External Publications Using GUI Data

The prevalence of low birth weight is an important aspect of public health which has been linked to increased risk of infant death, increased cost of care, and a range of later life outcomes. Using data from a new Irish cohort study, I document the relationship between birth weight and socio-economic status. The association of maternal education with birth weight does not appear to be due to the timing of birth or complications during pregnancy, even controlling for a wide range of background characteristics. However, results do suggest intergenerational persistence in the transmission of poor early life conditions. Birth weight predicts a number of outcomes at age 9, including test scores, hospital stays and health. An advantage of the data is that I am able to control for a number of typically unmeasured variables. I determine whether parental investments (as measured by the quality of interaction with the child, parenting style, or school quality) mediate the association between birth weight and later indicators. For test scores, there is evidence of non-linearity, and boys are more adversely affected than girls. I also consider whether there are heterogeneous effects by ability using quantile regression. These results are consistent with a literature which finds that there is a causal relationship between early life conditions and later outcomes.

Background
The COVID-19 pandemic has been dubbed the “biggest public health crisis since the Second World War”. In Ireland, schools were closed for 141 days, dramatically altering the day to day lives of children in Ireland. This research aimed to evaluate the overall wellbeing of schoolchildren in Ireland and capture the prevalence and factors contributing to poor mental health.

Methods
A cross-sectional study was performed based on data from the Growing Up in Ireland COVID-19 web survey of the ’08 Infant cohort. Mental Health Inventory-5 scores were used to assess children at risk of mental health disorders. Logistic regression examined associations between various demographic and psychosocial factors and risk of mental health disorders.

Results
This study included 2,867 primary caregiver- child dyads. Almost 25% of 12/13-year-olds were at risk of mental health disorders (MHDs). An adjusted logistic regression model found associations between being at higher risk of MHDs and factors such as reduced physical activity levels (OR 1.35, 95% CI 1.10-1.66), spending less time outdoors (OR 1.48, 95% CI 1.18-1.85), increased screen-time (OR 1.35, 95% CI 1.09-1.67) and increased arguments with PCGs (OR 3.44, 95% CI 2.78-4.27). Having a trusted adult confidante reduced the risk of MHD (OR 0.25, 95% CI 0.14-0.45).

Conclusions
The prevalence of 12/13-year olds at elevated risk of MHD was high, indicating an urgent need for enhancement of child and adolescent mental health services in Ireland. Physical activity, time outdoors and supportive relationships with primary caregivers were positively associated with reduced MHD risk.

Key messages

• Children were impacted by the COVID-19 restriction measures in a way that was disproportionate to their risk.
• To reduce the risk of poor mental health outcomes for a generation of “quarantweens” we need to place children front-andcentre of our response as we recover from COVID-19.

It is well established that stressful life events (e.g., family bereavements or moving to a new country) are damaging to psychological health and well-being. Indeed, social relationships are often noted as an important factor that can influence well-being and buffer the negative effects of stress. However, the quality and source of these relationships, particularly for adolescents, are often overlooked. Using the Growing Up in Ireland Survey, a population-based study of 13-year-old Irish adolescents (N = 7,525; 51.1% female), the current study examines the quality of both parent and peer relationships as potential mechanisms explaining the association between stressful life events and psychological well-being indices in adolescents. As expected, results showed that stressful life events negatively impacted the psychological well-being of adolescents. Parallel mediation analyses indicated that both parent and peer relationship quality mediated this association. Further exploratory analyses found that for girls, greater numbers of stressful life events were associated with poorer quality relationships with both their parents and peers, and in turn, these were linked to lower levels of psychological well-being. For boys, this effect was only evident for parental relationship quality, but not peers. The implication of these findings for adolescent’s psychological well-being, particularly for girls, is discussed.

