Research and analysis

Statistical commentary: child development outcomes at 2 to 2 and a half years, quarter 2, 2017 to 2018

Updated 24 October 2018

1. Main findings

The proportion of children at or above the expected level in all 5 areas of development in England is 78.5% (with confidence intervals 78.2% to 78.9%) for quarter 2, 2017 to 2018 (July to September 2017).

The proportion of children at or above the expected level in all 5 areas of development at a Public Health England (PHE) centre level can be published all PHE Centres.

The proportion of children at or above the expected level in all 5 areas of development can be published for 67 local authorities with complete submissions, and percentages range from 0% to 99.0%.

This statistical commentary should be considered alongside the 2017 to 2018 quarter 2 Child development outcomes at 2 to 2 and a years statistical release.

Please treat the figures with caution. Where totals are presented for England and PHE centres, these are aggregate totals of the areas that submitted information and passed initial validation. Percentages are based on local authorities that made submissions and passed initial validation. Confidence intervals are shown in brackets.

Indicator Quarter 1 England value Quarter 2 England value Quarter 3 England value Quarter 4 England value 2017/18 England value
C6iii: children who were at or above the expected level in communication skills % 81.9% (81.6 to 82.3) 85.8% (85.5 to 86.0)      
C6iv: children who were at or above the expected level in gross motor skills % 83.8% (83.5 to 84.1) 87.8% (87.5 to 88.0)      
C6v: children who were at or above the expected level in fine motor skills % 83.8% (83.5 to 84.1) 87.6% (87.3 to 87.9)      
C6vi: children who were at or above the expected level in problem solving skills % 84.5% (84.2 - 84.8) 88.4% (88.1 to 88.6)      
C6vii: children who were at or above the expected level in personal-social skills % 83.8% (83.5 to 84.1) 87.8% (87.6 to 88.1)      
C6viii: children who were at or above the expected level in all five areas of development % 74.5% (74.1 to 74.9) 78.5% (78.2 to 78.9)      

2. Background

From 2015 all children in England became eligible for a Healthy Child Programme development review, delivered as part of the universal health visitor service, around their second birthday. The Ages and Stages Questionnaire (ASQ-3TM) was identified through research to be suitable for generating data for a population measure of child development outcomes and from testing with parents and professionals to be acceptable for use in practice.

ASQ-3TM is not a screening tool, but does provide an objective measure of development and allows comparisons to be made helping to identify children who are not developing as expected and supporting decisions on closer monitoring of progress or targeting of services. Dimensions of development which are tested include communication, gross motor, fine motor, problem solving and social / emotional skills.

In October 2015, the responsibility for commissioning children’s public health for the 0 to 5 years’ population transferred from NHS England to local authorities. To support this transfer, PHE established an interim data collection for a number of main performance indicators associated with these services, which it is critical to monitor and report. The strategic reporting solution hosted by NHS Digital, the Community Services Dataset (formerly the Children and Young People’s Health Services Dataset), is collecting relevant data items directly from providers’ systems and in time will take on reporting of these indicators. This data, which is intended to support the generation of indicators for the Public Health Outcomes Framework, is continually increasing in coverage and quality.

The information on child development outcomes in this publication has been obtained via the interim reporting system. It was submitted to PHE by local authorities on a voluntary basis. It covers Quarter 2 of 2017 to 2018, which is the second reporting period. The full service data is available.

The data on child development outcomes reported here are from supplementary metrics for the number of health visitor reviews completed at 2 to 2 and a years using ASQ-3TM.

  1. C6iii: percentage of children who were at or above the expected level of communication skills.
  2. C6iv: percentage of children who were at or above the expected level in gross motor skills.
  3. C6v: percentage of children who were at or above the expected level in fine motor skills.
  4. C6vi: percentage of children who were at or above the expected level in problem solving skills.
  5. C6vii: percentage of children who were at or above the expected level in personal-social skills.
  6. C6viii: percentage of children who were at or above the expected level in all 5 areas of development.

These metrics are presented as management information and are reported by local authority, PHE centre and England level.

3. Data collection method

An interim reporting system is hosted on the Local Government Association (LGA) website to collect the data on health visiting indicators. The reporting window for quarter 1 and quarter 2 data was 20 November to 15 December 2017.

To support local authorities in submitting data, detailed guidance was circulated to explain how analysts and commissioners in local authorities should submit health visiting indicators. A dedicated mailbox ([email protected]) was also in place to respond to questions and comments.

Once the collection window closes the data received is centrally collated, validated and reported. This process will be repeated quarterly.

4. Data quality

The following data relates to quarter 2, 2017 to 2018.

A total of 145 reporting local authorities submitted a return for the interim reporting system for quarter 2, 2017 to 2018. The 5 local authorities that did not submit data are Kirklees, Middlesbrough, Newham, Nottinghamshire, and Sefton.

