External Publications Using GUI Data

This study is based on the first wave of data on the child cohort (nine year-olds) in the Growing Up in Ireland (GUI) survey. It examines family relationships and their associations with parent and child well-being in the families of the nine year-olds and explores social inequalities in these aspects of family circumstances. The analysis is presented under five headings: the structure of families (a term which encompasses family structure both currently and over time and also includes family size), relationship quality between parents, the individual well-being of parents, relationship quality between parents and children, and the well-being of children.

Background
The incidence and prevalence of childhood chronic disease is increasing worldwide. Obesity, poor diet and lifestyle may be more prevalent in children with a chronic disease than in their healthier contemporaries. The Growing Up in Ireland (GUI) study is a nationally representative cohort study of children living in the Republic of Ireland. The study has collected information from 8568 9-year-old Irish children on their experiences within their families, childcare settings, schools and communities, and how these impact on all aspects of children’s development.

Aims
This study aims to establish the prevalence of parentally reported chronic disease in children in Ireland and to describe their diet and lifestyle.

Methods
This study analyzed data from the Growing Up in Ireland longitudinal child cohort study and compared the diet, lifestyle and prevalence of obesity in children with and without a parentally reported chronic disease.

Results
Overall, 954 parents in the sample (11.1%) reported that their child had a chronic illness and 43.4% of these children are hampered by it in their daily activities. Respiratory disorders were the commonest type of chronic disease (46%) reported. Children with a chronic illness were more likely to be overweight or obese (32.9% compared to 25.0% of those without a chronic illness, p < 0.001). Children with chronic illness were also found to have a poorer diet, take less exercise and experienced significantly more social isolation than their peers (all p < 0.05).

Conclusions
Public health measures to address diet and lifestyle choices need to be cognisant of the needs of children with chronic diseases and tailor activities offered to be inclusive of all children. Medical professionals having contact with children with chronic conditions need to remember to reinforce the importance of diet and lifestyle whenever possible and to explore with families solutions to barriers to making healthy diet and lifestyle choices.

The COVID-19 lockdown and closure of schools, clinics, and community-based services put children with autism spectrum disorders (ASDs) and other developmental disabilities (DDs) at increased risk of negative outcomes. This study aimed to investigate parents’ perceptions of their children’s behavioural outcomes during the COVID-19 lockdown, parents’ satisfaction with services during this time, and willingness to engage in telehealth. A cross-sectional study was conducted in Ireland. Parents (n = 89) completed an online questionnaire that included the strengths and difficulties questionnaire (SDQ-P). Results demonstrated that children with ASD/DDs were vulnerable to negative outcomes including hyperactivity, emotional symptoms, problems with peers and fewer prosocial behaviors. Children’s behavioral outcomes (‘current sample’, n = 89) were also compared with pre-COVID-19 data taken from the Growing Up in Ireland Study (‘GUI sample’, n = 327). The current sample exhibited significantly more behavioral difficulties than the pre-COVID GUI sample (p < 0.001). For the current sample, scores on each of the five SDQ subscales were significantly associated with a total impact score, and parents reported dissatisfaction with support services provided and willingness to engage in behavioral telehealth. Commitment is required to identify barriers to services faced by families in Ireland and to address the need for adapted behavior support services during periods of emergency.

Keywords: COVID-19; intellectual disabilities; developmental disabilities; autism; behavior; behavioral support

Internationally and in Ireland, much of the research around gender and educational engagement has centred on the academic differences between boys and girls (Warrington and Younger 2000; Francis 2009; O’Connor 2007). Less is known however about the factors shaping affective school engagement and student self-concept and how this can affect participation in learning. Children and young people emphasise the affective or emotional as much as the learning aspects of school life (Alexander 2008). Drawing on data from the 9-year cohort of the Growing Up in Ireland study, this paper examines self-concept among boys and girls in Irish primary schools. The findings show important differences in terms of the affective elements of school engagement, with boys more likely than girls to score significantly lower levels on measures of ‘good’ behaviour and intellectual school status, while girls score significantly lower on freedom from anxiety than boys. The findings also illustrate that predictors of disengagement are about more than the child’s gender – in that working class children and students with special educational needs are faring less well in terms of affective engagement in school.