This article explores the role that home-learning activities (HLAs) play in the relationship between social origin and cognitive development using an Irish birth cohort study, Growing Up in Ireland. Numerous studies using different measures of the home-learning environment (HLE) have shown that it has considerable influence on young children’s cognitive development, and that the HLE is often linked to social origin. We find a social gradient in vocabulary even at age 3 years, with the largest gaps for mothers’ education. Family income, mothers’ education, and social class are also associated with vocabulary independently, though these associations are reduced by adding all three measures simultaneously. The extent of HLAs helps explain a very small part of the education differences and none of the income or social class differences in vocabulary. We find some evidence that HLAs may be more salient for children from families with low income and lower social class backgrounds in terms of supporting vocabulary development, thereby compensating somewhat for disadvantage. HLAs also appear to encourage vocabulary development between age 3 and 5, and play a role in reducing the gap in vocabulary between high- and low-income children.

This study reports recent trends in periconceptional folic acid use in Ireland using archived data from Growing Up in Ireland – the National Longitudinal Study of Children. Of a sample of 10,891 mothers, 6,936 (64%) reported taking folic acid before conception and 10,157 (93%) reported taking folic acid during the first trimester of pregnancy. Younger (OR=0.38, 95% CI=0.29-0.50), lower income (OR=0.59, 95% CI=0.51-0.68), lower educated (OR=0.77, 95% CI=0.66-0.89), and single mothers (OR=0.46, 95% CI=0.40-0.52) were less likely to have taken folic acid pre-conception. A similar pattern was found post-conception with younger (OR=0.58, 95% CI=0.40-0.84), lower income (OR=0.40, 95% CI=0.30-0.53), lower educated (OR=0.50, 95% CI=0.38-0.66), and single mothers (OR=0.74, 95% CI=0.60-0.91) less likely to have taken folic acid post-conception. The findings highlight an ongoing need for targeted promotional campaigns to increase supplementation rates among younger and socially disadvantaged mothers.

This nationally representative study of Irish infants explores whether the set of child and environmental factors established as predicting language outcomes aged 3 years would also predict language and communication development as early as age 9 months. Associations between infant and environmental characteristics and infant language outcomes at 9 months, as measured on the ASQ 10-month communication questionnaire, were explored in a series of bivariate logistic regression models and in a fully adjusted multivariable logistic regression model. Infant gender, health, birthweight and temperament were significantly associated with passing the ASQ communication measure at 9 months. Being an only child and having some experience of relative childcare predicted positive communication outcomes. Infants of older mothers and mothers who spoke less to the child while doing other things were significantly less likely to pass. Infants of mothers with the lowest educational level were more likely than their peers to pass at 9 months. Unlike language outcomes at 3 years, low maternal education does not appear to be a risk factor for poorer outcomes at 9 months. This study adds significantly to the infant language development literature by focussing on communication outcomes in early infancy and identifying protective and risk factors at such an early stage.

Anecdotal evidence suggests that grandparents provide a substantial amount of childcare support to parents of infants in Ireland yet there has been little attention to the provision of grandparent childcare at policy level. Using nationally representative data on childcare provision in the Republic of Ireland, this study examined the prevalence of grandparent childcare provision for very young children, and associations between this choice of childcare and key infant, family, and community factors. Using archived data from the Infant Cohort of the Growing Up in Ireland study, descriptive data regarding use of grandparents as childcare providers were outlined. A series of bivariate analyses were then conducted to examine the independent association between a range of infant, family, and community variables and use of grandparent childcare. Finally, a multivariate analysis using binomial logistic regression was used to examine the association of each of these variables in a fully adjusted model. The results show that 38.6% of infants experienced non-parental childcare: 12.4% were looked after by grandparents, 15.7% by other home-based carers and 10.5% in childcare centres such as crèches. Grandparents were the cheapest source of childcare but also provided fewer hours on average. Multivariate analysis indicated the importance of parental income, age, and education in choosing grandparental childcare, with younger, less well-off parents using grandparent childcare more than any other type of childcare. The findings suggest that, whether by choice or by economic pressure, grandparents represent a huge resource in terms of providing childcare for infants. Current childcare policy needs to be cognisant of the significant contribution of grandparents in helping families with young children participate in the labour force. Constraints on the amount of care grandparents are able to provide may have knock-on constraints for parents’ participation in the labour force and earnings.

