The 50 Things Approach: Harnessing the Research to Give Children The Best Possible Start in Life
Mark Mon Williams, Professor of Psychology at the Bradford Institute of Health Research, spoke at our most recent webinar: 'Placing families and early years at the heart of your COVID recovery strategy'. Below, he details the child health, development and social mobility research which underpins the 50 Things offer. Read the transcript here or scroll down to see the recorded video.
I'm currently sat in Bradford Royal Infirmary which is very much at the sharp end of the pandemic. Clearly, the pandemic has created huge amounts of work for a large number of my colleagues. It's undoubtedly the case that Covid has directly impacted older adults primarily, so our wonderful paediatricians have seen little direct impact of Covid. However, it is very clear that this terrible situation, this lockdown occurrence, has really had an incredibly deleterious effect on our children and young people. I'll talk through some data that back up that suggestion.
We are now faced with a major problem. We have large numbers of children who are experiencing very poor mental health. We have large numbers of children who have been inactive for long periods of time with levels of obesity that you would expect. We have huge numbers of safeguarding issues. So lots of problems that we need to tackle. But there is some good news. The good news is that we do have the tools to tackle these problems. Humans possess the most powerful tool of all and that is the tool of science.
My message today is that science really does work. It allows us to identify a problem, it allows us to understand a problem, and most importantly it allows us to find a solution to the problem. Let’s start by using our scientific tools to really identify the problems that we are facing as a society.
Identifying the Problem
Let’s go back to pre-pandemic. We're all aware of the catastrophic impact of the pandemic but let’s go back a year ago and see where we were. A year ago, we had all kinds of problems. We had a non-communicable disease epidemic. We had an increasingly unhealthy population. So Bradford is hitting a raise of diabetes of 10.8% - 1 in 10 adults has diabetes and that number is growing. This has been reflected up and down the UK. We have half of our children leaving schools without Cs in English or Mathematics. Of course, these two facts are related because education is the most powerful tool that we have to prevent these non-communicable diseases. Bradford is bad but as are many other areas of the UK and arguably we're just slightly ahead of the curve. This is the current situation within our country- we're facing a non-communicable disease epidemic and this is why the pandemic has hit us so hard as a country. The pandemic was bad but we had a tinder box of poor health that the pandemic has exploited.
We have, of course, lots of data showing us the inequalities that exist within our society. We can see those inequalities within our district. But we can zoom out and we can see those inequalities nationally. Ten years ago, Marmot showed that there was this huge north-south divide. Ten years later, after much outcry about these inequalities, Marmot reports that things have gotten worse. The point is that we know scientifically that inequalities are bad for everybody - that these inequalities are creating major problems for us as a society.
Let's think about what that looks like here in Bradford. We have one of the wealthiest wards outside of London and some of the poorest wards outside of London. If we go to an area like Holme Wood in the south of Bradford, we find that the life expectancy within that place is less than ten years below the UK average. We see major mental health problems played out within that locality. So we have huge inequalities over a national and over a regional level. These inequalities are feeding this non-communicable disease epidemic and we are failing the generation of children.
It's costing us a fortune. In 2012, our Chief Medical Officer pointed out that the annual long term cost of us not properly supporting children is coming out at about £2.3 billion per year. That's back in 2012 and I think all of us can imagine how many numbers have been added to that value since then.
So we have a major problem. But the power of science is having identified the problem, we can then start understanding it by using our scientific tools. That's what we do in Bradford and we have the great advantage of the Born in Bradford longitudinal cohort study. So for a four year period, we recruited all of the pregnant mothers within our district and sought their permission to follow the mothers through the pregnancy, follow the children through the birth and follow the children as they grow up. What that allows us to do is get this uniquely rich picture of all of those early life factors that influence a child's outcomes - in terms of their physical health, in terms of their mental health, in terms of their educational attainment and in terms of their social mobility. This is why we know that 50 Things To Do Before You're Five is so important because we can see the impact of acting early in children's lives, in terms of protecting children, in terms of removing risk factors so children have better outcomes. So children grow up to be well educated, healthy individuals with all of life's potential open to them.
Understanding the Problem
Science allows us to understand this problem and then science allows us to start finding solutions. Born in Bradford has revealed to us the importance of acting early and what we've been able to do during the pandemic is start really using our Born in Bradford community. There are over 30,000 people to get a really good understanding of how the pandemic has affected children and young people.
What we've done in our partnership with our colleagues at Stanford University is really identify the four major issues that are going to impact children. One is the digital divide. 19% of our children were unable to access digital technologies during the lockdown period. Whilst schools were encouraged to put all their materials online, what we were actually doing is creating greater inequalities. For some of our children, they were unable to access that digital education resource.