Background
Population-based studies provide important data to inform policy and service planning for vulnerable children in society. The aim of this study was to characterise social and educational circumstances and self-concept among a nationally representative sample of 13 year olds with developmental disabilities in Ireland.

Methods
A cross-sectional, secondary analysis of data collected from the Growing Up in Ireland (GUI) study was conducted. Descriptive statistics were used to calculate the reported prevalence of disabilities as reported by parents. Differences across the groups (those with and without disabilities) were analysed in relation to gender, socio-economic and school factors. Special education support received in school was described. The association between low self-concept scores (as measured by the Piers Harris Self-Concept Scales 2) and disability type was examined by use of multi-level logistic regression.

Results
Seventeen percent (17.36%) of the sample was reported to have a diagnosis of one or more developmental disabilities. Those with a disability were more likely to live in poorer households, have poorer health status, to experience more episodes of bullying at school, and to have more negative views of school (p<0.05) than their typically-developing peers.

Forty nine percent of children with developmental disabilities were not receiving support in school as reported by parents. Discrepancies in the nature of support received were identified across disability types. Adjusting for individual and school level factors, a disability diagnosis was associated with increased odds of low self-concept scores on three of five self-concept domains. Further associations were identified which differed across disability type.

Conclusions
The findings show that 13 year olds with a disability in Ireland have complex social and educational needs. Findings also suggest significant levels of unmet educational need across this age group. Apparent inequities in access to support in school require further investigation. Reliable measures to provide robust prevalence figures about childhood disabilities in Ireland are needed.

Epidemiological evidence suggests that poor physical health and depression are highly co-morbid. To date, however, no study has considered whether depression in parents caring for children with developmental disabilities is partly driven by poor physical health. Using data from the Growing Up in Ireland national cohort study (2006 to date), 627 parents of children with developmental disabilities were compared with 7941 parents of typically developing children on scores from the Centre for Epidemiological Depression Scale, chronic health conditions, socio-demographic and child behavioural characteristics. Having a child with disabilities was associated with a higher risk of depression (odds ratio (OR) = 1.83, 95% confidence interval (CI): 1.43, 2.35) compared to parents of typically developing children. Adjusting for the presence of chronic health conditions accounted for some of this excess risk (OR = 1.77, 95% CI: 1.38, 2.27). The association between having a child with disabilities and increased risk of depression was explained, however, by adjusting for the child problem behaviours (OR = 1.07, 95% CI: 0.81, 1.43). This study has confirmed, in a population-based sample, the high risk of depression in parents caring for children with developmental disabilities after adjusting for the presence of a chronic health condition. Importantly, given that poor mental health in these parents is associated with a battery of negative health and social family outcomes, it is imperative that health professionals pay attention to the mental health needs of these parents.

Epidemiological evidence suggests that obesity and depression are highly co-morbid. In a national cohort study, we examined whether parents caring for children with disabilities were more likely to be classified as obese compared to parents of children without disabilities and if obesity was associated with depressive symptoms or child behaviour characteristics. Using data from the Growing Up in Ireland National Longitudinal Study of Children (2006 to date), 627 parents of children with developmental disabilities were compared with 7941 parents of typically developing children on objectively measured levels of obesity (body mass index ≥30 kg/m2), depression, health behaviours, chronic health conditions, socio-demographic and child behavioural characteristics. Parents of children with disabilities were more likely to be classified as obese compared to control parents (24.5% vs. 19.6%, p = 0.005, Cramer’s V < 0.1). Depression was not associated with obesity. However, the odds of obesity increased with increasing child problem behaviour (OR 1.05, 95% CI 1.03–1.06). Over half (57%) of obese parents caring for children with disabilities reported trying to lose weight often or very often. This study has confirmed, in a population-based sample, the high risk of obesity in parents caring for children with disabilities after adjusting for the presence of depression and other health behaviours; increasing child problem behaviours were predictive of obesity. Importantly, given the negative health correlates of obesity, it is imperative that health professionals pay attention to weight issues in these parents and support their efforts in managing these issues.

