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What is the ECHILD project researching?

During the national lockdowns fewer people have been attending A&E, non-emergency surgeries are being delayed, and schools and some nurseries are closed to the majority of children. We are using the ECHILD Database to understand how these kinds of disruptions to services have affected children’s health and education.

Boy smiling in learning environment

The ECHILD project focuses on understanding health and educational outcomes for children and young people with additional needs (sometimes called “vulnerable groups”). This includes children with chronic health issues, receiving special educational needs support, or who are in care. All the information used in the project is anonymous. No individual child can be identified. (There is more about how the data is kept confidential here).

The ECHILD Database covers all of England and it allows us to gain a detailed picture of the challenges that many children face as they grow up. Our results will help government, and the providers of services for these children to better understand their needs and to see who might be falling through the gaps.

The ECHILD Database uses Hospital Episode Statistics (HES) (recorded whenever a person uses a hospital’s services) to categorise different types of vulnerability amongst children and young people.  We then look at hospital use by these children - including planned admissions and visits to A&E - and compare that with use by children not classed as vulnerable. And then we want to know whether any similarities or differences between those groups have been affected by the lockdowns. 

We also want to find out whether delays in surgery or treatments during lockdown could affect children’s health or education in the longer term. We are using the example of children born with a cleft lip or palate and are analysing the number of surgeries that have been delayed because of the pandemic. This will give us an indication of how much extra support might be needed for this group of children to help them do well in school in the future.

Focus on children who require extra support

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The other key set of information in the ECHILD Database comes from The National Pupil Database (NPD).  Having this information is crucial to our research into whether schools being closed to most children during the lockdowns has had a more serious impact on the education of vulnerable children than on those without any particular health or social care need. 
We expect that our results will help health services and policymakers to better understand how best to meet the needs of vulnerable children during a time of crisis such as the COVID-19 pandemic.

These are just some of the areas we have already started work on. We will also use the ECHILD Database to find out how effective support for special educational needs or disability (SEND) is in improving children’s health. SEND provision is not evenly distributed across local authorities in England and the level of provision to individual children has varied over time. So that means we can compare health outcomes for children who have special needs, but who will have received different levels of support or in some cases, none at all. 

To help those researchers, as part of the ECHILD project we are also looking at the quality of the ECHILD Database to find out its strengths and limitations. It is vital that as well as knowing what is included in the data, we have a clear understanding of what is missing. For example, if information on school absence is weak, then the database shouldn’t be used to answer research questions related to absence. 

We are talking to young people and parents to find out what they think about the ECHILD Database and the kinds of questions they think future research should address.  More details of how you can get involved are found on our engaging the public page here.

As part of the ECHILD project, we are looking at:

The relationship between education and health outcomes for children and young people across England: the value of using linked administrative data. 

Project leadProf Ruth Gilbert

Start date: August 2017

Summary:

The study tests the feasibility and success of linkage between health and education data, using a subset of the Education and Child Health Insights from Linked Data database (ECHILD). The study evaluates the ECHILD linkage method to support wider use of linked administrative data for research.  This includes assessment of data quality, consistency between sources, linkage bias and the development of optimal strategies for linking large administrative datasets.  The study also evaluates the association between hospital admissions for children and adolescents with underlying chronic conditions and subsequent school achievement and evaluates the association between education outcomes and subsequent use of hospital services, taking into account underlying chronic conditions.

Further information and findings:

  • Linking education and hospital data in England: Linkage process and quality: N Libuy, K Harron, R Gilbert, Et al.  IJPDS 2021. https://doi.org/10.23889/ijpds.v6i1.1671.
  • Gestational age at birth, chronic conditions and school outcomes: a population-based data linkage study of children born in England: N Libuy, R Gilbert, L Mc Grath-Lone, Et al.  IJE 2022. https://doi.org/10.1093/ije/dyac105.

Funding: ESRC via the Administrative Data Research UK through the Strategic Hub; the Administrative Data Research Centre for England; the NIHR Great Ormond Street Hospital Biomedical Research Centre and the Health Data Research UK.  

Linking health and education data for research to improve outcomes for children in England. 

Project leadProf Ruth Gilbert

Start date: April 2020

Summary:

The study establishes the Education and Child Health Insights from Linked Data database (ECHILD), a linked health-education dataset to enable researchers to produce reliable and policy-relevant research. The study delivers two exemplar studies of strategic research to demonstrate the database’s value for policy.  Strategic research addresses two specific areas, firstly predicting academic performance based on measures of early social disadvantage and health, and secondly assessing the impact of the COVID-19 pandemic on health and education outcomes for vulnerable children.  The strategic research studies are detailed directly below.  

Further information and findings:

Funding: ADR UK (Administrative Data Research UK), an Economic and Social Research Council (part of UK Research and Innovation) programme ECHILD project (ES/V000977/1).

Joint inequalities in early health, early skills and early socio-economic disadvantage across England. 

Project lead: Christine Farquharson

Start date: April 2020

Summary:

The study investigates the relative importance of early health, skills and disadvantage in predicting later educational attainment; the importance of health, skills and disadvantage changes over the lifecycle and whether early health continues to matter over and above later health and attainment.  The study researches the role that policy measures, such as school or early intervention funding, can play in reducing the impact of poor early circumstances on children's later attainment.  Answering these questions is critical to social and health policymaking in the wake of the pandemic.

