External Publications Using GUI Data

Authors	Year	Title ↑	Link	Journal/Book
Banks J., McCoy S., Shevlin M.	2013	Inclusive Education Research: Evidence from Growing Up in Ireland	Open	Trinity Education Papers

Roddy, Á.	2022	Income and conversion handicaps: estimating the impact of child chronic illness/disability on family income and the extra cost of child chronic illness/child disability in Ireland using a standard of living approach	Open	The European Journal of Health Economics
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.
Smyth, E.	2016	Inequalities from the Start? Children’s Integration into Primary School	Open	Cherishing All the Children Equally? Children in Ireland 100 Years on from the Easter Rising
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: Introduction Changing Perceptions and Experiences of Childhood, 1916-2016 Children and Families, Then & Now Is Family Structure a Source of Inequality in Children’s Lives? Parental Investment & Child Development Inequalities in Access to Early Care and Education in Ireland Inequalities from the Start? Children’s Integration into Primary School Insights into the Prevalence of Special Educational Needs The Experiences of Migrant Children in Ireland Social Variation in Child Health & Development: A Life-course Approach Child Access to GP Services in Ireland: Do User Fees Matter? Anti-Social Behaviour at Age 13 Child Economic Vulnerability Dynamics in the Recession Concluding Observations
Murray, A., McGinnity, F., Russell, H.	2016	Inequalities in Access to Early Care and Education in Ireland	Open	Cherishing All the Children Equally? Children in Ireland 100 Years on from the Easter Rising
Chapter 6 provides a detailed discussion of the history of childcare provision in Ireland throughout the 20th century before investigating trends in non-parental childcare for infants in the first few years of life. The role of the Free Pre-school Year, a major policy shift in the Irish context, is also discussed.
Smyth, E., Duta, A.	2023	Inequalities in children’s skills on primary school entry in Ireland and Scotland: do home learning environment and early childhood childcare explain these differences?	Open	Longitudinal and Life Course Studies
This article draws on the Growing Up in Ireland study and the Scottish sample of the Millennium Cohort Study to explore the factors influencing inequalities in children’s cognitive skills on entry to primary education. It adopts a multidimensional comparative approach, which directly compares the effects of parental education and household income on several cognitive outcomes (vocabulary, language, reading and numbers) among five-year-old children and examines the extent to which inequalities in these outcomes are mediated by the home learning environment (HLE) and early childhood education (ECE). Home learning environment plays a stronger role in explaining actual vocabulary differences in Ireland while it plays a stronger role in school readiness (teacher-assessed skills) in Scotland. In both countries, use of centre-based care at 9 months and 3 years was markedly higher among the top income quintile. Centre-based care is found to play a mediating role in school readiness in Scotland. Nonetheless, the findings point to important direct effects of family background even when HLE and childcare are taken into account. The analyses point to differences in the trajectory of early skill development in the two countries, with the impact of early skill development being more marked in Scotland than Ireland. Comparative analyses of this kind thus yield important insights for policy development by highlighting potential domains (such as childcare) or timing (preschool or within-school) for intervention.
McCoy, S., Banks, J., Shevlin, M.	2016	Insights into the Prevalence of Special Educational Needs	Open	Cherishing All the Children Equally? Children in Ireland 100 Years on from the Easter Rising
Chapter 8 examines aspects of provision for children with special educational needs and considers their inclusion within Irish mainstream education in recent years. It considers how much of the education and care of children with special needs in the early decades of the 20th century was provided by religious orders before going on to discuss how, since the early 1990s, there has been a substantial shift in focus from segregated educational provision towards a more inclusive view of special education, mainly delivered within mainstream schools. In particular, the chapter considers the proportion of children with special educational needs and variations in levels according to the background characteristics of the children in question.
Dempsey, C., Devine, R., Symonds, J., Sloan, S., Hughes, C.	2024	Interacting adult-child relationships and school adjustment: Findings from growing up in Ireland	Open	Journal of Applied Developmental Psychology
Although children’s relationships with their parents and teachers contribute to their school adjustment and achievement, few studies have examined interactions between these relationships, particularly for father-child relationships. Using the Growing Up in Ireland birth cohort (N = 7507, 50.3% male), we examined child-adult relationship quality – rated by parents at age 3 and by teachers at age 5 – as predictors of teacher-rated behavioural adjustment and academic achievement at age 9 (indexed by self-reported academic self-concepts and performance on formal reading assessments). Controlling for prior levels of problem behaviours, verbal ability, and family SES, our results indicated that children’s relationships with parents and teachers showed small and comparable independent effects on school adjustment and achievement. For mothers and teachers, moderation analyses showed a cumulative risk pattern for conflictual relationships and a compensatory pattern for close relationships. Children are likely to benefit from improving closeness and reducing conflict in adult-child relationships as well as interventions that involve mothers, fathers, and teachers.
