverty. Research applying the FSM should seek to conceptualize children as active "child‐beings," rather than as passive "adult‐becomings." [ABSTRACT FROM AUTHOR]

Background: Higher risks of asthma have been observed in children with prenatal exposure to antibiotics and during early life compared with those who have not. However, the causality of such associations is unclear. Objective: To assess whether exposure to antibiotics in early life had a causal effect in increasing the risk of asthma in children diagnosed at 5–8 years of life, and the impact in the target population. Methods: Data were from electronic health records and questionnaires for children and their mothers in the Born in Bradford birth cohort. Exposure variables were prescriptions of systemic antibiotics to the mother during pregnancy (prenatal) and to the children at 0–24 months of life (postnatal). We assessed the association in 12,476 children with several approaches to deal with different sources of bias (triangulation): the interactions with mother's ethnicity, mode of delivery, and between prenatal and postnatal exposures; dose‐response; and estimated the population attributable risk. Results: There was an association between prenatal exposure at 7–27 days before the child's birth and asthma (adjusted OR = 1.40; 1.05, 1.87), but no association with the negative control exposure (before pregnancy) (adjusted OR = 0.99 (0.88, 1.12)). For postnatal exposure, the adjusted OR was 2.00 (1.71, 2.34), and for sibling analysis, it was 1.99 (1.00, 3.93). For postnatal exposure, the risk of asthma increased with the number of prescriptions. The observed effect of both exposures was lower among children with mothers of Pakistani ethnicity, but inconclusive (p >.25). The interaction between prenatal and postnatal exposures was also inconclusive (p =.287). The population attributable risk of postnatal exposure for asthma was 4.6% (0.1% for prenatal). Conclusions: We conclude that the associations between both late‐pregnancy prenatal exposure to antibiotics and postnatal exposure to antibiotics and an increased risk of asthma are plausible and consistent with a causal effect. [ABSTRACT FROM AUTHOR]

This essay explores the insidious but persistent desire to affix whiteness to modes of bondage and to argue for an original 'white slavery' located in early modern forms of traffic, indenture and forced transport. This essay aims to recover the genealogy of this belief, beginning with one of its conceptual origins: the practice of 'spiriting' in the seventeenth century. Reading accounts of 'spiriting', I firstly trace the narrative genealogies of English bondage to argue that consent emerges as a racialised rubric. Secondly, I think in particular about the representation of (very different kinds of) spirits in contemporary literary and cultural texts, including The Tempest, to suggest that even as they engage and anticipate the practice of 'spiriting', they also strategically elide their own histories of the traffic and transport of non‐white bodies. As one early modern understanding of 'spiriting' specifically comes to associate the practice with the capture and bondage of children, the nexus of slavery, race and children emerges as particularly fraught. If 'white slavery' denotes the limit case for the legibility of slavery, the photographs of 'white' enslaved children later circulated by white abolitionists in the nineteenth century to invoke sympathy for their cause played on the fundamental irreconcilability of 'whiteness' and bondage even as they re‐asserted the imbrication of slavery and sanguinity. This study attends to the trajectory of discourses of slavery written on and in the body to explore the histories of both a contemporary and an insistently current investment in frameworks of 'white slavery', as it attempts to discover the early modern frameworks for the legibility of race and slavery as they were co‐articulated 'before' the supposed 'emergence' of either. [ABSTRACT FROM AUTHOR]

