Janet Boddy

The Developmental Sequelae of Nonorganic Failure to Thrive

The developmental sequelae of infant failure to thrive (FTT) were examined in an unreferred group of 6-year-olds with a history of severe nonorganic growth retardation, sampled from a 1-year birth cohort in an inner-city area of South London. Children who failed to thrive in infancy (weight below the third centile for at least 3 months) and their pairwise matched comparisons were originally studied at 15 months, and 42 cases and 42 controls (89.5% of the sample) were followed up. At 6 years, previously growth-retarded children were considerably smaller than matched comparisons, in terms of body mass index (BMI), and height and weight for age Z scores. History of FTT explained substantial variance in weight and BMI at 6 years, with maternal height also contributing to variation in height for age. Child cognitive functioning at 6 years was examined using the McCarthy Scales: cases had more limited quantitative and memory skills than comparisons, but there was no intergroup variation in general cognitive performance. In contrast to analyses of physical development, failure to thrive did not account for cognitive functioning; maternal IQ was the sole significant predictor of performance on all indices of child cognitive abilities. At 15 months, earlier growth faltering was linked to limitations in mental development, but these findings were not confirmed by the follow-up data: the timing of FTT was not related to cognitive abilities at 6 years. Results correspond to past research indicating that nonorganic failure to thrive is associated with persistent limitations in physical stature. There was little evidence of cognitive disadvantage for case group children at school age, suggesting that the adverse effects of early malnutrition on cognitive functioning appear to diminish over time.

Understandings of efficacy: cross-national perspectives on 'what works' in supporting parents and families

The research literature on parenting support typically focuses on English-speaking countries, such as England, the United States and Australia. This article draws on a review, commissioned by the English government, which examined policies and services to support parenting in five European countries: Denmark, France, Germany, Italy and the Netherlands, and considered the evidence for effectiveness. In exploring differences between the five countries, and with England, this article raises questions about the way in which understandings of ‘what works’ can inform the ways in which support for parents and families is designed and delivered. An emphasis on formal outcome evaluations, as in England, favours the use of standardised parenting programmes, which are more amenable to evaluation of effectiveness using quasi-experimental research designs. In some other European countries, support for parents and families is embedded in universal service provision, rather than a discrete, time-limited ‘intervention’, and hence evaluation is more likely to involve assessment of individual progress (is this working for this family?) rather than assessment of the overall efficiency of a standardised programme.

What counts as research? The implications for research governance in social care

Formal independent ethics review has rarely been required for social research, but in England this has changed with the implementation of the Department of Health’s Research Governance Framework for Health and Social Care. Permission to conduct research with populations relating to the responsibilities of the Secretary of State for Health now depend on a process of independent review. A clear definition of social care research seems vital in implementing the Framework, but establishing such a definition is not straightforward. This paper reports on two data‐gathering exercises conducted in councils with social services responsibilities: a survey of all councils about their systems for recording and monitoring research undertaken within their organizations, and case studies in eight councils on the range, nature and volume of social care research. These exercises form the basis of a broader theoretical discussion about which activities should require independent regulation, and how best to define what counts as research.

Approaches to Developing Health in Early Years Settings.

Purpose – The purpose of the paper is to consider the opportunities and difficulties in developing health-promotion work in early years settings in the UK. Design/methodology/approach – As the first study of its kind conducted in the UK, a multi-method approach was adopted involving: an overview of health-related guidance and of effective interventions in early years settings to promote health among young children; 26 interviews with key informants in the early years and health fields, regional coordinators for the National Healthy Schools Programme (NHSP) and Foundation Stage regional advisers; a survey of 145 local Healthy Schools Programme coordinators with a response rate of 75 per cent; and six case studies of early years settings representing promising practice in the promotion of health and wellbeing. Findings – There is considerable enthusiasm for health promotion work within early years organisations, and interest in developing such work in early years settings. The study suggests that building on existing early years curriculum frameworks, developing partnerships between health and early years professionals, engaging both parents and practitioners, and adequate national and local resourcing will facilitate development of health promoting work in the early years sector. Practical implications – This paper and the outputs from the study offer useful evidence for health and early years professionals who are developing health-promoting work in early years settings. Originality/value – The paper reports on the first study of its kind in which the perceptions of both early years and health professionals are brought together to consider the issues involved in developing healthy early years practice.

