External Publications Using GUI Data

The present study investigated the home learning environment of three to five-year-old children (n = 429) living in an area designated as socio-economically disadvantaged, involved in the Area Based Childhood (ABC) programme, compared to a nationally representative sample of three-year-old children (n = 9793), from the Growing Up in Ireland (GUI) Study. Statistical analysis of the frequency of engagement in home learning activities across both samples, revealed a significant difference in the environments to which children are exposed, with families from the GUI sample engaging more frequently in these activities than families from the ABC sample. Among the family demographic factors investigated, parent’s age and household type were significantly related to the frequency of engagement in home learning activities. Based on these findings, policy and practice implications are discussed.

Keywords
home learning environment, socio-economic disadvantage, family demographics, early childhood development

Whether school composition makes a difference for student outcomes has been the subject of much controversy. This article draws on Growing Up in Ireland data, a rich source of information on nine-year-old children along with the characteristics of their school and classroom teacher. In contrast to many studies which rely on a single measure of social background, the use of a range of measures (including social class, parental education and income) allows us to provide precise estimates of differences in performance between schools designated as disadvantaged and other schools. The analyses also provide new insights into the processes underlying such differences. Only the most disadvantaged schools, those in Urban Band 1, are found to have a contextual effect for both reading and mathematics. This achievement gap is found to reflect differences in teacher experience and turnover, the concentration of additional learning needs, absenteeism levels and children’s engagement in school.

Keywords
school social mix, primary education, academic performance

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

A small minority of Irish students attend fee-charging second-level schools. However, media analyses of the backgrounds of those students who go on to more sought-after tertiary educational institutions or degree courses suggest that a disproportionate number of them were attendees at fee-charging schools. There are a few reasons why this might be the case. In this analysis, the longitudinal data points of the Growing Up in Ireland (GUI) study are exploited to weigh up the evidence behind differing explanations. An estimated measure of Leaving Certificate success was generated for 3105 participants in wave 4 of the GUI. From waves 1 and 2, the ability of those participants was calculated based on their performance in several standardised tests taken prior to attending second-level school. The analysis found that while the students who attended fee-charging schools were about 9% ahead in Leaving Certificate performance, they had roughly the same lead in measured ability on entry into the second-level schools. The analysis found a significant but marginal positive effect on attending private schools. This result is in line with the general international findings. Ireland’s hybrid funding structure for fee-paying schools is discussed. Gender and household income effects were noted.

Keywords
Longitudinal data, non-state schools, ability, exam performance, school value added

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

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

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

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

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

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

The Growing Up in Ireland Infant Cohort dataset (n = 11,134) includes information on fertility treatments for over 400 infants. IVF (28.1 %) and IVF-related treatments (17.8 %) were the most frequent, but there was also a high percentage following clomiphene citrate alone (31.5 %). Infants born following fertility treatment were much more likely to be in higher income families, and this relationship was not accounted for by older mothers in wealthier families. Analysis of fertility-treatment pregnancies among Irish infants, controlling for income and maternal age, shows a greater risk of multiple birth and low birth-weight, although the latter appears to be largely related to the former especially for IVF-type treatments.

Objective
This study examines the association between attention-deficit/hyperactivity disorder (ADHD) and overweight/obesity in a large-scale longitudinal study of children, while controlling for a range of psychosocial factors.

Method
Data were obtained from Growing Up in Ireland, a nationally representative and longitudinal study of approximately 6500 children who were assessed at 9 and 13 years of age. Body mass index (BMI) was determined using measured height and weight, ADHD status was determined by parent reports of professional diagnoses and ADHD symptoms were measured using the Strengths and Difficulties Questionnaire (SDQ).

Results
The associations between ADHD status, ADHD symptoms (SDQ) and BMI category at age 9 and 13 years were evaluated using logistic regression. Adjustments were made for child factors (sex, developmental coordination disorder, emotional symptoms, conduct problems, birth weight and exercise) and parental factors (socio-economic status, parental BMI, parental depression, and maternal smoking and alcohol use during pregnancy). Logistic regression indicated that ADHD status was not associated with BMI category at 9 or at 13 years of age, but children with ADHD at 9 years were significantly more likely to be overweight/obese at 13 years than those without ADHD. However, when other child and parental factors were adjusted for, ADHD status was no longer significantly associated with weight status. Female sex, low levels of exercise, overweight/obese parents and prenatal smoking during pregnancy consistently increased the odds of childhood overweight/obesity.

