Our History / Achievements
The charity is established as The Little Foundation’s on 14th May 1990. Its charitable objectives are defined as:
To relieve sickness by promoting (i) the study of diseases and disorders of the brain, whether human or otherwise, especially but not exclusively developmental disorders and generally to improve the standard of knowledge of the means of diagnosis, prevention, treatment and care of such diseases and disorders and (ii) research and investigation into the causes of such diseases and disorders and the possibilities of prevention, alleviation or cure and to disseminate the useful results of such research and investigation.
Prof Michael Crawford reported on the Foundation’s Think-Tank on Nutrition in the Primary Prevention of Low Birthweight, Cerebral Palsy and Related Handicaps with its conclusions that research should be focused on “the prevention of low birth weight through nutrition intervention prior to conception to test the possibility of simultaneous reduction in the incidence of neurodevelopmental disorder” and “in those babies that are born of low birth weight, to examine the relationship between biochemically defined nutrient status at birth to neurophysiological follow-up. Will making good such deficits help prevent the development or exacerbation of post-natal disorder?”
The Foundation supported a taskforce set up by the World Federation of Neurology to review the appropriate use of the term ‘birth asphyxia’ in medical practice around the world.
The Foundation mounted its first international workshops in Oxford: The Middle Trimester of Gestation & Etiologies of Cerebral Palsy and Pre-term Birth & Cerebral Palsy: Is Tumor Necrosis Factor the Missing Link?
The Foundation funded Dr Martin Bax’s proposed international, ten-centre study of 1,000 children with cerebral palsy to pinpoint the nature and timing of the brain damage. The Times reported his comments that the main problem with research into causation is lack of co-ordination and underfunding. ‘People are willing to put their pennies into a tin to help people with a distressing condition but are not so willing to contribute money to prevent it.’
The Little Foundation worked again with the World Federation of Neurology, forming a joint committee addressing the need for revising the research world’s understanding of the causes and prevention of CP.
An article by Prof Michael Crawford highlighting the considerable disparity between what is spent on medical care and what is spent on prevention was published in The Lancet.
The University of Manchester reports the findings of its Foundation-funded research by Prof R D Lees: Nitric Oxide Does Not Modulate Kainate Receptor Binding in the Human Brain.
A workshop organised by the Foundation provided the inspiration for A Neurodevelopmental Approach to Specific Learning Disorders, edited by Kingsley Whitmore, Hilary Hart, Guy Willems. The workshop concluded that, “if our knowledge of specific learning disorders was applied, it could be used to lead to prevention, or, rather, such effective early intervention that the child would not get into difficulties. The editors were therefore asked to create a book providing the understanding that could lead to effective prevention. The task was not a simple one. They have called on an international group of authors who have created a depth and diversity of information and knowledge that should allow the reader to provide effective help for children who may either have a specific learning disorder or be at risk of developing one.” This volume is considered essential reading for anyone planning epidemiological research in this area.
A workshop organised by the Foundation brings together another international group on the theme of Neuroprotection of the infant brain ‐ how many roads? This covered a wide range of topics, providing “a variety of new ideas – food for thought about the question of how to design an effective safe and feasible intervention to protect the new-born infant’s brain.”
A further workshop organised by the Foundation on the theme of What Obstetricians Can Do to Prevent Disability attracts considerable interest in the research community.
Reports from an international community of researchers commended the Foundation for its workshop programme: “The current volume is a response to the many developments in the field of cerebral palsy research since the early 1980s that are outlined below…During these decades, excellent meetings organized by…the Little Foundation… have enabled researchers to keep in touch.” [1]
[1] Cerebral Palsies: Epidemiology and Causal Pathways – Fiona Stanley; Eve Blair; Eva Alberman
Further workshops were organised by the Foundation: Drugs in Pregnancy and Their Consequences and Asperger Syndrome – Management in Children and Young People.
The Foundation hosted a discussion with the Novartis Foundation on How Soon Will We Prevent Neurodisability in Childhood?, with its proceedings published by Cambridge University Press.
A research project initiated by the Foundation, Outcomes in Young Adulthood for Very-Low-Birthweight Infants, led by Dr Maureen Hack confirms that educational disadvantage associated with very low birth weight persists into early adulthood.
A research project led by Prof Michael Crawford, The Potential Role for Arachidonic and Docosahexaenoic Acids in Protection Against Some Central Nervous System Injuries in Preterm Infants, reports that an important component of the complications of prematurity is loss of blood vessel integrity. The research confirms the vital role of the placenta in supplying the fatty acids crucial to the baby’s brain development and the blood vessels that feed it, and highlights the impact on the fetal central nervous system if this supply is restricted as a result of low maternal levels of AA/DHA.
The Foundation mounted an international conference – Folic Acid & the Prevention of Neural Tube Disorders: are we getting the message across to those who need it? This led to several articles highlighting the dangers of continued inaction from governments in mandating the addition of folic acid to flour. It is only now in 2020 that the UK government has begun a consultation process on making this change.
