External Publications Using GUI Data

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.

It is well established that stressful life events (e.g., family bereavements or moving to a new country) are damaging to psychological health and well-being. Indeed, social relationships are often noted as an important factor that can influence well-being and buffer the negative effects of stress. However, the quality and source of these relationships, particularly for adolescents, are often overlooked. Using the Growing Up in Ireland Survey, a population-based study of 13-year-old Irish adolescents (N = 7,525; 51.1% female), the current study examines the quality of both parent and peer relationships as potential mechanisms explaining the association between stressful life events and psychological well-being indices in adolescents. As expected, results showed that stressful life events negatively impacted the psychological well-being of adolescents. Parallel mediation analyses indicated that both parent and peer relationship quality mediated this association. Further exploratory analyses found that for girls, greater numbers of stressful life events were associated with poorer quality relationships with both their parents and peers, and in turn, these were linked to lower levels of psychological well-being. For boys, this effect was only evident for parental relationship quality, but not peers. The implication of these findings for adolescent’s psychological well-being, particularly for girls, is discussed.

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.

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.

This report uses data from the ‘98 cohort of Growing Up in Ireland (GUI) to examine when, where and how young people receive information on sex and relationships, and the role of this information in shaping sexual competence (or readiness) and behaviours among Irish adolescents.

Previous research has suggested that the children of teenage parents are at a high risk of developing both internalising and externalising behaviour disorders. The current study aimed to explore pathways through which children of teenage mothers show more externalising and internalising psychopathology than their peers whose parents were older. The present study used data from the first wave of the ‘Growing Up in Ireland’ 9-year-old cohort and employed structural equation modelling to assess the explanatory value of a model informed by previous research findings. Goodness-of-fit indices indicated that many aspects of the familial environment of Irish teenage families did indeed place children at a substantial risk of problematic developmental outcomes. In particular, the results implicated the influential power of economic stability and familial conflict on the well-being of teenage families and related child outcomes, results similar to those reported in international studies.

Keywords: teenage mothers in Ireland, economic stability, externalising problems, internalising problems

The Strengths and Difficulties Questionnaire (SDQ) is a brief 25-item instrument that has been widely employed in clinical and epidemiological studies to assess children’s psychological adjustment. Despite its widespread application in child and adolescent research, concerns have been expressed regarding the construct validity of the instrument and whether it might be tainted by a method factor that may undermine its utility as a diagnostic tool. We employed a confirmatory factor analytic approach to compare the goodness of fit of four competing models suggested by the extant literature for the parent-informant version of the questionnaire using data for 8514 nine-year-old children participating in the Growing Up in Ireland Study – a large population based cohort study in the Republic of Ireland. While analysis of the data provided support for the traditional five-factor conceptualisation of the instrument, a six-factor model which incorporated a method factor was found to fit the data marginally better. Nevertheless, we conclude that the existence of method effects does not present any great threat to the structural validity of the instrument taking account of patterns in the data and model parsimony.

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.

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
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.

Background
The association between multidimensional household poverty (MHP) and child and mother psychopathology trajectories is not well understood. The aim of this paper is to explore this association.

Methods
We analysed 9241 infants and mothers recruited at 9-months (m) and 32-years (y) respectively from the Growing-up-in-Ireland study and followed up when the child was aged 3, 5, 7, 9 and 13y. MHP was derived from monetary, subjective and material poverty questionnaires completed by mothers before infant age 3y using latent-class-analysis. Confounder-adjusted linear spline multilevel models were used to examine the association between MHP before 3y and trajectories of child (3-to-13y) and mother (34-to-46y) psychopathology wellbeing measures (Strengths-and-difficulties-questionnaire and Centre-for-epidemiological-studies-depression-scale, respectively).

Results
In adjusted models, MHP before 3y was associated with a higher mean difference(MD) (MD:0.67, 95%CI 0.41,0.92) in child psychopathology at 3y and this was broadly similar at age 13y (MD:0.87, 95% CI 0.57,1.17). MHP prior to 3y was associated with a higher mother psychopathology when her child was age 3y (MD:1.07, 95% CI 0.90,1.23) and this persisted albeit with a slight reduction in magnitude at age 13y of the child (MD:0.72, 95% CI 0.53,0.90).