Conclusions
While ADHD and overweight/obesity co-occur in general populations, this relationship is largely explained by a variety of psychosocial factors.

Keywords
ADHD, longitudinal, obesity, overweight, psychosocial

Objectives
Migrant youths endure many challenges. Such challenges can be stressful and lead to psychological difficulties. We investigated the relationship between migration, psychopathology and stressful events in children and adolescents. We hypothesised that migrant youths would show higher levels of psychopathology and more stressful life events than non-migrant youths.

Method
Using the Child cohort (Cohort ‘98) of the ‘Growing up in Ireland’ study we investigated psychopathology, as measured by the Strengths and Difficulties questionnaire (SDQ) at age 9 and 13 and stressful life events in migrant and non-migrant youths.

Results
There was no significant difference between the proportion of migrant and non-migrant youths reporting psychopathology in childhood (p>0.05) or adolescence (p>0.05). Analysis of the SDQ subscales revealed that a significantly greater proportion of migrant youths had hyperactivity problems in childhood (p = 0.04) but a greater proportion of non-migrant youths had emotional problems in early adolescence (p = 0.04). We found that migrant youths experienced significantly more stressful life events than their non-migrant counterparts (p<0.01), however, once ‘Moving house/country‘ was removed as a stressor, there was no difference between the groups (p>0.27).

Conclusions
Contrary to our hypothesis, we observed that there were few differences between migrant and non-migrant youths in the levels of psychopathology. Migrant youths experienced a greater number of stressful life events, however, this was attributable to stressors relating to moving. An increased understanding of the factors promoting resilience, as demonstrated by the migrant youths, could aid health professionals and policy makers to effectively tailor interventions for mental health promotion.

Keywords
Early life stress, immigration, migrants, psychopathology

Background
Abnormal body mass index (BMI) has been associated with development of psychopathology. This association in children is well documented, for both overweight and underweight children. However, the association between change in BMI and the development of psychopathology has been less investigated.

Aim
To investigate the association between change in BMI between childhood and adolescence and psychopathology in adolescence.

Methods
Data from the Growing Up in Ireland cohort were used. We investigated the ’98 cohort (also known as the child cohort) at age 9/13. BMI, defined using internationally recognised definitions as underweight, healthy or overweight, was used as the exposure, and abnormal Strength and Difficulties Questionnaire scores were used as the outcome. Logistic regression was undertaken for the analysis. All analyses were adjusted for confounders.

Results
A change to overweight from healthy BMI was significantly associated with increased risk of psychopathology (adjusted OR 1.66; 95% CI 1.19–2.32). Both change from underweight to healthy (adjusted OR 0.12; 95% CI 0.03–0.43) or from overweight to healthy (adjusted OR 0.47; 95% CI 0.79–0.8) was associated with a significantly reduced risk of developing psychopathology.

Discussion
As a child’s BMI returns to within the healthy range, their risk of adolescent psychopathology is reduced. Interventions to restore healthy BMI, in both underweight and overweight, children may reduce their risk of adolescent psychopathology.

Keywords
adolescence, body mass index, childhood, psychopathology, weight change

This study reports recent trends in periconceptional folic acid use in Ireland using archived data from Growing Up in Ireland – the National Longitudinal Study of Children. Of a sample of 10,891 mothers, 6,936 (64%) reported taking folic acid before conception and 10,157 (93%) reported taking folic acid during the first trimester of pregnancy. Younger (OR=0.38, 95% CI=0.29-0.50), lower income (OR=0.59, 95% CI=0.51-0.68), lower educated (OR=0.77, 95% CI=0.66-0.89), and single mothers (OR=0.46, 95% CI=0.40-0.52) were less likely to have taken folic acid pre-conception. A similar pattern was found post-conception with younger (OR=0.58, 95% CI=0.40-0.84), lower income (OR=0.40, 95% CI=0.30-0.53), lower educated (OR=0.50, 95% CI=0.38-0.66), and single mothers (OR=0.74, 95% CI=0.60-0.91) less likely to have taken folic acid post-conception. The findings highlight an ongoing need for targeted promotional campaigns to increase supplementation rates among younger and socially disadvantaged mothers.