Conica, M., Nixon, E., Quigley, J.	2022	Interparental Relationship Satisfaction from Nine Months to Nine Years and Children’s Socioemotional Competencies at Nine Years	Open	Journal of Child and Family Studies
The quality of the interparental relationship bears important implications for children’s socioemotional development. Given evidence that relationship satisfaction among parents tends to decline over time this study examined how change in parents’ relationship satisfaction from nine-months-old until nine-years-old related to children’s socioemotional difficulties at nine-years-old. Participants were 2074 mothers, fathers, and their child (55.1% male) recruited through random sampling of the Child Benefit Registrar by Growing Up in Ireland cohort study. Mothers ranged in age from 18 to 40 years (M = 31.06, SD = 4.70) and fathers ranged in age from 18 to 60 years (M = 33.50, SD = 5.54). Mothers and fathers completed the Dyadic Adjustment Scale at nine-months-old and at nine-years-old whereas child socioemotional development was assessed via teacher report on the Strengths and Difficulties Questionnaire at nine-years-old. Residualised change analysis indicated that both parents experienced declines in relationship satisfaction from nine-months-old until nine- years-old. However, in families where initial levels of relationship satisfaction were high, there was no significant association between decline in satisfaction and child socioemotional difficulties. Conversely, in couples where initial levels of satisfaction were low, mothers, but not fathers, who experienced further declines had female, but not male, children with more socioemotional difficulties at nine years (β = −0.22, p = 0.01; R2 = 0.15, F = 2.31, p = 0.02). These findings highlight the need for carefully tailored interventions aimed at promoting couple relationship satisfaction during transition to parenthood such that the negative impact on children of any decline experienced over time can be mitigated.
Ng, K., Healy, S., O’Brien, W., Rodriguez, L., Murphy, M., Carlin, A.	2023	Irish Para Report Card on Physical Activity of Children and Adolescents With Disabilities	Open	Adapted Physical Activity Quarterly
For the first time, data on children and adolescents with disabilities in Ireland are reported based on the Active Healthy Kids Global Alliance Para Report Card methodology. The most recent data from the last 10 years were used in the grading process (A+ to F), and indicators with insufficient data were graded as incomplete. Of the 10 indicators from the Global Matrix Para Report Cards, grades were assigned to Overall Physical Activity (F), Organized Sport (D), Active Transport (D−), Sedentary Behaviors (D−), Family & Peers (C), School (C−), Community & Environment (B−), and Government (B). Irish disability sport organizations were invited to assess the research-led audit and provided commentary around the final grading. The contextual discussion of the grades is presented through the lens of strengths, weaknesses, opportunities, and threats with the purpose being to provide direction for the reduction of physical activity disparities among children with disabilities.
Reynolds, D., Hennessy, E., Polek, E.	2013	Is breastfeeding in infancy predictive of child mental well-being and protective against obesity at 9 years of age?	Open	Child: Care, Health & Development
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.
Nixon, E., Swords, L.	2016	Is Family Structure a Source of Inequality in Children’s Lives?	Open	Cherishing All the Children Equally? Children in Ireland 100 Years on from the Easter Rising
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: Introduction Changing Perceptions and Experiences of Childhood, 1916-2016 Children and Families, Then & Now Is Family Structure a Source of Inequality in Children’s Lives? Parental Investment & Child Development Inequalities in Access to Early Care and Education in Ireland Inequalities from the Start? Children’s Integration into Primary School Insights into the Prevalence of Special Educational Needs The Experiences of Migrant Children in Ireland Social Variation in Child Health & Development: A Life-course Approach Child Access to GP Services in Ireland: Do User Fees Matter? Anti-Social Behaviour at Age 13 Child Economic Vulnerability Dynamics in the Recession Concluding Observations
Hadfield, K., O'Brien, F. K., & Gerow, A.	2017	Is level of prematurity a risk/plasticity factor at three years of age?	Open	Infant Behaviour and Development
Children born preterm have poorer outcomes than children born full-term, but the caregiving environment can ameliorate some of these differences. Recent research has proposed that preterm birth may be a plasticity factor, leading to better outcomes for preterm than full-term infants in higher quality environments. This analysis uses data from two waves of an Irish study of children (at 9 months and 3 years of age, n = 11,134 children) and their caregivers (n = 11,132 mothers, n = 9998 fathers) to investigate differences in how caregiving affects social, cognitive, and motor skills between full-term, late preterm, and very preterm children. Results indicate that parental emotional distress and quality of attachment are important for child outcomes. Both being born very preterm and late preterm continue to be risk factors for poorer outcomes at 3 years of age. Only fathers’ emotional distress significantly moderated the effect of prematurity on infants’ cognitive and social outcomes—no other interactions between prematurity and environment were significant. These interactions were somewhat in line with diathesis stress, but the effect sizes were too small to provide strong support for this model. There is no evidence that preterm birth is a plasticity factor.
