External Publications Using GUI Data

Background
Past empirical evidence on the longitudinal relations between emotional mental health symptoms and parent-child close relationships has produced mixed and inconclusive results. Some studies suggest a unidirectional relation, whereas other studies point toward a bidirectional association. Additionally, most of the past research has been carried out with adolescent samples, rather than children. Hence, this study aimed to estimate the longitudinal relations between children’s trait emotional difficulties and trait parent-child closeness, accounting for the time-invariant and time-varying state components of each factor.

Methods
Participants were 7,507 children (ages 3 years, 5 years, 7 years, and 9 years) from the Growing Up in Ireland cohort. Α bivariate stable trait, autoregressive trait, and state (STARTS) model was estimated using Bayesian structural equation modelling.

Results
The STARTS model revealed that children’s emotional difficulties and parent-child closeness were relatively stable across time, and these overarching traits were strongly negatively correlated. Children’s earlier trait emotional difficulties predicted later trait parent-child closeness and vice versa between 3 years and 5 years, and between 5 years and 7 years, but these effects disappeared between 7 years and 9 years. At all pairs of time points, state emotional difficulties and state parent-child closeness were weakly negatively correlated.

Conclusions
Overall, the results suggest that early and middle childhood are critical stages for improving parent-child relationships and reducing children’s emotional difficulties. Developing close parent-child relationships in childhood appears to be a key factor in reducing children’s subsequent emotional difficulties. Children who face greater than usual emotional difficulties tend to be more withdrawn and less receptive to close parent-child relationships and this could serve as an important screening indicator.

Background
Parental obesity is a predominant risk factor for childhood obesity. Family factors including socio-economic status (SES) play a role in determining parent weight. It is essential to unpick how shared family factors impact on child weight. This study aims to investigate the association between measured parent weight status, familial socio-economic factors and the risk of childhood obesity at age 9.

Methodology/Principal Findings
Cross sectional analysis of the first wave (2008) of the Growing Up in Ireland (GUI) study. GUI is a nationally representative study of 9-year-old children (N = 8,568). Schools were selected from the national total (response rate 82%) and age eligible children (response rate 57%) were invited to participate. Children and their parents had height and weight measurements taken using standard methods. Data were reweighted to account for the sampling design. Childhood overweight and obesity prevalence were calculated using International Obesity Taskforce definitions. Multinomial logistic regression examined the association between parent weight status, indicators of SES and child weight. Overall, 25% of children were either overweight (19.3%) or obese (6.6%). Parental obesity was a significant predictor of child obesity. Of children with normal weight parents, 14.4% were overweight or obese whereas 46.2% of children with obese parents were overweight or obese. Maternal education and household class were more consistently associated with a child being in a higher body mass index category than household income. Adjusted regression indicated that female gender, one parent family type, lower maternal education, lower household class and a heavier parent weight status significantly increased the odds of childhood obesity.

Conclusions/Significance
Parental weight appears to be the most influential factor driving the childhood obesity epidemic in Ireland and is an independent predictor of child obesity across SES groups. Due to the high prevalence of obesity in parents and children, population based interventions are required.

Background
Globally, childhood obesity is a significant public health problem associated with adverse health and economic consequences. To tackle the problem, we need a comprehensive understanding on how the environment in which we live may influence obesity related behaviours and weight status. Thus, we explore if distance to and number of food outlets ([1] supermarkets and [2] convenience stores) in the local area impact on either dietary quality or body mass index (BMI) in 9-year-old children whilst controlling for socio-economic characteristics of the family.

Methods
Cross sectional analysis of the Growing Up in Ireland (GUI) Study, a two-stage clustered sample of 8568 nine year old children from the Republic of Ireland. Children were recruited from schools (response rate 82%) and age eligible children (response rate 57%) were invited to participate. Height and weight measurements were used to calculate BMI. Diet was assessed using a short food frequency questionnaire and a dietary quality score was generated based on Irish healthy eating guidelines. Socio-economic status was measured using parent reported household class, household net equivalised income and highest level of maternal education. Food access was measured as network distance to (in quintiles) and number of (within 1000km) convenience stores and supermarkets to each participant’s household within the local area. Separate fixed effects regression models were used to assess the impact of local area food access on (1) dietary quality and (2) BMI, stratified by gender.

