National Children's Bureau

ObjectivesEarly childhood development shapes children’s future well-being.1 2 The Ages and Stages Questionnaire-3 (ASQ-3) is used to assess children’s development aged between 2–2.5 years as part of England’s Healthy Child Programme (HCP).3 This study aims to use secondary data to understand whether children living in Lambeth experiencing risk factors for disadvantage, social vulnerability and different levels of health visiting input (Universal, Targeted and Specialist) are at greater risk of poorer developmental outcomes at age 2–2.5 years.MethodsData was cross-sectional and came from the local health visiting dataset. Chi-square and analysis of variance tests were used to test associations between children’s characteristics, HCP-level and ASQ-3 outcomes. Logistic regression was used to further evaluate the association between HCP-level and ASQ-3 outcomes.ResultsThe final sample included 12,712 children living in Lambeth who were assessed using the ASQ-3 at age 2–2.5 years between the 30th of June 2015 and the 2nd of August 2022. Sex, ethnicity, income deprivation affecting children index (IDACI) and HCP-level were very strongly associated with ASQ-3 outcomes (p<0.001). Males (Odds Ratio(OR) 2.33, 95%CI 2.13–2.55,p<0.001), Black children (OR 2.34, 95%CI 2.01–2.72,p<0.001) and children living in the most deprived areas (OR 2.13, 95%CI 1.76–2.59, p<0.001) had the highest odds of scoring below the expected ASQ-3 threshold, relative to White children, females and children living in the least deprived areas. After controlling for other variables, there was strong evidence that Targeted HCP was associated with five times the odds (OR 5.16, 95%CI 4.21–6.19, p<0.001) and Specialist HCP was associated with twice the odds (OR 2.13, 95%CI 1.45–3.12,p<0.001) of scoring below the expected ASQ-3 threshold compared with children receiving Universal HCP.ConclusionEarly-years services need to target children at greater risk of poorer developmental outcomes in a way that reduces inequities and is universally proportionate. The HCP in Lambeth needs to be reviewed using a cross-disciplinary approach to ensure each HCP- level meets the needs of all families whilst considering the limited resources.ReferencesThe United Nations Children’s Fund (UNICEF). Early Childhood Development. Switzerland2022 [cited 05/08/2023. Available from: https://www.unicef.org/early-childhood-development.Early Years Healthy Development Review. The Early Years Healthy Development Review Report. England 2021.Department of Health. Healthy Child Programme: Two year review England; 2009.

COVID-19 has had serious, negative impacts on children's health and development. But the impacts have not been felt equally. Disabled children and their families have been hit particularly hard. In this paper we summarize UK legislation to limit the spread of the virus and describe how services to disabled children changed as a result. We discuss the long-term deleterious impacts of changes in service provision on the health and wellbeing of disabled children and the parent carers supporting them. We close with lessons learned for resetting services to support the ongoing recovery of children and their families and recommendations for delivering services better in future emergencies to ensure that disabled children's health and wellbeing is maintained.

Did you do anything for this year's Playday? If not, you missed out on what was a super event. Of course, it was fun, but it also highlighted the importance of children being allowed to simply play.

While patient and public involvement (PPI) in health and social care research has progressed successfully in the last decade, a range of difficulties with the evidence base exist, including poor understanding of the concept of impact, limited theorization and an absence of quantitative impact measurement. In this paper, we argue that a pardigm change towards robust measurement of the impact of involvement in research is needed to complement qualitative explorations. We argue that service users should be collaboratively involved in the conceptualization, theorization and development of instruments to measure PPI impact. We consider the key advantages measurement would bring in strengthening the PPI evidence base through a greater understanding of what works, for whom, in what circumstances and why.

Times are tough in the UK, with recessions and never-ending budget cuts and deficits, but a trip to the USA, revealed to Sue Owen, that what we face here is mirrored by practitioners all across the world.

The coalition government's idea of a Big Society is not necessarily a novel idea, but it is in danger of being interpreted as an opportunity to make sweeping and dangerous cuts to vital children's services.

Working with parents as partners is critical for young children's development and learning, which is why highly effective settings and schools work hard to put partnership with parents into practice.