Further information and findings:

  • Manuscript being prepared.

Funding: ADR UK (Administrative Data Research UK), an Economic and Social Research Council (part of UK Research and Innovation) programme ECHILD project (ES/V000977/1).

Assessing the impact of the COVID-19 pandemic on cleft lip and/or cleft palate repair for infants. 

Project lead: Prof Ruth Gilbert

Start date: April 2020

Summary:

The study assesses the impact of the Covid-19 pandemic on the timing of repair surgery for children born with an oral cleft in England, and implications of delays for educational outcomes.  The study researches the impact of the pandemic on the timing surgery among children born with an oral cleft during and shortly before the pandemic; the relationship between the timing of surgery and educational outcomes at age five; and the implications of delayed surgeries for longer-term educational outcomes.

Further information and findings: 

  • Manuscript being prepared.

Funding:  ADR UK (Administrative Data Research UK), an Economic and Social Research Council (part of UK Research and Innovation) programme ECHILD project (ES/V000977/1).

Assessing the impact of the COVID-19 pandemic on vulnerable children. 

Project lead: Prof Ruth Gilbert

Start date: June 2020

Summary:

The study assess the impact of the COVID-19 pandemic on outcomes for vulnerable children and young people, using linked, longitudinal education, social care and hospitalisation data for children in England.  The study researches the differences in emergency hospital contacts during the COVID-19 pandemic for vulnerable compared with other children and young people.

Further information and findings: 

Funding: The study is a collaboration between the Department of Health and Social Care (DHSC), funding this project through the NIHR Children and Families Policy Research Unit, and the ADR UK (Administrative Data Research UK), an Economic and Social Research Council (part of UK Research and Innovation) programme ECHILD project (ES/V000977/1).

Health Outcomes of young People throughout Education (HOPE).

Project lead: Prof Ruth Gilbert

Start date: August 2021

Summary:

The study uses longitudinal linked data from education, social care and hospitalisation records to assess the impact of COVID-19 on vulnerable children and young people receiving, or likely to need special educational needs or disability provision (SEND). The study is investigating the impact of adjustments for SEND on children’s health outcomes using linked education and hospital data for all children in England. 

Further information: 

Funding: NIHR Programme Grant for Applied Research (NIHR202025)

Evaluating variation in special educational needs provision for children with Down Syndrome and associations with emergency use of hospital care.

Project lead: Prof Ruth Gilbert

Start date: September 2021

Summary:

The study evaluates variation in service provision from education, children’s social care and healthcare for children with Down's syndrome and determines the impact on emergency use of hospital care.  The study investigates trends in Down's syndrome to understand its associated impacts on health and mortality.  The anonymous ECHILD study linkage keys are used in this study to link education and health data for people with Down syndrome born between 1 April 1997 and 31 March 2020 (NPD agreement DR190417; HES agreement NIC-50975; and NCDSR agreement ODR1516_064).

Further information and findings: 

  • Ongoing research.

Funding:  NIHR Great Ormond Street Hospital Biomedical Research Centre.

Influence of health condition, social disadvantage and school on absenteeism and relationship with educational attainment.

Project lead: Prof Ruth Gilbert and Dr Ruth Blackburn 

Start date: September 2021

Summary:

The study investigates the relationships between chronic health conditions, school absence and school attainment, and how these relationships vary according to social disadvantage and school characteristics. Research findings detail the impact of prolonged school absence during the COVID pandemic on education and health outcomes, and which groups are likely to be most affected.

Further information 

Funding:  NIHR Children and Families Policy Research Unit.

Linking health and education data for research to improve outcomes for children in England - Supplement.

Project lead: Prof Katie Harron

Start date: September 2022

Summary:

The study continues UCL role in the Education and Child Health Insights from Linked Data database (ECHILD) database project (ES/V000977/1)). The study advances ECHILD with regular refreshes of NPD and HES data, alongside establishing ECHILD as a national Research Database.  

Further information and findings:


Funding: ADR UK (Administrative Data Research UK), an Economic and Social Research Council (part of UK Research and Innovation) programme ECHILD project (ES/X003663/1).

Enhancement of ECHILD with a mother-child and Unique Property Reference number link

Project lead: Prof Katie Harron

Start date: September 2022

Summary:

The study enhances ECHILD with a pseudonymised mother-child link and explores support and approches for encrypted UPRN to facilitate policy-relevant research on the impact of family, household and environmental characteristics on child outcomes, including how maternal mental health, family violence, and experience of maltreatment or adversity influence child health, early school outcomes and additional needs.

Further information and findings:

Funding: ADR UK (Administrative Data Research UK), an Economic and Social Research Council (part of UK Research and Innovation) programme ECHILD project (ES/X000427/1).

For a full list of ECHILD publications and other resources that support understanding and use of ECHILD, please see the News & resources page.

In 2023, other researchers will be able to apply to use the ECHILD Database to answer questions that benefit society. 

Research ready dataset

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Breaking the links between disadvantage and attainment

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