Results
After controlling for socio-economic characteristics of the household, distance to the nearest supermarket was not associated with dietary quality in boys (Q5 v Q1; B = 0.84, 95% CI, –0.49 to 2.18) or girls (Q5 v Q1; B = –0.41, 95% CI, –1.60 to 0.77). Distance to the nearest convenience store was associated with dietary quality in boys (Q5 v Q1; B = 1.01, 95% CI, 0.13 to 1.89) but not in girls (Q5 v Q1; B = 0.04, 95% CI, –0.71 to 0.80). The number of convenience stores or supermarkets within 1000m of the household did not impact on dietary quality. Access to food outlets was not associated with BMI in girls or boys.

Conclusion
There was little evidence to suggest that access to food stores impact dietary quality or BMI in children. From a population health perspective, strategies tackling environmental factors associated with making poor lifestyle choices are needed. Thus, further research on the association between food access and obesity risk is needed.

Background
Taking oral antibiotics during childhood has been linked with an increased risk of childhood obesity. This study assessed any potential association in number of courses of antibiotics taken between 2–3 and 4–5 years of age and body mass trajectory up to age 5.

Methods
The study was a secondary analysis of 8186 children and their parents from the infant cohort of the Irish National Longitudinal Study of Children. Antibiotic use was measured by parental recall between ages 2–3 and 4–5. Longitudinal models described the relationship between antibiotic exposure and body mass index (BMI) standard deviation scores and binary outcomes, and examined interactions between covariates, which included socioeconomic status, diet assessed by food frequency questionnaires and maternal BMI.

Results
Any antibiotic usage between 2 and 3 years did not predict risk of overweight or obesity at age 5. Four or more courses of antibiotics between 2 and 3 years were independently associated with obesity at age 5 (odds ratio 1.6, 95% confidence interval 1.11–2.31). Effect size was modest (coefficient + 0.09 body mass SD units, standard error 0.04, P = 0.037). Maternal BMI modified the relationship: ≥ 4 courses of antibiotics between 2 and 3 years were associated with a + 0.12 body mass SD units increase in weight at age 5 among children of normal-weight mothers (P = 0.035), but not in children of overweight mothers.

Conclusions
Number of antibiotic courses, rather than antibiotic use, may be an important factor in any link between early antibiotic exposure and subsequent childhood obesity. Research is needed to confirm differential effects on babies of normal versus overweight/obese mothers independent of socioeconomic factors.

Background
Orofacial clefts occur when the lips or the roof of the mouth do not fuse properly during the early weeks of pregnancy. There is strong evidence that periconceptional use of folic acid can prevent neural tube defects but its effect on oral clefts has generated debate.

Aim
To identify factors associated with suboptimal periconceptional use of folic acid and its potential effect on oral clefts.

Design and setting
The population-based infant cohort of the national Growing Up in Ireland study, which consists of 11 134 9-month-old infants.

Method
Data collection comprised questionnaires conducted by interviewers with parents in parents’ homes. Characteristics of mothers who did or did not take folic acid before and during pregnancy, as well as the effect of folic acid use on the prevalence of cleft lip and palate were recorded.

Results
The prevalence of cleft lip and palate was 1.98 (95% confidence interval [CI] = 1.31 to 2.99) per 1000 9-month-olds. The odds ratio for cleft lip was 4.36-fold higher (95% CI = 1.55 to 12.30, P = 0.005) for infants of mothers who did not take folic acid during the first 3 months of pregnancy, when compared with those who did have a folate intake during the first trimester. Folic acid use was suboptimal in 36.3% (95% CI = 35.4 to 37.2) of the sample.