Importance Birth weight percentiles (BWPs) are often dichotomized at the 10th percentile and show statistically significant association with later cognitive performance, for both preterm and term-born children. However, research testing nonlinear associations between BWPs and cognitive performance is scarce.

Objective To investigate culturally invariant, nonlinear associations of BWPs and gestational age with later cognitive performance.

Design, Setting, and Participants In this cohort study, participants with valid neonatal and cognitive data were combined from 4 observational cohorts, including the Millennium Cohort Study, the National Longitudinal Survey of Youth 1979 Child and Young Adult cohort, Growing Up in Ireland, and the Longitudinal Study of Australian Children, with children born between 2000 and 2002, 1980 and 2010, 2007 and 2008, and 2003 and 2004, respectively. Neonatal data were parent reported before age 1 year. At approximately 5 years of age, multiple cognitive tests were performed. Follow-up at 5 years of age was the predominant focus. Data were analyzed July 17, 2023.

Exposure The parent-reported neonatal data were used to calculate BWPs according to the Fenton growth chart.

Main Outcome and Measure Scores for IQ were created from multiple measures of cognition, which were z standardized separately within each cohort.

Results Of 30 643 participants (50.8% male), 7.5% were born preterm (before 37 weeks gestation) and 92.5% were term born (between 37 and 42 weeks gestation). In the pooled data using multivariate adaptive regression splines, IQ linearly increased by 4.2 points as BWPs increased from the first to the 69th percentile before completely plateauing. For gestational age, IQ linearly increased by 1.3 points per week up until 32 weeks, with the association reducing to 0.3 points per week after 32 weeks. The association of BWP with IQ was not moderated by gestational age. For term-born infants, the estimated IQ score was only clinically meaningfully lower than average when birth weight was below the third percentile. Consistent results were found when instead using multivariable regression where gestational age and BWPs were categorized into groups.

Conclusions and Relevance In this cohort study, lower BWPs and gestational age were independently associated with lower IQ. For term-born infants, a cutoff of the third percentile would be more appropriate than the traditionally used 10th percentile when the aim is estimating meaningful cognitive differences.

Importance Understanding which children in the general population are at greatest risk of poor functional outcomes could improve early screening and intervention strategies.

Objective To investigate the odds of poor outcomes in emerging adulthood (ages 17 to 20 years) for children with different mental health trajectories at ages 9 to 13 years.

Design, Setting, and Participants Growing Up in Ireland is a longitudinal, nationally representative population-based cohort study. Data collection began in August 2007 and was repeated most recently in September 2018. All results were weighted to account for sampling bias and attrition and were adjusted for socioeconomic factors. Data analysis took place from October 2022 to April 2023.

Exposure Four latent classes captured variation in mental health in children aged 9 and 13 years, based on the parent-completed Strengths and Difficulties Questionnaire. Classes included no psychopathology, internalizing, externalizing, and high (comorbid) psychopathology. Those who remained in the same class from ages 9 to 13 years were included.

Main Outcomes and Measures Poor functional outcomes in emerging adulthood were measured at approximate ages 17 years (range, 16 to 18 years) and 20 years (range, 19 to 21 years). Outcomes included poor mental health, poor physical health, social isolation, heavy substance use, frequent health service use, poor subjective well-being, and adverse educational/economic outcomes.

Results Of 5141 included participants, 2618 (50.9%) were male. A total of 3726 (72.5%) were classed as having no childhood psychopathology, 1025 (19.9%) as having persistent externalizing psychopathology, 243 (4.7%) as having persistent internalizing psychopathology, and 147 (2.9%) as having persistent high psychopathology. Having any childhood psychopathology was associated with poorer functional outcomes in emerging adulthood. The internalizing group had elevated odds of most outcomes except for heavy substance use (range of odds ratios [ORs]: 1.38 [95% CI, 1.05-1.81] for frequent health service use to 3.08 [95% CI, 2.33-4.08] for poor mental health). The externalizing group had significantly elevated odds of all outcomes, albeit with relatively small effect sizes (range of ORs: 1.38 [95% CI, 1.19-1.60] for frequent health service use to 1.98 [95% CI, 1.67-2.35] for adverse educational/economic outcomes). The high psychopathology group had elevated odds of all outcomes (nonsignificantly for frequent health service use), though with wide confidence intervals (range of ORs: 1.53 [95% CI, 1.06-2.21] for poor physical health to 2.91 [95% CI, 2.05-4.12] for poor mental health). Female participants with any psychopathology had significantly higher odds of poor physical health and frequent health service use compared with male participants with any psychopathology.