Background: NHS case note data are a potential source of practice-based evidence which could be used to investigate the effectiveness of different interventions for individuals with a range of speech, language and communication needs. Consistency in pre- and post-intervention data as well as the collection of relevant variables would need to be demonstrated as a precursor to adopting this approach in future investigations of speech and language therapy intervention. Aims: To explore whether routine clinical data collection for children with speech sound disorder (SSD) could be a potential source for examining the effectiveness of intervention(s). Methods & Procedures:We examined case notes from three UK NHS services, reviewing 174 sets of case notes and 234 blocks of therapy provided for school-age children with SSD. Main contribution: We found there was significant variation in pre- and postintervention data and variables collected by the services. The assessment data available in the case notes across all sites were insufficient to be used to compare the effectiveness of different interventions. Specific issues included lack of consistent reporting of pre- and post-intervention data, and use of a variety of both formal and informal assessment tools. Conclusions & Implications: The case notes reviewed were from three sites and may not represent wider clinical practice, nevertheless the findings suggest the sample explored indicates the need for more consistent and contemporaneous collection of data for children with SSD to facilitate the investigation of different interventions in practice. Researchers should work with the clinical community to determine a minimal dataset that includes a core outcome set and potential variables. This should be feasible to collect in clinical practice and provide a dataset for future investigations of clinically relevant research questions. This would provide an invaluable resource to the clinical academic and research communities enabling research questions to be addressed that have the potential to lead to improved outcomes and more cost-effective services. [ABSTRACT FROM AUTHOR]

Across the world, children are forced to leave their homes for far‐flung destinations. This global phenomenon has particular impact in Europe, where there are now more child refugees than since World War II. Education plays an important role for children with extraordinary experiences seeking to build meaningful lives in their new context. This article offers a new theoretical approach to underpin reforms to educational policy and practice for refugees in schools in resettlement contexts in Europe. The new conceptual framing is grounded in empirical work in England and Sweden, and brings two theories together: 'participatory parity' (Fraser) and 'resumption of an ordinary life' (Kohli). Kohli's concepts of 'safety', 'belonging' and 'success' have resonance with practitioners from Sweden and England as they work to meet the needs of their new arrivals. Fraser's conceptual lenses of redistribution, recognition and representation highlight the barriers to achieving the right to inclusive education for refugee children in each context. The interdependence of both theories shapes a new framework. The theoretical understandings offered in this article have been developed with practitioners and add to the field by offering a robust moral and operational approach to shaping pedagogical principles for policymakers and educators working in resettlement communities. [ABSTRACT FROM AUTHOR]

Early help or early intervention is increasingly recommended for safeguarding children living with domestic violence, but little is known about what is effective. This article discusses findings from an evaluation of a pioneering early help service in North West England. This new service aimed to improve the safety and wellbeing of families (mothers and children) who were assessed as below the level of 'high risk' domestic violence and below the threshold for a child protection order. Between January 2014 and March 2015, families (473 mothers and 541 children) were identified within multiagency safeguarding hubs and referred to the early help service. The service that emerged was somewhat different to the service expected. This article discusses findings from qualitative data gathered from 39 participants (mothers, children and service providers) involved in the programme. Three main issues emerged as themes from the interviews: the benefits of having any service at all for children living with domestic violence who slip off the agendas of professionals working with child protection and high‐risk domestic violence; the importance of flexibility of key worker‐led service delivery; and the suitability of current group work and therapeutic models for meeting the varied needs of families affected by domestic violence. Key Practitioner Messages: Children, mothers and service providers reported both a perceived need for early help and a positive impact from domestic violence early help services on child health and emotional wellbeing.The ability of services to flex their delivery model in response to the needs of families is important for supporting engagement of, and fostering a sense of control for, families receiving support.Confidentiality, reliability, respect and trust are key factors in developing an effective key worker‐family relationship. 'Discusses findings from an evaluation of a pioneering early help service in North West England' [ABSTRACT FROM AUTHOR]

