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Our research on the clinical effectiveness and cost effectiveness of cochlear implantation has had two impacts. First, the research informed the decision by the National Institute for Health and Care Excellence (NICE) to issue guidance to the effect that the National Health Service (NHS) in England and Wales should provide cochlear implants to both ears of deaf children, but to only one ear of deaf adults. Those recommendations are binding on the NHS in England and Wales and have also been adopted in Scotland and Northern Ireland. Second, we translated tests of spatial hearing, which were developed in the course of the research, for use by clinicians. We incorporated the tests in a unique apparatus which is being produced commercially and used in clinics to monitor candidacy for, and outcomes from, cochlear implantation and other treatments.
The psycholinguistic framework for research and practice developed by Stackhouse and Wells is now a key component of the majority of UK speech and language therapy courses at undergraduate and postgraduate levels. In addition to influencing the design and delivery of course curricula in the UK, Europe, Australia, South Africa and USA, the framework is used in continuing professional development for speech and language therapists (SLTs), special needs teachers, and with parents. The resultant impact on clinical and educational practice, the assessment of children and the planning of therapy interventions can be seen across the spectrum of persisting speech difficulties, including those related to dyspraxia, dysarthria, dyslexia, cleft palate, Down Syndrome, stammering, specific speech and language impairments.
Coordination between the eyes is vital for children's visual and motor development, yet it often fails to develop properly. Horwood and Riddell's research has had important implications for the clinical management of binocular coordination, particularly for infant squint and childhood long-sightedness. They have demonstrated that most newborn infants (approximately 75%) have intermittent misalignment (i.e. sometimes point their eyes in different directions), but after 4 months of age only 3.25% continue to squint and it is only these children that require intervention. As a result, concerned parents have been advised appropriately and unnecessary appointments with GPs and specialists have been reduced. Horwood and Riddell's findings have also led to a substantial change in the management of long-sightedness, from which about 5% of children in the UK suffer (i.e. approximately 300,000 children between 5 and 14 years of age). Traditionally, children with long-sightedness have been provided with glasses that under-correct their vision. Our findings, however, have (i) demonstrated that some long-sighted children choose not to focus on near objects, and (ii) informed clinicians that full correction of focussing is often required to ensure clear vision, for instance, when reading. In both areas, Horwood and Riddell's research has led to changes in clinical guidelines, training, and practice and the advice given to concerned parents.
Infantile nystagmus (IN), previously known as congenital nystagmus, is a condition that impairs vision by causing continual and involuntary oscillatory movements of the eyes. IN begins in infancy and is a lifelong disorder, affecting over 88,000 people in the UK. Leicester is the leading UK centre for research into the underlying mechanisms and treatment of IN: discovering the genetic mutations behind some of the common forms of nystagmus; pioneering early diagnosis of IN; and conducting randomised clinical trials into drug treatments and other therapies. The centre provides advanced scientific and medical knowledge, and support and advice to sufferers of this physically and psychologically debilitating condition. The work has resulted in new methods of diagnosis which are more comfortable and convenient for patients and enable cost-savings for healthcare providers; and has led to the testing and subsequent prescription of pharmacological treatments which offer patients improvements in quality of life.
Professor Sue Roulstone's research has contributed significantly and widely to a growing political appreciation of the crucial role that language plays in children's development, socially, emotionally and educationally. The research has contributed evidence to underpin policy initiatives to monitor language as an indicator of successful child development, to support the importance of children's early language development and to ensure services for those with impairments are evidence-based. These initiatives have in turn impacted upon the development of services and the use of parent and child perspectives in service design and development.
A research programme of randomised controlled trials undertaken at the University of Southampton demonstrating the efficacy of the New Forest Parenting Programme (NFPP) played a crucial role in: (i) influencing the developers of clinical guidelines to recommend parent training in general as a core part of the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) and (ii) establishing the NFPP, in particular, as a widely employed evidence-based treatment for ADHD, a condition estimated to affect up to 400,000 children in the UK alone. As a direct result of the trials, the programme, a novel therapeutic intervention that teaches parents of preschool children with ADHD how to modify their children's behaviour and improve their self-regulation, has been included in the National Institute for Health and Clinical Excellence (NICE) and other clinical guidelines and recommended internationally as an effective alternative to medication, which often brings only short-term benefits and is associated with a range of potentially debilitating side-effects.
Cardiff University has established the world's largest single cohort of children and young adults with Down's syndrome in which visual deficits have been characterised. Cardiff research studies over 20 years have informed evidence-based guidelines published by the Department of Health and national practitioner bodies for the recognition and practical management of common visual problems in children with Down's syndrome. Consequently, eye care specialists now recommend bifocals for these children. The Cardiff research has also supported changes to teaching methods and resources for children with Down's syndrome. Collectively these children are now benefiting from better eye care and improved learning and educational opportunities.