External Publications Using GUI Data

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

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.

A recent rise in home computer ownership has seen a growing number of children using computers and accessing the internet from a younger age. This paper examines the link between children’s home computing and their academic performance in the areas of reading and mathematics. Data from the nine-year-old cohort of the Growing Up in Ireland survey is adopted for this study. The survey reveals that searching for information is a more popular activity among the children than communicating online. Through regression analysis we find that using a computer is positively and significantly associated with children’s reading and mathematics scores in standardised tests. This result holds after controlling for multiple determinants of school performance. In addition, we investigate the effects of using various applications on the computer. Surfing the internet for fun, doing projects for school and emailing are associated with higher reading and maths test scores, while those who are permitted to use the computer unsupervised tend to have higher maths test scores. Instant messaging and downloading music or watching movies are negatively associated with both reading and maths scores. The results indicate that some forms of early computer use have significant associations with academic performance among children in primary school, although we could not establish the direction of causation definitively.

Keywords: home computer use, elementary education, academic performance

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

International studies have raised concerns about the academic and social implications of inclusive policies on school engagement and successful learning and, in particular, on the ways in which friendships are formed between students with SEN and other students. This article stems from research findings which show that Irish children with special educational needs like school less than their peers without SEN in mainstream settings. Using data from a large scale longitudinal study of 8578 9-year-olds, this paper uses a child centred research approach to investigate why this is the case particularly when they are in receipt of supports. To do this, we focus on processes underlying their dislike of school such as their academic engagement and social/peer relations. We measure academic engagement by looking at their interest in the subjects mathematics and reading and the extent to which they complete their homework. We examine the social/peer relations of students with special educational needs by assessing the extent to which they report liking their teacher. Using the Strengths and Difficulties Questionnaire (SDQ) Scale and the Piers-Harris Self-Concept Scale we also examine the nature of peer relations among children with special educational needs in mainstream settings. Both academic engagement and social engagement play a central role in understanding the broader school engagement of children with special educational needs. By simultaneously examining the role of academic and social relations in shaping the engagement of children with SEN, the analysis provides a unique opportunity to fundamentally assess the barriers to true inclusion for children with special needs.

Keywords
special educational needs, inclusive education, school engagement, academic engagement, peer relations

Despite dramatic changes in Irish special education policy during the last decade, there is little understanding of the factors influencing how special educational needs (SEN) are identified and whether identification varies across different school contexts. International research has tended to focus on how individual child characteristics influence SEN identification. Less attention has been given to other factors such as teacher characteristics or school social mix. Using data from the nine-year-old cohort of the Growing Up in Ireland study, this article examines which children are most likely to be identified with different SEN types taking into account student social background characteristics, teacher characteristics and school social mix. Findings show that children attending highly disadvantaged school contexts are far more likely to be identified with behavioural problems and less likely to be identified with learning disabilities than children with similar characteristics attending other schools. It seems that ‘behavioural’ issues take precedence over learning difficulties in these schools pointing to a culture of care/containment rather than academic progress.

Keywords
SEN identification, gender, social background, teacher characteristics, school context

It is well established that cultural and economic resources imparted to children vary significantly by social class. Literature on concerted cultivation has highlighted the way out-of-school activities can reproduce social inequalities in the classroom. Within this literature however, little attention has been given to the role of gender in concerted cultivation. In this paper, we use data from the first wave of the Growing Up in Ireland longitudinal study to consider how both social class and gender influence the out-of-school activities of children. Moreover, we examine how out-of-school activities, class and gender impact on children’s school engagement and academic achievement. We find that while childrearing logics tend to operate within social class categories, there is an additional cultural aspect of gender in the uptake of different types of out-of-school activities. Our findings suggest the need to move beyond explanations of concerted cultivation to explain gender differences in mathematics and reading attainment.

Background
Unintended pregnancy is associated with increased risk for adverse neonatal and early childhood outcomes spanning an array of indicators, but it remains unclear whether these risks hold independent of other biological, social and environmental risk factors.

