Children of the millennium

Children of the millennium: understanding the course of conduct problems during childhood | The Centre for Health Economics | University College London Institute of Education  

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This report presents an analysis of the Millennium Cohort Study which follows the lives of children born in 2000 and 2001.  The report finds that one child in every twelve in the UK has behavioural problems from a young age into their teenage years and calls for the government, NHS, schools and local authorities to do more to support children with persistent behavioural problems.

Children with persistent problems are much more likely to have a multitude of risks early in life, including poverty and housing insecurity, parental mental illness and developmental delay.


The report calls for:

  • Government to seek to reduce child poverty and housing insecurity
  • The NHS to continue to boost mental health support to new parents
  • Local authorities to get the funding they need to boost early years services such as Sure Start and to offer evidence-based parenting programmes to families with the greatest needs.

Full document: Children of the millenium: Understanding the course of conduct problems during childhood | Centre for Mental Health

Additional link: Centre for Mental Health press release

Nearly 50 per cent of sport injuries treated in A&E are in kids

University of Newcastle| November 2018 |Almost half of sport injury-related A&E attendances are children

New research indicates that children under the age of eighteen are the highest burden of sports-related injury to A&E. With 12 year-old females, and 14-year-old males being the most at risk of sustaining a sports injury. The research involved analysis of injury attendance data at two hospitals, one in Oxford and the other in Banbury, from January 2012 – March 2014. Attendances recorded totalled almost 64,000 (63,877), of these  11,676 were sport-related, with 5,533 of these in  children and young people aged 0-19.

The research conducted by researchers at the University of Newcastle and University of Oxford, found the most injurious sports activities for girls were trampolining, netball and horse riding; for boys this was rugby union, rugby league and football.


Graham Kirkwood, senior research associate at Newcastle University, said: “These figures are equivalent to 68 boys and 34 girls in every thousand attending NHS emergency departments in a year. This is a heavy burden on the NHS and on children and families from sport-related injury.”

He added: “Children need to be physically active but making organised sports as safe as possible needs to be part of any effective child obesity strategy.” (Source: University of Newcastle)

Full news release at the University of Newcastle

The full article is available to read at Journal of the Royal Society of Medicine 

To analyse and report on sports-related injuries using enhanced injury data collected by the testbed for the NHS emergency care injury data set and admissions data collected from inpatients.


Ecological study design.

Two Oxfordshire NHS England hospitals.

Emergency department attendees and inpatients aged 0–19 years with sports injuries.

Data were analysed from 1 January 2012 to 30 March 2014 by age, gender sport, injury location, injury mechanism and diagnosis including concussion/post-concussion, bone fractures and ligament damage. Admissions data were analysed from 1 January 2012 to 24 January 2015.


Children and adolescents aged 0–19 years accounted for almost half (47.4%) of sports injury-related emergency department attendances and almost one-quarter (23.5%) of sports injury-related admissions for all ages. The highest rates of attendance occurred at 14 years for boys (68.22 per 1000 person-years) and 12 years for girls (33.72 per 1000 person-years). For male 0–19-year-olds the three main sports were (in order) football (soccer), rugby union and rugby league and for females, trampoline, netball and horse-riding. The largest gender differences were in netball where injuries were predominantly in females and in wheeled motorsports where injuries were predominantly in males. Almost one-quarter of emergency department sports-related injuries recorded were fractures, the highest percentage to the upper limbs.


Public health departments in local authorities and schools should consider target sports injury prevention at children in the first four years of secondary school. For younger age groups, trampolines in the home warrant improved safety. Rugby and horse-riding should also be a focus for interventions.

Full reference: Kirkwood, G., Hughes, T. C., & Pollock, A. M. |2018 | Results on sports-related injuries in children from NHS emergency care dataset Oxfordshire pilot: an ecological study|Journal of the Royal Society of Medicine|

In the media:

BBC News Children and adolescents ‘account for half of sports A&E attendances’

Screen time does not impact sleep in children, finds study

Science Daily | November 2018 |Children’s sleep not significantly affected by screen time, new study finds

Earlier research has suggested that between 50 and 90 per cent of school- age children might not be getting enough sleep, citing digital technologies as a potential contributor to this. Now research findings from the Oxford Internet Institute at the University of Oxford, indicate that screen time has a modest impact on child’s sleep. The research team used data from the United States’ 2016 National Survey of Children’s Health, which included parents from across the country whom completed self-report surveys on themselves, their children and household. The survey included questions that required caregivers to estimate their child/ren’s sleep duration over one day, if their child/ren went to bed at approximately the same time each night and the amount of time spent on digital screens (including mobile phones, computers, handheld video games and other electronic devices). 