Conclusion
These findings support the hypothesis that taking folic acid may partially prevent cleft lip and palate. They are particularly relevant for GPs, because they are usually the first port of call for women before and during early pregnancy.

Keywords
cleft lip, epidemiology, folic acid, general practice, infant

Growing Up in Ireland (GUI) is the national longitudinal study of children and young people in the Republic of Ireland and has followed two cohorts for over ten years to date: Cohort ’98 who were recruited into the study at age nine years and Cohort ’08, recruited at age nine months. The study aims to describe the lives of Irish children and young people in terms of their development, with a view to positively affecting policies and services available for them. Traditionally, data collection involved in-home visits from an interviewer who conducted face-to-face interviews, recorded physical measurements of study participants and administered cognitive assessments. However, with the onset of the COVID-19 pandemic and the associated restrictions, significant adaptations were required to these methods to ensure data collection for the pilot and main fieldwork for Cohort ’08 at age 13 could continue to the expected timeline. Face-to-face interviews with participants were replaced with telephone and web-based modes, interviewer training was conducted online, online resources were made available for interviewers and participants and COVID-19 related items were added to questionnaires. In addition to the scheduled data collection, a special COVID-19 survey was also conducted on both GUI cohorts in December 2020 to explore the impact of the pandemic on participants’ lives. This paper outlines the adaptations made to traditional data collection methods in GUI, highlighting the challenges that were met, but also the benefits of some changes that may be worth incorporating into future waves of GUI.

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

Purpose
We investigated the hypothesis that mode of delivery affects childhood behavior and motor development and examined whether there are sex-specific associations, i.e., whether males and females have different risk estimates.

Methods
Families with infants born between December 2007 and May 2008 (N = 11,134) were randomly selected and recruited to the Growing Up in Ireland study. Mode of delivery was classified into spontaneous vaginal delivery; instrumental vaginal delivery; emergency Cesarean section (CS); and elective CS. The ‘Ages and Stages Questionnaire’ was completed at age 9-months and the ‘Strengths and Difficulties Questionnaire’ at 3 years. Data were weighted to represent the national sample (N = 73,662) and multivariate logistic regression was used for the statistical analyses.

Results
At age 9 months, elective CS was associated with a delay in personal social skills [adjusted odds ratio, aOR 1.24; (95 % confidence interval, CI 1.04, 1.48)] and gross motor function [aOR 1.62, (95 % CI 1.34, 1.96)], whereas emergency CS was associated with delayed gross motor function [aOR 1.30, (95 % CI 1.06, 1.59)]. At age 3 years there was no significantly increased risk of an abnormal total SDQ score across all modes of delivery.

Conclusions
Children born by elective CS may face a delay in cognitive and motor development at age 9 months. No increase in total SDQ score was found across all modes of delivery. Further investigation is needed to replicate these findings in other populations and explore the potential biological mechanisms.

Background
Physical activity (PA) can reduce young peoples’ risk of depressive symptoms. Associations between PA and depressive symptoms are often investigated over timeframes spanning minutes to weeks. Less is known about whether childhood/adolescent PA can predict depressive symptoms in early adulthood.

Methods
Using a nationally representative sample from Ireland, latent growth mixture modelling was performed to investigate the extent to which different PA trajectories existed from ages 9–17, whether gender, weight status, and socio-economic deprivation at age 9, predicted PA trajectories from ages 9–17, and whether trajectory class membership predicted depressive symptoms at age 20.

Results
A 4-class solution was the best fit to the data (AIC = 52 175.69; BIC = 52 302.69; ssaBIC = 52 245.49; entropy = 1.00). Classes were labelled according to their baseline PA and slope of their trajectory: ‘High-Decreasers’; ‘Moderate-Decreasers’; ‘Moderate-Stable’; and ‘Low-Increasers’. A negative linear association existed between activity trajectory and the likelihood class members were female, overweight or socioeconomically deprived at age 9. The most active class (High-Decreasers) were significantly less likely to report depressive symptoms at age 20 than other classes.