Infant facial features are typically perceived as "cute," provoking caretaking behaviours. Previous research has focused on adults' perceptions of baby cuteness, and examined how these perceptions are influenced by events of the adult reproductive lifespan, such as ovulation and menopause. However, globally, individuals of all ages, including pre‐pubertal children, provide notable proportions of infant care. In this study, we recruited participants in and around northern England, and tested 330 adults and 65 children aged 7–9 using a forced‐choice paradigm to assess preferences for infant facial cuteness in two stimulus sets and (as a control task) preferences for femininity in women's faces. We analysed the data with Hierarchical Bayesian Regression Models. The adults and children successfully identified infants who had been manipulated to appear cuter, although children's performance was poorer than adults' performance, and children reliably identified infant cuteness in only one of the two infant stimuli sets. Children chose the feminised over masculinised women's faces as more attractive, although again their performance was poorer than adults' performance. There was evidence for a female advantage in the tasks: girls performed better than boys when assessing the woman stimuli and one of the infant stimulus sets, and women performed better than men when assessing one of the infant stimulus sets. There was no evidence that cuteness judgements differed depending upon exposure to infants (children with siblings aged 0–2; adults with a baby caregiving role), or depending upon being just younger or older than the average age of menopause. Children and grandparents provide notable portions of infant caretaking globally, and cuteness perceptions could direct appropriate caregiving behaviour in these age groups, as well as in adults of reproductive age. [ABSTRACT FROM AUTHOR]

This article examines the limits to children giving research consent in everyday school contexts that emphasises their conformity to comply with adult expectations, and highlights children's competence and agency in navigating this conformity through different practices of dissent. It draws on research into children's agency, using a multimodal ethnography of Year 1 classrooms in two English primary schools. The article includes a reflexive methodological focus, exploring the extent to which I counter the schools' emphasis on conformity. This includes creating visuals for children to practice consent; positioning myself as the researcher in a non‐teacher role, as 'least adult' and the one who 'least knows'; and designing interview spaces markedly different from classrooms. The article examines how children navigate conforming discourses by finding different ways to dissent in the research. Firstly, children demonstrate a sophisticated awareness of the cultural norms of indicating refusals beyond saying the word 'No'. Secondly, children achieve unnoticeability, by which they absent themselves from the 'on‐task' classroom culture, and by extension the research process. Thirdly, they engage in playful dissent, demonstrating their political knowingness of the classroom social order. The article discusses the implications for educational research when the values of consent are in conflict with a schooling focused on conformity. This includes emphasising the limits of consent procedures, paying closer attention to how researchers recognise and respond ethically to children's multiple practices of dissent, and using research to disrupt problematic power structures in education settings that limit possibilities for children's consent. [ABSTRACT FROM AUTHOR]

Objectives: The FiCTION trial compared co‐primary outcomes (dental pain and/or infection) and secondary outcomes (child oral health‐related quality of life [COHRQOL], child dental anxiety, cost‐effectiveness, caries development/progression and acceptability) across three treatment strategies (Conventional with Prevention [C + P]; Biological with Prevention [B + P]; Prevention Alone [PA]) for managing caries in children in primary care. COHRQOL and child dental anxiety experiences are reported upon here. Methods: A multi‐centre, 3‐arm, parallel‐group, unblinded patient‐randomized controlled trial of 3‐ to 7‐year‐olds treated under NHS contracts was conducted in 72 general dental practices in England, Wales and Scotland. Child participants (with at least one primary molar with dentinal caries) were randomized (1:1:1) to one of three treatment arms with the intention of being managed according to allocated arm for 3 years (minimum 23 months). Randomization was via a centrally administered system using random permuted blocks of variable length. At baseline and final visit, accompanying parents/caregivers completed a parental questionnaire including COHRQOL (16 item P‐CPQ‐16), and at every visit, child‐ and parental‐questionnaire‐based data were collected for child‐based dental trait and state anxiety. Statistical analyses were conducted on complete cases from the modified intention‐to‐treat (mITT) analysis set. Results: A total of 1144 children were randomized (C + P: 386; B + P: 381; PA: 377). The mITT analysis set included the 1058 children who attended at least one study visit (C + P: 352; B + P: 352; PA: 354). Median follow‐up was 33.8 months (IQR: 23.8, 36.7). The P‐CPQ‐16 overall score could be calculated after simple imputation at both baseline and final visit for 560 children (C + P: 189; B + P: 189; PA: 182). There was no evidence of a difference in the estimated adjusted mean P‐CPQ‐16 at the final visit which was, on average, 0.3 points higher (97.5% CI: −1.1 to 1.6) in B + P than C + P and 0.2 points higher, on average, (97.5% CI: −1.2 to 1.5) in PA than for C + P. Child dental trait anxiety and child dental state anxiety, measured at every treatment visit, showed no evidence of any statistically or clinically significant difference between arms in adjusted mean scores averaged over all follow‐up visits. Conclusions: The differences noted in COHRQOL and child‐based dental trait and dental state anxiety measures across three treatment strategies for managing dental caries in primary teeth were small, and not considered to be clinically meaningful. The findings highlight the importance of including all three strategies in a clinician's armamentarium, to manage childhood caries throughout the young child's life and achieve positive experiences of dental care. [ABSTRACT FROM AUTHOR]