Although the study found a correlation, the lead researcher, Professor Andrew Przybylski, author of the study published in the Journal of Pediatrics explains it is modest. “The findings suggest that the relationship between sleep and screen use in children is extremely modest. Every hour of screen time was related to 3 to 8 fewer minutes of sleep a night.” (Source: Science Daily)



To determine the extent to which time spent with digital devices predicts meaningful variability in pediatric sleep.

Study design

Following a preregistered analysis plan, data from a sample of American children (n = 50 212) derived from the 2016 National Survey of Children’s Health were analyzed. Models adjusted for child-, caregiver-, household-, and community-level covariates to estimate the potential effects of digital screen use.


Each hour devoted to digital screens was associated with 3-8 fewer minutes of nightly sleep and significantly lower levels of sleep consistency. Furthermore, those children who complied with 2010 and 2016 American Academy of Pediatrics guidance on screen time limits reported between 20 and 26 more minutes, respectively, of nightly sleep. However, links between digital screen time and pediatric sleep outcomes were modest, accounting for less than 1.9% of observed variability in sleep outcomes.


Digital screen time, on its own, has little practical effect on pediatric sleep. Contextual factors surrounding screen time exert a more pronounced influence on pediatric sleep compared to screen time itself. These findings provide an empirically robust template for those investigating the digital displacement hypothesis as well as informing policy-making.


Full reference: Przybylski, Andrew K. | 2018| Digital Screen Time and Pediatric Sleep: Evidence from a Preregistered Cohort Study | The Journal of Pediatrics| Volume 0 | Issue 0 |DOI:

The full article is available from the Journal of Pediatrics 

Unnecessary tonsil ops for 7 in 8 children finds, University of Birmingham study

Šumilo, D.,  Nichols, L.,  Ronan, R. & Marshall, T. | 2018| Incidence of indications for tonsillectomy and frequency of evidence-based surgery: a 12-year retrospective cohort study of primary care electronic records| 

A retrospective cohort study that looked at the incidence of tonsil removal (tonsillectomy) in children aged 0-15 years has found that the majority of these operations were not evidence-based. The main criteria for tonsillectomy are

  • more than seven documented sore throats in a year
  • more than five sore throats per year for two successive years
  • three sore throats per year for three successive years

According to the study’s findings 2,144 tonsillectomies out of 18,281 were evidence-based. Of those children who had their tonsils removed  12.4 per cent had reported five to six sore throats in a year; 44.7 per cent had suffered two to four sore throats in a year; and one in ten children (9.9 per cent) had just one sort throat in a year with experiencing one sore throat before having the procedure.


The researchers from the University of Birmingham show that showed every year over 32,000 children undergo needless tonsillectomies, which costs the NHS of £36.9 million. They also underline that of the 15,764 children who might benefit from the operation hat of  children who had records showing sufficient sore throats to undergo a tonsillectomy, just 2,144 (13.6 per cent) actually went on to have the operation.

Read the full University of Birmingham press release here 


Background Neither the incidence of indications for childhood tonsillectomy nor the proportion of tonsillectomies that are evidence-based is known.

Aim To determine the incidence of indications for tonsillectomy in UK children, and the proportion of tonsillectomies meeting evidence-based criteria.

Design and setting A retrospective cohort study of electronic medical records of children aged 0–15 years registered with 739 UK general practices contributing to a research database.

Method Children with recorded indications for tonsillectomy were identified from electronic medical records. Evidence-based indications included documented sore throats of sufficient frequency and severity (Paradise criteria); periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA); or tonsillar tumour. Other indications were considered non-evidence-based. The numbers of children subsequently undergoing tonsillectomy was then identified. The numbers with evidence-based and non-evidence-based indications for surgery among children who had undergone tonsillectomy were determined.