Methods
This study uses data from the first wave of the ‘Growing Up in Ireland Study’, a large nationally representative cohort study of more than 11 000 infants, to examine the risk factors associated with unintended pregnancy. Adopting a staged approach to the analysis, the study investigates whether pregnancy intention influences maternal health behaviours during pregnancy independent of background characteristics, and whether pregnancy intention carries any additional risk for adverse infant and maternal health outcomes when we adjust for background characteristics and prenatal behaviours.

Results
The study confirmed that sociodemographic factors are strongly associated with unintended pregnancy and that unintended pregnancy is associated with a range of health compromising behaviours that are known to be harmful to the developing fetus. While there was little evidence to suggest that pregnancy intention was associated with adverse neonatal outcomes or developmental delay independent of other covariates, there was strong evidence that intention status had a bearing on the mother’s psychosocial health. Unintended pregnancy was associated with increased risk of depression (risk ratio 1.36 [95% confidence interval 1.19, 1.54]), and higher parenting stress (risk ratio 1.27 [95% confidence interval 1.16, 1.38]).

Conclusions
Ascertaining the mother’s pregnancy intention during the first antenatal visit may represent a means for monitoring those at greatest risk for adverse mother and child outcomes.

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

Within categories of special educational needs, emotional and behavioural difficulties have received much attention in recent years, particularly in relation to their definition and identification by parents and teachers. This paper stems from previous research which highlights how children from disadvantaged backgrounds and those attending schools designated as socio-economically disadvantaged are significantly more likely than their peers to be identified as having a special educational need of a non-normative type such as emotional behavioural difficulty (EBD). Using data from the Growing Up in Ireland study, it examines whether the EBD identified by teachers or within certain schools is matched by the child’s own performance on an internationally validated emotional and mental health measure – the Piers–Harris. Findings show that overall self-reported social emotional well-being bears a strong relationship to the probability of being identified with an EBD. However, boys, children from economically inactive and one-parent households and children attending the most disadvantaged school contexts are more likely to be identified with having an EBD, even after taking into account their social background characteristics and their scoring on the Piers–Harris measure. These findings suggest that the subjective nature of EBD identification is resulting in a disproportionate number of these children being identified with EBD. The implications of this study are explored for existing disability/SEN classification systems, school-wide intervention models and the impact on individual students labelled as EBD. Overall, the findings pose searching questions about the validity of employing SEN classification systems in deciding eligibility and types of appropriate provision.

Whether breastfeeding is protective against the development of childhood overweight and obesity remains the subject of considerable debate. Although a number of meta-analyses and syntheses of the literature have concluded that the greater preponderance of evidence indicates that breastfeeding reduces the risk of obesity, these findings are by no means conclusive. The present study used data from the Growing Up in Ireland study to examine the relationship between retrospectively recalled breastfeeding data and contemporaneously measured weight status for 7798 children at nine-years of age controlling for a wide range of variables including; socio-demographic factors, the child’s own lifestyle-related behaviours, and parental BMI. The results of the multivariable analysis indicated that being breastfed for between 13 and 25 weeks was associated with a 38 percent (p < 0.05) reduction in the risk of obesity at nine-years of age, while being breastfed for 26 weeks or more was associated with a 51 percent (p < 0.01) reduction in the risk of obesity at nine-years of age. Moreover, results pointed towards a dose–response patterning in the data for those breastfed in excess of 4 weeks. Possible mechanisms conveying this health benefit include slower patterns of growth among breastfed children, which it is believed, are largely attributable to differences in the composition of human breast milk compared with synthesised formula. The suggestion that the choice of infant feeding method has important implications for health and development is tantalising as it identifies a modifiable health behaviour that is amenable to intervention in primary health care settings and has the potential to improve the health of the population.

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.