Another major issue that we have been able to identify because we can compare baselines of data with these extensive surveys that we have carried out are issues related to food insecurity, big issues related to obesity and big issues related to physical activity. We have found that, within children of south Asian heritage, the physical activity levels are significantly lower than their white British heritage peers.
We've also identified the huge impacts of classroom inequalities - so the impact on children with special educational needs will be a major problem that we will need to tackle as we move forward.
Perhaps of no surprise to anybody, we are observing a massive increase in mental health problems amongst our children and young people.
Finding a Solution
We're starting to understand the problems we need to tackle. So what is the solution? Science has given us the vaccine that is going to allow us to combat this dreadful communicable virus- Covid-19. What we now need is a non-communicable disease vaccination. What we need is something that will protect our children and young people and allow them to maximise their physical health, their mental health, their educational attainment and their social mobility. The beautiful thing about 50 Things To Do Before You're Five, is that it provides activities that are based on scientific evidence that we know can protect children and young people - that can vaccinate them against the problems that they will otherwise face.
The Digital Divide
What I love about this app is that instead of many digital solutions that increase inequality this is an approach that levels the playing field. There are non-digital versions of this incredible program. But, it's also a program that doesn't rely on mum or a guardian having credit on their phones; once the app is installed it can be used. That's something we found important in Born in Bradford, that time and time again a middle-class solution is ‘let's just have an app to encourage mums to be more engaged with their children’ - but what about those mums who don't have a credit or those who don't have mobile phones? The beautiful thing I love about 50 Things To Do Before You're Five is directly tackling that digital divide. What it's doing is supporting parents to undertake evidence-based activities with their children, activities that we know will protect the children in the long term.
Academic Performance and Cognitive Capacity
I don't want to bore people with the science behind this but I do want to emphasise the rich data that we managed to collect that shows that children being active, engaging in the type of activities that 50 Things supports, that these activities benefit learning. We conducted large randomised control trials that show that if you encourage children to be active that actually enhance their working memory capacity (their cognitive capacity), they're better equipped to learn. These activities directly impact upon children's ability to take advantage of the educational system. We have even managed to show that children's motor skills are highly predictive of their SATs. So how well the children do in school relates to children's motor competence. The beautiful thing about motor competence is that it's something that can be trained and that's what 50 Things does!
It allows children to acquire those fundamental building blocks upon which education is grounded. You don't suddenly acquire the ability to do abstract mathematics. First of all, you put the fundamental mathematical building blocks in place through your physical interactions with the environment. We've known this since Piaget first described it in 1954, and that's what all the evidence shows. These activities that are being supported in 50 Things are laying down the foundation, this is why it helps children be school-ready, this is why it will vaccinate our children and protect our children so that they can best take advantage of the school system. Again, all of the data within Born in Bradford shows that school readiness plays out right across the children's trajectory. The more we can make children ready for school, the better the long term outcomes. 50 Things really is giving the best possible start in life.
Special Educational Needs and Disabilities
What we've been able to do in Born in Bradford is to look at very small genetic abnormalities that exist. We have large numbers with SEND within the system, and often we don't know why that child has special educational needs. Through Born in Bradford we have such rich genetic data we can start to identify that large numbers of our children with SEND, actually very small subtle genetic abnormalities, what we've been able to show is that it directly impacts on children's motoric abilities. So protecting children, giving them these core skills actually starts giving them protective factors that means that their special educational needs can be decreased. This is all about acting early to protect children to remove those risk factors.
Remarkably, what we've been able to show is that giving children these abilities, these skills, protects their mental health. These children's motor skills, those skills that are being encouraged and developed through 50 Things, relate directly to teacher evaluations of social and emotional wellbeing.
We can use science to identify a problem, understand a problem and then tackle a problem. The thing that I love 50 Things is that it's based on the best possible science. We have the tools available that allow us to really make a significant change in children and young people's lives. I want everyone (on this call) to make those changes because we have the tools to do that, we have the scientific tools. But thanks to 50 Things we actually have a tangible offer to families to help them support their children with all of the long term benefits that that will then accrue.
Professor Mark Mon-Williams
Professor Mark Mon-Williams holds a Chair in Cognitive Psychology at the University of Leeds, and is Professor of Psychology at the Bradford Institute of Health Research, and Professor of Paediatric Vision at The Norwegian Centre for Vision. He is also a Turing Fellow at The Alan Turing Institute (the UK’s National data analytics centre). MMW is also leading the creation of a Centre of Applied Education Research (a partnership between the Universities of Leeds and Bradford together with the Department for Education, the Education Endowment Foundation, and the Bradford Local Authority) – a multidisciplinary Centre based at the Bradford Royal Infirmary.