External Publications Using GUI Data

Background
The use of dietary quality scores/indices to describe diet quality in children has increased in the past decade. However, to date, few studies have focused on the use of these scores on disease outcomes such as childhood obesity and most are developed from detailed dietary assessments. Therefore, the aims of this study were: firstly to construct a diet quality score (DQS) from a brief dietary assessment tool; secondly to examine the association between diet quality and childhood overweight or obesity; thirdly we also aim to examine the associations between individual DQS components and childhood overweight or obesity.

Methods
A secondary analysis of cross sectional data of a sample of 8,568 9-year-old children and their families as part of the Growing Up in Ireland (GUI) study. Subjects were drawn from a probability proportionate to size sampling of primary schools throughout Ireland over the school year 2007–2008. Height and weight were measured by trained researchers using standardised methods and BMI was classified using the International Obesity Taskforce cut-points. The DQS (un-weighted) was developed using a 20-item, parent reported, food frequency questionnaire of foods consumed over the past 24 h. Adjusted odds ratios for overweight and obesity were examined by DQS quintile, using the first quintile (highest diet quality) as the reference category.

Results
The prevalence of normal weight, overweight and obese was 75, 19 and 6 % respectively. DQS ranged from -5 to 25, higher scores indicated higher diet quality in the continuous score. In analyses adjusted for gender, parent’s education, physical activity and T.V. viewing, child obesity but not overweight was significantly associated with poor diet quality: OR of 1.56 (95 % CI 1.02 2.38) in the 5th compared to the 1st DQS quintile. Findings from individual food items were inconsistent.

Conclusions
The findings suggest that diet quality may be an important factor in childhood obesity. A simple DQS developed from a short dietary assessment tool is significantly associated with childhood obesity.

This study uses high-quality longitudinal data from the Growing Up in Ireland study to examine the interplay between home learning environment (HLE) and early childhood education (ECE) in explaining children’s skills development from 9 months to 5 years old across parental socioeconomic status (SES). Random-effects linear regression models show that: (1) supportive HLE improves children’s cognitive and socioemotional skills and ECE quality critically fosters early socioemotional skills; (2) SES is associated with higher early cognitive and socioemotional outcomes, while responsive and consistent parenting behaviours among low-SES parents is particularly critical to improve their children’s socioemotional well-being; (3) high-quality ECE attendance compensates for children’s behavioural problems in less responsive parenting environments, especially among low-SES families, whereas home literacy stimulation is necessary condition for high-quality ECE attendance to benefit children’s early cognitive skills. Overall, HLE and ECE mutually interact in explaining differences in children’s early skills development across SES groups.

Parent-child interactions are influenced by factors outside the immediate family. A recent paper † based on data from the Growing Up in Ireland study (GUI) focuses in particular on the support provided by grandparents in caring for very young children. Such support can have important direct and indirect influences on child development. For example, a grandparent who babysits a young child while parents have a night out has a direct interaction with the child in the context of providing care. However, there is also an indirect influence in the context of supporting the mother-father relationship which, in turn, could be expected to affect (positively) parental interactions with the child.

The transition to parenthood and early infancy have been identified in the literature as the critical periods requiring most support. Infancy is a particularly intensive parenting period. Children at this stage remain highly dependent on caregivers for their basic needs but, by 9 months (the age of infants at the time of data collection in the GUI study), they are also starting to become more mobile and interaction-seeking. In the Irish context, 9 months may also be the stage when mothers may be contemplating a return to work or education following maternity leave (paid and unpaid) – and those who have been breastfeeding will likely have finished at least exclusive breastfeeding.

Here we report some key results from the paper; further detail, and a full set of references to the literature can be found in the paper itself.

Using the first wave of the Growing Up in Ireland Survey of nine year old children we examine whether a teacher’s assessment of their pupil’s academic ability is influenced by the weight status of the child and/or the child’s mother. Multivariate regression analyses of the teacher’s assessment, controlling for the child’s actual test performance, their BMI, their mother’s BMI, other socio-demographic and teacher characteristics were undertaken. The study highlighted that child BMI was not a significant determinant but that children whose mother was obese were more likely to be rated as below average in reading and in maths compared to those whose mother was leaner, after adjusting for their measured ability. The potential for mother’s weight status to influence teachers’ assessments of their children’s perceived ability could have long term ramifications for educational outcomes and warrants further 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

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.

Aim
To explore the association between weight and bullying; considering victims and perpetrators as two aspects of bullying, and subjective perception and objective measurement as two aspects of weight.

Methods
This study is based on the first wave of data collection from Growing Up in Ireland – the National Longitudinal Study of Children. The two-stage sample design included a sample of 910 primary schools in Ireland, from which a sample of 8568 nine-year-old children and their families was randomly selected. Analysis is based on statistically reweighted data to ensure that it is representative of all 9-year-olds in Ireland.

