Children exposed to general anaesthestic have poorer development, literacy and numeracy scores

Study finds that children exposed to general anesthesia before 4 years have poorer development at school entry and school performance | Pediatric Anesthesia | via Journal of Anaesthesia Practice


The new finding is based on a data-linkage study of over 210,000 children in New South Wales, Australia.

211,978 children included in the study were born in New South Wales at 37-plus weeks’ gestation without major congenital anomalies or neurodevelopmental disability. Of these, researchers had data on their school entry developmental assessment in 2009, 2012, or their Grade-3 school test results in 2008-2014.

The researchers compared the development and school results of children exposed to general anaesthesia during hospital procedures (37,880) up to 48 months of age to same-aged children with no exposure to general anaesthesia or hospitalisation (197,301).

Key findings

Compared to children unexposed to general anaesthesia, those exposed to general anaesthesia had a:

  • 17 per cent increased risk of poor child development
  • 34 per cent increased risk of lower numeracy scores on school tests
  • 23 per cent increased risk of lower reading scores on school tests

When the researchers restricted their analyses to children who’d had only one hospitalisation involving a procedure requiring general anaesthesia, they found no increased risk for poor development or reduced reading scores, however the risk of poor numeracy scores remained.

Full story at Journal of Anaesthesia Practice

Journal reference: Francisco J Schneuer, et al. The impact of general anesthesia on child development and school performance: a population-based study |  Pediatric Anesthesia |  2018; DOI: 10.1111/pan.13390

A new study looks at home treatment for children with Chronic Fatigue Syndrome (CFS)/ ME

NIHR | May 2018 | Worries that keep you awake at night

A new blog post on the NIHR blog, from  Professor Esther Crawley, Professor of Child Health, University of Bristol, highlights the impact of CFS or ME (myalgic encephalomyelitis) on condition.

Most of the children who attend Professor Crawley’s clinic are only attending school for two days a week. These patients have overwhelming fatigue and many are in constant pain. Because of their illness, they lose their friends, miss out on education and it causes almost unbearable stress and hardship on families. Now, a new randomised controlled trial led by Professor Crawley, the FITNET-NHS study, is comparing two treatments for children with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) who do not have access to a local specialist CFS/ME service. The study will investigate whether FITNET-NHS, an online Cognitive Behavioural Therapy (CBT) program, is effective in the NHS, and whether it offers value for money compared to Activity Management (delivered remotely through Skype) (via NIHR).

Further information about the trial can be found from the University of Bristol here 

New Green Paper on Child Mental Health lacks ambition, say Committees

Parliament UK | Green Paper on Child Mental Health lacks ambition | May 2018

The Education and Health and Social Care Committees in a joint report say that the Government’s proposed Green Paper on Transforming Children and Young People’s Mental Health ignores hundreds of thousands of children and lacks ambition. 

Chair of the Health and Social Care Committee, Dr Sarah Wollaston MP, says

The Green Paper is just not ambitious enough and will leave so many children without the care they need. It needs to go much further in considering how to prevent mental health difficulties in the first place. We want to see more evidence that Government will join up services in a way which places children and young people at their heart and that improves services to all children rather than a minority.

The Government’s Green Paper on mental health: failing a generation can be read at Parliament.UK

The interactive report can be accessed here 

A summary is available here 


The report’s conclusions and recommendations can be read here



Paediatric services audit

The Royal College of Paediatrics and Child Health has published Facing the Future Audit 2017.  This report presents evidence to demonstrate how paediatric services across the UK are meeting standards within ‘Facing the Future: Standards for acute general paediatric services’ and ‘Facing the Future: Together for child health’.  The audits seek to draw out the intended and unintended impact of standards whilst collecting and sharing practice examples where standards are being met particularly well.

Additional link: RCPCH press release

Support to help at-risk children living with alcohol-dependent parents

Department of Health and Social Care | April 2018 | New support to help children living with alcohol-dependent parents

Jeremy Hunt has announced new plans to identify at-risk children and provide them with rapid access to support and advice. He said, “the consequences of alcohol abuse are devastating for those in the grip of an addiction- but for too long, the children of alcoholic parents have been the silent victims. This is not right, not fair. These measures will ensure thousands of children affected by their parent’s alcohol dependency have access to the support they need and deserve.”


As part of these plans, a £4.5 million fund has been promised to support at-risk children,  is for local authorities to develop plans that improve outcomes for children of alcohol-dependent parents. Steve Brine MP will have a specific responsibility for children with alcohol-dependent parents.

The measures include:

  • fast access to support and mental health services for children and their families where there is a dependent drinker
  • quicker identification of at-risk children, including those undertaking inappropriate care responsibilities
  • the provision of outreach programmes to get more parents successfully through addiction treatment
  • early intervention programmes to reduce the numbers of children needing to go into care

They are designed to help an estimated 200,000 children in England living with alcohol-dependent parents.

Further details are at the Department of Health and Social Care

Young people bullied online twice as likely to self-harm

A new study examines  the relationship between cyberbullying and self- harm (SH) and suicidal behaviour. The researchers reviewed the evidence and found victims of cyber bullying are twice as likely to self harm than their peers. They also noted perpetrators are at risk of suicidal behaviors and suicidal ideation when compared with nonperpetrators. 