The present study examines whether breastfeeding is associated with neuro-developmental advantages at 9 months of age on a standardised measure of infant development in a large cohort study of Irish children. It is hypothesised that if breast-milk confers an independent benefit, infants who were never breastfed will have reached fewer developmental milestones than those who were partially or exclusively breastfed, after controlling for putative confounding variables. Families with infants aged 9-months were recruited as part of a nationally representative sample for the birth cohort of the Growing Up in Ireland study (n = 11,134). Information was collected from mothers on breastfeeding practices, socio-demographic characteristics and developmental progress during a household interview. Parent-report items on development covered communication, gross motor, fine motor, problem solving and personal-social skills. Analysis of pass/fail status in each developmental domain using binary logistic regression showed a positive effect of any breastfeeding on gross motor, fine motor, problem solving and personal-social skills (but not communication) and these remained after adjustment for a range of confounding variables. There was, however, little evidence of a dose–response effect or advantage of exclusive over partial breastfeeding. A clear advantage of breastfeeding on infant development was demonstrated. However, the lack of a dose–response association on pass rates suggests that the breastfeeding effect may be confounded by other unobserved factors or that there is a critical threshold during which time the effect of breast milk may be particularly salient for bolstering brain development.

Previous research has tended to classify stepfamilies based on self-report of their familial relationships. However, some stepfamily members do not identify as being part of a stepfamily, leading to the exclusion of certain stepfamilies from stepfamily research. Using data from the first national cohort study of children in Ireland, the aim of this study was to compare the characteristics of self-identifying stepfamilies with those of non-self-identifying stepfamilies, a group about which little is known. The analysis revealed that in approximately 10% of stepfamilies, neither parent declared their stepfamily status (n = 34, N = 288 stepfamilies). No differences emerged between self-identifying and non-self-identifying stepfamilies in the quality of the parent–child or spousal relationships. Non-self-identifying stepfamilies were less likely to be complex, and were more likely to be stepmother and simple stepfamilies than self-identifying stepfamilies. These findings suggest that non-self-identifying stepfamilies constitute a significant minority of stepfamilies who may exhibit unique structural characteristics.

Keywords: stepfamily; family  relationships; identity; stepchildren; stepparents; membership status

A Tobacco-Free Future – An all-island report on tobacco, inequalities and childhood 2013 reveals declines in smoking rates among both children and pregnant women over the past decade, both North and South of the border. This report published by the Institute of Public Health in Ireland (IPH) and the TobaccoFree Research Institute Ireland (TFRI), shows that while tobacco control measures are being successful, disadvantaged children are at particular risk of tobacco-related harms.

Children growing up in disadvantaged circumstances face a number of threats to their health and development. Protecting children from the burden of tobacco related harm from both active and passive smoking is a priority action in enhancing population health and reducing health inequalities. Population health strategies on the island of Ireland are increasingly focussing on addressing the root causes of health inequality through social determinants of health approaches and through focussing on early childhood as a key period for intervention. At the same time, governments in both jurisdictions are working to enhance their approaches to effective tobacco control.

The World Health Organization considers that there are three key ‘windows of exposure’ in terms of tobacco-related harm in childhood – in the womb (associated with active or passive smoking by the mother), directly through children taking up smoking and through exposure to second hand smoke (SHS) in indoor and outdoor environments.

This report presents findings on these three windows of exposure based on a range of data sources in the Republic of Ireland and Northern Ireland. The central aim of the report is to contribute to knowledge on the exposure of children to the harmful effects of tobacco smoke at various stages of their development. The findings of the report can support policy makers and service providers in their efforts to make tobacco-free childhoods a reality on the island of Ireland.

This paper outlines the development of an index of child well-being using data from the first wave of the Child Cohort in the Growing up in Ireland study. This national longitudinal study explores children’s lives by collecting data from 8,568 nine-year-old children, their caregivers and their teachers. Well-being indices are useful to describe children’s circumstances, to monitor child outcomes, and to create and assess the efficacy of social polices involving children. Traditionally, macro-level data has been used in the construction of child well-being indices. However, micro-level data is used in this paper to provide a child-centered perspective on their well-being. This index is comprised of three domains; physical health, social & emotional functioning and educational attainment. Fourteen measures were used in the creation of these domains utilising data from children, caregivers and teachers on the child’s current development. The domain content, protocol followed and confirmatory pro-cess used in creating this index are discussed. Evidence is provided supporting the inclusion of the domains and the factorial structure of the index. A child well-being index of this sort is valuable as it manages to efficiently summarize the richness of information provided by multiple informants on the multidimensional nature of child well-being into a single index. Consequently, it can be easily used and understood by the various stakeholders involved in services related to child welfare.