Keywords
Grandparents, Childcare, Policy, Infants, Ireland

Growing Up in Ireland (GUI) is a two-cohort, longitudinal study of children and young people. The study aims to describe the health and development of Irish children across a range of topics; these include physical and mental health, family socio-demographic status, education, and the child’s behaviour, attitudes and key relationships. The study has been collecting data since 2007, beginning with a child cohort at nine years old (n = 8,568) and then an infant cohort at nine months old (n = 11,134). These data provide researchers and policy makers with a unique analytical tool to explore the well-being of children in Ireland. This paper provides an overview of all the stages involved in the development of the study, from its inception, to the establishment of the study’s aims, objectives and design, the ongoing data collection and panel maintenance, and the many uses of GUI data today.

Using data from Ireland’s national longitudinal study of children, this paper employs a capabilities approach to disability to understand how individual characteristics as well as home and school environmental factors at age 9 relate to academic and socio-emotional outcomes of students with special educational needs (SEN) at age 17. Results suggest that young people with SEN register both lower average scores and make less academic progress between the age of 9 and their national lower secondary examination, with the exception of young people with a physical SEN. Both home and school environmental factors at 9 years have long-term associations with the academic outcomes of young people with SEN, after controlling for individual characteristics and prior academic achievement. Home and school environmental factors had less consistent associations with the socio-emotional outcomes of young people with SEN. By using rigorous nationally representative longitudinal data, this paper offers a more holistic understanding of the development of young people with SEN. The paper also provides important evidence that a more inclusive approach for supporting students with additional needs, their parents, and their schools is needed.

Keywords
Special educational needs, capabilities approach, academic achievement, socio-emotional outcomes, Growing Up in Ireland

While the role parents play in supporting young people is well established, support from other caring adults also becomes important during adolescence, particularly when young people are facing problems in their lives. The goal of this paper is to reflect on youth support seeking when facing problems, exploring differences between youth who seek support from parents only and those who seek support from parents and other non-parental adults. This paper outlines the findings of a secondary analysis of data from the third wave of the Growing up in Ireland child cohort at 17/18 years, collected from primary caregivers and youth. From 6126 young people in the national sample, 91.3% answered the selective question about the type of adult support they seek. Of this cohort, 36% of young people seek support from a parent and 48% go to a parent and another adult. Comparing these groups, there are significant differences found in both their individual and contextual characteristics, with better outcomes for youth with additional non-parental adult support, including using active coping strategies, better self-esteem, and identity resolution. While the findings indicate that non-parental adults have a positive influence in different areas of youth well-being, further research is required to better understand the ways in which support from non-parental adults helps young people in their transition to adulthood.

Keywords
Supportive adults, natural mentors, youth, transition to adulthood, parenting

Large-scale international migration continues apace. From a health-care services perspective, it is important to understand the influence of migrant heritage on utilization, to allocate resources appropriately and facilitate equity. However, the differences in utilization across different migrant groups remain poorly understood, particularly so for paediatric populations. This paper contributes to filling this gap in knowledge, examining the health-care contact of children for whom their primary caregiver is foreign-born, using longitudinal data from two nationally representative surveys. The study setting is Ireland, which provides an interesting case as a small, open European country, which for the first-time experienced net inward migration in the past two decades. For both cohorts, panel regression models, adjusting for socioeconomic and health indicators, demonstrated lower utilization of general practitioner (GP) services for children of caregivers from ‘less-advanced, non-Anglosphere, non-European Union (EU)’ nations, relative to native-born counterparts. Relatively lower attendances at Emergency Departments and hospital nights were also observed for this group, as well as for children born to EU (non-UK) caregivers. The insights provided are instructive for policymakers for which immigration is a substantial phenomenon in current and future population demographics.

Background
Energy poverty, typified by cold homes and/or an inability to afford energy bills, presents risks to the mental health of occupants. Parents of young children may be especially susceptible to a mental health toll from energy poverty since they have a significant care obligation and spend much of their day at home.

Methods
Data from the Growing Up in Ireland study inform this longitudinal analysis.