Background: Given the concerns about bullying via electronic communication in children and young people and its possible contribution to self-harm, we have reviewed the evidence for associations between cyberbullying involvement and self-harm or suicidal behaviors (such as suicidal ideation, suicide plans, and suicide attempts) in children and young people.Objective: The aim of this study was to systematically review the current evidence examining the association between cyberbullying involvement as victim or perpetrator and self-harm and suicidal behaviors in children and young people (younger than 25 years), and where possible, to meta-analyze data on the associations.

Methods: An electronic literature search was conducted for all studies published between January 1, 1996, and February 3, 2017, across sources, including MEDLINE, Cochrane, and PsycINFO. Articles were included if the study examined any association between cyberbullying involvement and self-harm or suicidal behaviors and reported empirical data in a sample aged under 25 years. Quality of included papers was assessed and data were extracted. Meta-analyses of data were conducted.

Results: A total of 33 eligible articles from 26 independent studies were included, covering a population of 156,384 children and young people. A total of 25 articles (20 independent studies, n=115,056) identified associations (negative influences) between cybervictimization and self-harm or suicidal behaviors or between perpetrating cyberbullying and suicidal behaviors. Three additional studies, in which the cyberbullying, self-harm, or suicidal behaviors measures had been combined with other measures (such as traditional bullying and mental health problems), also showed negative influences (n=44,526). A total of 5 studies showed no significant associations (n=5646). Meta-analyses, producing odds ratios (ORs) as a summary measure of effect size (eg, ratio of the odds of cyber victims who have experienced SH vs nonvictims who have experienced SH), showed that, compared with nonvictims, those who have experienced cybervictimization were OR 2.35 (95% CI 1.65-3.34) times as likely to self-harm, OR 2.10 (95% CI 1.73-2.55) times as likely to exhibit suicidal behaviors, OR 2.57 (95% CI 1.69-3.90) times more likely to attempt suicide, and OR 2.15 (95% CI 1.70-2.71) times more likely to have suicidal thoughts. Cyberbullying perpetrators were OR 1.21 (95% CI 1.02-1.44) times more likely to exhibit suicidal behaviors and OR 1.23 (95% CI 1.10-1.37) times more likely to experience suicidal ideation than nonperpetrators.

Conclusions: Victims of cyberbullying are at a greater risk than nonvictims of both self-harm and suicidal behaviors. To a lesser extent, perpetrators of cyberbullying are at risk of suicidal behaviors and suicidal ideation when compared with nonperpetrators. Policy makers and schools should prioritize the inclusion of cyberbullying involvement in programs to prevent traditional bullying. Type of cyberbullying involvement, frequency, and gender should be assessed in future studies.

Full reference:

The full article can be read at JMIR

Related: Science Daily Young victims of cyberbullying twice as likely to attempt suicide and self-harm, study finds

School-based yoga can help children better manage stress and anxiety

The introduction of a mindfulness and yoga programme with child-friendly poses in an US public school yielded improvement in emotional and psychosocial quality of life for the pupils who participated in this intervention. Researchers worked with a school New Orleans to add mindfulness and yoga to the school’s programming for students needing additional support.  Pupils who were screened for symptoms of anxiety previously were randomly assigned to two groups. The school children participated in the small group activities at the beginning of the school day, these sessions included breathing exercises, guided relaxation and several traditional yoga poses. A control group (n= 32 students) received care as usual, which included counselling and other activities led by a school social worker.  Researchers evaluated each group’s health related quality of life before and after the intervention, using two widely recognized research tools, this included one specifically designed for children, the Paediatric Quality of Life Inventory  (via Science Daily).


Principal author of the study  Alessandra Bazzano said : “The intervention improved psychosocial and emotional quality of life scores for students, as compared to their peers who received standard care.”

The full news release from Science Daily can be read here


Objective: To assess the impact of a yoga curriculum in an elementary school on student quality of life, and to assess teacher and staff perception of potential barriers to, and benefits of, introducing yoga and mindfulness into the classroom.

Methods: A randomized controlled trial was utilized to assess the impact of a brief intervention on third-grade students who screened positive for symptoms of anxiety. Students were randomized to an intervention group of 20 students receiving small-group yoga/mindfulness activities for 8 weeks between October 2016 and February 2017, and a control group of 32 students receiving care as usual. The Brief Multidimensional Students’ Life Satisfaction Scale-Peabody Treatment Progress Battery and the Pediatric Quality of Life Inventory (PedsQL) served as outcomes. Teachers were invited to participate in two professional development sessions about introducing yoga and mindfulness into the classroom, and completed a survey following each of the sessions.

Results: In generalized estimating equation models adjusted for time, the yoga-based intervention was associated with a 14.17 unit increase in student emotional PedsQL (p-value 0.001) and a 7.43 unit increase in psychosocial PedsQL (p-value 0.01). Results were not attenuated by adjustment. Teachers and staff reported using yoga more frequently in the classroom following the second of two professional development sessions (p-value less than 0.05). Perceived barriers to introducing yoga to the classroom were similar at two data collection time points, while perceived benefits remained high.

The intervention was associated with a significant improvement in emotional and psychosocial quality of life in the intervention group when compared to the control group, suggesting that yoga/mindfulness interventions may improve symptoms of anxiety among students. Yoga/mindfulness activities may facilitate stress management among elementary school students and may be added as a complement to social and emotional learning activities.

The paper is published in  Psychology Research and Behavior Management where it can be downloaded