An increasing number of disabled infants are surviving into childhood and adulthood, presenting a challenge to front-line health, education and social care services. Families with disabled children report that it is often a struggle to lead ordinary lives, and surveys show that many have experienced poor services. Every Disabled Child Matters (EDCM), launched in 2006, is a UK campaign to achieve rights and justice for every disabled child. It is a consortium campaign with four lead members: Contact a Family, the Council for Disabled Children, Mencap and the Special Educational Consortium, and represents the 770,000 disabled children and young people in the UK. With 28,000 supporters and more than 300 Members of Parliament signed up to the campaign, EDCM has succeeded in influencing Government policy to make children with disabilities a political priority. The Government's Aiming High for Disabled Children programme will provide over pounds 430 million to improve disabled children's services over the next three years. For the first time there is a national target on services for disabled children and a new legal duty on local authorities to provide these. However, more still needs to be done to help families with disabled children to lead ordinary lives and local health, education and social care services must play a greater role in making this happen.

Despite structural changes made to central government and the development of the Every Child Matters programme in England, compartmentalised child policy proposals are often created for service settings and in response to a specific political imperative. This article provides a rationale for child impact assessment — a systematic process in which proposals for policy and legislation are reviewed and assessed for their potential impact on children and young people — and reviews project work in England involving the National Children's Bureau and the Children's Legal Centre.

by T Okitikpi ( ed .) Lyme Regis : Russell House , 2005 ISBN 1903855640 , 143 pp , £15.95 (pb) Almighty God created the races white, black, yellow, Malay and red, and he placed them on separate continents. The fact that he separated the races shows that he did not intend for the races to mix. (Judge Leon Bazile, 1959, sentencing a couple to one year in jail for ‘inter-racial’ marriage in Caroline County, Virginia in Time Magazine, 19) In 1967, when the US Supreme Court ruled that anti-miscegenation laws were unconstitutional, 16 states still had laws prohibiting marriage between different ‘races’. Alabama did not repeal its law until 2000. I did not read this book expecting a history lesson. Not least because the editor had promised ‘an account of the lived experience of mixed race families rooted in empirical research and to identify their particular problems’ I initially struggled to understand the relevance of the US socio-historical context — until I realised that my real problem was not the relevance of the material, but my own discomfort at reading it. In 21st century Britain, we do not have a legally enshrined ‘one-drop’ rule that defines any child with even a distant African ancestor as ‘Black’. But, as Charlie Owen points out, there were no specific categories for ‘mixed’ in the 1991 Census —‘if the person is descended from more than one ethnic or racial group, please tick the group to which the person considers he/she belongs’. How many people with one White parent have had to opt for ‘Black Other'? The 18th century classification of people of African and White descent into categories based on the presumed proportion of ‘Black blood’—‘sambo’, ‘mango’, and so on — is disturbing, albeit farcical. Contributors such as Kwame Owusu-Bempah make it very clear that although the words might be different, the categories still confound. The book explores many of the areas one would expect — terminology, self-esteem and group identification, the experiences of lone White mothers. Not unsurprisingly, the ongoing theme is of definition and categorisation — be it biological (such as White carers’ capacity to meet the needs of mixed parentage children) emotionally (the psychological aspects of being expected to identify with one parent above the other, for example) or downright physically, as in June Thoburn's contribution about permanent family placement for children of dual heritage. It is a book about helping children to find their own place, or more frequently, questioning the place where practitioners have decided that children should be put. Okitikpi, the editor, stresses that this book is not an ‘uncomplicated ready-made, ‘how-to’, step-by-step guide’. (One wonders how any book about working with families in all their complexity can be) What is offered here is a compelling mix of research, theory and refreshing subjectivity. One senses frustration and sometimes anger from some contributors who feel that negative stereotypes and damaging myth still inform much practice with children of mixed parentage. The book also reminds us that we do not practice in a neutral space. The impact of colonialism and racism is yet to be eradicated. There are some challenges, including a couple of annoying typos. I envisaged ‘Paul Boating’ (Boateng) sailing away from politics forever. In the same chapter, Zadie Smith's and Oona King's names are also incorrectly spelt recalling the frustration of many Black and other minority ethnic people having to Anglicise or endure incorrect spelling and pronunciation of their names. There were, for me, problematic references in some chapters to acting ‘White’ or ‘Black’. As a Black woman, I have never worked out whether I am acting it or playing it for real. Isn't that reinforcing the stereotypes and the binary view that the book argues need to be challenged? Finally, there is the expected repetition that occurs when many contributors are addressing the same issue, even if from varying routes. Yet, for me these are small criticisms. I may not work on the frontline with mixed parentage children, but as a member of an Italian, African Caribbean, Indian Caribbean and White English family, these things really matter! Katz and Treacher quote Root's ‘Multiethnic Bill of Rights’— the right to self-definition, to resist being forced to choose one category, the right to be complex, ambiguous and change. Copy it, laminate it and stick it to your wall.