Background
The aim of this study was to use a social-ecological approach to examine the influence of individual, social, and environmental factors on moderate-to-vigorous physical activity (MVPA) and screen-time in a sample of 9-year-old children in Ireland.

Methods
The sample was 1509 boys and girls from the Growing Up in Ireland (GUI) national study. MVPA, screen time, and individual, social, and environmental variables were assessed via questionnaires completed by children, their parents, and their teachers. Multiple regression was used to identify factors that correlated with children’s MVPA and screen-time levels.

Results
For boys, factors such as activity with friends (P < .0001) and popularity (P < .01) were associated with MVPA, while factors such as BMI (P < .01) and MVPA (P < .01) were associated with screen time. Similarly for girls, factors such as activity with friends (P < .0001) and sociability were associated with MVPA, however factors such as BMI (P < .05), and access to play space (P < .05) were more closely associated with screen time.

Conclusion
Social factors were more closely associated with MVPA, while individual factors were significantly correlated with screen time for both boys and girls. Correlates differed for boys and girls, suggesting that interventions should consider both the target population as well as the activity behavior.

Empirical research into the relationship between economic well-being and child outcomes has been limited by its cross-sectional nature, or its narrow focus on predominantly financial aspects of economic well-being. This article attempts to overcome these shortcomings by using data from the Growing Up in Ireland Cohort98 (age: 9–17; N = 5,748; female: 51.4%) and Cohort08 studies (age: 3–9 years; N = 7,208; female: 49.8%), which cover a period of large macroeconomic fluctuation (2007–2017). This fluctuation makes a robust fixed effects analysis feasible, allowing for economic well-being effects to be isolated by controlling for all time-invariant confounders. The article uses three different measures of economic well-being (subjective financial strain, material deprivation, income) to explore how distinct forms of economic well-being affect child behavior. The results suggest that household income is not related to behavioral difficulties, whereas subjective financial strain is predictive of externalized behavioral difficulties in adolescent boys. Material deprivation is predictive of externalized behavioral difficulties in adolescent boys and internalized behavioral difficulties in younger boys, but has no effect on girls’ behavioral outcomes. The findings indicate that the relationship between economic well-being and child behavioral outcomes is complex, and requires multi-dimensional measures of economic well-being to accurately ascertain the different effects.

This paper explores the role of antenatal care in determining mode of birth in the Irish healthcare system using data from the Growing Up in Ireland study. Results indicate that midwifery-led antenatal care is independently associated with significantly higher rates of normal delivery and significantly lower rates of elective caesarean section relative to consultant-led care in both the public and private sectors. Given concerns over increasing rates of caesarean section, our results are consistent with calls nationally and internationally for further investment in midwifery-led antenatal care services, and for stricter regulation of the actors, both providers and patients, engaged in the private antenatal care pathway.

This study investigated trajectories of concomitant internalising, externalising, and peer problems, and associated risk factors for group-membership, using a person-centered approach to better understand heterogeneity in subgroups identified. A cohort of 7,507 children in Ireland was followed from infancy to late childhood (50.3%, males; 84.9% Irish). The parent-version of the Strengths and Difficulties Questionnaire was used when children were 3, 5, 7 and 9 years of age. Information on antecedent risk factors was collected when children were 9 months. Group-based multi-trajectory modelling and multinomial logistic regression were used. Six subgroups of children with distinct profiles were identified, evidencing both homotypic and heterotypic comorbidity. No support of a ‘pure’ internalising, externalising or peer problems group was found in any identified trajectory group. Difficulties in one problem domain indicated the presence of difficulty in another problem domain for all children in elevated groups. Risk factors associated with group-membership were complex, with only three common factors across elevated groups: prenatal exposure to smoking, maternal education, and maternal stress. Specific risk factors for group-membership included low birth weight, sex, maternal age, maternal depression, family composition, social class, medical card status and quality of attachment. Despite some overlap in predictors, the combination of predictors specific to each group would suggest tailored programming. For children with the most acute problems, programming targets should include families with boys, born with low birth weight, exposed to smoking prenatally, with mothers who have lower levels of education, postnatal depression, increased stress and fewer financial resources.

