Child Health and Education Study (CHES) - The Ten-year Follow-up, 1980
Rationale and Overall Design
Like its 5-year predecessor, this follow-up was originally titled the Child Health and Education Study (CHES). But in 1991 the whole project was renamed the British Cohort Study 1970 (BCS70) and the ten-year sweep became known as the BCS70 Ten-year Follow-up.
Objectives of the Ten-year Follow-up
A number of considerations influenced the development of the survey instrumentation used for the BCS70 Ten-year Follow- up:
(a) Educational Progress: A major factor in this follow-up was to examine ten year old children's educational achievement and the ways in which it is influenced by other events. For this it was decided to give each cohort child a number of educational tests administered by the class teacher, and in particular reading, mathematics, language, and reasoning. Parents, Health Visitors and Head Teachers would report on the home and educational milieu in which the Study children were developing. Relationships would be studied between children's test performance and parental attitudes, teacher interest, home environment, and also the `ethos'' of the school as a social and educational institution. Longitudinally the educational progress of this nationally representative sample of children could be evaluated in relation to a wide range of earlier developmental, educational, social and health factors recorded previously on the same cohort and in particular the effects of pre-school education and daycare.
(b) Education of Handicapped Children: The Warnock Committee had reported on the education of handicapped children and young people just before the Ten-year follow-up (Warnock, 1978). It estimated that as many as one in five of all children experienced learning difficulties which could interfere with the realisation of their full potential. This area had been under-researched due mainly to the difficulty in examining a representative childhood sample. The educational part of this ten year national Study was well situated to examine the school progress and needs, not only of handicapped children but of a whole population.
(c) Specific and Non-specific Learning Difficulties: Much- needed information could be provided about the prevalence of learning difficulties in mid-childhood. Educational tests were chosen with a wider range than usual in order to encompass the lower ranges. Evaluation could be made of the influence on children with learning problems of life events, stress or ill health also the influence of their home and family circumstances. Children with specific reading and mathematical difficulties such as developmental dyslexia could be examined in relation to social, health and other educational factors. Specific questions were included to identify attention deficit and/or hyperactivity (ADHD). In addition children who could not be tested with the normal tests were to be evaluated using a wide range of special educational tests. It was also planned that the special tests should be administered to those children achieving below the fifth percentile for this age group in reading and mathematics.
(d) Health Hazards: The Health part of the Study was designed to measure their medical, social and family status at 10 years. In order to compare this with what had been found out at five years, this was to be obtained in a similar way to five years. An interview would be held with the parents, usually the mother, who was also to fill in a self-completion form describing their child's behaviour, life skills and activities. A medical examination by the school doctor would provide measures which could be related to the child's health at birth, at pre-school, and at infant and primary school.
(e) Special Health Study: Ten year children with impairments, disabilities or handicap, many of whom had already been identified at the five-year follow-up, were to be made the subjects of a special study of their use and their family's use of health and social services, though the results of this special study are not reported here.
(f) Longitudinal Element: This is of course above all a longitudinal study. It is worth repeating that the comprehensive nature of the data gathered from birth onwards enabled a study of the effects on the 10-year child's education, health and general progress, of perinatal problems, serious childhood illnesses and critical episodes in the family or social environment.
The names and addresses for the BCS70 Ten-year Follow-up were obtained initially through School Registers on which a pupils sex, name, address and date of birth were recorded. Late in 1978, help for this was obtained from every Local Education Authority (LEA) in England and Wales and every Regional Council (RC) in Scotland. A supply of numbered and addressed school trace forms were sent to all LEAs and RCs throughout Britain. LEAs and RCs were asked to send these to the Head Teacher of each maintained primary (junior), middle school or special school within their boundaries. Each school was asked to provide the survey team with the name, address and exact date of birth of each child born in that particular week in April 1970 and the name of parent(s) or guardian(s).
Information came to the survey team from these tracing forms over a six month period. From these forms an initial ten-year survey address file was compiled.
A second index was compiled from study records of the cohort children in England, Scotland and Wales who had taken part previously in the survey at birth, or at five-years (n="13,135)," or 7years (n="1,915)."
From the two registers the survey team were able to match through their surname the children on the 10-year register with those who had taken part in one or more previous follow- ups. This matching process was a lengthy procedure and was made more difficult by change(s) of name or address which some of the children had experienced during their short lives. Matched children were allocated the same Central Survey Number as used on the birth or five-year file. For those who could not yet be matched, a new Central Survey Number was allocated and this was retained unless or until matching could be accomplished.
During the course of the survey the number of children traced was augmented in many areas by asking Family Practitioner Committees (FPCs) in England or Health Boards (HBs) in Scotland to notify the survey team of those 10-year old children in their area born in that particular week in April 1970 who were on the list of an NHS General Practitioner. Other methods of updating addresses are described in the section on fieldwork in the Health Pack (see paragraph 1.35 below).
The co-operation of Local Education Authorities (LEAs) and Regional Councils (RCs) was sought to trace the whereabouts of cohort children who were on their school registers. LEAs and RCs were also asked to appoint an education co-ordinator to received and distribute an Educational Pack for completion in school, and return the packs for analysis. On the health side, Area Health Authorities (AHAs) and Scottish Health Boards (HBs) were asked to co-operate and to appoint a health co-ordinator (usually a doctor or nurse) with the remit to arrange for each study member a home interview and a medical examination. The vast majority of Education and Health Authorities agreed readily to join in as will be seen from the very high yield of completed questionnaires.
Co-operation from Official Bodies
Approval was obtained of among others, the Society of Chief Education Officers; the Association of Metropolitan Authorities; the Health Visitors Association; the Royal College of Nursing; the British Medical Association; the Scottish Medical Association; the National Union of Teachers and the Association of Head Teachers.
A Parental Pack seeking informed consent and including explanatory letters to parents and cohort members was sent out early in 1980 to current addresses if already traced, or to last known address if so far untraced. AHA/HB and LEA/RC co-ordinators were supplied with Parental Packs to send on to any cohort members subsequently identified.