External Publications Using GUI Data

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.

Collecting accurate and detailed dietary intake data is costly at a national level. Accordingly, limited dietary assessment tools such as Short Food Questionnaires (SFQs) are increasingly used in large surveys. This paper describes a novel method linking matched datasets to improve the quality of dietary data collected. Growing Up in Ireland (GUI) is a nationally representative longitudinal study of infants in the Republic of Ireland which used a SFQ (with no portion sizes) to assess the intake of “healthy” and “unhealthy” food and drink by 3 years old preschool children. The National Preschool Nutrition Survey (NPNS) provides the most accurate estimates available for dietary intake of young children in Ireland using a detailed 4 days weighed food diary. A mapping algorithm was applied using food name, cooking method, and food description to fill all GUI food groups with information from the NPNS food datafile which included the target variables, frequency, and amount. The augmented data were analyzed to examine all food groups described in NPNS and GUI and what proportion of foods were covered, non-covered, or partially-covered by GUI food groups, as a percentage of the total number of consumptions. The term non-covered indicated a specific food consumption that could not be mapped using a GUI food group. “High sugar” food items that were non-covered included ready-to-eat breakfast cereals, fruit juice, sugars, syrups, preserves and sweeteners, and ice-cream. The average proportion of consumption frequency and amount of foods not covered by GUI was 44 and 34%, respectively. Through mapping food codes in this manner, it was possible, using density plots, to visualize the relative performance of the brief dietary instrument (SFQ) compared to the more detailed food diary (FD). The SFQ did not capture a substantial portion of habitual foods consumed by 3-year olds in Ireland. Researchers interested in focussing on specific foods, could use this approach to assess the proportion of foods covered, non-covered, or partially-covered by reference to the mapped food database. These results can be used to improve SFQs for future studies and improve the capacity to identify diet-disease relationships.

Despite dramatic changes in Irish special education policy during the last decade, there is little understanding of the factors influencing how special educational needs (SEN) are identified and whether identification varies across different school contexts. International research has tended to focus on how individual child characteristics influence SEN identification. Less attention has been given to other factors such as teacher characteristics or school social mix. Using data from the nine-year-old cohort of the Growing Up in Ireland study, this article examines which children are most likely to be identified with different SEN types taking into account student social background characteristics, teacher characteristics and school social mix. Findings show that children attending highly disadvantaged school contexts are far more likely to be identified with behavioural problems and less likely to be identified with learning disabilities than children with similar characteristics attending other schools. It seems that ‘behavioural’ issues take precedence over learning difficulties in these schools pointing to a culture of care/containment rather than academic progress.

Keywords
SEN identification, gender, social background, teacher characteristics, school context

Despite the right of disabled people to full social and economic inclusion, many face multiple day-to-day and systemic challenges. These include but are not limited to additional expenses, access to housing, and everyday accessibility difficulties. Surveys show the general public hold positive attitudes towards policies that seek to enable disabled people to overcome these challenges, but standard survey methods are susceptible to response biases that may overestimate this support. This study aimed to test whether two such biases influence support for disability policy in Ireland: social desirability bias (i.e. the tendency for survey respondents to alter their responses in order to present themselves in a positive light); and inattention to the implications of policy support (e.g. that welfare policies require funding). Together the survey experiments covered a range of policy issues and types of disability, as identified in previous research and in consultation with the disability advisory group for the project.

Differentials in physical activity (PA) between social and economic groups has been shown to contribute significantly to social gradients in health and life expectancy, yet relatively little is known about why differentials in PA emerge. This paper uses longitudinal data on a nationally representative sample of 6,216 young people aged between 9 and 18, from Ireland, to measure the role of family, school and neighbourhood level factors in accounting for differentials in PA trajectories between groups of young people, defined by level of maternal education, whilst adjusting for the individual characteristics of the young person (sex, age, personality, body mass index and health-status). Levels of PA fall significantly across the sample between 9 and 18, and the decline in PA is larger for the children of lower educated mothers. We find a clear gradient in PA at each age by maternal education for both males and females. Descriptive analyses found social gradients in the majority of our risk factors. Using multi-level, linear spline regression models to decompose differentials between groups, we find that family-level mechanisms account for the biggest proportion of the differential in PA for both males (50.8%) and females (35.1%). Differences in income across maternal education categories accounted for 24.1% of the differential for males and 14.7% among females, making it the second most effective mechanism in explaining the social patterning of PA. Neighbourhood-level processes resulted in a modest reduction in the same differential, while school level processes had the effect of equalising differences in PA across maternal education groups.

Digital technologies have become an increasingly prominent feature of children’s lives both within and outside educational environments (McCoy, Quail, and Smyth 2012. Influences on 9-Year-Olds’ Learning: Home, School and Community. Dublin: Department of Children and Youth Affairs). Despite considerable media debate, we have little robust evidence on the impact of technology use on children’s development, both academically and socially. Much of the literature in this area relies on small-scale cross-sectional studies. Using longitudinal data on 8500 9-year-old children in Ireland, we examine the influence of early mobile phone ownership on children’s performance in reading and maths between 9 and 13 years of age. Across both reading and maths domains, children who already report owning a phone by the age of nine fare less well in terms of their academic development as they move into adolescence. The measured effects are sizeable, implying about 4 percentile lower ranking on standardised tests for an average student. Our results are consistent with the idea that there may be significant educational costs arising from early mobile phone use by children. Parents and policymakers should consider whether the benefits of phone availability for children are sufficiently large to justify such costs. We suggest a range of direct and indirect cognitive effects that could help explain these results.

