The Infant Index: a new outcome measure for pre-school children's services

Background The evaluation of community services for preschool children is h ampered by the lack of valid and routinely available outcome measures. Th i s study examines the use of data collected by teachers in response to educa tional legislation to determine whether a routine measure of attainments in primary school is sensitive to factors known to affect mental development. Method A community child health dataset for the cohort of children born in Sheffield in 1990-1991 was matched with a dataset provided by schools in 19 95-1996. The educational data consisted of the Infant Index scores which me asure education attainments in reception class pupils. Results We matched 4487 children from both datasets, which represented 75 p er cent of all children born in the 1990-1991 cohort. Factors which predict ed a poor Infant Index included male gender (odds ratio (OR)= 2.1, 95 per c ent confidence interval (CI)= 1.8-2.6), low birthweight (OR = 1.4, 95 per c ent Cl = 1.1-1.9) and lack of breast feeding either by intention to feed (O R = 1.3, 95 per cent CI = 1.1-1.7) or actual feeding practice at one month (OR = 1.5, 95 per cent CI = 1.1-2.0). Other factors associated with a poor outcome for the child were postnatal depression, number of pregnancies, eth nicity, pre-school educational experiences and poor housing. Conclusions Although the results are interesting in themselves, the main si gnificance of our project is in establishing a link between routinely colle cted health data and routine education data. This could facilitate research in the future thus leading to a considerable saving in the cost of long-te rm intervention studies.