Conclusions
Though replication in other cohorts is required, findings suggest that MHP exposure in child infancy may have early negative life course impacts on mother and child wellbeing that persist for up to a decade. If causal, these findings underscore the importance of early life course policy interventions to prevent and ameliorate poverty to reduce long term psychopathology of mothers and their children.

We analyse parental smoking and cessation (quitting) associations with teenager e-cigarette, alcohol, tobacco smoking and other drug use, and explore parental smoking as a mechanism for social reproduction. We use data from Waves 1–3 of Growing Up in Ireland (Cohort ’98). Our analytic sample consisted of n = 6,039 participants reporting in all 3 Waves. Data were collected in Waves 1 and 2 when the children were 9 and 13 years old and in Wave 3 at age 17/18 years. Generalized Estimating Equations (GEE) models were used to analyse teenage substance use at Wave 3. Parental smoking was associated with significantly increased risk of all teenage substance use, adjusted odds ratios were aOR2.13 (ever e-cigarette use); aOR1.92 (ever alcohol use); aOR1.88 (current alcohol use); aOR1.90 (ever use of other drugs); aOR2.10 (ever-smoking); and aOR1.91 (current smoking). Primary caregiver smoking cessation (quitting) was associated with a lower risk for teenager current smoking aOR0.62, ever e-cigarette use aOR 0.65 and other drug use aOR 0.57. Primary caregiver smoking behaviour had greater associations than secondary, and age13 exposure more than age 9. Habitus seems to play a role and wealth was protective for teenage smoking. The findings suggest that prevention interventions should target both caregivers and their children.

The COVID-19 lockdown and closure of schools, clinics, and community-based services put children with autism spectrum disorders (ASDs) and other developmental disabilities (DDs) at increased risk of negative outcomes. This study aimed to investigate parents’ perceptions of their children’s behavioural outcomes during the COVID-19 lockdown, parents’ satisfaction with services during this time, and willingness to engage in telehealth. A cross-sectional study was conducted in Ireland. Parents (n = 89) completed an online questionnaire that included the strengths and difficulties questionnaire (SDQ-P). Results demonstrated that children with ASD/DDs were vulnerable to negative outcomes including hyperactivity, emotional symptoms, problems with peers and fewer prosocial behaviors. Children’s behavioral outcomes (‘current sample’, n = 89) were also compared with pre-COVID-19 data taken from the Growing Up in Ireland Study (‘GUI sample’, n = 327). The current sample exhibited significantly more behavioral difficulties than the pre-COVID GUI sample (p < 0.001). For the current sample, scores on each of the five SDQ subscales were significantly associated with a total impact score, and parents reported dissatisfaction with support services provided and willingness to engage in behavioral telehealth. Commitment is required to identify barriers to services faced by families in Ireland and to address the need for adapted behavior support services during periods of emergency.

Keywords: COVID-19; intellectual disabilities; developmental disabilities; autism; behavior; behavioral support

This study draws on data on Growing Up in Ireland (GUI) Cohorts ’98 and ’08 to document changes in the lives of adolescents over the period 2011/12 to 2021/22, building on an earlier study (Smyth, 2022) which compared their experiences at nine years of age. This decade was a period of considerable social and policy change, including reform of the junior cycle, growing digitalisation and the disruption of the pandemic to all aspects of young people’s lives. Changes were also evident in the profile of young people and their families, with increasing cultural diversity, higher education levels among parents, lower levels of financial strain and increasing numbers with a disability among members of Cohort ’08 than among their older cohort counterparts. The study looks at changes in 13-year-olds’ relationships with their parents and peers, in their day-to-day activities and in their experiences of school. The main research questions addressed by the study are: How have the quality of relationships, experience of learning and activities engaged in by adolescents changed over the course of a decade? To what extent do any such changes reflect differences in the family characteristics of the young people? Are any such changes more evident for boys or girls or for young people from different social backgrounds? Is differentiation by gender and social background in adolescents’ social worlds less evident for the younger cohort than previously?

Background
Population-based studies provide important data to inform policy and service planning for vulnerable children in society. The aim of this study was to characterise social and educational circumstances and self-concept among a nationally representative sample of 13 year olds with developmental disabilities in Ireland.