Results
Significantly (P < 0.001) more girls were overweight or obese (33.1%: 23.1% overweight and 10% obese) than boys (25.2%: 18.3% and 6.9%). Children who were body mass index (BMI) classified as overweight or obese were significantly (P < 0.001) more likely to be victimised when compared with children whose BMI was not classified as overweight or obese. BMI-classified thinness was not significantly associated with victimisation; however, the body image of being skinny or very skinny was significantly (P = 0.015) associated with being victimised. Bullying perpetration was not associated with BMI-derived weight classification but was significantly (P < 0.001) associated with the child’s own self-description of weight.

Conclusions
Overall body image was found to have a stronger association with victimisation and bullying perpetration than objective BMI-derived weight classification. Further research investigating the mediating role of body image in the relationship between weight, victimisation and bullying is necessary to better understand this association.

Objective
Childhood chronic illness can have a high impact on the child’s quality of life. The foundations of health are established in early life, and are shaped by biological, psychosocial, spiritual and environmental processes and influences. The objectives of this presentation are twofold: firstly to describe the prevalence of chronic illness in 9-year-olds in Ireland, secondly to illustrate how chronic illness influences the psychological and social development of the children.

Methods
Analysis was based on data of 8570 9-year old children, and their families who participated in Growing Up in Ireland—the National Longitudinal Study of Children. The sample was generated through the primary school system. A representative sample of 910 schools participated; the sample of children and their families was randomly selected from within the schools. Questionnaires were administered in schools; and after completion of this phase, the project interviewers visited the families of the 9-year olds in their homes and administered core questionnaires to the Study Child and his/her carers who provided either home-based or centre-based care on a regular basis.

Results
The overall prevalence of chronic illness reported by mothers among the 9-year old cohort was 11% (gender-specific prevalence for boys: 13%, and significantly lower for girls: 10%). Respiratory illnesses accounted for almost half (46%) of all chronic illnesses, followed by mental and behavioural conditions with 19% (high gender dysbalance: reported for boys in 24%, for girls in 12%). Children with a reported chronic illness had significantly more emotional, conduct, hyperactivity, peer-based and prosocial difficulties when compared with children without a reported chronic illness. Abnormal scores, based on the Strengths and Difficulties Questionnaire were found in 20% in children with a chronic disease, and in 5.5% in children without a chronic disease. Socio-economic Status was associated with poorer health outcomes. Furthermore, primary care givers’ views and perceptions regarding the chronic illness of the child were found to be a significant factor on child strengths and difficulties in a multivariate model.

Conclusions
The majority of 9-year old children can be assessed as healthy. The most common chronic illness in this large cohort was respiratory disease and overall, chronic conditions were found to have a negative impact on the child’s emotional and social state.

Background
Preventing child mental health problems and child obesity have been recognized as public health priorities. The aim of the present study was to examine whether being breastfed (at all or exclusively) in infancy was a predictor of mental well-being and protective against risk of obesity at age 9.

Methods
Cross-sectional data from a large, nationally representative cohort study in the Republic of Ireland was used (n = 8357). Data on breastfeeding were retrospectively recalled. Child mental well-being was assessed using a parent-completed Strengths and Difficulties Questionnaire (SDQ). Child’s height and weight were measured using scientifically calibrated instruments.

Results
Logistic regression analyses indicated that, after controlling for a wide range of potential confounding variables, being breastfed in infancy was associated with a 26% (P < 0.05) reduction in the risk of an abnormal SDQ score at 9 years. Being breastfed remained a significant predictor of child mental well-being when child obesity was controlled for, indicating that being breastfed, independent of child obesity, is a predictor of child mental well-being. The results of a second logistic regression indicated that, after controlling for a wide range of potential confounding variables, being breastfed for between 11 and 25 weeks was associated with a 36% (P < 0.05) reduction in the risk of obesity at 9 years, while being breastfed for 26 weeks or longer was associated with a 48% (P < 0.01) reduction in the risk of obesity at 9 years.

Conclusions
Breastfeeding in infancy may protect against both poor mental well-being and obesity in childhood.

Background
Public health policies attempt to increase parental identification of child overweight and obesity. The objective of the present research was to determine the cross-sectional, prospective and longitudinal associations between parental identification of child overweight and child mental health problems.

Methods
We made use of two cohort studies of Australian (Longitudinal Study of Australian Children, LSAC) and Irish children (Growing up in Ireland Study, GUI) that measured parental identification of child overweight and child mental health problems. Participant included 6502 (LSAC) and 7503 (GUI) children (49% female) and their parents. Child mental health problems were measured using child, parent and teacher-reported Strengths and Difficulties Questionnaires (SDQ) at ages 9/10 years old to 12/13 years old. In all analyses we controlled for child Z-BMI.