We seek to explain the development of the educational gap between children in "out‐of‐home care" (CLA), children deemed in social need (CIN), and other pupils. A cohort of 642,805 pupils aged 16 in 2013 was used to chart the educational progress of the full cohort, the CLA (n = 6,236), the CIN in 2012 or 2013 but not CLA (n = 20,384), and a sample individually matched with the CLA (n = 11,084). At age 7, attainment of the CLA and CIN was approximately 1 standard deviation lower than the cohort average and predicted attainment at 16. At this point, the persistent "CIN" (those with earlier and persistent needs) had the lowest attainment relative to others, and this declined further during secondary school. Those entering care before or during primary school had very low attainment at age 7, but their relative attainment did not decline. Attainment of CLA and CIN at age 16 likely reflects early environment, special educational needs, and poor relationships with secondary school. Policy, research, and intervention should focus on CIN as well as CLA, do so before entry to care, and take account of the onset of, and probable reasons for, educational difficulties. [ABSTRACT FROM AUTHOR]

Background: PTSD in youth may lead to long‐lasting psychological implications, educational difficulties and increased healthcare costs. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost‐effectiveness of a range of psychological interventions for children and young people with PTSD. Methods: A decision‐analytic model was constructed to compare costs and quality‐adjusted life years (QALYs) of 10 psychological interventions and no treatment for children and young people with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta‐analysis. Other model input parameters were based on published sources, supplemented by expert opinion. Results: Cognitive therapy for PTSD, a form of individual trauma‐focused cognitive behavioural therapy (TF‐CBT), appeared to be the most cost‐effective intervention for children and young people with PTSD (with a probability of.78 amongst the 11 evaluated options at a cost‐effectiveness threshold of £20,000/QALY), followed by narrative exposure (another form of individual TF‐CBT), play therapy, and other forms of individual TF‐CBT. After excluding cognitive therapy from the analysis, narrative exposure appeared to be the most cost‐effective option with a.40 probability of being cost‐effective amongst the remaining 10 options. EMDR, parent training and group TF‐CBT occupied middle cost‐effectiveness rankings. Family therapy and supportive counselling were less cost‐effective than other active interventions. There was limited evidence for some interventions, in particular cognitive therapy for PTSD and parent training. Conclusions: Individual forms of TF‐CBT and, to a lesser degree, play therapy appear to be cost‐effective in the treatment of children and young people with PTSD. Family therapy and supportive counselling are unlikely to be cost‐effective relative to other interventions. There is a need for well‐conducted studies that examine the long‐term clinical and cost‐effectiveness of a range of psychological treatments for children and young people with PTSD. [ABSTRACT FROM AUTHOR]

Child mental health is a growing concern for policymakers across the global north. Schools have become a key site for mental health interventions, with new programmes aimed at promoting 'resilience', through which children may maintain or regain mental health during adversity. As one of the first studies to explore the early impact of intensive mental health promotion in schools from children's perspectives, we adopt a governmentality approach to consider the logic and techniques of such programmes with a specific focus on England. An innovative visual methodology was used to focus on student perspectives of mental health interventions in school. Young peoples' photo representations of mental health were collected and used to stimulate focus group discussions with 65 students aged 12–14, across seven schools. 'Resilience' was seen to be the key organising concept for mental health interventions in schools. The concept was viewed as narrowly focused on attitude towards—and performance in—school work, with individuals being encouraged to 'push on through' difficulties to achieve success. Young people were critical of this approach, suggesting several alternatives. These included increased access to independent mental health professionals, safe spaces within schools and mental health education that addressed the social and affective dimensions of mental health difficulties. [ABSTRACT FROM AUTHOR]

