External Publications Using GUI Data

A small proportion of children experience social-emotional difficulties from early childhood onwards. Longitudinal studies with nationally representative samples are needed to identify the prevalence and the characteristics of children and families persistently experiencing these difficulties. Secondary analysis of data collected on over 7500 Irish children and with the Strengths and Difficulties Questionnaire as the primary indicator, found that 6% of children when they were five year olds and 8% when they were nine-years, had above threshold scores that warranted further investigation. A smaller proportion—2.9% had elevated scores at both ages. Logistic regression analyses found that children with one or more developmental disabilities were up to six times more likely to have sustained difficulties. There were also significant associations with the lower education attainment of primary caregivers and the socio-economic deprivation of families. Primary caregivers and teachers reported higher conflict in their relationships with these children. Although the number of Irish children presenting with continuing social-emotional difficulties is small, they can present an ongoing and future societal cost in terms of the impact on family relations and demands placed on educational, health and social services. This study identified the children and families who are at greatest risk and for whom targeted early intervention services could be provided.

A Tobacco-Free Future – An all-island report on tobacco, inequalities and childhood 2013 reveals declines in smoking rates among both children and pregnant women over the past decade, both North and South of the border. This report published by the Institute of Public Health in Ireland (IPH) and the TobaccoFree Research Institute Ireland (TFRI), shows that while tobacco control measures are being successful, disadvantaged children are at particular risk of tobacco-related harms.

Children growing up in disadvantaged circumstances face a number of threats to their health and development. Protecting children from the burden of tobacco related harm from both active and passive smoking is a priority action in enhancing population health and reducing health inequalities. Population health strategies on the island of Ireland are increasingly focussing on addressing the root causes of health inequality through social determinants of health approaches and through focussing on early childhood as a key period for intervention. At the same time, governments in both jurisdictions are working to enhance their approaches to effective tobacco control.

The World Health Organization considers that there are three key ‘windows of exposure’ in terms of tobacco-related harm in childhood – in the womb (associated with active or passive smoking by the mother), directly through children taking up smoking and through exposure to second hand smoke (SHS) in indoor and outdoor environments.

This report presents findings on these three windows of exposure based on a range of data sources in the Republic of Ireland and Northern Ireland. The central aim of the report is to contribute to knowledge on the exposure of children to the harmful effects of tobacco smoke at various stages of their development. The findings of the report can support policy makers and service providers in their efforts to make tobacco-free childhoods a reality on the island of Ireland.

Adolescence and young adulthood are critical periods in the development of healthy sexual health and relationships, as patterns of behaviour that develop during these life stages shape outcomes throughout the life course. Recent rises in notifications of certain sexually transmitted infections (STIs) among young people in Ireland have raised concerns over the extent to which young people have the skills and information to make healthy choices in relation to their sexual health and wellbeing. In this context, sexual health literacy – i.e., the degree to which individuals have the ability to find, understand and use information and services to inform decisions and actions – is a key protective factor for the prevention of negative sexual health outcomes and for allowing young people to be more in control of their own sexual and reproductive health. In this report, we used data from Cohort ’98 of Growing Up in Ireland, the national longitudinal study of children and young people in Ireland, to examine the factors associated with sexual health literacy among young adults, and how sexual health literacy is associated with sexual health behaviours (i.e., condom and contraception use). The Growing Up in Ireland data on sexual health literacy were collected in 2018 when the young people were 20 years of age, and the measure of sexual health literacy was based on answers to two questions that gauged knowledge of female fertility and STI prevention methods.

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.

Although children’s relationships with their parents and teachers contribute to their school adjustment and achievement, few studies have examined interactions between these relationships, particularly for father-child relationships. Using the Growing Up in Ireland birth cohort (N = 7507, 50.3% male), we examined child-adult relationship quality – rated by parents at age 3 and by teachers at age 5 – as predictors of teacher-rated behavioural adjustment and academic achievement at age 9 (indexed by self-reported academic self-concepts and performance on formal reading assessments). Controlling for prior levels of problem behaviours, verbal ability, and family SES, our results indicated that children’s relationships with parents and teachers showed small and comparable independent effects on school adjustment and achievement. For mothers and teachers, moderation analyses showed a cumulative risk pattern for conflictual relationships and a compensatory pattern for close relationships. Children are likely to benefit from improving closeness and reducing conflict in adult-child relationships as well as interventions that involve mothers, fathers, and teachers.