BACKGROUND AND OBJECTIVES
There is mixed evidence from correlational studies that breastfeeding impacts children’s development. Propensity score matching with large samples can be an effective tool to remove potential bias from observed confounders in correlational studies. The aim of this study was to investigate the impact of breastfeeding on children’s cognitive and noncognitive development at 3 and 5 years of age.

METHODS
Participants included ∼8000 families from the Growing Up in Ireland longitudinal infant cohort, who were identified from the Child Benefit Register and randomly selected to participate. Parent and teacher reports and standardized assessments were used to collect information on children’s problem behaviors, expressive vocabulary, and cognitive abilities at age 3 and 5 years. Breastfeeding information was collected via maternal report. Propensity score matching was used to compare the average treatment effects on those who were breastfed.

RESULTS
Before matching, breastfeeding was associated with better development on almost every outcome. After matching and adjustment for multiple testing, only 1 of the 13 outcomes remained statistically significant: children’s hyperactivity (difference score, –0.84; 95% confidence interval, –1.33 to –0.35) at age 3 years for children who were breastfed for at least 6 months. No statistically significant differences were observed postmatching on any outcome at age 5 years.

CONCLUSIONS
Although 1 positive benefit of breastfeeding was found by using propensity score matching, the effect size was modest in practical terms. No support was found for statistically significant gains at age 5 years, suggesting that the earlier observed benefit from breastfeeding may not be maintained once children enter school.

This paper examines patterns of continuity and change in the texture, meanings and rhythms of family relationships between young (school-aged) children and their grandparents in Ireland, from the first half of the twentieth century through 2008, focusing on memories and contemporary experiences of grandparent/grandchild relationships from a ‘child’s eye’ perspective. The paper is based on a qualitative longitudinal analysis of two major datasets:
(1) Life Histories and Social Change, which consists principally of life history interviews with three twentieth century birth cohorts of Irish people and
(2) the Growing Up in Ireland Qualitative Study which consists of semistructured interviews with a sub-sample of children born at the turn of the twenty-first century (and their parents) in one of the two birth cohorts that form part of a prospective national panel study.

None of the many critical moments in Ireland’s often tumultuous history was more significant or defining than the Easter Rising of 1916. Central to the Rising was the Proclamation of Independence, in which Pádraig Pearse declared the new nation’s resolve to cherish all its children equally. CHERISHING ALL THE CHILDREN EQUALLY? brings together contributions from a range of disciplines to shed light on the processes of child development and to investigate how that development is influenced by a variety of demographic, family and socio-economic factors. Making extensive use of research and data that have emerged over recent years from the Growing Up in Ireland longitudinal study of children, the book considers whether or not all children can participate fully and equitably in contemporary Irish society. It asks whether or not we do, in fact, cherish all our children equally in modern Ireland, regardless of their family circumstances, health or ethnic background.

TABLES OF CONTENTS:

1. Introduction
2. Changing Perceptions and Experiences of Childhood, 1916-2016
3. Children and Families, Then & Now
4. Is Family Structure a Source of Inequality in Children’s Lives?
5. Parental Investment & Child Development
6. Inequalities in Access to Early Care and Education in Ireland
7. Inequalities from the Start? Children’s Integration into Primary School
8. Insights into the Prevalence of Special Educational Needs
9. The Experiences of Migrant Children in Ireland
10. Social Variation in Child Health & Development: A Life-course Approach
11. Child Access to GP Services in Ireland: Do User Fees Matter?
12. Anti-Social Behaviour at Age 13
13. Child Economic Vulnerability Dynamics in the Recession
14. Concluding Observations