Results
In LSAC children whose parents identified them as being overweight at age 10 experienced worse mental health at age 10 (β = 0.21, SE = 0.04) and age 12 (β = 0.13, SE = 0.04) than children whose parents failed to identify them as overweight. In GUI children whose parents identified them as being overweight at age 9 experienced worse mental health at age 9 (β = 0.20, SE = 0.04) and age 13 (β = 0.22, SE = 0.04). In LSAC parental identification of child overweight at age 10 did not significantly predict changes in mental health problems from age 10 to 12 (β = −0.02, SE = 0.03). In GUI parental identification of child overweight was predictive of increases in mental health problems from age 9 to 13 (β = 0.08, SE = 0.03).

Conclusions
Parental identification of child overweight and obesity is associated with worse child mental health, independent of child body weight. Parents should be aware of the potential stigma and mental health difficulties associated with labelling a child as overweight.

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.

This study examines how the presence of outdoor areas such as parks and playgrounds affects children’s well-being and how this effect is moderated by families’ socioeconomic status. Specifically, I aim to answer two research questions. First, does the presence of outdoor areas in children’s neighborhoods affect their well-being? Second, is there a differential effect depending on children’s socioeconomic status? The main part of the study uses data from the International Survey of Children’s Well-Being. The results suggest that the presence of outdoor areas in children’s neighborhoods has a positive effect on their well-being. In addition, the estimated effect of outdoor areas is larger for children from families with low socioeconomic status. Finally, findings from the Growing Up in Ireland data set suggest that children’s mental problems are a plausible mechanism through which outdoor areas affect children’s well-being. These findings have meaningful policy implications. Efforts to provide access to appropriate outdoor areas may be more likely to benefit disadvantaged children and thus reduce inequality in children’s well-being.

This report investigates the effects of childcare in early life on children’s socio-emotional development at age five using a large representative sample of children (circa 9,000) from the Growing Up in Ireland study. At age three, prior to the Free Preschool Year, around half the children in the study were in non-parental childcare. There were three categories of non-parental childcare:

• Relative care, usually by a grandparent
• Non-relative care, typically a childminder
• Centre-based care, e.g. crèche

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?

Several approaches frame childbirth as an event that can reduce partnership quality, generate work-family conflicts, intensify financial pressures, and increase separation risk. The present study discusses theories of separation in relation to pregnancy intentions leading to a birth and analyses data from Growing Up in Ireland. Transition rate models of parental separation nine months to five years after childbirth show higher risks of separation after pregnancies described as “somewhat too early”, “much too early” and after “unwanted” pregnancies. These differences are due partly to sociodemographic factors that influence unplanned pregnancies and subsequent separation. Increases in workfamily conflicts after birth do not increase separation risk.

This paper discusses the role of grandparents in informal childcare in Ireland. It considers how recent demographic change and government policy on childcare have the potential to place greater pressures on the provision of grandparent childcare. It illustrates research literature that has examined the prevalence and intensity of grandparent care, factors influencing such care, and the role and needs of grandparents in childcare. We argue that there are significant gaps in Irish research evidence about the extent of, role and needs of grandparents as childcarers and outline a data and research agenda that builds on previous research in this area.

Keywords
Childcare, Policy, Grandparents, Intergenerational

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

Background
The gold standard for categorisation of weight status is clinically measured body mass index (BMI), but this is often not practical in large epidemiological studies.

Objectives
To determine if a child’s weight perception or a mother’s perception of a child’s weight status is a viable alternative to measured height and weight in determining BMI classification. Secondary outcomes are to determine the influence of a mother’s BMI on her ability to categorise the child’s BMI and a child’s ability to recognise his/her own BMI.

Methods
Cross-sectional analysis of the growing up in Ireland cohort study, a nationally representative cohort of 8568 9-year-old children. The variables considered for this analysis are the child’s gender, BMI (International Obesity Taskforce grade derived from measured height and weight) and self-perceived weight status, and the mother’s weight perception of the child, BMI (derived from measured height and weight) and self-perceived weight status. Cohen’s weighted-kappa was used to evaluate the strength of the agreement between pairwise combinations of the BMI variables. Cumulative and adjacent categories logistic regression were used to predict how likely a person rates themselves as under, normal or overweight, based on explanatory variables.

Results
Mothers are more accurate at correctly classifying their child’s BMI (κ=0.5; confidence intervals (CI) 0.38–0.51) than the children themselves (κ=0.25; CI 0.23–0.26). Overweight mothers are better raters of their child’s BMI (κ=0.51; CI 0.49–0.54), compared with normal (κ=0.44; CI 0.41–0.47) or underweight mothers (κ=0.4; CI 0.22–0.58), regardless of whether the mother’s BMI is derived from measured height and weight or self-perceived. The mother’s perception of the child’s weight status is not an influencing factor on the child’s ability to correctly classify him/herself, but the child’s self-perceived weight status influences the mother’s ability to correctly classify the child.

Conclusions
A mother’s BMI classification of her child is a viable alternative to BMI measurement in large epidemiological studies.