Conclusions and Relevance In this longitudinal cohort study, childhood psychopathology was associated with a widespread pattern of functional impairment in emerging adulthood. Findings point to the need for a wider range of preventive interventions in child and adolescent mental health services.

Importance As young people’s mental health difficulties increase, understanding risk and resilience factors under challenging circumstances becomes critical.

Objective To explore the outcomes of the COVID-19 pandemic on secondary school students’ mental health difficulties, as well as the associations with individual, family, friendship, and school characteristics.

Design, Setting, and Participants For this cohort study, follow-up data from the My Resilience in Adolescence (MYRIAD) cluster randomized clinical trial were collected across 2 representative UK cohorts. Mainstream UK secondary schools with a strategy and structure to deliver social-emotional learning, with an appointed head teacher, and that were not rated “inadequate” in their latest official inspection were recruited. A total of 5663 schools were approached, 532 showed interest, and 84 consented. Cohort 1 included 12 schools and 864 students, and cohort 2 included 72 schools and 6386 students. COVID-19 was declared a pandemic after cohort 1 had completed all assessments (September 2018 to January 2020), but cohort 2 had not (September 2019 to June 2021).

Exposures Cohort 2 was exposed to the COVID-19 pandemic, including 3 national lockdowns. Associations of individual, family, friendship, and school characteristics with students’ mental health were explored.

Main Outcomes and Measures Changes in students’ risk for depression (Center for Epidemiological Studies-Depression scale); social, emotional, and behavioral difficulties (Strengths and Difficulties Questionnaire); and mental well-being (Warwick-Edinburgh Mental Well-Being Scale).

Results Of the 7250 participants included, the mean (SD) age was 13.7 (0.6) years, 3947 (55.4%) identified as female, and 5378 (73.1%) self-reported their race as White. Twelve schools and 769 of the 864 students (89.0%) in cohort 1 and 54 schools and 2958 of the 6386 students (46.3%) in cohort 2 provided data and were analyzed. Mental health difficulties increased in both cohorts but to a greater extent among students exposed to the pandemic, including for risk of depression (adjusted mean difference [AMD], 1.91; 95% CI, 1.07-2.76); social, emotional, and behavioral difficulties (AMD, 0.76; 95% CI, 0.33-1.18); and mental well-being (AMD, −2.08; 95% CI, −2.80 to −1.36). Positive school climate, high home connectedness, and having a friend during lockdown were protective factors during the pandemic. Female gender and initial low risk for mental health difficulties were associated with greater mental health deteriorations. Partial school attendance during lockdown was associated with better adjustment than no attendance when returning to school.

Conclusions and Relevance This cohort study of secondary school students demonstrated that to promote mental health and adjustment, policy interventions should foster home connectedness, peer friendship, and school climate; avoid full school closures; and consider individual differences.

Investigations into the wider bioecological understanding of dental problems in early childhood are limited in national surveys. Classification tree analysis (CTA) was used to explore multilevel interactions among key aspects of child and primary caregiver (PCG) psychosocial and physical health affecting dental problems in preschool children. Data were derived from the Growing Up in Ireland study, a nationally representative sample of 9-mo-olds (N = 11,134) in 2007/2008 followed up at age 3 y (N = 9,793) in 2010/2011. Analysis included PCG reports of children’s dental problems, general health, temperament, emotional and behavioral difficulties, and their own general health, stress and depression, relationship, and sociodemographic variables. Misclassification costs were specified for the model by applying a higher penalty for misclassifying those with a dental problem (minority class). Logistic regression analyses were carried out for comparison. Dental problems were reported among 302 infants (2.7%) at 9 mo of age and 493 children (5.0%) at 3 y. CTA identified infant temperament (Infant Characteristics Questionnaire unpredictable) as the primary predictor of dental problems at 9 mo and child global health at 3 y of age. First-level predictors were PCG depression score and use of a soother at 9 mo and PCG ethnicity and unscheduled hospital visits at 3 y of age. Regression analyses results supported the most important predictors at 9 mo and 3 y of age. The CTA model for 9-mo-old infants had a specificity of 90.4%, sensitivity of 31.2%, and overall accuracy of 88.8% while that for 3-y-olds had a specificity of 58.5%, sensitivity of 66%, and overall accuracy of 59%. Key aspects of infant/child and PCG health, as well as psychosocial characteristics associated with reported dental problems, should be considered in future multidisciplinary approaches to child health.

