External Publications Using GUI Data

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.

This collection brings together various cutting-edge and accessible perspectives and insights into the rich, complex and intriguing stage of life that is childhood. Contributions here relate specifically to the Irish context, with many seamless connections also made to the universal themes of childhood and their relevance within the international context. The chapters are organised into four themes: (1) Children and families in education and special education settings; (2) Childrenâ (TM)s environment and play spaces; (3) Childrenâ (TM)s voice in research, classrooms and non-traditional settings; and (4) Childrenâ (TM)s experiences in STEM education. Across the chapters, the authors identify current best practices and place them within the overall context of current trends in research into childhood. There is a complementary balance of theoretical and practical knowledge presented throughout the volume. Given the variety of perspectives and contributions presented here, it will be of interest to those working in professional practice, such as educators, psychologists, sociologists, and the more general public, including parents and policymakers.

It is well-established that participation in shared book reading interactions with caregivers supports children’s early language and literacy development. Most of this literature focuses on reading experiences during the preschool period. Less is known about the nature and importance of such practices during infancy. Therefore, the goal of this study was to examine literacy practices between parents and infants in a large cohort study, Growing Up in Ireland. Interview, survey, and direct measurements of children’s language skills were used to examine whether parent-report of book reading practices when children were 9-months predicted child expressive vocabulary at 36-months (N = 9171). Regression analysis indicated that approximately 80% of 9-month-old Irish children are read to by parents. Characteristics of families who were more likely to report reading with children emerged: those with higher educational attainment, fewer depressive symptoms, and those who report a high-quality home language environment (e.g., reported talking more to children during everyday activities). Furthermore, children who were read to at 9-months had stronger expressive vocabulary skills at 36-months, even after accounting for socio-demographic and home literacy environment covariates measured at both 9- and 36-months. Results are discussed using a bioecological framework to describe how proximal and distal factors in the child’s environment converge to impact early childhood literacy development.

This study investigates the relationship between multidimensional household poverty and cognitive and behavioural development during the formative years of childhood (from 9 months to 9 years), using nationally representative longitudinal data from Ireland for the cohort of children born in 2007-2008. The results indicate substantial inequalities in Irish children’s cognitive and behavioural outcomes at age 9 by multidimensional poverty duration. Children with at least one spell in poverty (out of four interviews) have worse cognitive and behavioural outcomes. Dynamic structural equation models provide evidence in support of a hybrid family investment/family stress model. Although family investment processes account for some of the cumulative effects of childhood poverty on cognitive outcomes, family stress processes help explain the links between poverty and both cognitive and behaviour outcomes in early childhood. Overall, poverty is strongly related to child outcomes over time via the direct effects of current poverty on child outcomes and path dependency in both poverty and child outcomes over time. There are also indirect effects via the two child outcomes reinforcing each other as children grow older (with the effects of behaviour problems dominating those of cognitive ability), even as the parental investment and maternal stress pathways become less pronounced.

Keywords
Early childhood, child poverty, cognitive ability, behaviour problems, growing up in Ireland

Whilst there is a large evidence base demonstrating the impact of maternal depression on the development of adolescent internalising problems, less is known about the association between paternal depression and adolescent internalising problems, and the mechanisms through which risk is conferred. This study examined the association between paternal depression and adolescent internalising problems, investigating parenting style as a pathway through which this association may be mediated. Participants included 4048 families taking part in the Growing Up in Ireland child cohort study. Self-report measures of paternal depression were completed when the study child was aged 9. Adolescents assessed paternal demandingness, responsiveness and autonomy granting at the age of 13. Adolescent internalising symptoms were measured at the age of 17/18 by the primary caregiver. A parallel multiple mediator model was used to test the total and specific indirect effects of the three parenting styles, whilst controlling for covariates and other mediators in the model. A direct effect of paternal depression on adolescent internalising problems was found (B = .051, 95% CI: 0.020, 0.083). However, no support for mediation via any of the paternal parenting styles (i.e., responsiveness, demandingness, or autonomy-granting) were found. These findings build on an emerging evidence-base demonstrating a specific direct association between paternal depression and adolescent internalising problems, and suggest that interventions ought to also target fathers suffering from depression to help reduce the risk of adolescent internalising problems.

This paper examines multidimensional poverty for three waves of a cohort of Irish children ranging from ages 9 to 17. Poverty is measured over the dimensions of health, education and family resources and both unidimensional and multidimensional poverty is examined. Both show a clear gradient with respect to maternal education. The dynamics of both unidimensional and multidimensional poverty are also analysed. The greatest degree of mobility is observed with respect to family resources. Mobility also is higher for children whose mothers have lower levels of education, with net movements into rather than out of poverty.