Bilgin, A., Sloan, S., Neville, R.	2024	Is the association between infant regulatory problems and trajectories of childhood internalizing and externalizing symptoms moderated by early screen media exposure?	Open	PsyArXiv Preprints
Background: Regulatory problems in infancy are associated with internalizing and externalizing symptom trajectories across childhood. It is unknown whether early screen media exposure exacerbates the association between infant regulatory problems and childhood internalizing and externalizing symptom trajectories. Methods: We studied 10,170 individuals from the Growing Up in Ireland ’08 cohort. Parents reported on their children’s regulatory problems at 9 months, screen media exposure at 3 years, and internalizing and externalizing symptoms at 3, 5, 7, and 9 years. Children were categorized based on their patterns of co-developing internalizing and externalizing symptoms using parallel process latent class growth analysis. Subsequently, multinominal logistic regression analyses were conducted to estimate whether screen media exposure (>1 hour or >2 hours) moderated the association between regulatory problems in infancy and co-developing internalizing and externalizing symptom classes across childhood. Results: There were four groups of children with distinct patterns of co-developing internalizing and externalizing symptoms: 1) low stable internalizing and low decreasing externalizing symptoms (N= 6236; 61.3%); 2) low stable internalizing and moderate stable externalizing symptoms (N= 2029; 20%); 3) moderate increasing internalizing and moderate decreasing externalizing symptoms (N= 1263; 12.4%); 4) moderate increasing internalizing and high increasing externalizing symptoms (N= 642; 6.3%). Presence of regulatory problems at 9 months and excessive screen media exposure at 3 years (particularly >2 hours) were independently associated with increased likelihood of all classes. Excessive screen media exposure at 3 years did not significantly moderate the association between regulatory problems at 9 months and internalizing and externalizing symptom trajectories. Conclusions: Both regulatory problems in infancy and screen media exposure >2 hours in early childhood are early risk factors for the development of internalizing and externalizing symptoms. However, the association between infant regulatory problems and childhood internalizing and externalizing symptoms appears to operate independently of excessive screen media exposure. Clinicians should be aware of, and treat, regulatory problems in infancy to prevent chronic patterns of self-regulatory problems across childhood. Further, they should discuss and advocate for family media plans with parents to help decrease the long-term negative effects on internalizing and externalizing symptoms.