Although there is a wealth of research addressing the association between mental health and school absenteeism, there are calls for a better understanding of how mental health difficulties might predict SAPs (Egger et al., 2003; Finning et al., 2022; Ingul et al., 2019; Wood et al., 2012). The aim of this paper was to create a more nuanced understanding of SAPs by exploring how different constellations of mental health difficulties might be predictive of absenteeism in 9-year-olds. Using a sample of Irish 9-year-olds (N = 8570) from the Growing Up In Ireland Study (GUI’98), the research used latent class analysis (LCA) to identify combinations of mental health symptoms. Twenty items from the Strengths and Difficulty Questionnaire (SDQ) were used to measure a range of emotional and behavioural difficulties. The analysis yielded four mental health classes—High Risk of Emotional and Behavioural Difficulties (EBD), High Risk of Emotional Difficulties (ED), High Risk of Behavioural Difficulties (BD) and Low Risk of Emotional and Behavioural Difficulties (EBD). The study assessed whether rates of student absenteeism varied across different classes of mental health as identified through LCA and explored risk factors associated with different classes. Children in the high-risk mental health symptomology groups had significantly higher odds of absenteeism compared to the low-risk class and significantly greater odds of experiencing multiple family, school and demographic risk factors. The distinct profiles of mental health symptoms observed within the classes and their patterns of associations with risk factors and days absent indicated classes were theoretically distinct. The results illustrate the importance of recognising the relationship between mental health and school absenteeism in primary school children when developing early intervention strategies for SAPs. As one of the few studies to focus on 9-year-olds, the current study contributes to current knowledge on the complexities of emerging SAPs in primary school children.

Keywords
Mental health, School attendance problems, School avoidance, Truancy, Risk factors

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

Both psychological and sociological accounts have suggested that the home learning environment play an important role in children’s cognitive development and may provide insights into inequalities in cognitive outcomes. Using the infant cohort of the Growing Up in Ireland Study (GUI), this chapter investigates firstly if differences in the home learning environment at age three helps to explain the social gradient in childhood cognitive outcomes, measured as expressive vocabulary, at age five; and second, can childcare outside the home compensate for a poor home learning environment? Home learning environment is measured as the number of children’s books in the home and a combined index of parental activities with the child that includes reading, crafts and games. A rich home learning environment at age 3 is associated with higher vocabulary scores at age 5 years for all children. The children of lower educated parents tend to live in poorer home learning environments, and this partly explains their lower vocabulary scores at age 5. The chapter also provides some evidence that centre-based childcare was associated with an increase in vocabulary score for children from poor home learning environments. However, this effect is very small and only slightly reduces the gap in vocabulary scores between children from a rich and poor home learning environment.

Bullying can occur at all ages and has been associated with several negative impacts on the psychological and emotional well-being of victims. While the transition to adulthood may be an opportunity for victims to escape bullying, prior research has suggested some continuity of victimisation experiences into adulthood. However, research on victimisation among young adults remains scarce and no prior study has examined this issue in the Irish context. Binary logistic regression was used to examine the likelihood of victimisation at age 20 based on the respondent’s prior victimisation history and other risk factors, using data from 4693 respondents in the Growing Up in Ireland National Longitudinal Study at age 9, 13, 17 and 20. Moreover, the risk of depression and levels of global self-esteem at age 20 were examined in terms of (long-term) victimisation experiences. Respondents who were previously victimised in adolescence and respondents who were chronically victimised in childhood and adolescence were approximately 3.5 and 4 times more likely to be victimised at age 20 respectively than respondents who were never victimised. The negative outcomes of victimisation regarding the risk of depression and lower levels of self-esteem were more severe for respondents who experienced more persistent prior victimisation. In conclusion, more persistent long-term victimisation experiences are associated with more severe negative outcomes and an increased risk of continued victimisation throughout the transition to adulthood compared to less persistent or no prior victimisation. Therefore, supporting affected individuals to escape victimisation as early as possible is crucial.