This paper examines developments in childhood and adolescent obesity in Ireland using two waves of the Growing Up in Ireland survey. Obesity appears to level off between the two waves though there is tentative evidence that the socioeconomic gradient, measured with respect to maternal education and family income, becomes steeper. Exploiting the longitudinal nature of the data, transitions into and out of obesity are examined, with higher rates of transition into obesity observed for those whose mothers have the lowest level of education. Decomposition of the concentration index with respect to income reveals a greater role for income related obesity mobility rather than obesity related income mobility.

There is now fairly substantial evidence of a socioeconomic gradient in low birth weight for developed countries. The standard summary statistic for this gradient is the concentration index. Using data from the recently published Growing Up in Ireland survey, this paper calculates this index for low birth weight arising from preterm and intrauterine growth retardation. It also carries out a decomposition of this index for the different sources of low birth weight and finds that income inequality appears to be less important for the case of preterm births, while father’s education and local environmental conditions appear to be more relevant for intrauterine growth retardation. The application of the standard Blinder–Oaxaca decomposition also indicates that the socioeconomic gradient for low birth weight appears to arise owing to different characteristics between rich and poor, and not because the impact of any given characteristic on low birth weight differs between rich and poor.

This paper examines mobility and changes in Body Mass Index (BMI) for a sample of Irish children/adolescents across three waves of the longitudinal Growing Up in Ireland dataset. Particular attention is paid to transitions across the key BMI thresholds of overweight and obesity. Analysis is carried out by gender and by maternal education. In general, mobility is observed, with intra-generational rank-rank BMI coefficients of around 0.63 compared to coefficients of around 0.77 for the mothers of the children over the same time period. Across the distribution as a whole there is relatively little variation by gender and maternal education. However there a gender difference in terms of mobility out of obesity with the Shorrocks mobility index across categories of normal weight/overweight/obesity taking a value of 0.56 for females as opposed to 0.71 for males. This relative lack of mobility is more observed in later rather than earlier adolescence.

Background
The Covid pandemic arrived in Ireland on February 29, 2020. In the following weeks various restrictions were introduced to stem the spread of the disease. Anxiety over the spread of the disease and over the restrictions introduced had an adverse effect upon mental health. This study examines the change in mental health for two groups: young adults aged around 23 at the time of onset of Covid (the 1998 cohort) and a sample of principal carers (PCs) of children who were aged 13 at the onset of Covid (the 2008 cohort).

Methods
Data were obtained from the two cohorts of the longitudinal Growing Up In Ireland (GUI) survey. The sample included 1953 young adults (from the 1998 cohort) and 3547 principal carers (from the 2008 cohort). Mental health as measured by the Centre for Epidemiological Studies Depression—8 scale was obtained for the last pre-Covid wave and for the Covid wave (surveyed in December 2020). Observations for which CES-D8 was not available in either pre or post Covid waves were excluded. Post-Covid sampling weights were applied. The change in depression rates was decomposed into a growth and distribution effect using a Shapley decomposition. The socioeconomic gradient of CES-D8 was examined pre and post Covid using concentration indices and a transition matrix was constructed to examine the dynamics of changes in CES-D8 and depression pre and post-Covid.

Results
Relative to the last pre-Covid survey, mental health, as measured by CES-D8 deteriorated for both the young adults of the 1998 cohort and the PCs of the 2008 cohort. For young adults, the deterioration was more pronounced for females. There was no observable socioeconomic gradient for poor mental health amongst young adults, both pre and post Covid. For mothers from the 2008 cohort, a gradient was observed during the pre-COVID-19 pandemic period with poorer mental health status for lower-income and less educated mothers. This gradient was less pronounced post-Covid, the levelling-off arising from a greater deterioration in mental health for higher-income and better-educated PCs.

Conclusion
Both observed cohorts showed a significant deterioration in mental health post Covid. For young adults the effect was significantly more pronounced among females and this is consistent with generally poorer mental health amongst females in this age group. There was little or no socioeconomic gradient observed for young adults, but the gradient became more shallow for principal carers. Care must be taken in terms of drawing policy implications from this study as the Covid-19 pandemic was arguably a unique event, even allowing for the likelihood of future pandemics. However, the study highlights the vulnerability of young adults, especially females, to the mental health effects arising from major public health shocks.

Objectives
To examine the associations between preeclampsia and longitudinal child developmental and behavioural outcomes using data from a nationally representative study of children living in Ireland.