Results The authors included 1 630 807 children followed up for 7 200 159 person–years between 2005 and 2016. Incidence of evidence-based indications for tonsillectomy was 4.2 per 1000 person years; 13.6% (2144/15 760) underwent tonsillectomy. Incidence of childhood tonsillectomy was 2.5 per 1000 person years; 11.7% (2144/18 281) had evidence-based indications, almost all with Paradise criteria. The proportion of evidence-based tonsillectomies was unchanged over 12 years. Most childhood tonsillectomies followed non-evidence-based indications: five to six sore throats (12.4%) in 1 year, two to four sore throats (44.6%) in 1 year, sleep disordered breathing (12.3%), or obstructive sleep apnoea (3.9%).

Conclusion In the UK, few children with evidence-based indications undergo tonsillectomy and seven in eight of those who do (32 500 of 37 000 annually) are unlikely to benefit.

Source British Journal of General Practice 

Please contact the Library to access the full article

In the media:

BBC News ‘Too many children’ have tonsils removed unnecessarily

The Guardian Nine in 10 operations to remove children’s tonsils ‘unnecessary’

Promoting healthy weight in children, young people and families

A resource to support local authorities, NHS commissioners and providers, voluntary and community sector organisations to take action to reduce obesity | Public Health England


This resource is made up of briefings and practice examples to promote healthy weight for children, young people and families as part of a whole systems approach.

It supports:

  • local authorities
  • Clinical Commissioning Groups
  • other NHS partners and non-government agencies

The briefing papers help to:

  • make the case for taking action to reduce childhood obesity
  • give examples of actions that can be taken
  • provide key documents that form the evidence base and other useful resources

Practice examples are also given to illustrate what local areas are doing.

The briefings have been developed so they can be used as standalone documents and downloaded separately, or as part of the wider resource.

Full documents:

A&E visits by young people with mental health problems have almost doubled in five years

There has been a steep rise in the number of young people aged 18 or under arriving at A&E departments in England with psychiatric conditions, according to new figures released this week | via YoungMinds


The Department of Health and Social Care has revealed that, in 2017-18, there were 27,487 attendances in A&E by young people aged 18 or under with a recorded diagnosis of a psychiatric condition. This figure has almost doubled since 2012-13, when there were 13,800 equivalent attendances, and almost tripled since 2010.

The findings coincide with a survey by mental health charity YoungMinds, which revealed that 61 per cent of parents said the care their child received in crisis was “bad” or “unacceptable.” In the survey of 1,531 parents whose children have experienced a mental health crisis:

  • 75% agreed that “it would have been helpful for my child to have a safe place to go to while they were in crisis within our local community”.
  • 65% agreed that “It would have been helpful for me or my child to have access to a mental health crisis telephone hotline”.
  • 86% agreed that “it would have been helpful for my child to have access to support before they reached crisis point.”

Full detail: A&E attendances by young people with psychiatric conditions almost doubled in five years – new figures | YoungMinds

A Crying Shame A report by the Office of the Children’s Commissioner into vulnerable babies in England

Children’s Commissioner | October 2018 | A Crying Shame  A report by the Office of the Children’s Commissioner into vulnerable babies in England

This report  from the Children’s Commissioner looks at how many babies might be vulnerable to severe harm  and presents the facts about the sort of risks even very young children are being exposed to.  A Crying Shame suggests there are 15,800 babies under the age of 1 considered by local authorities to be vulnerable or highly vulnerable and at risk of harm, but still living at home. The report comes as many local authorities are struggling with unprecedented financial pressures that are putting increasing strain on children’s social services (Source: Children’s Commissioner).


Alice Miles, the Children’s Commissioner’s Director of Strategy and author of the report, said:

“This analysis suggests there are many thousands of babies living in households carrying very high risks, many of whom may not even be known to social services. We know infants are especially vulnerable to being harmed by parental abuse or neglect. With local authorities under such pressure financially, and troubled families funding coming to an end in 2020, it’s vital that ministers make the protection of vulnerable children a priority in policy and funding. The country is rightly shocked and outraged when serious case reviews reveal the circumstances in which young children live and sometimes die; however, sadly these are the tip of the iceberg.”


Read the report in full from the Children’s Commissioner 

 Children’s Commissioner publishes report into vulnerable babies [Press release]