Introduction to the Special Issue: Research Ethics in Challenging Contexts

The rise in ethical regulation of social research has brought about an increased interest in research ethics; much of this has focused on concerns about ethical regulation and its impact on social research rather than exploring the everyday challenges that researchers encounter in the process of research and how these are, or might be, managed in ethical ways. This special issue explores some of the ethical challenges that are raised in conducting qualitative social research in contexts which raise specific ethical challenges because of the nature of the participants or the specific methodological approach taken. These include research with children, research in global contexts, longitudinal research, e-research and data archiving and secondary analysis of qualitative material. Drawing on a range of research projects, these papers explore some of the key ethical challenges raised by these contexts and how researchers have engaged with the issues that arise.

Research across cultures, within countries: Hidden ethics tensions in research with children and families?

There is a substantial academic literature on ethics in research with children and young people in low income or economically developing countries, emphasizing the need to be aware of special cultural and social considerations. However, considerations of culture and ethnicity are not particular to development studies. This article draws on examples from my own UK research with children, young people and families, alongside a wider academic literature, to reflect on the need to address ethics considerations in relation to culture and ethnicity when working within ethnically and culturally diverse societies.

Asking the experts : developing and validating parental diaries to assess children's minor injuries

Abstract The methodological issues involved in parental reporting of events in children’s everyday lives are discussed with reference to the development and validation of an incident diary, collecting concurrent data on minor injuries in a community study of children under eight years old. Eighty-two mothers participated in a comparison over nine days of daily tele-phone interviews and structured incident diaries. Telephone methods resulted in more missing data, and participants in both groups expressed a preference for the diary method. This diary was then validated on a sample of 56 preschool and school-aged children by comparing injury recording by a research health visitor with that of their mothers. Each failed to report some injuries, but there was good agreement overall, and in descriptive data on injuries reported by both. Parental diaries have the potential to provide rich data, of acceptable validity, on minor events in everyday life.

Contextualising Inequalities in Rates of School Exclusion in English Schools: Beneath the ‘Tip of the Ice-Berg’

ABSTRACT There is an increasing emphasis internationally on better understanding the links between inequalities and processes within school systems. In England there has been a particular focus on rates of school exclusion because the national data has consistently highlighted troubling patterns of over-representation. This paper argues that a move away from recorded exclusion to other forms of sanction and provision makes more contextualised readings of these data key to better understanding their association with inequalities. It also explores the challenges faced by key stakeholders working to reduce inequalities within an increasingly marketised system. It concludes that embedding consistent good practice across the system remains a critical challenge.

What Kind of Trouble? Meeting the Health Needs of ‘Troubled Families’ through Intensive Family Support

The policy rhetoric of the UK Coalition governments ‘Troubled Families’ initiative, and that of New Labours earlier Respect Agenda, share an emphasis on families’ responsibilities, or rather their irresponsibility, and their financial costs to society. Giving children a chance of a better life coincides, in this framing, with reducing costs for the taxpayer. The research reported here was based on a national study of Family Intervention Projects (FIPs), funded by the UK government between 2009 and 2012, beginning under New Labour, continuing over a period when the FIP programme was discontinued, and ending after the Troubled Families programme had begun. The research involved over 100 in-depth interviews with stakeholders, including service managers, family key workers, and caregivers and children in twenty families, to consider critical questions about the kinds of trouble that families experience in their lives, and how they are recognised in the policy and practice of intensive family intervention.

“Another long and involved story”: narrative themes in the marginalia of the Poverty in the UK survey

Phoenix, Boddy, Edwards and Elliott use historical material to explore the importance of marginalia drawing on Townsend’s renowned Poverty in the UK Study 1967/8 (PinUK). Rather than focusing on the extensive data collected by Townsend’s team in the original survey research Phoenix et al. explore the detailed handwritten notes on the paper questionnaires. The authors use 69 annotated questionnaires from the original study to develop a typology of marginalia. This consists of seven different categories that enabled them to analyse the comments made by the interviewers as amplifications, justifications and explanations of codes and evaluations of responses made by participants. They then use narrative analysis to reveals much about the research process and the ways in which the field interviewers positioned themselves in relation to their interviewees in the marginalia and as a way of making sense of research encounters.