Natural History of Stuttering to 4 Years of Age: A Prospective Community-Based Study

These findings from a community-ascertained cohort refute long-held views suggesting that developmental stuttering is associated with a range of poorer outcomes. If anything, the reverse was true, with stuttering predicting subsequently better language,nonverbal skills, and psychosocial health-related quality of life at 4 years of age.Future research with this cohort will support a more complete longitudinal understanding of when and in whom recovery occurs. Current best practice recommends waiting for 12 monthsbefore commencing treatment, unlessthe child is distressed, there is parental concern, or the child becomes reluctant to communicate. It may be that for many children treatment could be deferred even longer. Treatment is efficacious15 but is both intensive (median of 15.4o ne-hour clinical sessions followedby 10 one-hour clinical maintenance sessions) and expensive; this "watchful waiting" recommendation would therefore help target allocation of scarce resources to the small number of children who do not resolve and experience adverse outcomes, secure in the knowledge that delaying treatment by a year or more has been shown not to compromise treatment efficac

The Las Campanas/AAT Rich Cluster Survey III: Spectroscopic Studies of X-ray Bright Galaxy Clusters at z~0.1

[abridged] We present the analysis of the spectroscopic and photometric catalogues of 11 X-ray luminous clusters at z=0.07-0.16 from the Las Campanas / Anglo-Australian Telescope Rich Cluster Survey. Our spectroscopic dataset consists of over 1600 galaxy cluster members, of which two thirds are outside r_200. We assign cluster membership using a detailed mass model and expand on our previous work on the cluster colour-magnitude relation where membership was inferred statistically. We confirm that the modal colours of galaxies on the colour magnitude relation become progressively bluer with increasing radius and decreasing local galaxy density. Interpreted as an age effect, we hypothesize that these trends in galaxy colour should be reflected in mean Hdelta equivalent width. We confirm that passive galaxies in the cluster increase in Hdelta line strength as dHdelta / d r_p = 0.35 +/- 0.06. A variation of star formation rate, as measured by [OII], with increasing local density of the environment is discernible and is shown to be in broad agreement with previous studies from 2dFGRS and SDSS. We find that clusters at z~0.1 are less active than their higher redshift analogues. We also investigate unusual populations of blue and very red nonstarforming galaxies and we suggest that the former are likely to be the progenitors of galaxies which will lie on the colour-magnitude relation, while the colours of the latter possibly reflect dust reddening. The cluster galaxies at large radii consist of both backsplash ones and those that are infalling to the cluster for the first time. We make a comparison to the field population at z~0.1 and examine broad differences between the two populations. Individually, the clusters show significant variation in their galaxy populations which reflects their recent infall histories.Comment: 25 pages, 16 figures. Accepted for publication in MNRA

Silk garments plus standard care compared with standard care for treating eczema in children: A randomised, controlled, observer-blind, pragmatic trial (CLOTHES Trial)

© 2017 Thomas et al. Background: The role of clothing in the management of eczema (also called atopic dermatitis or atopic eczema) is poorly understood. This trial evaluated the effectiveness and cost-effectiveness of silk garments (in addition to standard care) for the management of eczema in children with moderate to severe disease. Methods and findings: This was a parallel-group, randomised, controlled, observer-blind trial. Children aged 1 to 15 y with moderate to severe eczema were recruited from secondary care and the community at five UK medical centres. Participants were allocated using online randomisation (1:1) to standard care or to standard care plus silk garments, stratified by age and recruiting centre. Silk garments were worn for 6 mo. Primary outcome (eczema severity) was assessed at baseline, 2, 4, and 6 mo, by nurses blinded to treatment allocation, using the Eczema Area and Severity Index (EASI), which was log-transformed for analysis (intention-to-treat analysis). A safety outcome was number of skin infections. Three hundred children were randomised (26 November 2013 to 5 May 2015): 42% girls, 79% white, mean age 5 y. Primary analysis included 282/300 (94%) children (n = 141 in each group). The garments were worn more often at night than in the day (median of 81% of nights [25th to 75th centile 57% to 96%] and 34% of days [25th to 75th centile 10% to 76%]). Geometric mean EASI scores at baseline, 2, 4, and 6 mo were, respectively, 9.2, 6.4, 5.8, and 5.4 for silk clothing and 8.4, 6.6, 6.0, and 5.4 for standard care. There was no evidence of any difference between the groups in EASI score averaged over all follow-up visits adjusted for baseline EASI score, age, and centre: adjusted ratio of geometric means 0.95, 95% CI 0.85 to 1.07, (p = 0.43). This confidence interval is equivalent to a difference of −1.5 to 0.5 in the original EASI units, which is not clinically important. Skin infections occurred in 36/142 (25%) and 39/141 (28%) of children in the silk clothing and standard care groups, respectively. Even if the small observed treatment effect was genuine, the incremental cost per quality-adjusted life year was £56,811 in the base case analysis from a National Health Service perspective, suggesting that silk garments are unlikely to be cost-effective using currently accepted thresholds. The main limitation of the study is that use of an objective primary outcome, whilst minimising detection bias, may have underestimated treatment effects. Conclusions: Silk clothing is unlikely to provide additional benefit over standard care in children with moderate to severe eczema. Trial registration: Current Controlled Trials ISRCTN77261365

Children's voices: working with children and young people with additional needs.