Background
We examined the role of neighbourhood characteristics in explaining socioeconomic inequalities in child mental health in Ireland.Methods: Data from Cohort ’08 of Growing Up in Ireland with Wave 3 (age 5) as the baseline and Wave 5 (age 9) as the follow-up (n=8,373 for cross-sectional and n=6,349 for longitudinal analyses) were used. Socioeconomic status (SES) indicators were caregiver education, occupation, and equivalised household income. Caregiver and teacher reports of total difficulties score (TDS) from the Strength and Difficulties Questionnaire were combined with a higher score indicating more mental health difficulties. Twenty neighbourhood items rated by caregivers were grouped into five domains (neighbourhood safety, built environments, cohesion, interaction, and disorder) using exploratory factor analysis. We used linear regression to assess the associations between SES indicators, neighbourhood characteristics, and TDS, controlling for sociodemographic covariates. Mediation analysis informed the extent to which (%) neighbourhood domains explained the SES-TDS associations. Network psychometric analysis was used to identify neighbourhood items that were most strongly linked to TDS.Results: Lower SES was consistently associated with a higher baseline, follow-up TDS, and longitudinal changes in TDS. Favourable neighbourhood domains (higher safety, cohesion, interaction, lower disorder) were associated with lower baseline and follow-up TDS. Neighbourhood safety, cohesion, and disorder were also associated with longitudinal changes in TDS across waves. Four neighbourhood domains (except built environments) explained the associations between SES and baseline and follow-up TDS by 3% to 18% in separate single mediation models, and these four domains in concert explained 12% to 23% in multiple mediation models. Built environments domain predicted TDS and mediated the associations between SES and baseline TDS (5% to 11%) in urban children only. No mediation of the associations between SES and longitudinal changes in TDS by neighbourhood domains was observed. Findings from network analysis indicated that specific concerns over “people being drunk or taking drugs in public” and whether “this is a safe neighbourhood” may act as key conceptual bridges between neighbourhood characteristics and TDS.

Conclusions
Neighbourhood characteristics may explain cross-sectional socioeconomic inequalities in child mental health. Improving neighbourhood characteristics where lower-SES children live may be important to reduce SES-based inequalities in child mental health.

Background
We examined the role of neighbourhood characteristics in explaining socioeconomic inequalities in child mental health in Ireland.Methods: Data from Cohort ’08 of Growing Up in Ireland with Wave 3 (age 5) as the baseline and Wave 5 (age 9) as the follow-up (n=8,373 for cross-sectional and n=6,349 for longitudinal analyses) were used. Socioeconomic status (SES) indicators were caregiver education, occupation, and equivalised household income. Caregiver and teacher reports of total difficulties score (TDS) from the Strength and Difficulties Questionnaire were combined with a higher score indicating more mental health difficulties. Twenty neighbourhood items rated by caregivers were grouped into five domains (neighbourhood safety, built environments, cohesion, interaction, and disorder) using exploratory factor analysis. We used linear regression to assess the associations between SES indicators, neighbourhood characteristics, and TDS, controlling for sociodemographic covariates. Mediation analysis informed the extent to which (%) neighbourhood domains explained the SES-TDS associations. Network psychometric analysis was used to identify neighbourhood items that were most strongly linked to TDS.Results: Lower SES was consistently associated with a higher baseline, follow-up TDS, and longitudinal changes in TDS. Favourable neighbourhood domains (higher safety, cohesion, interaction, lower disorder) were associated with lower baseline and follow-up TDS. Neighbourhood safety, cohesion, and disorder were also associated with longitudinal changes in TDS across waves. Four neighbourhood domains (except built environments) explained the associations between SES and baseline and follow-up TDS by 3% to 18% in separate single mediation models, and these four domains in concert explained 12% to 23% in multiple mediation models. Built environments domain predicted TDS and mediated the associations between SES and baseline TDS (5% to 11%) in urban children only. No mediation of the associations between SES and longitudinal changes in TDS by neighbourhood domains was observed. Findings from network analysis indicated that specific concerns over “people being drunk or taking drugs in public” and whether “this is a safe neighbourhood” may act as key conceptual bridges between neighbourhood characteristics and TDS.