Knowledge Transfer Statement: The results of this data analysis should help raise awareness among clinicians of how primary caregiver and child psychosocial and general health factors are associated with early childhood dental problems, even before the primary dentition is complete. Classification tree analysis visually demonstrates how factors such as infant temperament (9 mo) and child global health (3 y) can interact at multiple levels and affect different subgroups of the child population. Future intervention strategies for oral health should involve consideration of the psychological and general health characteristics of the young child and PCG at both the patient and population levels. This knowledge could assist decision makers adopt an integrated multidisciplinary approach in formulating a coherent oral health policy for preschool children.

This retrospective cross-sectional paper examines the relationship between maternal smoking during pregnancy and children’s behavioural problems at 9 years of age independent of a wide range of possible confounders. The final sample comprised 7,505 nine-year-old school children participating in the first wave of the Growing Up in Ireland study. The children were selected through the Irish national school system using a 2-stage sampling method and were representative of the nine-year population. Information on maternal smoking during pregnancy was obtained retrospectively at 9 years of age via parental recall and children’s behavioural problems were assessed using the Strengths and Difficulties Questionnaire across separate parent and teacher-report instruments. A quasi-experimental approach using propensity score matching was used to create treatment (smoking) and control (non-smoking) groups which did not differ significantly in their propensity to smoke in terms of 16 observed characteristics. After matching on the propensity score, children whose mothers smoked during pregnancy were 3.5 % (p < 0.001) and 3.4 % (p < 0.001) more likely to score in the problematic range on the SDQ total difficulties index according to parent and teacher-report respectively. Maternal smoking during pregnancy was more strongly associated with externalising than internalising behavioural problems. Analysis of the dose–response relationship showed that the differential between matched treatment and control groups increased with level of maternal smoking. Given that smoking is a modifiable risk factor, the promotion of successful cessation in pregnancy may prevent potentially adverse long-term consequences.

Psychotic experiences (PEs) are common in early adolescence and are associated with nonpsychotic psychopathology. However, not all adolescents with PEs have subsequent psychopathology, and vice versa. To date, factors mediating the relationship between PEs and psychopathology have been understudied. The aims of this study were to investigate the bidirectional relationship between PEs and psychopathology in adolescence and to investigate potentially malleable mediators of these relationships. Data from 2 waves (age 13 and 17 years) of Cohort ’98 of the Growing Up in Ireland study were examined (n = 6,206). Using KHB pathway decomposition, we investigated the following as potential mediators of the relationship between psychopathology and PEs: parent-child relationship (conflict and positive), self-concept, and child-peer relationship (alienation and trust). Supplementary counterfactual mediation and sensitivity analyses were conducted. Early adolescents with psychopathology had twofold increased odds of late adolescent PEs (internalizing problems: odds ratio [OR] = 2.03, 95% confidence interval [CI; 1.56, 2.62]; externalizing problems: OR = 1.99, CI [1.51, 2.60]). Parent-child conflict explained between 23% and 34% of the associations between internalizing and externalizing problems and subsequent PEs. Early adolescents with PEs had increased odds of late adolescent psychopathology (internalizing problems: OR = 2.01, CI [1.61, 2.50]; externalizing problems: OR = 1.70, CI [1.25, 2.31]). Self-concept alone accounted for 52% of the relationship between PEs and subsequent internalizing problems. There is a bidirectional heterotypic relationship between psychopathology and PEs. Parent-child conflict and self-concept are important characteristics that mediate a proportion of the relationship between PEs and psychopathology. Interventions targeting parent-child conflict in the context of psychopathology and self-concept in the context of PEs may assist in reducing the incidence of poorer outcomes.