Methods
A cross-sectional, secondary analysis of data collected from the Growing Up in Ireland (GUI) study was conducted. Descriptive statistics were used to calculate the reported prevalence of disabilities as reported by parents. Differences across the groups (those with and without disabilities) were analysed in relation to gender, socio-economic and school factors. Special education support received in school was described. The association between low self-concept scores (as measured by the Piers Harris Self-Concept Scales 2) and disability type was examined by use of multi-level logistic regression.

Results
Seventeen percent (17.36%) of the sample was reported to have a diagnosis of one or more developmental disabilities. Those with a disability were more likely to live in poorer households, have poorer health status, to experience more episodes of bullying at school, and to have more negative views of school (p<0.05) than their typically-developing peers.

Forty nine percent of children with developmental disabilities were not receiving support in school as reported by parents. Discrepancies in the nature of support received were identified across disability types. Adjusting for individual and school level factors, a disability diagnosis was associated with increased odds of low self-concept scores on three of five self-concept domains. Further associations were identified which differed across disability type.

Conclusions
The findings show that 13 year olds with a disability in Ireland have complex social and educational needs. Findings also suggest significant levels of unmet educational need across this age group. Apparent inequities in access to support in school require further investigation. Reliable measures to provide robust prevalence figures about childhood disabilities in Ireland are needed.

The prevalence of obesity in children is rapidly rising, leading to many serious consequences worldwide. In 2005, the World Health Organisation (WHO) Regional Office for Europe issued recommendations and guidelines for regular collection of data on weight, height, and waist and hip circumference in children worldwide in order to monitor prevalence trends of growth, overweight and obesity. The Department of Health and the Health Service Executive commissioned the National Nutrition Surveillance Centre, based at the School of Public Health, Physiotherapy and Population Science in University College Dublin, to carry out this surveillance work in the Republic of Ireland.

This report presents the findings from three waves of the WHO Childhood Obesity Surveillance Initiative survey in the Republic of Ireland in 2008, 2010 and 2012. In 2008, 163 randomly selected primary schools participated in this project and in the first round the protocol as set out by the WHO for participating countries was followed. The target age was children aged exactly 7 years. In the subsequent two waves, the same WHO protocol was followed and the same schools were contacted again and this time, as well as 7-year-olds, 9-year-olds were also selected for participation in the second round. In the third round, 7-year, 9-year, as well as 11-year-olds were included.

This means that there are three cross-sectional surveys of 7-year-old children, two cross-sectional surveys of 9-year-olds and one cross-sectional comparison group of 7-, 9- and 11-year-old children. Using a unique identifier there are also two cohort groups of the same children followed on two separate occasions from ages 7 to 9 and ages 9 to 11, respectively. In this report, we also compare the data on 9-year-old children to the findings from the Growing Up in Ireland Cohort study.

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.

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 retrospective cross-sectional paper examines the relationship between early breastfeeding exposure and children’s academic test scores at nine years of age independent of a wide range of possible confounders. The final sample comprised 8226 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 relating to breastfeeding initiation and exposure duration was obtained retrospectively at nine years of age via parental recall and children’s academic performance was assessed using standardised reading and mathematics tests. Hierarchical linear regression analysis with robust standard errors to control for clustering at the school level was used to quantify the effect of breastfeeding on children’s test scores. Propensity score matching was used to compare treatment effects across groups defined by their propensity to breastfeed. In unadjusted analysis, children who were breastfed scored 8.67 percentage points higher on reading and 7.42 percentage points higher on mathematics compared to those who were never breastfed. While the breastfeeding advantage attenuated appreciably when adjusted for a range of child, maternal, socio-economic and socio-environmental characteristics, children who were breastfed continued to enjoy a significant test score advantage of 3.24 (p < 0.001) and 2.23 (p < 0.001) percentage points on reading and mathematics respectively compared to those who were never breastfed. Any amount of breastfeeding was associated with significantly higher test scores than no exposure, but evidence of a dose-response relationship was weak. The results of the propensity score matching analysis indicated that the test score advantage of breastfed children is robust and that the magnitude of the effect varies across groups defined by their propensity to breastfeed, being largest amongst the most socially disadvantaged and falling to near zero among the most advantaged group.