Conclusions
Neighbourhood characteristics may explain cross-sectional socioeconomic inequalities in child mental health. Improving neighbourhood characteristics where lower-SES children live may be important to reduce SES-based inequalities in child mental health.

Although an increasing proportion of people in Ireland are living in stepfamilies, little research has explored the dynamics within these families. Drawing on data from the Growing Up in Ireland (GUI) study (9-year-old cohort), this paper aims to compare family processes within stepmother (n=89) and stepfather families (n=295). No stepfathers were primary caregivers to their stepchild(ren), whereas stepmothers tended to assume this role. Stepmothers were less romantically happy than either stepfathers or biological mothers in stepfather families and experienced more interparental conflict than stepfathers. They also had less close and more conflicted relationships with their stepchild(ren) than mothers in stepfather families. These findings are in line with previous research and point to the applicability of international research to stepfamilies in Ireland. The findings suggest that stepmother families may face particular challenges and may benefit from parenting and relationship support.

Previous research has tended to classify stepfamilies based on self-report of their familial relationships. However, some stepfamily members do not identify as being part of a stepfamily, leading to the exclusion of certain stepfamilies from stepfamily research. Using data from the first national cohort study of children in Ireland, the aim of this study was to compare the characteristics of self-identifying stepfamilies with those of non-self-identifying stepfamilies, a group about which little is known. The analysis revealed that in approximately 10% of stepfamilies, neither parent declared their stepfamily status (n = 34, N = 288 stepfamilies). No differences emerged between self-identifying and non-self-identifying stepfamilies in the quality of the parent–child or spousal relationships. Non-self-identifying stepfamilies were less likely to be complex, and were more likely to be stepmother and simple stepfamilies than self-identifying stepfamilies. These findings suggest that non-self-identifying stepfamilies constitute a significant minority of stepfamilies who may exhibit unique structural characteristics.

Keywords: stepfamily; family  relationships; identity; stepchildren; stepparents; membership status

Children born preterm have poorer outcomes than children born full-term, but the caregiving environment can ameliorate some of these differences. Recent research has proposed that preterm birth may be a plasticity factor, leading to better outcomes for preterm than full-term infants in higher quality environments. This analysis uses data from two waves of an Irish study of children (at 9 months and 3 years of age, n = 11,134 children) and their caregivers (n = 11,132 mothers, n = 9998 fathers) to investigate differences in how caregiving affects social, cognitive, and motor skills between full-term, late preterm, and very preterm children. Results indicate that parental emotional distress and quality of attachment are important for child outcomes. Both being born very preterm and late preterm continue to be risk factors for poorer outcomes at 3 years of age. Only fathers’ emotional distress significantly moderated the effect of prematurity on infants’ cognitive and social outcomes—no other interactions between prematurity and environment were significant. These interactions were somewhat in line with diathesis stress, but the effect sizes were too small to provide strong support for this model. There is no evidence that preterm birth is a plasticity factor.

A large body of international literature has documented a correlation between nontraditional family structure and poorer child outcomes, yet researchers continue to disagree as to whether the association represents a true causal effect. This article extends this literature by employing propensity score matching using the first wave of data from the Growing up in Ireland child cohort study. We argue that the Irish case is of particular interest given the highly selective nature of non-marriage. We find that, on average, non-marriage has negative effects on a child educational development at age 9 but the effects are smaller in relation to health outcomes and the child’s self-concept. However, selection effects account for a non-trivial proportion of the differences in child outcomes across lone-mother and cohabiting families although hidden bias remains an important issue. This has important implications for policies which promote marriage as the key to child development as it appears that much of the benefits of marriage are not related to marriage per se but to the socio-economic background of mothers.