Edward Melhuish

Effects of fully-established Sure Start Local Programmes on 3-year-old children and their families living in England: a quasi-experimental observational study

BACKGROUND Sure Start Local Programmes (SSLPs) are area-based interventions to improve services for young children and their families in deprived communities, promote health and development, and reduce inequalities. We therefore investigated whether SSLPs affect the wellbeing of 3-year-old children and their families. METHODS In a quasi-experimental observational study, we compared 5883 3-year-old children and their families from 93 disadvantaged SSLP areas with 1879 3-year-old children and their families from 72 similarly deprived areas in England who took part in the Millennium Cohort Study. We studied 14 outcomes-childrens immunisations, accidents, language development, positive and negative social behaviours, and independence; parenting risk; home-learning environment; fathers involvement; maternal smoking, body-mass index, and life satisfaction; familys service use; and mothers rating of area. FINDINGS After we controlled for background factors, we noted beneficial effects associated with the programmes for five of 14 outcomes. Children in the SSLP areas showed better social development than those in the non-SSLP areas, with more positive social behaviour (mean difference 0.45, 95% CI 0.09 to 0.80, p=0.01) and greater independence (0.32, 0.18 to 0.47, p<0.0001). Families in SSLP areas showed less negative parenting (-0.90, -1.11 to -0.69, p<0.0001) and provided a better home-learning environment (1.30, 0.75 to 1.86, p<0.0001). These families used more services for supporting child and family development than those not living in SSLP areas (0.98, 0.86 to 1.09, p<0.0001). Effects of SSLPs seemed to apply to all subpopulations and SSLP areas. INTERPRETATION Children and their families benefited from living in SSLP areas. The contrast between these and previous findings on the effect of SSLPs might indicate increased exposure to programmes that have become more effective. Early interventions can improve the life chances of young children living in deprived areas.

Preschool Influences on Mathematics Achievement

The advantages of home learning environment and preschool are apparent years later in childrens math achievement.

Towards the transformation of practice in early childhood education: the effective provision of pre‐school education (EPPE) project

The introduction of the Foundation Stage and its associated legislation has constituted a radical innovation that is transforming early childhood education. In this paper we show how the Effective Provision of Pre‐school Education (EPPE) research programme continues to contribute towards achieving these improvements in practice. In focusing upon the EPPE programmes influence upon pedagogic practice in particular, the paper draws predominantly upon the research findings and recommendations associated with our qualitative case studies. This work was first published in the Researching Effective Pedagogy in the Early Years (REPEY) report in 2002, and in the EPPE Technical Paper 10 in 2003. Practitioners respond positively to research when it is focused on specific teaching and learning contexts and practices. The EPPE project therefore applied Environment Rating Scales to identify the quality of educational provision, and used multilevel analysis to isolate the independent variables of most significance in explaining variations in the progress and development of young children during their time in pre‐school. The multi‐level analysis identified ‘good’ and ‘excellent’ centres, based on measurable child outcomes. Twelve of these centres were selected for in‐depth qualitative case study enquiries that both extended and triangulated the quantitative analysis. This paper shows how the qualitative findings, as well as some of the data that they have been drawn from, have subsequently been applied to provide the practical guidance and exemplar resources needed in the development and improvement of early years educational practice.The Effective Provision of Pre-School Education (EPPE) project is the first major European longitudinal study of a national sample of young children’s development between the ages of 3 and 7 years. To investigate the effects of pre-school education, the EPPE team collected a wide range of information on 3,000 children. The study also looks at background characteristics related to parents, the child’s home environment and the pre-school settings children attended. Settings (141) were drawn from a range of providers (local authority day nurseries, integrated1 centres, playgroups, private day nurseries, nursery schools and nursery classes). A sample of ‘home’ children (who had no or minimal pre-school experience) were recruited to the study at entry to school for comparison with the pre-school group. In addition to investigating the effects of pre-school provision, EPPE explored the characteristics of effective practice (and the pedagogy which underpins it) through twelve intensive case studies of settings where children had positive outcomes. EPPE has demonstrated the beneficial effects of high quality provision on children’s intellectual and social/behavioural development measured at primary school entry as well as at the end of Years l and 2 of primary school. This research brief describes the effects of education in the pre-school period (ages 3 and 4) as measured at primary school entry (rising 5) and in Years 1 and 2 (ages 6 and 7). The brief summarises the empirical work published in eleven Technical Papers (www.ioe.ac.uk/projects/eppe). Those interested in statistical methods or detailed findings should consult the Technical Papers.