Caesarean section (CS) rates are increasing globally and exceed 50% in some countries. Childhood obesity has been linked to CS via lack of exposure to vaginal microflora although the literature is inconsistent. We investigated the association between CS birth and the risk of childhood obesity using the nationally representative Growing-Up-in-Ireland (GUI) cohort. The GUI study recruited randomly 11134 infants. The exposure was categorised into normal vaginal birth (VD) [reference], assisted VD, elective (planned) CS and emergency (unplanned) CS. The primary outcome measure was obesity defined according to the International Obesity Taskforce criteria. Statistical analysis included multinomial logistic regression with adjustment for potential confounders. Infants delivered by elective CS had an adjusted relative risk ratio (aRRR) = 1.32; [95% confidence interval (CI) 1.01–1.74] of being obese at age three years. This association was attenuated when macrosomic children were excluded (aRRR = 0.99; [95% CI 0.67–1.45]). Infants delivered by emergency CS had an increased risk of obesity aRRR = 1.56; [95% CI 1.20–2.03]; this association remained after excluding macrosomic children. We found insufficient evidence to support a causal relationship between elective CS and childhood obesity. An increased risk of obesity in children born by emergency CS, but not elective, suggests that there is no causal effect due to vaginal microflora.

Care is fundamental to the fabric of social relationships and a significant proportion of the adult population is engaged in regular care for children and/or adults with illnesses or disabilities. Increasing attention internationally is being paid to the role of young carers (those under 18) and young adult carers (usually 18–25 years of age). However, much of the research conducted has been cross-sectional in nature and has focused on care for those with illnesses, rather than the full spectrum of care for others. This report draws on rich data on over 4,000 young people from Cohort ’98 of the Growing Up in Ireland (GUI) study to take a longitudinal perspective, documenting the profile of young adult carers at 17 and 20 years of age and exploring the implications of such caregiving for their wellbeing, relationships and educational pathways.

In this study, we address the following research questions:

1. What is the profile of young adult carers, in terms of gender,social background, family size and structure, migrant status, urban/rural location, and own and parental illness/disability? To whom do they provide care and how much time do they allocate to caregiving?

2. What factors predict young people’s caring at ages 17 and 20?

3. How are care responsibilities associated with young people’s wellbeing, physical health and family relationships?

4. How are care responsibilities at age 17 associated with the post-school pathway pursued at age 20 (higher education, further education and labour market entry), controlling for other factors?

Does a care role constrain postschool choices, either directly through ongoing involvement in care, or indirectly via a potential effect on academic performance?

Chapter 11 discusses healthcare use among children and the extent to which the current system of healthcare financing in Ireland leads, in particular, to differences in patterns of the use of GP services by children that are not predicted by their need for healthcare. The analysis investigates not only variations in use levels but also considers the demand implications of future policy proposals around extending free GP care to further cohorts of children.

Chapter 12 considers the prevalence of anti-social behaviour in the early teenage years in Ireland, the nature of this behaviour and the extent to which anti-social behaviour is associated with socio-economic characteristics of the family, family structure and other factors such as parenting style, the adolescent’s self-esteem and peer influences.

Chapter 6 provides a detailed discussion of the history of childcare provision in Ireland throughout the 20th century before investigating trends in non-parental childcare for infants in the first few years of life. The role of the Free Pre-school Year, a major policy shift in the Irish context, is also discussed.

Chapter 8 examines aspects of provision for children with special educational needs and considers their inclusion within Irish mainstream education in recent years. It considers how much of the education and care of children with special needs in the early decades of the 20th century was provided by religious orders before going on to discuss how, since the early 1990s, there has been a substantial shift in focus from segregated educational provision towards a more inclusive view of special education, mainly delivered within mainstream schools. In particular, the chapter considers the proportion of children with special educational needs and variations in levels according to the background characteristics of the children in question.

Child chronic illness/ disability can present significant challenges for children, families and society that require appropriate policy responses; yet little is known about the demands placed on families resources from an economics perspective in terms of its impact on household income and the extra income required to achieve the same standard of living as families who do not have a child with a chronic illness/disability. The paper uses data from the Growing Up in Ireland National survey dataset for nine year olds. It is the first study to empirically investigate the impact of child chronic illness/disability on earnings, standard of living and the extra cost of disability together. It is also the first study to explicitly address endogeneity in the standard of living model by using a two-stage process where residuals were harvested to provide efficient estimates. The findings show that families experience significant disadvantage and economic hardship due to reduced household income and a lower standard of living due to the extra cost of disability that would require considerable income to compensate. Policy implications of these findings suggest that a tiered approach to disability support payments which encompass broader criteria for inclusion based on varying severity levels be introduced to alleviate the financial hardship and compromised economic wellbeing of families affected. In addition, more innovative policies are required to implement appropriate timely access to health and social care services and flexi parental employment, which in turn requires the provision of adequate access to high quality educational and care facilities.