KEYWORDS: Mobile phone ownership; child development; academic outcomes; early owners; longitudinal data

Drawing on curriculum differentiation theory, this paper discusses exemptions from learning Irish granted to Irish post-primary students. In order to explore the profile of students granted such exemptions, the study utilises data from a national longitudinal study, Growing Up in Ireland. Additional information is provided by administrative data collected by the Department of Education and Skills to show trends in the number of exemptions granted over time. The findings show that factors impacting on being exempt include gender, social class, having a special educational need at primary school and being born outside Ireland.

Keyword(s): post-primary schools, curriculum differentiation, exemptions from Irish, Ireland

Early nutrition plays a pivotal role in long-term health. The World Health Organization (WHO) recommends exclusive breastfeeding during the first six months of life, with the gradual introduction of solids after this period. However, studies in the Republic of Ireland (ROI) have shown poor compliance with guidelines. The ROI continues to have one of the lowest breastfeeding rates worldwide. Our objective was to analyse differences in breastfeeding and complimentary feeding behaviours between Irish and non-Irish mothers residing in the ROI, as well as the role of acculturation on these behaviours, using the national longitudinal study, Growing Up in Ireland (GUI). Mothers (n = 11,134) residing in the ROI were interviewed when their infants were nine months of age. The percentage of Irish mothers who initiated breastfeeding was 49.5%, as opposed to 88.1% among the non-Irish cohort (p < 0.001). Breastfeeding initiation reduced from 89.4% of non-Irish mothers who had arrived within the last year to five years ago to 67.5% for those who had arrived 11 to >20 years ago (p < 0.001). Our results indicate that cultural differences are an important factor in shaping patterns of infant feeding in the ROI. Reviewing existing support and education policies for parents is required to achieve the implementation of desirable infant feeding practices.

Keywords: infant feeding; breastfeeding; complimentary feeding; acculturation

Economic recessions have been linked to adult health, but few studies have examined how recessions influence the health of young children. This study examined the impact of life transitions linked to the recent financial crisis on the health of young children in Ireland. Data came from the Growing Up in Ireland Infant Cohort Study (n = 11,134), which assessed children before (2008), during (2011), and after (2013) the Great Recession that followed the financial crisis of 2008 and incorporated questions on the impacts of the financial crisis on families. Using fixed-effects models to control for confounding, we found that a reduction in welfare benefits during the recession was associated with a significant increase in the risks of asthma (β = 0.014, 95% confidence interval (95% CI): 0.004, 0.023) and atopy (β = 0.014, 95% CI: 0.001, 0.027). While parental job loss was not associated with child health, a reduction in working hours was associated with increased reports of child health problems (β = 0.024, 95% CI: 0.004, 0.043), as were difficulties affording basic necessities (β = 0.019, 95% CI: 0.001, 0.038). Results suggest that failing to protect vulnerable families and children during economic recessions may have long-lasting implications for child health.

Educational expectations and the way in which they shape actual outcomes act as an important vehicle for the intergenerational reproduction of social inequality. This article draws on rich information from the Growing Up in Ireland longitudinal study to explore the factors influencing the educational expectations of 13-year-old young people and their parents. The findings point to high levels of expectations among parents but one-third of young people are found to hold lower expectations than their parents. Both sets of expectations are shaped by parental education, social class and household income, though parental expectations are more strongly structured by social background than those of young people. The article seeks to contribute to the literature on educational expectations in three interrelated ways. Firstly, it focuses on a phase of schooling, the transition to secondary education, which represents a time of significant change in young people’s learning experiences, and transition difficulties are found to dampen their expectations. Secondly, the analyses unpack the extent to which signals from the school influence parental perspectives, with academic achievement, child attitudes to maths, ability group assignment and teacher reprimands emerging as significant drivers of parental views of their children’s potential. Thirdly, the analyses take account of both the primary and secondary school attended and indicate significant between-school differences in young people’s intentions to go on to higher education.

Keywords
Educational expectations, social class differences, parent influence, school effects

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.

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.

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.

Family and home environment factors have been outlined in previous literature as important variables that affect early reasoning development. However, little research has focused on the association between screen use in the home environment and nonverbal reasoning ability. The aim of this cross-sectional study is to examine the role of both screen time and various screen activities (e.g., television, video, or educational games) in nonverbal reasoning ability in 9,001 5-year-old children using a large birth cohort study (Growing Up in Ireland). Interviews conducted with parents related to the children’s screen use and various family factors, while reasoning ability was measured using a standardized task (Picture Similarities Task, British Ability Scales II). A hierarchical multiple regression examined the role of screen use in nonverbal reasoning, while also statistically controlling for family factors such as parental education and employment status. Screen use variables made a significant contribution to the regression model, even after family factors were accounted for, although the effect sizes were very small. Playing educational games, video games, or engaging in over three hours screen use per day were all significant predictors of nonverbal reasoning scores in the final adjusted model. The results of this study suggest that screen use may play a small role in the development of nonverbal reasoning in young children. The findings highlight the need for further studies in this area and may have implications for current debates in screen time research.

