“Behind the closed door”: Educational psychologists’ experiences and views of home-educated children with special educational needs

This study considers the experiences and views of educational psychologists (EPs) of those children and young people who have special educational needs and who are being home-educated. The literature review highlights that there is limited research on this area and that there is an increasing population of children becoming home-educated, especially those with special educational needs, given the difficulties presented by a school education. Educational psychologists, nevertheless, have limited experience and knowledge of working with home-educated children. A qualitative method which employed semi-structured interviews conducted with nine educational psychologists with experience of working with home-educated children with special educational needs was utilised. Reflexive thematic analysis (Braun & Clarke, 2019) was used to consider the data. The findings from these data showed that educational psychologists viewed the home education of children with special educational needs as a ‘last resort’ because there were no other options, as opposed to a positive and deliberate choice of education. The findings also revealed that a number of factors were at play in prompting parents’ decision to home educate, including their child’s special educational needs not being met at school, the lack of inclusive practice in schools, and the impact of changes in educational practice due to government policy such as a movement towards a traded model of educational psychology service and the Special Educational Needs (SEN) Code of Practice (Department for Education (DfE), 2014). Educational psychologists constructed home education as an inferior form of education in terms of what, where and how it happened and compared it to the preferred and established educational setting of the school. The school, as an educational establishment was constructed as the preferred option and natural domain of educational psychologists. The findings from this study have a number of implications for EP practice, including a consideration of how a school-dominated role is impacting the profession, how trading has affected those children with no commissioner (i.e., the ‘unsupported’), and how the failure of schools to address the needs of children with special educational needs leads to their becoming home-educated due to having no other option

Exascale Agent-Based Modelling for Policy Evaluation in Real-Time (ExAMPLER)

Exascale computing can potentially revolutionise the way in which we design and build agent-based models (ABM) through, for example, enabling scaling up, as well as robust calibration and validation. At present, there is no exascale computing operating with ABM (that we are aware of), but pockets of work using High Performance Computing (HPC). While exascale computing is expected to become more widely available towards the latter half of this decade, the ABM community is largely unaware of the requirements for exascale computing for agent-based modelling to support policy evaluation. This project will engage with the ABM community to understand what computing resources are currently used, what we need (both in terms of hardware and software) and to set out a roadmap by which to make it happen

The ORACLE Children Study:Educational outcomes at 11 years of age following antenatal prescription of erythromycin or co-amoxiclav

Background Antibiotics used for women in spontaneous preterm labour without overt infection, in contrast to those with preterm rupture of membranes, are associated with altered functional outcomes in their children. Methods From the National Pupil Database, we used Key Stage 2 scores, national test scores in school year 6 at 11 years of age, to explore the hypothesis that erythromycin and co-amoxiclav were associated with poorer educational outcomes within the ORACLE Children Study. Results Anonymised scores for 97% of surviving children born to mothers recruited to ORACLE and resident in England were analysed against treatment group adjusting for key available socio-demographic potential confounders. No association with crude or with adjusted scores for English, mathematics or science was observed by maternal antibiotic group in either women with preterm rupture of membranes or spontaneous preterm labour with intact membranes. While the proportion receiving special educational needs was similar in each group (range 31.6-34.4%), it was higher than the national rate of 19%. Conclusions Despite evidence that antibiotics are associated with increased functional impairment at 7 years, educational test scores and special needs at 11 years of age show no differences between trial groups. Trial registration number ISCRT Number 52995660 (original ORACLE trial number).</p

Association between congenital toxoplasmosis and parent-reported developmental outcomes, concerns, and impairments, in 3 year old children

BACKGROUND: Information is lacking on the effects of congenital toxoplasmosis on development, behavior, and impairment in later childhood, as well as on parental concerns and anxiety. This information is important for counselling parents about the prognosis for an infected child and for policy decisions on screening. METHODS: We prospectively studied a cohort of children identified by screening for toxoplasmosis in pregnant women or neonates between 1996 and 2000 in ten European centers. At 3 years of age, parents of children with and without congenital toxoplasmosis were surveyed about their child's development, behavior, and impairment, and about parental concerns and anxiety, using a postal questionnaire. RESULTS: Parents of 178/223 (80%) infected, and 527/821 (64%) uninfected children responded. We found no evidence that impaired development or behavior were more common in infected children, or that any potential effect of congenital toxoplasmosis was masked by prenatal treatment. Parents of infected children were significantly more anxious and reported more visual problems in their children. CONCLUSION: On average, children aged three to four years with congenital toxoplasmosis identified by screening and treated during infancy in this European setting had risks of abnormal development and behavior similar to uninfected children. Parental anxiety about infected children needs to be addressed by clinicians. Future studies with longer follow up and clinician-administered assessments may be better able to detect any subtle differences in child outcomes

Exascale Agent-Based Modelling for Policy Evaluation in Real-Time (ExAMPLER)

Exascale computing can potentially revolutionise the way in which we design and build agent-based models (ABM) through, for example, enabling scaling up, as well as robust calibration and validation. At present, there is no exascale computing operating with ABM (that we are aware of), but pockets of work using High Performance Computing (HPC). While exascale computing is expected to become more widely available towards the latter half of this decade, the ABM community is largely unaware of the requirements for exascale computing for agent-based modelling to support policy evaluation. This project will engage with the ABM community to understand what computing resources are currently used, what we need (both in terms of hardware and software) and to set out a roadmap by which to make it happen

The effect of a monetary incentive on return of a postal health and development questionnaire: a randomised trial [ISRCTN53994660]