A workshop run by the Foundation led to a special supplement collated by Dr Martin Bax and published by Developmental Medicine & Child Neurology: Prevention Requires Identification – Can We Do It? This posed challenges and questions still unresolved today: we still do not know with any certainty the numbers of children and adults with CP, there is still an international need for CP registers that need to be consistently completed, registers still frequently do not recognise or record comorbidities (the additional medical issues that pursue those with CP into adulthood), diagnosis of CP is still inconsistent. Without the true picture of who has been born and is living with CP, we cannot measure change. If we cannot measure change, we cannot tell if we can successfully prevent CP.
Dr Martin Bax co-chaired an international panel to confirm a globally recognised and shared Definition and Classification of Cerebral Palsy. This remains the definitive interpretation of what CP is.
A research project funded by the Foundation and led by Dr Martin Bax reports a significant finding in its study of children with CP from 8 different nations: Clinical & MRI Correlates of Cerebral Palsy – The European Cerebral Palsy Study. MRI brain scans of the lesions (injuries to the brain) confirmed that, in most cases, that these had occurred very early on in the pregnancy and not at the time of birth – contrary to what has historically been assumed.
The key to this important insight is that, once we are able to determine the cause of these lesions to the brain, we can then find a way of preventing them and, thus, most cases of CP.
A research project initiated by the Foundation, Periconceptional Folic Acid and Multivitamin Supplementation for The Prevention of Neural Tube Defects and Other Congenital Abnormalities, led by Dr Andrew Czeizel publishes the findings of its randomised control trial in Hungary. It reports “…an unexpected finding was a significant reduction in the rate of congenital abnormalities” as a result of periconceptional doses of folic acid.
A research project funded by the Foundation reported on the differences in skills and behaviours between children who have both Autistic Spectrum Disorder (ASD) and epilepsy and those with ASD alone. These previously unrecognised differences found have both diagnostic and therapeutic implications.
Our Chairman, Lord Hameed, tables a motion in the House of Lords asking the Government what measures have been taken to prevent cerebral palsy which now costs the NHS and social care nearly £2 billion every year.
Prof Michael Crawford and Dr Louise Brough reported on their research, Effect of Multiple-Micronutrient Supplementation on Maternal Nutrient Status, Infant Birth Weight and Gestational Age at Birth in a Low-Income, Multi-Ethnic Population, which addressed the issue of the adverse effects on maternal and infant health of poor nutrient intake during pregnancy. They concluded that use of a multiple-micronutrient supplement from the first trimester improved nutrient status amongst a socially deprived, multi-ethnic population, but also added weight to the argument that treatment with low-dose iron supplements may be preferable to using high doses in improving iron status during pregnancy. While the study suggests that this supplementation may also improve fetal growth, it recommends further, larger studies are required to corroborate these results, especially amongst disadvantaged populations within developed countries.
Lord Hameed hosts an expert seminar to discuss new evidence that can assist the prevention of cerebral palsy and other developmental disorders of the brain. Chaired by Lord Turnberg, the seminar heard from eminent scientists including Professor Michael Crawford, Dr Enitan Ogundipe and Professor Mark Johnson of Imperial College. The scientists report new evidence that severe brain disorders such as CP may have infectious-nutritional causes prior to the normal birth date. New evidence suggests that the foetal stages of brain development are put at risk by malnutrition affecting brain-specific fats and thus their ability to control inflammations caused by maternal infections. The implications are that cerebral palsy, like neural tube defects, is preventable and also that, with very early detection and intervention, the outcomes of the condition may be ameliorated.
The Foundation held an event at the House of Lords to launch To Be Born with a Healthy Brain, a report focused on the impact of maternal nutrition on foetal brain development. The audience heard from Prof Michael Crawford and AnnieBelle Sassine of the advances being made in our understanding of the important role docosahexaenoic acid (DHA) plays in the development of the baby’s brain and its potential to prevent the lesions that are the primary cause of CP. The report focused on the crucial importance of ensuring a mother’s diet is rich in Omega-3 DHA are able to provide sufficient levels of this during pregnancy and goes on to highlight the need for greater research resource to be devoted to this potentially significant area of study. You can read Prof Crawford’s speech here.
The Foundation commissioned a review by Dr AnnieBelle Sassine and Dr Norman Freshney of CP-related scientific research undertaken around the world to identify the key trends, insights and gaps in research globally. The report highlights the disparity between what the UK spends on the care and treatment of people affected by CP with the overall lack of substantial investment to build on years of research insight; it suggests areas where research could make a transformational impact on the lives of those affected by CP.
The William Little Foundation has now taken the initiative to bring together 12 NGOs and research charities to form a steering group with the intention of establishing the UK’s first Cerebral Palsy Coalition – a network of organisations with a direct and indirect interest in CP that will seek to work collaboratively on behalf of the country’s CP-affected population to drive changes in policy, improvements in health and social care, share insights and best-practice and help shape the direction of research that will have the greatest impact in the shortest time.