For the first time, data on children and adolescents with disabilities in Ireland are reported based on the Active Healthy Kids Global Alliance Para Report Card methodology. The most recent data from the last 10 years were used in the grading process (A+ to F), and indicators with insufficient data were graded as incomplete. Of the 10 indicators from the Global Matrix Para Report Cards, grades were assigned to Overall Physical Activity (F), Organized Sport (D), Active Transport (D−), Sedentary Behaviors (D−), Family & Peers (C), School (C−), Community & Environment (B−), and Government (B). Irish disability sport organizations were invited to assess the research-led audit and provided commentary around the final grading. The contextual discussion of the grades is presented through the lens of strengths, weaknesses, opportunities, and threats with the purpose being to provide direction for the reduction of physical activity disparities among children with disabilities.

Gender inequality in housework divisions is persistent. This study examined early-emerging patterns in gender roles via children’s gendered housework time in the Irish context using time-use diary and questionnaire data, controlling for key demographic variables. This study utilized longitudinal “Growing up in Ireland” data, comparing the same children’s behaviour at age 9 and 13. Participants were a nationally representative, weighted sample of school going children living in Ireland, including 4,135 girls, 3,831 boys and their caregivers. The results highlight that inequalities in domestic chores occur at nine and are even greater at 13: girls do more housework and children tend to do “gender typical” chores. Consequences are discussed in relation to gender inequality and policy implications.

Given growing concerns about disadvantaged boys’ achievement and disengagement from learning, this paper investigates differences in reading ability by gender and social origin. It uses data from the Growing Up in Ireland study to investigate how parents’ approach to learning at home and children’s exposure to early care and education contribute to these differences. We find that both children’s gender and their family’s social class influence their cognitive development between age 3 and age 9, though the effects are additive, with little variation in the gender gap across social class groups. Parents from more advantaged social classes read more to their 3-year-old children than other parents, yet by age 5, when most children have started primary school, these class differences in parental reading are much lower. Parental reading, ECCE participation and length of primary school exposure were found to facilitate language development and partly explain differences in reading scores at age 9, although strong direct effects of social class remained, even accounting for vocabulary score at age 3. The benefits from parental reading, ECCE and exposure to school are broadly similar for boys and girls, though there is some evidence that boys benefit more than girls from longer exposure to school.

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.

Growing Up in Ireland (GUI) is the national longitudinal study of children and young people in the Republic of Ireland and has followed two cohorts for over ten years to date: Cohort ’98 who were recruited into the study at age nine years and Cohort ’08, recruited at age nine months. The study aims to describe the lives of Irish children and young people in terms of their development, with a view to positively affecting policies and services available for them. Traditionally, data collection involved in-home visits from an interviewer who conducted face-to-face interviews, recorded physical measurements of study participants and administered cognitive assessments. However, with the onset of the COVID-19 pandemic and the associated restrictions, significant adaptations were required to these methods to ensure data collection for the pilot and main fieldwork for Cohort ’08 at age 13 could continue to the expected timeline. Face-to-face interviews with participants were replaced with telephone and web-based modes, interviewer training was conducted online, online resources were made available for interviewers and participants and COVID-19 related items were added to questionnaires. In addition to the scheduled data collection, a special COVID-19 survey was also conducted on both GUI cohorts in December 2020 to explore the impact of the pandemic on participants’ lives. This paper outlines the adaptations made to traditional data collection methods in GUI, highlighting the challenges that were met, but also the benefits of some changes that may be worth incorporating into future waves of GUI.

Identifying the clustering and correlates of physical activity (PA) and sedentary behavior (SB) is very important for developing appropriate lifestyle interventions for children and adolescents. This systematic review (Prospero CRD42018094826) aimed to identify PA and SB cluster patterns and their correlates among boys and girls (0-19 years). The search was carried out in five electronic databases. Cluster characteristics were extracted in accordance with authors’ descriptions by two independent reviewers and a third resolved any disagreements. Seventeen studies met the inclusion criteria and the population age ranged from six to 18 years old. Nine, twelve, and ten cluster types were identified for mixed-sex samples, boys, and girls, respectively. While girls were in clusters characterized by “Low PA Low SB” and “Low PA High SB”, the majority of boys were in clusters defined by “High PA High SB” and “High PA Low SB”. Few associations were found between sociodemographic variables and all cluster types. Boys and girls in “High PA High SB” clusters had higher BMI and obesity in most of the tested associations. In contrast, those in the “High PA Low SB” clusters presented lower BMI, waist circumference, and overweight and obesity. Different cluster patterns of PA and SB were observed in boys and girls. However, in both sexes, a better adiposity profile was found among children and adolescents in “High PA Low SB” clusters. Our results suggest that it is not enough to increase PA to manage the adiposity correlates, it is also necessary to reduce SB in this population.