A total of 69 local authorities submitted data for at least one of the supplementary metrics, and 67 submitted data for all 6 supplementary metrics.

5. Validation rules

Local authorities submitting a nil return will be classed as a non-submission.

Areas with incomplete submissions are excluded from the relevant indicator.

All complete submissions are included in their respective PHE centre and the England aggregated calculations. A comprehensive breakdown of the results following the application of the validation is available.
  ## Summary of quarter 2 data

5.1 Indicator C6iii: percentage of children who were at or above the expected level of communication skills

The aggregate percentage of children at or above the expected level in communication skills (indicator C6iii) for England for quarter 2 is 85.8% (with confidence intervals of 85.5% to 86.0%).

Values for percentages of children at or above the expected level in communication skills could be published for all PHE centres for quarter 2. Values ranged from 62.4% to 92.9%.

The percentage of children at or above the expected level in communication skills could be published for 68 local authorities with complete submissions. Values ranged from 0% to 98.6%, with the majority (61) reporting between 80% and 100%.

5.2 Indicator C6iv percentage of children who were at or above the expected level in gross motor skills

The aggregate percentage of children at or above the expected level in gross motor skills (indicator C6iv) for England for quarter 2 is 87.8% (with confidence intervals of 87.5% to 88.0%).

Values for percentages of children at or above the expected level in gross motor skills could be published for all PHE centres for quarter 2. Values ranged from 62.8% to 97.2%.

The percentage of children at or above the expected level in gross motor skills could be published for 67 local authorities with complete submissions. Values ranged from 0% to 100%, with the majority of areas with complete submissions (64) reporting between 80% and 100%.

5.3 Indicator C6v percentage of children who were at or above the expected level in fine motor skills

The aggregate percentage of children at or above the expected level in fine motor skills (indicator C6v) for England for Quarter 2 is 87.6% (with confidence intervals of 87.3% to 87.9%).

Values for percentages of children at or above the expected level in fine motor skills could be published for all PHE centres for quarter 2. Values ranged from 63.7% to 97.2%.

The percentage of children at or above the expected level in fine motor skills could be published for 67 local authorities with complete submissions. Values ranged from 0% to 100%, with the majority of areas with complete submissions (57) reporting between 80% and 100%.

5.4 Indicator C6vi percentage of children who were at or above the expected level in problem solving skills

The aggregate percentage of children at or above the expected level in problem solving skills (indicator C6vi) for England for quarter 2 is 88.4% (with confidence intervals of 88.1% to 88.6%).

Values for percentages of children at or above the expected level in problem solving skills could be published for all PHE centres for quarter 2. Values ranged from 63.1% to 96.8%.

The percentage of children at or above the expected level in problem solving skills could be published for 67 local authorities with complete submissions. Values ranged from 0% to 99.1%, with the majority of areas with complete submissions (61) reporting between 80% and 100%.

5.5 Indicator C6vii percentage of children who were at or above the expected level in personal-social skills

The aggregate percentage of children at or above the expected level in personal-social skills (indicator C6vii) for England for quarter 2 is 87.8% (with confidence intervals of 87.6% to 88.1%).

Values for percentages of children at or above the expected level in personal-social skills could be published for all PHE centres for quarter 2. Values ranged from 63.0% to 96.3%.

The percentage of children at or above the expected level in personal-social skills could be published for 66 local authorities with complete submissions. Values ranged from 0% to 100%, with the majority of areas with complete submissions (57) reporting between 80% and 100%.

5.6 Indicator C6viii percentage of children who were at or above the expected level in all 5 areas of development

The aggregate percentage of children at or above the expected level in all 5 areas of development (indicator C6viii) for England for Quarter 2 is 78.5% (with confidence intervals of 78.2% to 78.9%).

Values for percentages of children at or above the expected level in all 5 areas of development could be published for all PHE centres for quarter 2. Values ranged from 56.9% to 88.6%.

The percentage of children at or above the expected level in all 5 areas of development could be published for 65 local authorities with complete submissions. Values ranged from 0% to 99.0%, with the majority of areas with complete submissions (51) reporting between 80% and 100%.

6. Data quality notes

When making a submission, local authorities have the opportunity to enter comments in a free text box to explain any issues with reporting. During the quarter 2 submission, comments were received from 29 local authorities, of collective interest.

A total of 29 local authorities reported they knew, or suspected, that they had made an incomplete submission. This may include receiving confirmation of nil returns from neighbouring authorities.

A total of 23 local authorities reported that recent migration to a new Child Health Information System or problems with their existing system had impacted on their ability to submit, or on the short-term reliability of the figures.

For queries relating to this document, please contact: [email protected]

Responsible statistician/product lead: Helen Duncan