Sure Start had positive health benefits for children in poorer neighbourhoods

A new evaluation conducted by the Institute for Fiscal Studies considers the overall impacts on children’s health of the Sure Start programme as a whole between its inception in 1999 and its peak in the late 2000s. Sure Start is an early intervention programme targeted at parents and children under the age of four living in the most disadvantaged areas. Sure Start projects deliver a wide variety of services, which are designed to support children’s learning skills, health and well-being, and social and emotional development. They include preschool education; medical, dental, and mental health care; nutrition services; and efforts to help parents encourage their child’s development.

The study, funded by the Nuffield Foundation, followed children who had access to Sure Start right through to the end of primary school, and found that Sure Start had major health benefits for children living in disadvantaged areas. The main findings of the study include:

  • Sure Start reduced hospitalisations among children by the time they finished primary school, and these effects built over time. By age 11, greater Sure Start coverage (one more centre per thousand children ages 0–4) prevented around 5,500 hospitalisations per year (18% of the pre-Sure Start baseline).
  • Sure Start benefited children living in disadvantaged areas most. While the probability of any hospitalisation fell by 11% at age 10 and 19% at age 11 for children in the poorest 30% of areas; those in more affluent areas saw smaller benefits, and those in the richest 30% of areas saw practically no impact at all.
  • At every age in primary school, Sure Start reduced hospital admissions for injuries. At younger ages, injury-related hospitalisations fell by around 17% of their pre-Sure Start (1998) baseline; at ages 10 and 11 they fell by 30%. 

The authors suggest that a reason greater benefits were seen in the poorest neighbourhoods could be because disadvantaged children were more able to benefit from Sure Start as the types of services the programme offered in poorer areas were more helpful, or because children in disadvantaged areas were more likely to attend a centre.

In 2012 the Department for Education published a report on the impact of Sure Start Local Programmes (SSLPs) on seven-year-olds and their families, which found no impact on children’s outcomes.

Source: The health effects of Sure Start (June 2019), The Institute for Fiscal Studies

Can attention span in infancy predict later executive function?

Infant attention skills are significantly related to preschool executive function at age three, according to a new study published in the Yale Journal of Biology and Medicine.

One hundred and fourteen children took part in the study. Jessica H. Kraybill and colleagues measured children’s attention at five months by using parental-report questionnaires and by assessing look duration and shifting rate while the children watched a video clip.

Children’s single longest continuous look and the number of shifts of gaze at the video were recorded. Shorter looking durations were taken as an indication of better information processing, and high shift rates typically represent better attention. The performance on four different executive function tasks for these same children was then measured when they were three years old.

Results indicated that higher attention at age five months was related to higher executive function at age three (effect size = + 0.05), supporting the notion that attention span in infancy may serve as an early marker of later executive function.

Source: Infant Attention and Age 3 Executive Function, (March 2019), Yale Journal of Biology and Medicine.

Positive results for early years maths apps

A randomised controlled trial of two new maths apps to support young children’s early maths development has shown positive results. The apps, “Maths 3–5” and “Maths 4–6”, are based on core mathematical concepts in number and shape, and space and measure, which are covered in the Early Years Foundation Stage, and also start to introduce children to topics covered in Key Stage 1.

Laura Outhwaite and colleagues conducted the randomised controlled trial of the apps with 389 children aged 4–5 years from 12 schools in the UK. The trial took place over 12 weeks in the last weeks of their Reception school year before pupils moved to Key Stage 1. Pupils were randomised to either use the apps in addition to standard maths teaching activities (treatment); use the apps instead of a regular small group-based maths activity (time-equivalent treatment), or continue with usual maths teaching activities (control).

The results showed that pupils in the treatment group made more progress on standardised assessments of maths performance over 12 weeks than pupils in the control group (effect size = +0.31). Similarly, pupils in the time-equivalent treatment made more progress in maths performance than pupils in the control group (effect size = +0.21). There was no significant difference in maths performance between pupils in the two treatment groups (effect size = +0.08).

A randomised controlled trial of apps developed for primary children in Malawi, which we covered in a previous issue of Best Evidence in Brief, also showed positive results for maths achievement.