Objective: Young people and parents want to be more active in treatment decisions. Using the Theoretical Domains Framework (TDF), which segments behaviour change into barriers and facilitators across fourteen domains, the aim of this study is to explore the barriers and facilitators to shared decision‐making (SDM) from young people and their parents' perspectives. Method: The sample comprised nine young people who presented with internalising difficulties and ten parents of young people with internalising difficulties across two sites in England. Interviews were conducted, and transcripts were analysed using a deductive thematic analysis. Results: Overall, 15 barriers to and facilitators for SDM in child and youth mental health were identified. Under capability, these included an awareness of SDM, forgetting discussions or not asking questions, clinician listening skills and communication skills. For opportunity, these included the availability of treatment options, availability of understandable resources, staff shortages, the environment being conducive to SDM, and if the school, or parents of young people, facilitated decisions. For motivation, these included whether SDM was thought to empower individuals, result in better treatment, or individuals making the 'wrong' decision, as well as whether individuals felt capable to be involved in treatment decision‐making, whether young people lacked capacity, and whether they could make decisions due to enhanced emotional states. Conclusions: Barriers and facilitators across capability, opportunity and motivation were identified. Interventions which target these barriers and facilitators may facilitate young people and their parents' involvement in decision‐making. [ABSTRACT FROM AUTHOR]

Background: Many young people are involved in caring for parents, siblings, or other relatives who have an illness or disability. The aim of this study was to estimate the prevalence of caring by young people in England. Method: A national survey of 925 English young people was conducted using the 18‐item survey version of the Multidimensional Assessment of Caring Activities Checklist for Young Carers. Results: Around 7% of young people were identified as doing at least a high amount of caring activity and 3% a very high amount. Most frequently, caring by a young person is for a mother or a sibling, with a physical disability. Caring activity consisted mostly of domestic activities, household management, and emotional care. Conclusion: This study provides the most up to date and methodologically sophisticated survey data on the prevalence of young caring in England, with implications for policy and practice. [ABSTRACT FROM AUTHOR]

Summary This study examined whether the implementation of Section 28 of the Youth Justice and Criminal Evidence Act (1999) improved lawyers' questioning strategies when examining child witnesses in England. The government's Section 28 pilot study involved judges holding Ground Rules Hearings, during which restrictions and limitations were placed on the duration, content, and manner of questions to be asked. Afterwards, children's cross‐examinations were pre‐recorded and later played as part of their evidence at trial. The current study compared cases involving 6‐ to 15‐year‐old alleged victims of sexual abuse in which Section 28 was (n = 43) and was not (n = 44) implemented. Defence lawyers in Section 28 cases asked significantly fewer suggestive questions and more option‐posing questions than defence lawyers in Nonsection 28 cases. Younger children complied more with defence lawyers' suggestive questions. Ground Rules Hearings improved lawyers' questioning strategies, regardless of the case's involvement in the Section 28 pilot study. [ABSTRACT FROM AUTHOR]