The engagement of children and young people at the centre of policy and service provision has long been regarded as a central tenet of the Every Child Matters agenda. However, it has become increasingly apparent that there are critical gaps in training professionals to communicate effectively with children and young people (Lefevre et al., 2008), meaning that the experience of involvement may be inconsistent (Ofsted, 2009) and therefore unsatisfactory. This book endeavours to address some of these gaps by examining the literature and identifying the crucial communication skills that professionals require. The book also seeks to develop a political argument as to why children and young people should be listened to and supported to have a voice in their present and future care and education. All contributors to this edited book are experienced practitioners covering a wide range of professional backgrounds, although it is noted that a social work perspective appears to be missing. Situating their work within an evolving policy framework, each contributing author deals with a particular aspect of effective communication with children and young people in a logical, flowing sequence. The book challenges the reader to think about their attitudes towards working with children and young people as well as identifying key principles of good practice. I particularly liked Chapter Four, written by Eileen Wake, which looks at a variety of complex situations requiring different communication techniques as well as encouraging professionals to interact with children and young people about their wishes, feelings and needs-highly personal matters that can often be difficult to engage with or ascertain. However, there are some key omissions that mean that this book is a useful first text, but is limited in terms of a more comprehensive look at the issue of effective communication with children and young people. The first omission highlights the book's lack of a social work perspective, as there is no mention of the excellent work by Lefevre et al. (2008) on communicating with looked after children. Their core conditions of knowing, being and doing would have been extremely valuable to discuss and incorporate within this book, enabling practitioners to better understand the complexity of effective communication with children and young people. Second, the authors do not fully engage with an exploration of communication methods and skills with children under eight years of age. There were many missed opportunities to look at this key area of work that raises anxiety for practitioners that can often mean young children are not communicated with effectively or at all. Penny Lancaster's excellent work is referred to (e.g. Lancaster and Broadbent, 2003), but could have been used more substantially, thereby emphasising the importance of direct communication with young children and enabling a full exploration of possible methods, skills and resources. Third, there were several points where key issues were raised without development, which became frustrating. For example, on p. 35, an examination of Roger Hart's ladder of participation could have been developed in terms of encouraging practitioners to challenge those practices and procedures that regularly exclude children's voices. Additionally, on p. 25, in a subsection entitled ‘Skills', there is comment that some children do not communicate verbally and thus an adaptation of personal communication style might be necessary. The author does not engage sufficiently with this comment or signpost the reader to where in the book this issue might be dealt with. Lastly, the book does not look at the significance of silence in communication, especially for children and young people for whom silence may the only protection they have and how the choices they make to speak or not to speak tell a significant story about their lives and needs should practitioners be prepared and equipped to listen (Kohli, 2006). Overall, this book is a worthwhile addition to the discourse concerning communication with children and young people at an introductory level. I hope that a second edition will develop some of the themes and grapple with the more complex issues, offering practitioners a greater opportunity to explore possible methods of communication and thereby give encouragement to develop their own practice

Communicating with children: the legal dimensions

This chapter will explore the rights of children and young people and the resultant implications for practitioners in relation to communication. A wide range of areas will be considered in terms for example children and young people’s right to honesty, confidentiality and advocacy. An important dimension in working with children and young people is capacity to make decisions for themselves regarding care and health treatment for example. Therefore the duty of care for practitioners to empower and support children and young people in such decision making using a range of communication skills will be examined. The needs of children and young people who have limited capacity to express their needs and wishes will be explored. The chapter will also carefully examine the communication skills and knowledge needed in working with children and young people with fluctuating capacity due to health needs. In addition, the rights and resultant communication issues in working in partnership with young people aged 16-17 years will also be specifically explored. In order to enhance the readers’ understanding of these complex communication issues a range of legislation such as Children Act 1989, 2004, Mental Capacity Act (2005) and the Mental Health Act (2007) will be examined where appropriate and examples provided from case law to enhance practitioners understanding of the issues raised. The chapter will conclude with guidance for further reading and resources to build upon practice from statutory and non statutory agencies

Communicating with children: the legal dimensions

This chapter will explore the rights of children and young people and the resultant implications for practitioners in relation to communication. A wide range of areas will be considered in terms for example children and young people’s right to honesty, confidentiality and advocacy. An important dimension in working with children and young people is capacity to make decisions for themselves regarding care and health treatment for example. Therefore the duty of care for practitioners to empower and support children and young people in such decision making using a range of communication skills will be examined. The needs of children and young people who have limited capacity to express their needs and wishes will be explored. The chapter will also carefully examine the communication skills and knowledge needed in working with children and young people with fluctuating capacity due to health needs. In addition, the rights and resultant communication issues in working in partnership with young people aged 16-17 years will also be specifically explored. In order to enhance the readers’ understanding of these complex communication issues a range of legislation such as Children Act 1989, 2004, Mental Capacity Act (2005) and the Mental Health Act (2007) will be examined where appropriate and examples provided from case law to enhance practitioners understanding of the issues raised. The chapter will conclude with guidance for further reading and resources to build upon practice from statutory and non statutory agencies

Data resource profile: the Child LAnguage REpository (CLARE)

Oral language is a characteristic that defines the human species. How this ability develops underpins the health, productivity, and social well-being of individuals.1 Whereas most children acquire speech and language skills with relative ease, many do not, placing a sizeable burden on our health, education, social and economic systems.2,3 Considering this, research in the field has been chronically underfunded and fragmented, resulting in evidence gaps, limited research capacity and uncoordinated, poorly informed and often contradictory advice for policy makers and practitioners.4,5 Although language promotion and early intervention are clearly warranted, efforts to understand how and when best to target interventions have been hampered by a lack of appropriate longitudinal data. Only a few international population cohort studies have collected the detailed language measures required for accurate descriptions of the trajectories and outcomes of children’s language phenotyping.5,6 Studies measuring language in depth have been limited by small, non-representative samples, often drawn from clinical populations and/or commencing at preschool or school age,5 and thus missing the critical early years when the foundations for language are established. In addition, little is known about genetic and/or neural underpinnings, that is, the neurobiology of developmental language disorders (DLD).7Griffith Health, Menzies Health InstituteNo Full Tex