Results
A 1.64 greater odds of maternal depression were estimated for households containing young children characterized by energy poverty [P = 0.000; 95% confidence interval (CI): 1.31–2.05]. For energy poor households with older children (9 years and above), the odds of maternal depression were also higher [odds ratio (OR) 1.74, P = 0.001; 95% CI: 1.27–2.39]. Fathers of young children had greater odds of depression in energy poor households (OR 1.59, P = 0.002; 95% CI: 1.19–2.12), though the deleterious effect on mental health was not statistically significant for fathers of older children.

Conclusions
Energy poverty increases the likelihood of depression in parents. These findings merit policy attention since a mental health burden is in itself important, and more widely, parental well-being can influence child development and outcomes.

Children, particularly those of preschool ages (below 3 years), spend the majority of time indoors in the family home. Home conditions can impact upon occupant’s health, with energy poverty identified as a public health concern in Europe and internationally. Children growing up in energy poor homes may be especially vulnerable to health impacts, though the area is relatively understudied. This study addresses a gap in understanding, examining the effect of household energy poverty on the health of resident children using longitudinal data from two cohorts – an Infant Cohort (aged 9 months to 5 years) and a Child Cohort (aged 9 years to 17–18 years), growing up in Ireland.

Panel logistic regression models adjust for a range of covariates including socioeconomic and household information as well as smoking in the household. For the Infant Cohort, household energy poverty was associated with a 1.41 times higher odds of child respiratory illness (p = 0.003; 95% Confidence Interval (CI) 1.12–1.77), and 1.47 times the odds of child wheezing (p < 0.001; 95% CI 1.25–1.74). The odds of a young child being rated as very healthy was lower (point estimate: 0.85, p = 0.011; 95% CI 0.75–0.96). For older children, the relationships were not statistically significant. The risk that energy poverty presents for the health of young children merits continued policy attention.

The internet provides opportunities for social interactions which first occur in an online environment that can lead to meeting up in real life. However, growing concerns around safety and privacy warrant greater study of this modern-day phenomenon. Using a longitudinal dataset of approximately 4,300 20-year-olds in Ireland, this study finds one-in-three report meeting someone from online. Multiple regression reveals that females are less likely to engage in such behaviour, while the trait of ‘openness’, spending more time on the internet, being non-heterosexual, using dating apps, and being sexually active at 17 years are positively associated. Early exposure to information and communication technologies, as indicated by mobile phone ownership at 9 years, is also associated with online-to-offline encounters. A range of policy considerations are discussed, including the continued need for education in e-safety and cyber safety awareness from a young age through young adulthood, particularly for groups such as LGBT communities.

Co-payments for prescription drugs are a common feature of many healthcare systems, although often with exemptions for vulnerable population groups. International evidence demonstrates that cost-sharing for medicines may delay necessary care, increase use of other forms of healthcare and result in poorer health outcomes. Existing studies concentrate on adults and older people, particularly in the US, with relatively less attention afforded to paediatric and European populations. In Ireland, prescription drug co-payments were introduced for the first time for medical cardholders (i.e. those with public health insurance) in October 2010, initially at a cost of €0.50 per item, rising to €1.50 in January 2013, and further increasing to €2.50 in December 2013. Using data from the Growing Up in Ireland longitudinal study of children, and a difference-in-difference research design, we estimate the impact of the introduction (and increase) of these co-payments on health, healthcare utilisation and household financial wellbeing. The introduction of modest co-payments on prescription items was not estimated to impinge on the health of children and parents from low-income families. For the younger Infant Cohort, difference-in-difference estimates indicated that the introduction (and increase) in co-payments was associated with a decrease in GP visits and hospital nights, and a decrease in the proportion of households reporting ‘difficulties with making ends meet’. In contrast, for the older cohort of children (the Child Cohort), co-payments were associated with an increase in GP visiting, and an increase in household deprivation. While the parallel trends assumption for difference-in-difference analysis appeared to be satisfied, further investigation revealed that there were other time-varying observable factors (such as exposure to the economic recession over the period) that affected the treatment and control groups, as well as the two cohorts of children differentially, that may partly explain these divergent results. For example, while the analysis suggests that the introduction of the €0.50 co-payment in 2010 was associated with an increase in the probability of treated families in the Child Cohort being deprived by 9.4 percentage points, the proportion of treated families experiencing unemployment and reductions in household income also increased significantly around the time of the co-payment introduction. This highlights the difficulty in identifying the effect of the co-payment policy in an environment in which assignment to the treatment (i.e. medical cardholder status) was not randomly assigned.