Background: Diagnosis of attention deficit hyperactivity disorder (ADHD) relies on subjective methods which can lead to diagnostic uncertainty and delay. This trial evaluated the impact of providing a computerised test of attention and activity (QbTest) report on the speed and accuracy of diagnostic decision‐making in children with suspected ADHD. Methods: Randomised, parallel, single‐blind controlled trial in mental health and community paediatric clinics in England. Participants were 6–17 years‐old and referred for ADHD diagnostic assessment; all underwent assessment‐as‐usual, plus QbTest. Participants and their clinician were randomised to either receive the QbTest report immediately (QbOpen group) or the report was withheld (QbBlind group). The primary outcome was number of consultations until a diagnostic decision confirming/excluding ADHD within 6‐months from baseline. Health economic cost‐effectiveness and cost utility analysis was conducted. Assessing QbTest Utility in ADHD: A Randomised Controlled Trial was registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT02209116). Results: One hundred and thirty‐two participants were randomised to QbOpen group (123 analysed) and 135 to QbBlind group (127 analysed). Clinicians with access to the QbTest report (QbOpen) were more likely to reach a diagnostic decision about ADHD (hazard ratio 1.44, 95% CI 1.04–2.01). At 6‐months, 76% of those with a QbTest report had received a diagnostic decision, compared with 50% without. QbTest reduced appointment length by 15% (time ratio 0.85, 95% CI 0.77–0.93), increased clinicians' confidence in their diagnostic decisions (odds ratio 1.77, 95% CI 1.09–2.89) and doubled the likelihood of excluding ADHD. There was no difference in diagnostic accuracy. Health economic analysis showed a position of strict dominance; however, cost savings were small suggesting that the impact of providing the QbTest report within this trial can best be viewed as 'cost neutral'. Conclusions: QbTest may increase the efficiency of ADHD assessment pathway allowing greater patient throughput with clinicians reaching diagnostic decisions faster without compromising diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Little is known about whether and how children combine categories of race, ethnicity, language and religion in multicultural settings where more than one of these dimensions is salient. Ethnographic data from a multicultural London primary school found that children usually organised multiple categories congruently (e.g. 'If you're Indian you are Sikh'), despite strong opposition from teachers. This congruent organisation may originate in an undifferentiated experience of categories in the family and/or represent the best 'fit' with a local population in which categories were correlated. Children used congruent organisation to infer peers' group membership, which may amplify intergroup contrasts. [ABSTRACT FROM AUTHOR]

Objective: To test the impact of obesity on health and health care use in children, by the use of various methods to account for reverse causality and omitted variables.Data Sources/study Setting: Fifteen rounds of the Health Survey for England (1998-2013), which is representative of children and adolescents in England.Study Design: We use three methods to account for reverse causality and omitted variables in the relationship between BMI and health/health service use: regression with individual, parent, and household control variables; sibling fixed effects; and instrumental variables based on genetic variation in weight.Data Collection/extraction Methods: We include all children and adolescents aged 4-18 years old.Principal Findings: We find that obesity has a statistically significant and negative impact on self-rated health and a positive impact on health service use in girls, boys, younger children (aged 4-12), and adolescents (aged 13-18). The findings are comparable in each model in both boys and girls.Conclusions: Using econometric methods, we have mitigated several confounding factors affecting the impact of obesity in childhood on health and health service use. Our findings suggest that obesity has severe consequences for health and health service use even among children. [ABSTRACT FROM AUTHOR]

In 2002 a UK Government initiative enabled the fostering of links between UK school children and school children in Low and Middle Income Countries through the shared Just Like You project about health and rights. This manuscript reports English children's perspectives on the lives of their peers in Kenya, whose school link began in 2007. Data were gathered and analysed in 2014 via six focus groups with 132 children. The result was a constructed grounded theory of respectful reflection that represents a basic social process. Respectful reflection comprises three categories; being similar, living differently and finding the strengths. [ABSTRACT FROM AUTHOR]

Dietary intake during pregnancy may influence child neurodevelopment and cognitive function. This study aims to investigate the associations between dietary patterns obtained in pregnancy and intelligence quotients (IQ) among offspring at 8 years of age. Pregnant women enrolled in the Avon Longitudinal Study of Parents and Children completed a food frequency questionnaire at 32 weeks' gestation ( n = 12,195). Dietary patterns were obtained by cluster analysis. Three clusters best described women's diets during pregnancy: 'fruit and vegetables,' 'meat and potatoes,' and 'white bread and coffee.' The offspring's IQ at 8 years of age was assessed using the Wechsler Intelligence Scale for Children. Models, using variables correlated to IQ data, were performed to impute missing values. Linear regression models were employed to investigate associations between the maternal clusters and IQ in childhood. Children of women who were classified in the meat and potatoes cluster and white bread and coffee cluster during pregnancy had lower average verbal (β = −1.74; p < .001 and β = −3.05; p < .001), performance (β = −1.26; p = .011 and β = −1.75; p < .001), and full-scale IQ (β = −1.74; p < .001 and β = −2.79; p < .001) at 8 years of age when compared to children of mothers in the fruit and vegetables cluster in imputed models of IQ and all confounders, after adjustment for a wide range of known confounders including maternal education. The pregnant women who were classified in the fruit and vegetables cluster had offspring with higher average IQ compared with offspring of mothers in the meat and potatoes cluster and white bread and coffee cluster. [ABSTRACT FROM AUTHOR]