Methods
We used maternal-reported data from the Growing Up in Ireland longitudinal study of children. Data on preeclampsia and preeclampsia + small for gestational age (SGA) were collected when children were 9-months old. Data on child development and behavioural outcomes were collected at 9-months using the Ages and Stages Questionnaire (ASQ), and at 3 years, 5 years and 7–8 years using the Strengths and Difficulties Questionnaire (SDQ). Multivariate logistic regression analysis was used to examine the association between preeclampsia exposure and failure of ASQ domains, and abnormal SDQ domains. Linear spline multilevel models were used to examine the association between preeclampsia and preeclampsia + SGA and repeated measures of SDQ. All models controlled for several perinatal and sociodemographic factors.

Results
A total of 10,692 children were included in the study at baseline, representing a weighted total of 70,791. Multivariate logistic regression suggested that preeclampsia was not associated with failing any ASQ domain. Preeclampsia was associated with abnormal SDQ cut-off of emotional (≥ 5) and hyperactivity (≥ 7) domains at age 5 years only. In the linear spline model, mean SDQ score was higher at each time point in exposed groups.

Conclusions for Practice
While we did not find strong evidence of associations between preeclampsia and child developmental and behavioural outcomes overall, some associations between preeclampsia-exposure and subtle behavioural issues did persist. Further research is needed to replicate these findings, and determine the clinical significance of changes in SDQ scores.

BACKGROUND
Early studies show that children might be ‘resilient’ when families navigate economic crises and related job loss. What resilience means is unclear, though, and why and from whom resilience is required has seldom been examined.

OBJECTIVE
I theorise children’s prosociality – helping, supporting and comforting others – as a form of transformative resilience. From a social reproduction perspective, I also consider how prosociality imbues and is influenced by caregiving relationships within families. I examine how children’s prosociality/caregiving (unpaid labour) developed in response to parents losing and regaining employment (paid labour) amid the Great Recession in Ireland.

METHOD
I rely on cohort data from children’s early years to adolescence (Growing Up in Ireland, 2008-2022). I estimate growth-curve and OLS models for prosocial development and outcomes tapping into paid and unpaid labour. Associations with parental job loss are identified net of observables while outlining conditions for causal claims. FINDINGS Children whose mothers experienced job loss are rated more prosocial than their peers from middle childhood onwards. Girls with younger siblings drive this finding. At age 13, the same group is more likely to provide regular care within the household, while their mothers scale back caregiving and reprise paid work after heightened childcare responsibilities during the crisis.

CONTRIBUTION
The study contributes to debates on the formation of prosociality, the intergenerational consequences of job loss, and the household division of labour among adults and children. Findings suggest focusing on if and how families cope with a context unequally structured by (labour) markets and gender norms.

The study examines whether and why parental job loss may stifle early child development, relying on cohort data from the population of children born in Ireland in 2007–2008 (N = 6,303) and followed around the time of the Great Recession (2008–2013). A novel approach to mediation analysis is deployed, testing expectations from models of family investment and family stress.

Parental job loss exacerbates problem behavior at ages 3 and 5 (.05–.08 SDs), via the channels of parental income and maternal negative parenting. By depressing parental income, job loss also hampers children’s verbal ability at age 3 (.03 SDs). This is tied to reduced affordability of formal childcare, highlighting a policy lever that might tame the intergenerational toll of job loss.

Background
Meeting physical activity and screen time guidelines has been associated with improved health in children. Research has shown that lifestyle behaviours happen in combination and can be tracked into later life. Thus, a complex approach is needed to identify the effects of physical activity and screen time altogether. This study aims to identify clusters of both behaviours in a cohort of Irish 3-year-old children (n = 8833) and determine the association with sociodemographic characteristics and behaviours at age 5 and 7-8.

Methods
Data from the “Growing Up in Ireland” study collected between 2010 and 2016 was used in this study. Two-step cluster analysis was used to understand how physical activity and recreational screen time behaviours group together among 3-year-old children. Binary logistic regressions were conducted to examine if cluster placement at age 3 determined physical activity and recreational screen time behaviours at age 5 and 7-8 years, while controlling for gender of child, gender, age and employment status of the primary caregiver.

Results
Six clusters were identified in 9771 (49.3% female) 3-year-old children with the majority falling into a “High Active & Mixed Screen Time” (23.2%). Those in the “High Active & Mixed Screen Time” cluster at age 3 were more likely to engage in all physical activities reported at age 5 (p < 0.01) and age 7-8 (p < 0.01) when compared to a “Low Active & Screen Time Exceed” cluster. Children categorised in a “Moderate Active & Screen Time Below” and “Moderate Active & Screen Time Exceed” were more likely to engage in the same physical activities at age 5 and 7-8 (p < 0.05 – p < 0.01). However, children in the latter cluster were also more likely (p < 0.05) to play on a computer or tablet device.