Williams, J., Greene, S.	2010	Key Outcomes for Children: New Evidence from 'Growing up in Ireland'	Open	ESRI Research Bulletin

Dempsey, S., Lyons, S., McCoy, S.	2019	Later is better: mobile phone ownership and child academic development, evidence from a longitudinal study	Open	Economics of Innovation and New Technology
Digital technologies have become an increasingly prominent feature of children’s lives both within and outside educational environments (McCoy, Quail, and Smyth 2012. Influences on 9-Year-Olds’ Learning: Home, School and Community. Dublin: Department of Children and Youth Affairs). Despite considerable media debate, we have little robust evidence on the impact of technology use on children’s development, both academically and socially. Much of the literature in this area relies on small-scale cross-sectional studies. Using longitudinal data on 8500 9-year-old children in Ireland, we examine the influence of early mobile phone ownership on children’s performance in reading and maths between 9 and 13 years of age. Across both reading and maths domains, children who already report owning a phone by the age of nine fare less well in terms of their academic development as they move into adolescence. The measured effects are sizeable, implying about 4 percentile lower ranking on standardised tests for an average student. Our results are consistent with the idea that there may be significant educational costs arising from early mobile phone use by children. Parents and policymakers should consider whether the benefits of phone availability for children are sufficiently large to justify such costs. We suggest a range of direct and indirect cognitive effects that could help explain these results. KEYWORDS: Mobile phone ownership; child development; academic outcomes; early owners; longitudinal data
Ceatha, N., Gates, G. J., Crowley, D.	2023	LGBT+ Self-Identification Among Youth in Ireland Aged 17-18 Years: A Research Brief	Open	Population Research and Policy Review
In 2016, for the first time, a nationally representative survey of 6216 respondents, Growing Up in Ireland (GUI), included measurement of sexual orientation and gender identity (SOGI) among young people. Irish LGBTI+ youth and inclusion strategies identified collection of SOGI data as a policy objective, prioritizing analyses of GUI. In line with policy objectives, this research brief reports previously unpublished LGBT+ self-identification for youth in Ireland from Cohort ’98 born five years after decriminalization of homosexuality, with their coming-of-age coinciding with the marriage equality referendum, and legislation providing for greater gender recognition (2015). Ten percent of youth in Ireland, at 17-18 years, identify as lesbian, gay, bisexual, transgender, questioning, asexual or describe their gender as other. Female youth are significantly more likely to identify as a sexual minority, and to be bisexual than their male peers. A quarter of LGBT+ youth are questioning their sexual orientation. This finding supports the inclusion of a ‘questioning’ response in surveys collecting SOGI data, and also suggests sexual orientation self-identification is a dynamic process. A small percentage identify as asexual (0.2%). Just over 1% of young people identify as transgender or describe their gender as other. As the first generation in Ireland to grow up in an environment with increased LGBT+ visibility and social acceptance, these findings of a relatively high proportion of sexual and gender minorities among young people likely reflect improved social and legal climates. The importance of publication of SOGI estimates is underscored. GUI are committed to ensuring visibility of LGBT+ youth populations in data collection. Suggestions for improved SOGI placement and phrasing will be considered in the questionnaire with Cohort ’08 at age 17, currently being drafted. The findings from these analyses will inform future policy and research. GUI offers rich possibilities for future comparative cross-cohort analyses.
Ceatha, N., Koay, A. C. C., Kelly, A., Killeen, T., McCabe, K., Murray, J., Pope, J., Scully, N., Buggy, C., Crowley, D.	2023	LGBT+ Youth Perspectives on Sexual Orientation and Gender Identity Questions in the Growing Up in Ireland Survey: A Qualitative Study	Open	Youth
The increasing importance of identifying lesbian, gay, bisexual and transgender (LGBT+) populations is a key driver in changes to demographic data collection in representative surveys of youth. While such population-based data are rare, Growing Up in Ireland (GUI), an Irish, government-funded, longitudinal survey, includes sexual orientation and gender identity (SOGI) measurements. This qualitative study responds to a query from the GUI study team and aims to identify how best to collect SOGI data in future waves of GUI. A university Human Research Ethics Committee granted approval for online consultations with LGBT+ youth (n = 6) with experiential expertise in policy making. The research is underpinned by rights-based public patient involvement (PPI) with recorded discussions, which were transcribed and imported into NVivo 12, generating the theme “recognition in research, policy and society”. This co-created article, with the LGBT+ young PPI Panel members, commends the inclusion of SOGI data in GUI and recommends changes in question placement and phrasing. Aligning with best practice, the PPI members provide a template for wording on consecutive sex and gender questions, expanded sexual orientation identity categories and maintaining the existing well-phrased transgender question from GUI. This offers potential to improve the quality of the SOGI data collected and the experience of those completing the questionnaire. These findings extend beyond GUI, with relevance for surveys with youth populations. This paper underscores the potential and benefits of participatory approaches to research with youth and views their role beyond simply as sources of data. Keywords: LGBT+, sexual minority youth (SMY), gender minority youth (GMY), Growing Up in Ireland (GUI), SOGI measurement, quantitative, qualitative, survey design, PPI
Neville, R.D., Guo, Y., Boreham, C.A., Lakes, K.D.	2021	Longitudinal Association Between Participation in Organized Sport and Psychosocial Development in Early Childhood	Open	The Journal of Pediatrics
Objective To explore whether the associations between developmental delays in the first year of life and psychosocial outcomes in preschool children are affected by participation in organized sport. Study design Data were obtained from the infant cohort of the Growing Up in Ireland project. Parents reported on child development (Ages and Stages Questionnaire) at age 1 year, psychosocial characteristics (Strengths and Difficulties Questionnaire) at ages 3 and 5 years, and engagement in organized sport at age 5 years. Data were analyzed using mixed models. Results At age 1 year, 15% of the cohort was classified as having developmental delays. These children exhibited more behavioral difficulties (0.55, ±0.27; mean difference, ±95% confidence limits [CL]) (P < .0001) and fewer prosocial behaviors (−0.54, ±0.11) (P < .0001) at age 3 years. For boys in this group, engagement in sport was associated with a significant decrease in behavioral difficulties between ages 3 and 5 years (−0.44, ±0.39) (P = .03). Compared with those classified as lacking regular engagement (ie, never engaging, or engaging <1 hour/week), the relative effect of sport on changes in behavioral difficulties for boys with developmental delays was statistically significant (0.70, ±0.59) (P = .02). Participation in sport was not associated with significant changes in behavioral difficulties for girls, or a significant change in prosocial behaviors for boys or girls. Conclusions Regular participation in sport by boys could attenuate some of the behavioral difficulties associated with early development. Lack of opportunities for engaging in sport could negatively affect boys’ behavioral regulation in the preschool period.