Conclusions
Multiple PA trajectories exist throughout childhood and adolescence although differences in PA levels reduced over time. The most/least active children continued to be the most/least active throughout adolescence. Those most active were least at risk of depressive symptoms in early adulthood. Being female, overweight or experiencing deprivation at age 9 were all risk factors for inactivity throughout adolescence. Findings have implications for public health and PA promotion in young people

The purpose of the study was, 1) to identify risk and protective factors that predict academic achievement in low socioeconomic status (SES) pupils in Ireland; and 2) to establish if these predicting factors are unique and applicable only in low-SES pupils. Using two waves of the Irish nationally representative longitudinal data, a multi-informant design was applied to analyse data from over 7,000 children along with their caregivers and teachers. A series of multilevel regression analyses were performed to compare data from low-SES and high-SES pupils. After controlling for prior achievement, findings suggested that academic achievement in both low and high-SES pupils are promoted by educational aspirations, attentional skills and being in the rural area. The strength of the association between protective factors and academic achievement, however, varies between the two groups. Nonetheless, close parent-child relationship in low-SES female pupils appears to be a unique factor that promotes academic resilience that does not apply to the rest of the pupils. The study contributes credible evidence and fresh insights into protective factors that exclusively promote academic resilience in low-SES pupils. From the perspective of policy and intervention, the differentiated knowledge gained is useful to inform the provision of targeted efforts aimed at closing the gap in achievement between pupils from different socioeconomic backgrounds.

Background
Historically, breastfeeding rates in Ireland have been low compared with international averages. It has been suggested that maternal ethnicity and citizenship may influence breastfeeding rates, with ethnic minorities thought more likely to breast feed.

Aim
The aim of this study is to investigate the association among maternal citizenship, ethnicity, birthplace and breast feeding. It is hypothesised that Irish mothers (identified through Irish citizenship, self-identified Irish ethnicity or Irish birthplace) are less likely to breast feed than non-Irish mothers.

Methods
The study population of Growing Up in Ireland: the National Longitudinal Study of Children was used for this study. Analysis was restricted to 11 092 biological mother and infant pairs with a complete breastfeeding history. Logistic regression analysis was used to estimate ORs and 95% CIs for breast feeding relative to maternal citizenship and ethnicity, controlling for the confounding effects of other maternal variables.

Results
Results indicated that 55.9% (6202 of 11 092) of mothers had initiated breast feeding, with only 7.9% (874 of 11 092) of mothers currently breast feeding their infant (at 9 months of age). Irish citizens (4693 of 9368, 50.0%) were significantly less likely to have initiated breast feeding compared with non-Irish citizens (1503 of 1695, 88.7%). Irish born mothers (4179 of 8627, 48.8%) were also significantly less likely to have initiated breast feeding than mothers born elsewhere (2023 of 2462, 82.2%).

Conclusions
Maternal citizenship and ethnicity appear to be the strongest influencing factors on breastfeeding initiation and duration. However, this raises a possibility that the increase in breastfeeding rates seen recently may be the result of increased immigration into Ireland, rather than the success of policy and research efforts.

Background
Independent associations between screen time (ST)/physical activity (PA) and overweight (OW)/obesity have been demonstrated but little research exists on the role of ST among sufficiently active children.

Purpose
To examine the combined influence of ST and PA on risk of OW/obesity in a nationally representative sample of 9-year-old Irish children.

Methods
The sample in this cross sectional analysis contained 8568 children. Self-report parent data were used to group children into ST and PA categories and related to OW/obesity using forced entry logistic regression.

Results
High ST (> 3 hours/day), bedroom TV and mobile phone ownership increased risk of OW/obesity in high and low active children (P < .05). Low PA (<9 bouts fortnightly) was also associated with OW/obesity. In combined analyses, OW/obesity was lowest in the reference low ST/high PA group with ORs of 1.38, 1.63, and 2.07, respectively, in the low ST/low PA, high ST/high PA, and high ST/low PA groups. Access to electronic media, low socioeconomic status, parental obesity, and not engaging in sports were all related to high ST (P < .05).

