Child growth and development in East London study: an update
Dr Joanna Orr, Postdoctoral researcher, Queen Mary University London (QMUL)
The Child Growth and Development in East London (CGEL) study is currently being rolled out in Tower Hamlets.
The study, conducted by our team at QMUL, is assessing the feasibility and acceptability of the use of growth screening in pre-school aged children. Early results show that screening children at age two as part of the Healthy Child Programme run by health visitors would be possible and likely beneficial to the child population.
The study has been running since May 2022 and has so far recruited over 450 children. Study participation involves the child having their standard two-to-two-and-a-half-year review with the study health visitor. The health visitor then collects some extra information about the child, their health, their circumstances, and the heights of the parents.
The child’s and the parents’ heights are then used to calculate a standardised height score for the child, and a measure of how close each child is to their expected height based on their parental heights.
Children who are below expected levels on either of these measures are flagged for referral to a specialist growth clinic. A follow-up visit will also allow us to look at children’s growth over time. Several children who have been identified by this screening have already been seen at Professor Helen Storr’s growth clinic. Our early experience is that this could have a positive impact on children living with growth-affecting conditions who have yet to receive a diagnosis.
To implement such a screening programme nationwide would require both healthcare providers and families to be on board. Because of this, the study has also collected qualitative focus group data on parents and health visitors’ views on growth screening. We found that parents would like more formal screening programmes for their children and would appreciate more clarity in the roles and what can be expected from the various healthcare professionals involved in their child’s care.
Health visitors were interested in new tools to help assess and refer children. Both parents and health visitors stressed the importance of properly resourcing any screening programme, so that children and families who were found to need support could access it.
Finally, we are also interested in the link between growth and early child development. We are collecting data from the standard developmental test used to assess children at this age (Ages and Stages Questionnaire – ASQ).
We are also conducting more detailed developmental assessments on a subsection of our participants. This data will help us understand the association between growth and development. We have explored this question before, as detailed here.
Growth in childhood is becoming increasingly recognised as a marker for a child’s health and environment. Recent reports of the UK’s declining position in the global height rankings for five year olds (NCD Risk Factors Collaboration) have raised questions on what the causes of this decline is, and whether austerity could be to blame.
Our group previously found that short stature in children was highly associated with deprivation, and that the most deprived areas of the country had higher rates of short stature (including East London). Whether these inequalities are also linked to poorer access to healthcare, diagnosis and treatment of growth-affecting conditions is an important future question.
If you would like to get in touch about this study or would like to input into our work, please contact Joanna at [email protected] or Helen at [email protected] by email.