Childhood obesity is a growing concern worldwide. The association between childhood obesity and maternal smoking and/or paternal smoking has been reported. However, few studies have explored the association between childhood obesity and exposure to carers’ smoking status. This study aimed to assess the impact of carers’ smoking status on childhood obesity in a cohort of children enrolled in the Growing up in Ireland (GUI) study. Participants from the GUI infant cohort were categorized into four groups based on their exposure status: Neither caregiver smoked (60.4%), only primary caregiver smoked (13.4%), both caregivers smoked (10.9%). Exposure to primary carers’ smoking (98% are biological mothers) was found to be significantly associated with childhood overweight/obesity at age three (Odds Ratio: 1.30, 95% CI: 1.17–1.46) and at age five (OR: 1.31, 95% CI: 1.16–1.49). Exposure to both carers’ smoking status was significantly associated with increased odds of childhood overweight/obesity across both waves. These findings emphasize the health burden of childhood obesity that may be attributable to maternal smoking postnatally and through early childhood in Ireland.

Keywords
growing up in Ireland, childhood obesity, primary carer, secondary carer

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.

Children live in a technology-mediated world, and most young people use a variety of technologies in their daily lives. However, despite intense public discourse, we have little empirical evidence on how technology use impacts on children’s development across a number of psycho-social domains. Research that has been conducted tends to be largely small-scale or cross-sectional in nature and most often focused on (young) adults rather than children. Using longitudinal data on one-in-eight Irish children, we use econometric methods to test for associations between early mobile phone ownership and two measures of children’s psycho-social development between 9 and 13 years of age. We examine the Piers Harris Self-Concept Scale, reported by children, and the Strengths and Difficulties (SDQ) score, completed by the primary caregiver. We find no generalised associations between early mobile phone ownership and psycho-social outcomes. However, there is evidence that associations differ by gender and across psycho-social sub-domains. We find no robust associations affecting boys, but girls who receive phones earlier fare less well in terms of their behavioural adjustment and academic self-concept scores at 13 years of age, all else being equal. Further research is needed to identify causal mechanisms and explore possible mediating effects of family/social context.

KEYWORDS: Mobile phone ownership; psychological adjustment; self-concept; gender; longitudinal data; Piers Harris; SDQ

Children with below average cognitive function represent a substantial yet under-researched population for whom academic and social demands, which increase in complexity year by year, pose significant challenge. Effects on emotional-behavioural development (EBD) are not well understood. The aim of this study was to compare trajectories of EBD for children with and without below average cognitive function. The underlying hypothesis was that trajectories of EBD would differ between groups, with divergence occurring as children are subject to increasingly complex cognitive demands.

Participants consist of 7,000 children and caregivers who completed the Growing Up in Ireland survey at age 3,5 and 9 years. Cognitive function was measured at age 3 using the Picture Similarities Scale. A t-score 1-2 standard deviations below the mean was categorised as below average cognitive function (n=767), and scores above this categorised as average cognitive function (n=6418). EBD was measured using the Strengths and Difficulties Questionnaire (SDQ) at age 3,5 and 9. Repeated measures ANOVA was used to examine the difference between the overall group means across the repeated measures of SDQ, the SDQ change over time, and the interaction between cognitive group and change over time. Further analysis of trajectories was performed using latent growth curve analysis.

Compared to those with average cognitive function, a significantly higher proportion of children with below average function were male (61.8% v 38.2%, χ2 (1, N=7134) = 42.07 p<0.001), born to a single parent family (22.4% v 14.7%, χ2 (1, N=7134) = 23.15 p<0.001), and had a parent who smoked (35.6% v 25.8%, χ2 (1, N=7134) = 33.23 p<0.001). Children with below average cognitive function had significantly higher mean total SDQ scores at all ages. Repeated measures ANOVA demonstrated a significant group-by-time interaction effect (F(2,7182)=4.649, p=0.010). The mean difference (MD) in SDQ between cognitive groups increased over time (MD Age 3:0.87, 95% confidence interval (CI) 0.53-1.21, Age 9 MD:1.49,95% CI 1.08-1.91). For those with average or above cognitive function the overall SDQ decreased between age 3-9 (MD: -0.49 95% CI -0.65—0.33). This decrease was not seen for those with below average function, who had a non-statistically significant increase in SDQ between age 3-9.

Children with below average cognitive function experience higher and worsening mean SDQ scores throughout childhood. A scalable method of early identification of children at risk for below average cognitive function should be a research priority for public health, enabling early intervention for cognitive and adaptive outcomes.