Purpose Most studies of growing up with a long-term condition focus on older children and adolescents and are condition-specific. Relatively few studies address the experiences of children in middle childhood or consider their experience across a range of conditions, countries, and health settings. This study aimed to explore children's perceptions and understandings of how their lives are shaped (or not) by a long-term condition and its associated management. Design and methods A qualitative, participatory methodology using autodriven photoelicitation interviews (PEIs) with 45 purposively recruited children (6-12 years) with long-term conditions (e.g., hemophilia, arthritis, Crohn's disease), from England, New Zealand, and Australia was utilized. PEI facilitated the construction of inductively derived understandings of the children's experiences as the children had control over creating and then selecting which photographs to discuss with the researcher. Results Interpretive thematic analysis of the interviews and content analysis of the photographs resulted in an overarching theme, 'It's not who I am ...' but it is part of me, and three subthemes: getting on with my life; the special value of family, friendship, support, and comfort; and things that get in the way of getting on. Across all ages and the three countries, the children actively projected their self-concept as 'well' children and they strove, through their photographs and their accompanying explanations of their lives, to emphasize that they were 'normal' children. They were active social agents who demonstrated their capacity to shape parts of their lives interdependently with their parents and the requirements of their condition. Practice implications Pediatric nurses should be aware of the importance that children with long-term conditions place on projecting and protecting their sense of being normal and ensure that when they engage with children that they take account of the children's understandings and efforts to live a life constrained but not limited by the condition. [ABSTRACT FROM AUTHOR]

Background Universal infant free school meals ( UIFSM) were introduced in September 2014 and are available to all key stage 1 (4-7 years) children attending state-maintained infant and primary schools in England. The present study aimed to investigate the school-based factors, child and family socio-demographic characteristics, and parental beliefs associated with UIFSM take up in an urban community. Methods A cross-sectional questionnaire survey was completed in October to November 2015, amongst parents whose children attended eligible schools in Leicester, England. A questionnaire about school meals was also completed by each school. Results Parents reported their child did not take (non- UIFSM, n = 159) or took ( UIFSM, n = 517) a UIFSM on most days. The non- UIFSM group were more likely to be White-British, have a higher socio-economic status, have English as a first language, and involve their child in the decision over whether or not to take UIFSM, compared to the UIFSM group. Cluster analysis revealed that non- UIFSM parents were either concerned over quality of meals and what/how much their child ate, concerned only by what/how much their child ate or whether their child did not like the food provided. Two subsets of parents in the UIFSM group were either very positive about UIFSM or appeared to take meals because they were free. Schools used a variety of measures to increase and maintain UIFSM take up. Conclusions Parents like to have control over what their child eats at school and children need to enjoy their school meals. Using a range of interventions to target subsets of parents may help local authorities, schools and caterers to increase UIFSM take up. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background An exploration of children and young people's views on a proposed web-based application to support personal management of chronic kidney disease at home is important for developing resources that meet their needs and preferences. Methods As part of a wider study to develop and evaluate a web-based information and support application for parents managing their child's chronic kidney disease, qualitative interviews were conducted with 26 children and young people aged 5-17 years. Interviews explored their views on content of a proposed child and young person-appropriate application to support personal management of their condition. Data were analysed by using framework technique and self-efficacy theory. Results One overarching theme of Access and three subthemes (information, accessibility and normalization) were identified. Information needed to be clear and accurate, age appropriate and secure. Access to Wi-Fi was essential to utilize information and retain contact with peers. For some, it was important to feel 'normal' and so they would choose not to access any care information when outside of the hospital as this reduced their ability to feel normal. Conclusion Developing a web-based application that meets children and young peoples' information and support needs will maximize its utility and enhance the effectiveness of home-based clinical caregiving, therefore contributing to improved outcomes for patients. [ABSTRACT FROM AUTHOR]