BACKGROUND: Postal questionnaires are widely used to collect data in healthcare research but a poor response rate may reduce the validity and reliability of results. There was a lack of evidence available relating to use of a monetary incentive to improve the response rate in the healthcare setting. METHODS: The MRC ORACLE Children Study is assessing the health and development of nearly 9000 seven year old children whose mothers' joined the MRC ORACLE Trial. We carried out a randomised controlled trial of inclusion of monetary incentive (five pound voucher redeemable at many high street stores) with the reminder questionnaire to parents. This trial took place between April 2002 and November 2003. When the parents were sent the reminder questionnaire about their child's health and development they were randomly assigned by concealed computer-generated allocation stratified by week of birthday to receive a five pound voucher or no incentive. The population were 722 non-responders to the initial mailing of a 12-page questionnaire. Main outcome measures: Difference in response rate between the two groups. RESULTS: Inclusion of the voucher with the reminder questionnaire resulted in a 11.7%(95% CI 4.7% to 18.6%) improvement in the response rate between the two groups. CONCLUSION: This improvement in response rate and hence the validity and reliability of results obtained appears to be justified ethically and financially

Mother–infant interactions with infants with congenital visual impairment and associations with longitudinal outcomes in cognition and language

Background: This study investigated mother–infant interactions, including maternal maintaining of infant attentional focus and sensitivity, with infants with congenital severe and profound visual impairment (VI) and the association with developmental trajectories from one to three years. Method: Fifty‐five infants and mothers were video‐recorded playing together with a standard set of toys at Time 1 (T1) mean age 12.95 months (8.13–17.05 months). Maintain was categorized as the mother following and maintaining the child’s focus, and Sensitivity, the mother’s responsiveness and contingency to infant behaviour. Vision level was measured using the Near Detection Scale. Cognition and language were measured at T1, 12 months later (T2) and 24 months later (T3) using the Reynell‐Zinkin Scales. Results: Cross‐sectional analyses showed that mothers of infants with severe VI (basic form vision) produced higher rates of Maintain compared to those with children with profound VI (light perception at best). Linear mixed‐effects models examining developmental progression from T1 to T3 (controlling for vision level) showed an average increase of 5 DQ points (CI 95%: 1.03–9.08) in verbal comprehension for higher Sensitivity. No significant findings were found for Maintain. Conclusions: The findings suggest that mother–infant interactions (maternal Maintain) are associated with level of vision at infancy, but only maternal Sensitivity has a long‐term positive association with advances in verbal comprehension from infancy to about three years. They highlight the need for incorporating strategies related to parent–infant interactions, including increased sensitivity, into early intervention for children with visual impairment

Development of a national monitoring protocol (developmental guide) for children with visual impairment 0-36 months

Objective: The aim of this project is to provide a national developmental monitoring protocol for infants and young children (0–36 months) with severe visual impairment (VI) that is underpinned by a scientific developmental framework. The profile will be used to inform and assist parents to help their baby progress and to recognise and, where possible, overcome areas of vulnerability in conjunction with their specialist teacher for the visually impaired and other professionals. Design: The work of our group and others has shown that infants with severe visual impairment are a particularly vulnerable group within the population of children with disability. They require a developmental profile that is specific to their developmental patterns and needs. The protocol is designed to provide practical guidance for parents and their keyworker on activities to promote the development of all skills. The development of the protocol draws on our specialist team's clinical experience, recent research and other developmental scales for young children with visual impairment (e.g. Oregon) and is informed by focus groups and piloting with parents and qualified teachers of children with visual impairment. Results: We describe the justification of the developmental framework, the outcome of focus groups with parents and specialist teachers and plans for implementation including the strategy for a local and regional health and education service framework for early intervention. Conclusions: This paper describes the first stage of development of this national monitoring protocol and guidance for parents of young children with visual impairment which will have important implications for services both nationally and internationally

MRC ORACLE Children Study. Long term outcomes following prescription of antibiotics to pregnant women with either spontaneous preterm labour or preterm rupture of the membranes

BACKGROUND: The Medical Research Council (MRC) ORACLE trial evaluated the use of co-amoxiclav 375 mg and/or erythromycin 250 mg in women presenting with preterm rupture of membranes (PROM) ORACLE I or in spontaneous preterm labour (SPL) ORACLE II using a factorial design. The results showed that for women with a singleton baby with PROM the prescription of erythromycin is associated with improvements in short term neonatal outcomes, although co-amoxiclav is associated with prolongation of pregnancy, a significantly higher rate of neonatal necrotising enterocolitis was found in these babies. Prescription of erythromycin is now established practice for women with PROM. For women with SPL antibiotics demonstrated no improvements in short term neonatal outcomes and are not recommended treatment. There is evidence that both these conditions are associated with subclinical infection so perinatal antibiotic administration may reduce the risk of later disabilities, including cerebral palsy, although the risk may be increased through exposure to inflammatory cytokines, so assessment of longer term functional and educational outcomes is appropriate. METHODS: The MRC ORACLE Children's Study will follow up UK children at age 7 years born to 4809 women with PROM and the 4266 women with SPL enrolled in the earlier ORACLE trials. We will use a parental questionnaire including validated tools to assess disability and behaviour. We will collect the frequency of specific medical conditions: cerebral palsy, epilepsy, respiratory illness including asthma, diabetes, admission to hospital in last year and other diseases, as reported by parents. National standard test results will be collected to assess educational attainment at Key Stage 1 for children in England. DISCUSSION: This study is designed to investigate whether or not peripartum antibiotics improve health and disability for children at 7 years of age. TRIAL REGISTRATION: The ORACLE Trial and Children Study is registered in the Current Controlled Trials registry. ISCRTN 52995660