Conclusions
This paper highlights the importance of establishing positive health-related behaviours during early childhood, as this predicts future engagement in health-promoting activities. Regardless of screen time level, being part of a cluster with moderate or high levels of physical activity positively influences a child’s future physical activity at age 5 and again at age 7 -8 years. The multiple layers of influence on a child’s development should be leveraged to support the adoption of health-enhancing behaviours.

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.

Introduction
The aim of this paper was to examine the role of perinatal, obstetric and post partum factors on maternal and paternal stress. It will present the first examination of the role of prenatal, obstetric, post-partum, and demographic variables in parenting stress for mothers and fathers at 9 months.

Methods
Data from 6821 parental dyads of 9-month-old infants were extracted from the Growing Up in Ireland National Longitudinal Study of Children. Participants completed the Parental Stress Scale, the Dyadic Adjustment Scale, the Quality of Attachment Sub-scale from the Maternal and Paternal Postnatal Attachment Scales, and a single item health status question from the Short Form 12 Health Survey. Information on prenatal care, pregnancy complications, obstetric outcomes, infant health, and participant demographics were also collected. Separate hierarchical linear regressions were conducted for mothers and fathers

Results
Mothers reported higher levels of parenting stress than fathers (p < 0.001). Maternal parenting stress was predicted by attachment, own health status, average sleep, occupation, household income, and having a very rapid labor. Paternal parenting stress was predicted by attachment and own health status.

Discussion
A range of perinatal factors was associated with an increased risk of higher parenting stress at 9 months post-partum and the roles of these factors differ between mothers and fathers. These findings are important for predicting and reducing risk of parenting stress in both genders.

Keywords
Attachment, obstetric outcomes, parenting stress, prenatal, well-being

Self-harm in adolescents and young adults (AYAs) is the result of a complex interaction of biological, psychiatric, psychological, social, and cultural risk factors. A lot of research has already been conducted to identify the risk factors for self-harm in AYAs. On the other hand, there has been less research conducted on the simultaneous effects of, and the interactions between, multiple risk factors for self-harm in heterogeneous AYA individuals. In this study, we conducted a latent class analysis (LCA) of three waves from the Growing Up in Ireland (GUI) longitudinal cohort study at ages 13, 17 and 20 to identify homogenous subgroups of AYA individuals who exhibit similar risk markers for self-harm at these three time points. Then, we evaluated the risk that these subgroups ever self-harmed by age 17, self-harmed at age 20, or were persistently self-harming across both time points. The most at-risk group appeared to be the individuals aged 17 who had been diagnosed with depression/anxiety. Compared to the low-risk-marker group, the ‘diagnosed with depression/anxiety’ group had a 30-fold risk of self-harm at age 17, and 32-fold risk of persistently self-harming by age 20. The ‘undiagnosed but high depression’ group at this time point was also at significant risk of self-harm. This research enables us to understand which risk markers tend to co-occur together and will help to identify high-risk groups for self-harm both clinically and in the community. An investigation of risk markers like this can potentially be used in the design of public health interventions to reduce the burden of self-harm, and indeed suicide, in young people.

Key messages

• We identified sub-groups of young people with a high-risk of self-harm and suicide from the general population.

• These identifiable sub-groups can inform intervention policies and strategies for prevention programmes both in clinical and non-clinical settings like schools.

Sociologists of childhood have stressed the importance of children’s experience in the present and children as agents who actively construct their own lives and influence relationships with family and friends. Current thinking in the field of child well-being emphasises the need to consult children as experts in their own lives. Findings from research with children have led to important insights about what contributes to well-being. Relationships with family and friends have been found to be central to well-being whilst bullying by peers deeply impacts on their well-being. Shared activities appear to be the context for children to not only master competences but also learn about and negotiate relationships. The Growing Up in Ireland interviews with 9 year old children were re-analysed with a view to exploring these crucial domains and how they impact on the children’s well-being. The children were found to have a wide circle of family connections and were particularly close to their mothers although also close to their fathers. Grandparents played a significant role in their lives and their relationships with siblings were often positive but did fluctuate. Reasons for closeness centred around trust. Lack of availability due to work was a key contributor to children feeling less close to a family member. The children were involved in a wide range of structured activities after school and at the weekend, This was usually balanced with free time although some ‘hurried’ children had frenetic lifestyles. Involvement in unstructured activities such as free play was particularly associated with time with friends and choice. Friendship was characterised by sharing and trust. On the other hand, bullying by peers had been experienced by many of the children and almost all were conscious of the danger of becoming bullied. The wider issues of work-family balance and its impact on children, the predominance of bullying and children’s right to be heard are reflected upon.

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.