Background While practitioners are increasingly asked to be mindful of the evidence base of intervention programmes, evidence from rigorous trials for the effectiveness of interventions that promote oral language abilities in the early years is sparse. Aims To evaluate the effectiveness of a language intervention programme for children identified as having poor oral language skills in preschool classes. Methods & Procedures A randomized controlled trial was carried out in 13 UK nursery schools. In each nursery, eight children ( N = 104, mean age = 3 years 11 months) with the poorest performance on standardized language measures were selected to take part. All but one child were randomly allocated to either an intervention ( N = 52) or a waiting control group ( N = 51). The intervention group received a 15-week oral language programme in addition to their standard nursery curriculum. The programme was delivered by trained teaching assistants and aimed to foster vocabulary knowledge, narrative and listening skills. Outcomes & Results Initial results revealed significant differences between the intervention and control group on measures of taught vocabulary. No group differences were found on any standardized language measure; however, there were gains of moderate effect size in listening comprehension. Conclusions & Implications The study suggests that an intervention, of moderate duration and intensity, for small groups of preschool children successfully builds vocabulary knowledge, but does not generalize to non-taught areas of language. The findings strike a note of caution about implementing language interventions of moderate duration in preschool settings. The findings also highlight the importance of including a control group in intervention studies. [ABSTRACT FROM AUTHOR]

This study is set in the North of England in the context of debates around the integration of communities, after a series of street disturbances in the early 2000s. The debates centred upon ‘social cohesion’ and the social mixing of Pakistani British and White British communities. The current study explores this from the context of 10‐ to 11‐year‐old Asian, Black and White British boys participating in cricket and football clubs. It draws on the sociology of childhood approach that sees children as active participants and co‐creators of their own lives. This more nuanced approach sheds important light on children's own negotiations of home, peers, sports clubs and identities that are key to how cohesion is achieved. [ABSTRACT FROM AUTHOR]

Since United Nations Convention on the Rights of the Child, social research has encouraged the involvement of children in research concerning them. However, there is little evidence to demonstrate how autistic children can be involved. Little is known about which methods are appropriate to research the social worlds of autistic children: adult‐centred or child‐centred methods? Empirical research with autistic children is used to illustrate the contribution that methods which involve children, and methods that do not, can make to the understanding of autistic children's social worlds. I argue while autistic children's participation contributed towards greater understanding, the understanding was enriched for having parents and teachers participate too. [ABSTRACT FROM AUTHOR]

Accessible summary The provision of care and support for people with learning disabilities and behaviour that challenges in England is mixed., Children and young people with learning disabilities and behaviour that challenges are likely to live within the community, while adults will be in residential care., Overall, supporting people with learning disabilities and behaviour that challenges within the community is likely to be less expensive than supporting them in residential care., Abstract Background: We describe current care arrangements in England for children, young people and adults with learning disabilities and behaviour that challenges, and estimate their comparative costs. Materials and Methods: A two-round Delphi exercise was performed in March and April 2014, followed by a costing exercise. Results: The study finds a mixed picture: participants reported that 60-87% of children, 66-88% of young people and 34-47% of adults were likely to be living within the community. Annual cost of care would range between £39 612 and £74 876 for children, between £35 235 and £52 832 for young people and between £81 478 and £94 799 for adults. Conclusion: While residential-based care may continue to be necessary for respite or for individuals with particular needs, community-based care may be an economically attractive alternative, supporting the inclusion of people with learning disabilities and behaviour that challenges within their communities, potentially at a lower cost. [ABSTRACT FROM AUTHOR]