Conclusion
This study supports findings that ST is associated with OW/Obesity demonstrating this separately in high and low active children.

There has been a good deal of attention in Irish policy discourse to housing supply and affordability. However, there has been less focus on the extent to which the quality of housing impacts the wellbeing of children and their parents. This study addresses this gap in knowledge by using data from Growing Up in Ireland (GUI) Cohort ’08 to explore the influence of housing and neighbourhood quality on parental and child wellbeing. In particular, it looks at how the length of time households have spent experiencing inadequate housing can shape families’ wellbeing. The study adopts a multidimensional approach to measuring inadequate housing, capturing whether the home is unsuitable (in terms of size or problems like damp), whether the household struggles to adequately heat the home, lack of access to a garden or play space, the number of residential moves and the type of tenure. In addition, neighbourhood quality is assessed in terms of local disorder, having low social capital (with few family and friends in the area) and having access to fewer local services. Child wellbeing is measured using the Strengths and Difficulties Questionnaire (SDQ), which captures the extent of children’s socio-emotional difficulties.

Introduction
The COVID-19 pandemic wrought acute harm to mental wellbeing across the globe; not least through its impact on morbidity and mortality, but also from health anxieties, lockdowns and their economic fallout, the closure of key services, as well as the disruption of social networks. However, while the pandemic’s onset was global, not everyone experienced the same harm to their mental health. This study draws on information on the mothers of 12-year-olds from the Growing Up in Ireland (GUI) study to look at what helped cushion the negative impact of the pandemic on their mental health.

Data and Methods
The study draws on GUI data on Cohort ’08, a nationally representative sample of children born 2007-2008 along with their caregivers. In December 2020, the GUI team conducted a survey of primary caregivers (98 per cent of whom are mothers) during the COVID-19 pandemic. Mothers’ mental health is captured using the Short-form Center for Epidemiological Studies Depression Scale (CES-D), with higher scores indicating a greater risk of depression. The longitudinal nature of GUI means we can compare measures of mothers’ mental health during the COVID-19 pandemic (December 2020) with two previous timepoints before the pandemic – wave 3 (2013/2014) and wave 5 (2017/2018) – to see whether trends in depression changed significantly over the pandemic.

The study looks at four sets of factors: (1) mothers’ social resources, such as the level of social cohesion in their neighbourhood (e.g., trust and reciprocity among neighbours) or the support they receive from friends/family; (2) their economic resources, such as the share of income received from welfare, or how difficult they feel it is to ‘make ends meet’; (3) the quality of mothers’ local environment, such as the degree of traffic problems; and (4) their religiosity, such as how often they attend church. All of these factors are measured prior to the onset of the pandemic to reflect the resources mothers had at their disposal going into the crisis.

To understand how these buffering factors may have cushioned mothers’ mental health, the study uses a set of measures on what experiences mothers had during the pandemic. These include whether they found supervising their child’s schoolwork stressful, whether they experienced a loss of income/employment, or whether they had COVID or were anxious about friends/family contracting it.

Results

What factors cushioned the impact of the pandemic on mothers’ mental health?

In the years prior to the pandemic (2013/2014 to 2017/2018), levels of depression among mothers remained relatively low and stable. However, depression scores among mothers rose steeply with the onset of the pandemic (compared to 2017/18), nearly doubling. Yet, not all mothers experienced an equal increase in depression scores.

Stronger economic resources, and better household conditions, played a protective role: depression scores rose less among mothers who reported being able to ‘financially make ends meet’ easily (compared to those who found it difficult) and among mothers who lived in less overcrowded housing. The local environments in which mothers were living also helped cushion their mental health. Mothers who lived in neighbourhoods where heavy traffic was not a problem, and those who lived in rural areas, saw their depression scores increase less over the pandemic, compared to mothers in more urban areas or where traffic was a major problem.

