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Research at the UCL Institute of Child Health underpinned the update in 2009 of children's growth charts, which allow for more accurate determination of a child's growth pattern and provide better tools for assessing possible weight problems in children. The new charts are now in universal use in the UK for children from birth to 18 years of age, including preterm babies. Having been quickly adopted, they now account for 90% of all growth chart sales. Modified versions of the charts are in use in Ireland and New Zealand. In the UK they are provided to all new parents as part of the Personal Child Health Record (PCHR) — known as the "red book". They are used in general practice, community paediatrics, general paediatrics and paediatric endocrinology. The most recent charts are for use in children with growth or nutritional problems.
Every year over 5,000 children and young people in the UK die. Previous research suggests that 20-25% of these deaths may be preventable, and in comparison to many other European countries, the UK has higher child mortality rates. Child Death Review processes, introduced in the USA in the 1970s have been proposed as a means of learning from child deaths and driving prevention initiatives. Prior to 2008, the UK had no national system for reviewing and learning from children's deaths.
From 2006 to 2007, a team from Warwick Medical School led by Dr Peter Sidebotham undertook government-funded research examining a number of Local Authorities across England who had set up pilot Child Death Overview Panels (CDOPs). The findings from this research were instrumental in developing national policy and procedures for child death reviews. The Warwick research emphasised the importance of a multi-agency approach to reviewing all child deaths, with a strong public health focus on learning lessons for prevention, and robust systems for notification and gathering information. This, together with other research by Warwick Medical School on fatal child maltreatment published between 2009 and 2011, has contributed to updated national policy and interagency practice to safeguard children.
Although it is too early in the process to demonstrate any impact on the ultimate goal of reducing preventable child deaths, CDOPs have now been established in every Local Authority in England, as well as an all-Wales panel, and current work in Scotland and Northern Ireland is considering how best to implement such reviews. These panels are reviewing all child deaths in England, resulting in local prevention initiatives, and national returns enabling a clearer picture of the nature of preventable child deaths.
Our work on children's agency in research has had three impacts:
This approach has been replicated in Australia, Turkey, New Zealand, Norway and Qatar. The CRC website hosts 150 successful projects by children and young people, and through the Diana Award more than 1500 children were supported in their research on cyberbullying.
The methodology for growth curve estimation developed by Rigby and Stasinopoulos (2004,2006) has been used worldwide. The World Health Organisation used the methodology and the related software exclusively for developing child growth standards, WHO (2006, 2007, 2009). The Global Lung Function Initiative (GLFI), (www.lungfunction.org, Stanojevic et al. 2008, Cole et al. 2009, ) use it for providing a unified worldwide approach to lung function in growth and ageing. The methodology is now the gold standard for developing growth curves.
Childhood obesity is a national problem but it is a problem even more keenly felt in the West Midlands where statistics show the percentage of children classified as obese is higher than the national average. Research demonstrating that simple measures such as waist circumference and body mass index (BMI) are every bit as effective as complex and expensive measuring processes such as magnetic resonance imaging (MRI) scans in identifying high risk obese children has fed into the evaluation and subsequent improvement of child weight management programmes in the region and more widely in the UK. It also informed the development of an obesity strategy and action plan for Worcestershire for the period 2008-11.
With childhood obesity now of global public health and clinical importance, attention had to be directed toward how best to identify the condition and more importantly those who are at further risk of serious obesity-related conditions. This case study illustrates how assessment has moved beyond the simple crude measure, challenging the accepted approach and developed more sensitive and specific assessment tools. Described is a new range of clinical assessment charts which allow practitioners and epidemiologists to evaluate a range of body characteristics known to be linked to morbidity, make a fuller assessment of individual risk and target better and specific intervention.
Professor Susan Golombok's research has made a significant contribution to policy formation and legislation regarding families created by assisted reproductive technologies. Her research has directly informed the Human Fertilisation and Embryology Act (2008); the policies of the Human Fertilisation and Embryology Authority (HFEA); and recommendations of the Nuffield Council on Bioethics, in relation to assisted reproductive technologies involving the donation of eggs, sperm or embryos and surrogacy, and with respect to families with single and same-sex parents. Moreover, her research has been widely recognised as having made a fundamental contribution to public debate on the social and ethical implications of assisted reproduction for individuals, families and society.
Research examining the best ways of identifying and diagnosing motor impairment in children has established a universal standard of assessment: the Movement Assessment Battery for Children (MABC). Co-authored by Sugden (University of Leeds), a complete new edition was developed in 2007. The second edition contains a new standardised test of motor impairment, a new criterion referenced checklist and a new intervention manual based on participation and learning, all informed by the authors' theoretical, empirical and professional research. The MABC is used in educational, health, and psychological services globally to provide detailed and accurate profiling of children 3 - 16 years, and through assessing children's motor skills and providing guidelines for intervention, it is used to determine strategies across the world to improve participation in activities in daily living for children with movement difficulties.
Research conducted by the Centre for the Study of Poverty and Social Justice (CSPSJ) led to a new way of assessing child poverty in developing countries. This novel method (termed the Bristol Approach) resulted in the United Nations General Assembly's adoption, for the first time, of an international definition of child poverty (2006). It also underpinned UNICEFs Global Study on Child Poverty and Disparities (2008-10), which was run in over 50 countries. In the last ten years, the CSPSJ's work has put child poverty at the centre of international social and public policy debates. Its researchers have advised governments and international agencies on devising anti-poverty strategies and programmes that specifically meet the needs of children, and have significantly influenced the way child poverty is studied around the world. The Centre has developed academic and professional training courses for organisations like UNICEF on the issues of children's rights and child-poverty. Our work has also spurred NGOs such as Save the Children to develop their own child-development indices, and so has had a direct and profound impact on the lives of poor children around the planet.
The University of Southampton's lifecourse cohort studies have led to a paradigm shift in the medical approach to obesity and non-communicable diseases. Research linking maternal pre-conception and early years nutrition with health outcomes for later life has directly influenced public healthcare policy at international (United Nations), national (Scientific Advisory Committee on Nutrition) and local (Southampton City) levels. Dissemination through medical practice and Southampton-designed public education programmes such as LifeLab means this research has already led to health benefits for tens of thousands of people, providing them with the information and tools to help prevent themselves and their children from succumbing to a non-communicable disease.