Source: Raising early achievement in math with interactive apps: A randomized control trial (February 2019), Journal of Educational Psychology, 111(2)

Self-regulation intervention improves school readiness

Adding a self-regulation intervention to a school readiness programme can improve self-regulation, early academic skills and school readiness in children at higher risk for later school difficulties, according to the results of a study published in Early Childhood Research Quarterly.

Robert J Duncan and colleagues looked at the effect of adding a self-regulation intervention to the Bridge to Kindergarten (B2K) programme – a three-week summer school-readiness programme – in the US state of Oregon. The B2K programme is aimed at children with no prior preschool experience, and therefore considered to be at risk for later school difficulties.

Children from three to five years old were randomly assigned to either a control group (B2K only) or the intervention group (B2K plus intervention). Children in the intervention group received two 20- to 30-minute sessions per week, involving movement and music-based games that encouraged them to practise self-regulation skills.

Results from this randomised controlled trial indicated that children who received the intervention scored higher on measures of self-regulation than children who participated in the B2K programme alone. There were no significant effects on maths or literacy at the end of the programme. However, four months into kindergarten, children from the intervention group showed increased growth in self-regulation, maths and literacy compared to expected development.

Source: Combining a kindergarten readiness summer program with a self-regulation intervention improves school readiness (November 2017) Early Childhood Research Quarterly, Volume 42, 1st Quarter 2018

Evaluation of a parent-delivered early language enrichment programme

A study, published in The Journal of Child Psychology and Psychiatry, evaluates the effectiveness of a parent-delivered language programme on pre-school children’s language and emerging reading skills.

Kelly Burgoyne and colleagues conducted a randomised controlled trial with 208 pre-school children (mean age 3 years, 1 month) and their parents living in socially diverse areas of the UK. Children and parents received either an oral language programme or an active control programme targeting motor skills. Parents delivered the 20-minute sessions to their child at home every day over 30 weeks. Children were assessed at pre-test, post-test, and 6 months after post-test on measures of language and motor skills. Early literacy skills (letter-sound knowledge, phoneme awareness and regular and irregular word reading) were assessed at 6 months after post-test only, as children were non-readers at pre- and post-test.

Children who received the language programme made larger gains in language skills (effect size = +0.21) and narrative skills (effect size = +0.36) at post-test than those children who received the active control programme, and these results were maintained six months later. Improvements were also seen in letter-sound knowledge (effect size = +0.42) and regular word reading (effect size = +0.35). No evidence was found that the control programme improved motor skills.

Source: Evaluation of a parent-delivered early language enrichment programme: evidence from a randomised controlled trial (September 2017), Journal of Child Psychology and Psychiatry. doi:10.1111/jcpp.12819

Evaluation of an early language intervention

A randomised controlled trial, conducted by Silke Fricke and colleagues, looked at the effect of an oral language intervention and compared the extent to which a 30-week programme beginning in nursery and continuing for 20 weeks in Reception was more effective than delivering a 20-week programme starting in Reception.

Children from 34 nurseries in the UK were randomly allocated to a 30-week intervention (n= 132), a 20-week intervention (n=133), or an untreated waiting control group (n=129). Allocation was minimized for gender, age and verbal skills. The children in the 30-week intervention group received the Nuffield Early Language Intervention programme for 10 weeks in nursery and continued for 20 weeks in Reception. The 20-week intervention group received only the final 20 weeks of the intervention, beginning when they entered primary school. The control group received their usual schooling.

Children in both the 20- and 30-week programme intervention groups showed greater improvement in oral language skills on measures including the CELF Expressive Vocabulary and CELF Sentence Structure subtests, and the Information Score from the Renfrew Action Picture Test, compared to children in the control group (effect size for the 20-week programme = +0.21; effect size for the 30-week programme = +0.30). However, there was no evidence to suggest that either programme improved early literacy or reading comprehension skills.

Source: The efficacy of early language intervention in mainstream school settings: a randomized controlled trial (October 2017), Journal of Child Psychology and Psychiatry, 58. doi:10.1111/jcpp.12737