The strongest protective factors were mothers’ social resources and their religiosity. Mothers who, just before the pandemic, had a partner in the household and who felt they got the help they needed from friends and family saw their depression scores increase less over the pandemic. Those who reported living in more socially cohesive neighbourhoods (where neighbours trust each other, exchange favours, or feel more attached) – what are termed in the research literature as high social capital areas – were more strongly protected against depression during the pandemic. Symptoms of depression also increased much more steeply among mothers who never attended church before the pandemic compared to mothers who used to attend daily or weekly (even though in-person services had not resumed at the time of the survey).

How did these buffering factors protect mothers’ mental health?

Social resources cushioned mothers’ mental health because, during the pandemic, these mothers experienced better family relations and struggled less with care work, home schooling, and their children’s return to school. Economic resources supported mental wellbeing by reducing financial stresses, enabling better home/outdoor environments, and likely allowing families to purchase the tablets, laptops, and high-speed internet needed to engage in home schooling and working more easily. A better-quality local environment allowed mothers to spend more time outside and improved family relations. It was harder to explain the protective role of religiosity, but it may relate to greater optimism or a stronger sense of meaning in life that help protect people from the stress of adversity.

Conclusion and policy implications
This study finds strong evidence that the social, economic, religious, and environmental characteristics in people’s lives protect their mental health when experiencing adverse life events. While some of these characteristics are personal, others can be influenced by policy. Investment in local infrastructure to enhance access to green spaces and reduce neighbourhood disorder will pay dividends in supporting the mental wellbeing of women and their families. Furthermore, community development initiatives to foster a sense of local belonging and trust will enhance families’ capacity to weather crises. Integrating such perspectives into crisis management could help protect societies, particularly more vulnerable groups, and potentially weaken the well-documented long-term scarring effects that adverse life events have on people’s lives.

While problems in the housing system in Ireland have been under the spotlight for the last decade, relatively little attention has been paid to the experience of children and to the consequences of housing issues for child development. International research has highlighted a range of effects of poor housing on children. Poor physical housing conditions has been associated with respiratory illnesses and childhood accidents. Overcrowding has been linked to poorer educational outcomes and deprived neighbourhood conditions to socio-emotional problems. Frequent residential mobility has also been found to lead to poorer cognitive and non-cognitive outcomes. However, there is a lack of evidence on how far these findings apply in Ireland where levels of home ownership are high and levels of neighbourhood segregation are lower. This study addresses this gap. Drawing on data from the ’08 Cohort of the Growing Up in Ireland study, we explore the housing conditions faced by children in early and middle childhood and the implications of these housing experiences for their cognitive, socio-emotional and health outcomes. We adopt a multi-dimensional approach to measuring housing conditions, incorporating housing tenure, suitability of accommodation, heating deprivation, neighbourhood disorder and housing mobility.

International research has shown that civic engagement, that is, volunteering in local services, can benefit both young people and their communities, while political engagement can strengthen a society’s democratic culture. The Better Outcomes, Brighter Futures (2019) policy framework highlights the importance of young people feeling connected, respected and contributing to their world. To date, however, there has been an absence of systematic research on this aspect of young people’s transition to adulthood in Ireland. Further, although the government strategy Our Rural Future highlights a lack of access to facilities and transport for young people living in rural areas, little is known about how this might impact on their civic and political engagement. It is therefore crucial to have an evidence base to identify the drivers of civic engagement in order to better support young people’s involvement. This study aims to fill this gap by drawing on rich information on 20 year olds from Cohort ’98 of the Growing Up in Ireland (GUI) study.

Objective
To examine the extent to which early child nutrition, maternal antenatal lifestyle behaviours and child diet and lifestyle explain social class inequalities in the risk of rapid weight gain between birth and 3 years and obesity at age 3 years.

Design
A longitudinal and prospective birth cohort study.