Importance As young people’s mental health difficulties increase, understanding risk and resilience factors under challenging circumstances becomes critical.

Objective To explore the outcomes of the COVID-19 pandemic on secondary school students’ mental health difficulties, as well as the associations with individual, family, friendship, and school characteristics.

Design, Setting, and Participants For this cohort study, follow-up data from the My Resilience in Adolescence (MYRIAD) cluster randomized clinical trial were collected across 2 representative UK cohorts. Mainstream UK secondary schools with a strategy and structure to deliver social-emotional learning, with an appointed head teacher, and that were not rated “inadequate” in their latest official inspection were recruited. A total of 5663 schools were approached, 532 showed interest, and 84 consented. Cohort 1 included 12 schools and 864 students, and cohort 2 included 72 schools and 6386 students. COVID-19 was declared a pandemic after cohort 1 had completed all assessments (September 2018 to January 2020), but cohort 2 had not (September 2019 to June 2021).

Exposures Cohort 2 was exposed to the COVID-19 pandemic, including 3 national lockdowns. Associations of individual, family, friendship, and school characteristics with students’ mental health were explored.

Main Outcomes and Measures Changes in students’ risk for depression (Center for Epidemiological Studies-Depression scale); social, emotional, and behavioral difficulties (Strengths and Difficulties Questionnaire); and mental well-being (Warwick-Edinburgh Mental Well-Being Scale).

Results Of the 7250 participants included, the mean (SD) age was 13.7 (0.6) years, 3947 (55.4%) identified as female, and 5378 (73.1%) self-reported their race as White. Twelve schools and 769 of the 864 students (89.0%) in cohort 1 and 54 schools and 2958 of the 6386 students (46.3%) in cohort 2 provided data and were analyzed. Mental health difficulties increased in both cohorts but to a greater extent among students exposed to the pandemic, including for risk of depression (adjusted mean difference [AMD], 1.91; 95% CI, 1.07-2.76); social, emotional, and behavioral difficulties (AMD, 0.76; 95% CI, 0.33-1.18); and mental well-being (AMD, −2.08; 95% CI, −2.80 to −1.36). Positive school climate, high home connectedness, and having a friend during lockdown were protective factors during the pandemic. Female gender and initial low risk for mental health difficulties were associated with greater mental health deteriorations. Partial school attendance during lockdown was associated with better adjustment than no attendance when returning to school.

Conclusions and Relevance This cohort study of secondary school students demonstrated that to promote mental health and adjustment, policy interventions should foster home connectedness, peer friendship, and school climate; avoid full school closures; and consider individual differences.

Background
Bullying has a profound and enduring impact on academic achievement. However, there is a lack of clarity surrounding the specific mechanisms of this relationship.

Aims
This study examined the link between bullying at age 9 and Numeracy/Literacy achievement at age 15 to determine if this relationship is partially or fully explained by psychological difficulties at age 13.

Sample
Secondary data analysis was completed on waves 1, 2 and 3 of child cohort (Cohort’98) of the Growing Up in Ireland (GUI) study, respectively, at 9 years (N = 8568), 13 years (N = 7527) and 15 years of age (N = 6216).

Results
Longitudinal path mediation model was conducted with bullying at age 9 as the predictor, total (emotional and behavioural) difficulties at age 13 as the mediator and Numeracy/Literacy scores at age 15 as outcomes revealing significant indirect effects of bullying on achievement, via psychological difficulties.

Conclusions
We discuss the impact of bullying on the student’s psychological well-being, the relationship between bullying and academic attainment and how this may be tackled to avoid consequences throughout education and later in life.

Educational Impact and Implications
This study emphasizes the need for schools to address the emotional and behavioural difficulties occurring as a result of bullying in order to improve the overall educational experience of a child. Existing interventions can be built upon by focusing on the continuous remediation of such psychological difficulties.