Bradshaw, D., Hannigan, A., Creaven, A.M., Muldoon, O.	2020	Longitudinal associations between parental incarceration and children's emotional and behavioural development: Results from a population cohort study	Open	Child: Care, health and development
Background Parental incarceration (PI) is associated with adverse developmental outcomes for children affected. However, research in this area often reports conflicting results with few studies following children across time in non-U.S. populations. Additionally, more research is called for using multi-informant perspectives rather than relying on adult reports of child outcomes alone. Methods This study used data from the first two waves of a nationally representative cohort study of 8,568 children aged 9 years and followed up at age 13 living in the Republic of Ireland (2007–2012). Propensity score matching was used to match children who had experienced PI by the age of nine to children who had not experienced PI by sociodemographics and experience of other stressful events. Mental health, as measured by self-concept (Piers-Harris II) and externalizing and internalizing difficulties (strength and difficulties questionnaire), was compared across both groups. Results Fifty of the 8,568 children (weighted percentage 0.9%) reported experiencing PI by the age of nine. These children came from more socially disadvantaged homes and were more likely to have experienced other potentially stressful life events. In comparison to a matched sample of children not affected by PI, children affected by PI reported higher levels of anxiety at age nine. Longitudinal analysis indicated these children affected by PI also reported lower levels of happiness at age 13 with higher levels of emotional difficulties reported by their primary caregiver. Conclusions Children of incarcerated parents face a greater array of life challenges. PI had an association with child-reported levels of anxiety at age nine. PI also had a medium-term association on caregiver assessments of emotional difficulties of children affected as well child-reported levels of happiness over time.
Culloty, A.M., O'Toole, C., Gibbon, F.E.	2019	Longitudinal Study of Expressive Language and Speech of Twins at 3 and 5 years: Outgrowing a Twinning Effect	Open	Journal of Speech, Language and Hearing Research
Purpose This study examines the expressive language and speech of twins, relative to singletons, at 3 and 5 years, with the aim of determining if a twinning effect occurs during this developmental period. The possibility of twins outgrowing a twinning effect was investigated. Method A weighted population-based sample of 185 twins and 1,309 closely spaced singletons who participated in the Growing Up in Ireland study was analyzed. Their development was compared using a standardized expressive vocabulary assessment and parent interview at 3 and 5 years as well as teacher reports at 5 years. Causal steps mediation analyses were subsequently conducted to determine if gestation and birth weight mediated twin–singleton differences in expressive vocabulary development. Results Twins’ expressive vocabulary scores were slightly lower than those of singletons at 3 years, but there was no significant difference at 5 years. More parents of twins reported “a little” concern about their child’s expressive language and speech skills at 3 years, although there was no significant twin–singleton difference 2 years later. Teachers’ ratings of twins’ and singletons’ expressive language and speech skills at 5 years were comparable. Shorter gestations and lower birth weights mediated twins’ lower expressive vocabulary scores at 3 years. Conclusions A very small twinning effect on expressive vocabulary development exists at 3 years and is outgrown by 5 years. Twins born after shorter gestations or at a lower birth weight are at an increased risk of having less developed expressive vocabulary skills at 3 years.

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