Subjects
Nationally representative sample of 11 134 children and their parents followed from 9 months of age until 3 years. Child weight and maternal height and weight were measured at 9 months and 3 years and child birth weight was extracted from hospital records. Other predictors of child growth and obesity were collected by maternal report at 9 months and 3 years.

Results
Although born lighter on average, children of unskilled manual parents were 274 g heavier than children of professional parents by 3 years of age. The fully adjusted model of rapid growth from birth to 3 years of age and obesity at 3 years of age accounted for all social class differentials. Breastfeeding and age at the introduction of solids were associated with the largest average reduction (41%) in the odds ratio (OR) of rapid growth in the first 9 months of life for each class relative to the professional class. In the period from 9 months to 3 years of age, the class differential in rapid growth was reduced most by measures of the child’s diet and lifestyle. However, the impact of the groups of predictors varied by social class. For early life growth, among the non-manual classes the proportionate reductions are largest when adjusted for early infant nutrition, whereas maternal prenatal smoking is more important for the manual social classes.

Conclusion
Preventative interventions to reduce levels of childhood obesity should be multi-dimensional but different dimensions should be given more or less significance depending on socio-economic group.

Background
Chronic illness in childhood is associated with worse educational outcomes. The association is usually explained via lowered cognitive development, decreased readiness to learn and school absence. However, this paper examines whether worse psychological adjustment may also play a role.

Methods
We use data from the Growing Up in Ireland study, a cohort study, which collected data on 8,568 nine-year-old children through the Irish national school system using a two-stage sampling method. Maximum likelihood path analytic models are used to assess the direct effect of child chronic illness on reading and maths test scores and the mediating role of emotional and behavioural problems.

Results
In unadjusted analyses, children with a mental and behavioural condition scored 14.5 % points less on reading tests and 16.9 % points less on maths tests than their healthy peers. Children with non-mental and behavioural conditions scored 3 % points less on both tests, a significant difference. Mental and behavioural (OR, 9.58) and other chronic conditions (OR, 1.61) were significantly more likely to have ‘high’ levels of difficulties on the SDQ. Path analysis models showed that the association between chronic illness and educational test scores was completely mediated by emotional and behavioural problems controlling for school absence and bullying by peers.

Conclusions
Child and adolescent chronic illness can have significant effects on educational development and a long-lasting impact on future life-chances. The psychological adjustment of the child is important in mediating the effect of chronic illness on educational outcomes. Interventions should target this developmental pathway.

None of the many critical moments in Ireland’s often tumultuous history was more significant or defining than the Easter Rising of 1916. Central to the Rising was the Proclamation of Independence, in which Pádraig Pearse declared the new nation’s resolve to cherish all its children equally. CHERISHING ALL THE CHILDREN EQUALLY? brings together contributions from a range of disciplines to shed light on the processes of child development and to investigate how that development is influenced by a variety of demographic, family and socio-economic factors. Making extensive use of research and data that have emerged over recent years from the Growing Up in Ireland longitudinal study of children, the book considers whether or not all children can participate fully and equitably in contemporary Irish society. It asks whether or not we do, in fact, cherish all our children equally in modern Ireland, regardless of their family circumstances, health or ethnic background.

TABLES OF CONTENTS:

1. Introduction
2. Changing Perceptions and Experiences of Childhood, 1916-2016
3. Children and Families, Then & Now
4. Is Family Structure a Source of Inequality in Children’s Lives?
5. Parental Investment & Child Development
6. Inequalities in Access to Early Care and Education in Ireland
7. Inequalities from the Start? Children’s Integration into Primary School
8. Insights into the Prevalence of Special Educational Needs
9. The Experiences of Migrant Children in Ireland
10. Social Variation in Child Health & Development: A Life-course Approach
11. Child Access to GP Services in Ireland: Do User Fees Matter?
12. Anti-Social Behaviour at Age 13
13. Child Economic Vulnerability Dynamics in the Recession
14. Concluding Observations

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.