The health and development of children born to older mothers in the United Kingdom: observational study using longitudinal cohort data

Objective To assess relations between children’s health and development and maternal age. Design Observational study of longitudinal cohorts. Setting Millennium Cohort Study (a random sample of UK children) and the National Evaluation of Sure Start study (a random sample of children in deprived areas in England), 2001 to 2007. Participants 31 257 children at age 9 months, 24 781 children at age 3 years, and 22 504 at age 5 years. Main outcome measures Childhood unintentional injuries and hospital admissions (aged 9 months, 3 years, and 5 years), immunisations (aged 9 months and 3 years), body mass index, language development, and difficulties with social development (aged 3 and 5 years). Results Associations were independent of personal and family characteristics and parity. The risk of children having unintentional injuries requiring medical attention or being admitted to hospital both declined with increasing maternal age. For example, at three years the risk of unintentional injuries declined from 36.6% for mothers aged 20 to 28.6% for mothers aged 40 and hospital admissions declined, respectively, from 27.1% to 21.6%. Immunisation rates at nine months increased with maternal age from 94.6% for mothers aged 20 to 98.1% for mothers aged 40. At three years, immunisation rates reached a maximum, at 81.3% for mothers aged 27, being lower for younger and older mothers. This was linked to rates for the combined measles, mumps, and rubella immunisation because excluding these resulted in no significant relation with maternal age. An increase in overweight children at ages 3 and 5 years associated with increasing maternal age was eliminated once maternal body mass index was included as a covariate. Language development was associated with improvements with increasing maternal age, with scores for children of mothers aged 20 being lower than those of children of mothers aged 40 by 0.21 to 0.22 standard deviations at ages 3 and 4 years. There were fewer social and emotional difficulties associated with increasing maternal age. Children of teenage mothers had more difficulties than children of mothers aged 40 (difference 0.28 SD at age 3 and 0.16 SD at age 5). Conclusion Increasing maternal age was associated with improved health and development for children up to 5 years of age.

Pre-school quality and educational outcomes at age 11: Low quality has little benefit

This article reports the effects of pre-school quality on children’s cognitive and behavioural outcomes at age 11 using a large-scale longitudinal study of 3000+ children in England (EPPE/EPPSE). The ECERS-R and a curricular extension to it (ECERS-E) were used to assess the quality of provision in 141 pre-school settings attended by the children. The quality measures were derived from observations throughout the day of interactions and resources related to Literacy, Numeracy and Science learning, as well as observational/ interview data related to how each centre catered to diverse needs of children. Multi-level modelling was used to investigate the effects of pre-school quality on children’s academic and social-behavioural outcomes at age 11. Pre-school quality significantly predicted most outcomes, after taking account of key child and family factors. More importantly, children who attended low quality pre-schools had cognitive and behavioural scores that were not significantly different from those of children with no pre-school experience.The methods and findings of this large-scale study are considered in terms of the strengths and limitations of ‘educational effectiveness’ designs. It is suggested that mixed methods designs can address many of the limitations.

Investigating the Effects of Pre-School Provision: Using Mixed Methods in the EPPE Research

The Effective Provision of Pre‐school Education (EPPE) project is a longitudinal study of young children between the ages of 3 and 7 years. Research began in 1997 and both quantitative and qualitative methods were used to explore the effects of pre‐school education on children’s attainment and social/behavioural development at entry to school, and of any continuing effects on such outcomes at the end of Key Stage 1 (age 7). The sample included over 3,000 children and 141 pre‐school centres drawn from six different types of providers. In addition, a home sample of children who had not attended a pre‐school centre was included. In order to identify the processes that might influence centre effectiveness, observational data were collected and centre managers interviewed. In‐depth case studies of 12 more effective centres were used to explore and illuminate the processes, particularly in relation to pedagogy, associated with better child outcomes. A mixed method approach was adopted to simultaneously answer both confirmatory and exploratory questions, to support user engagement and provide triangulation. The paper argues that the mixed method approach supported the development of stronger research inferences.

Maternal Prepregnancy BMI and Child Cognition: A Longitudinal Cohort Study

OBJECTIVE: To examine the association between maternal prepregnancy BMI and cognitive performance in children at 5 and 7 years of age. METHODS: This is a secondary analysis of data from the Millennium Cohort Study, a prospective population based cohort of 19 517 children in the United Kingdom. Standardized cognitive assessments of children, involving components of the British Ability Scales, second edition and a number skills test, were performed at 5 and 7 years of age. Principal components analysis was used to identify a general cognitive ability factor (g) from individual test scores. Maternal prepregnancy BMI was retrospectively self-reported when children were 9 months old. Mixed-effects linear regression models were fitted, controlling for multiple socio-demographic factors, child’s birth weight, child’s BMI, maternal smoking, and maternal diabetes. Complete data were available for 11 025 children at 5 years, and 9882 children at 7 years. RESULTS: Maternal prepregnancy BMI was negatively associated with children’s cognitive performance (g) at age 5 (P = .0069) and age 7 (P < .0001). The overall effect size was modest: a 10-point increase in maternal BMI was associated with a decrease in cognitive performance of ∼1/10th of an SD at age 7. CONCLUSIONS: Maternal prepregnancy BMI is negatively associated with children’s cognitive performance, even after adjusting for multiple socio-demographic confounders and children’s BMI. The relationship appears to become stronger as children get older, although the overall effect size is modest. In utero fetal programming or residual confounding may explain these findings.

The quest for quality in early day care and preschool experience continues

In research in the areas of day care for young children and preschool education at the end of the second millennium, common themes can be recognised. Early research was primarily concerned with whether children attending institutions (day care or preschool centre), developed differently from those not attending such centres. Later work recognised that day care or preschool experience is not unitary and that the quality or characteristic of experience matters. Yet further research drew attention to the importance of the interaction between home and out of home experience. These have been referred to as the three waves of research. In the 1980s, the proposition emerged that infant day care may be a risk factor for insecure attachment to the mother. In an ideologically and politically sensitive ” eld, the concern raised by this proposition that day care might be bad for infants, led to the funding of one of the largest studies of day care, the NICHD study. The results of this study so far indicate that quality of care is an important aspect of child care experience. This study is likely to be a watershed in that the sample size and detail of data are far greater than preceding studies. The conclusion that quality of experience for young children matters however, sets the agenda for research in the new millennium. Currently, approaches to this issue generally adopt the strategy of using a measure of child care quality and investigating associations with child development outcomes. An alternative approach derives from school effectiveness research. Children from specific centres are followed longitudinally. Their developmental progress is then considered in terms of family factors, type amount and quality of centre experience, and the specific centre attended. In this approach the presence of specific centre effects can be detected so that a specific centre can be identi” ed as associated with a quantifiable positive or negative effect on development. The resulting incongruence between traditional measures of quality and measures derived from developmental effects will require a reformulation of the links between child care characteristics, child experience, and developmental outcomes. As measures of quality become more ”rmly related to developmental outcomes child care research can become more integrated within developmental psychology.

Neonatal Abstinence Syndrome and High School Performance

BACKGROUND AND OBJECTIVES: Little is known of the long-term, including school, outcomes of children diagnosed with Neonatal abstinence syndrome (NAS) (International Statistical Classification of Disease and Related Problems [10th Edition], Australian Modification, P96.1). METHODS: Linked analysis of health and curriculum-based test data for all children born in the state of New South Wales (NSW), Australia, between 2000 and 2006. Children with NAS (n = 2234) were compared with a control group matched for gestation, socioeconomic status, and gender (n = 4330, control) and with other NSW children (n = 598 265, population) for results on the National Assessment Program: Literacy and Numeracy, in grades 3, 5, and 7. RESULTS: Mean test scores (range 0–1000) for children with NAS were significantly lower in grade 3 (359 vs control: 410 vs population: 421). The deficit was progressive. By grade 7, children with NAS scored lower than other children in grade 5. The risk of not meeting minimum standards was independently associated with NAS (adjusted odds ratio [aOR], 2.5; 95% confidence interval [CI], 2.2–2.7), indigenous status (aOR, 2.2; 95% CI, 2.2–2.3), male gender (aOR, 1.3; 95% CI, 1.3–1.4), and low parental education (aOR, 1.5; 95% CI, 1.1–1.6), with all Ps < .001. CONCLUSIONS: A neonatal diagnostic code of NAS is strongly associated with poor and deteriorating school performance. Parental education may decrease the risk of failure. Children with NAS and their families must be identified early and provided with support to minimize the consequences of poor educational outcomes.

The influence of child, family, home factors and pre-school education on the identification of special educational needs at age 10

The early identification of young children’s special educational needs (SEN), as well as the development of specific strategies to support those children identified with special needs, are increasingly recognised as crucial to facilitating good adjustment to school and to ensuring that such children are helped to reach their full potential in education. Using a large national sample of young children in England whose developmental progress was followed up from pre‐school, this study investigates which child, family, home and pre‐school factors can be viewed as risk or protective factors for later SEN‐status at age 10. The experience of high‐quality pre‐school education is shown to reduce the likelihood of a child being identified as experiencing SEN in the long run. Teachers’ assessments of SEN are found to be strongly related to children’s reading and mathematics attainment, but other factors also predict SEN, including a child’s age within a year group.