Healthy and ready for school? Findings from the Growing Up in Scotland study

1. Healthy and ready for school?Findings from the Growing Up in Scotland study Presentation to East & Midlothian Equally Well Test Site 28th October 2010

2. Today’s presentation • Background to the study • Health inequalities in the early years • ‘School readiness’ • Formal and informal support for parents • Discussion

3. Discussion questions • Are these findings useful, or not? • Do they confirm your experience, or not? • Do the findings have any implications for the way that services are resourced and/or delivered? • Who else needs to know about these findings and how should we communicate them?

4. What is the Growing Up in Scotland study? Physical activity Parental support GUS: The A to Z of the Early Years Mental health Family Obesity Diet Accidents and injuries Behaviour Parenting styles Resilience Child health Neighbourhood Childcare Attachment Lone parents Education Zoo visits! Social networks

5. Research Objectives • To provide data and information • Characteristics, circumstances and experiences of children in Scotland aged between 0 and 5 • Longer-term outcomes across a range of key domains • Levels of awareness and use of key services • Nature and extent of informal sources of help, advice and support for parents • To document differences • Characteristics, circumstances and experiences of children from different backgrounds • Longer-term outcomes for children from different backgrounds • To identify key predictors • E.g. of adverse longer-term outcomes • With particular reference to the role of early years

6. Study design: ages and stages

7. Sources of information

8. Study content: Core topics of the main interview • Household composition and family demographics • Non-resident parents • Parental support • Parenting styles • Childcare • Child health and development • Activities with others • Education and employment • Accommodation and transport • Income and benefits

9. Parental health and well-being Early experiences of pre-school Early experiences of primary school Pregnancy and birth Involvement of grandparents Material deprivation Food and nutrition Physical and sedentary activity Housing and neighbourhood Social networks and social capital Study content: Other topics covered in the interview

10. Health inequalities in the early years Research questions • What is the extent and character of health inequalities in the early years? • What factors, if any, correlate with the avoidance of negative early health outcomes, among families from disadvantaged backgrounds? (Resilience)

11. ‘Risk factors’ for poor health GUS shows that children living in households in areas of high deprivation and/or in low income households were more likely to have: • A mother who smoked (including during pregnancy) • Never been breastfed • A mother with a long-term health problem or disability • Poor diet and low levels of physical activity at age 3

12. Inequalities in pregnancy Area deprivation

13. Child health outcomes • Birth weight • General health (rated by parents) • Experience of long-term health problems • Accidents • Reported behaviour difficulties • Problems with cognitive or language development

14. Total number of negative outcomes

15. What might help disadvantaged children avoid negative outcomes? • Child factors • Being a girl • Maternal factors • Not experiencing a long-term condition in child’s early years • Older age at birth • Having a positive attitude towards seeking help and advice early on • Household factors • An enriched home learning environment • At least one adult in full-time work • Neighbourhood factors • Having higher satisfaction with facilities in local area

16. ‘Children’s social, emotional and behavioural characteristics at entry to primary school’Key research questions What is the extent and nature of social, emotional and behavioural difficulties among Scottish children around the time they enter primary 1? Which children are most likely to have such difficulties at school entry? • Methods • Analysis restricted to child cohort, all started school in Aug 2007 or 2008. • Social, emotional and behavioural development measured via Strengths and Difficulties Questionnaire (SDQ) What is the relationship between early behaviour (at pre-school) and later behaviour?

17. % of children with moderate or severe difficulties

18. Patterns of shared difficulties Cluster 2 – 37%: High pro-social scores, low scores on difficulty scales Cluster 1 – 17%: Low pro-social scores, but average scores for difficulty scales Cluster 3 – 11%: Low pro-social scores, high scores on all difficulty scales esp. hyperactivity Cluster 4 – 10%: Average pro-social scores, but high scores for difficulty scales esp. emotional symptoms Cluster 5 – 25%: High pro-social scores, generally low scores for difficulty slightly higher hyperactivity

19. Factors associated with behavioural difficulties Conduct problems Emotional symptoms Hyper- activity Peer problems Lone parent Less than 2 siblings Male Non-white mother Lower income Lower income Lower income Speech probs age 2 Poorer health Poorer health Poorer health Harsh discipline Develop-mental delay Younger mother Low parent interaction Low parent interaction Fewer social visits Fewer social visits Speech probs age 2

20. Classification at pre-school by classification at primary school entry

21. Summary of findings • Most children entering primary school in Scotland do not display any particular difficulties in their social, emotional and behavioural development. • A small proportion do have quite severe difficulties including around one-fifth who display higher than average difficulties across several developmental domains. • Health, development and parenting factors were more closely related to behavioural development than economic or demographic characteristics • There is a general decrease in difficulties between pre-school and primary school. But many who have difficulties at age 3 still have them at school entry other develop difficulties in the pre-school period.

22. Conclusions from maternal mental health report • Maternal mental health was associated with socio-economic disadvantage, poorer relationships and poor social support • Poor maternal mental health at 10 months was a predictor of poor mental health beyond the first year • Children’s emotional, social and behavioural development at 46 months was associated with their mothers’ emotional well-being • When controlling for other factors, maternal mental health did not have a significant impact on child cognitive development at 34 months • Should mothers’ mental health be monitored beyond the first year ?

23. Support for parents – formal and informal

24. Attitudes towards seeking help or advice from professionals • ‘If you ask for help or advice on parenting from professionals like doctors or social workers, they start interfering or trying to take over’ ‘If other people knew you were getting professional advice or support with parenting they would probably think you were a bad parent’ ‘Professionals like health visitors and social workers do not offer parents enough advice and support’

25. Attitudes towards professional support Agreement with statements by maternal age at child’s birth (Source: GUS Sweep 1 birth cohort, babies aged 10 months)

26. Informal support and social networks • Extensive use of informal support amongst parents with young children: • Information and advice from family and friends during pregnancy and in relation to child health. • Younger mothers less likely to attend classes or groups, more likely to say they feel shy or awkward and don’t like groups (including antenatal) • Grandparents a key source of support – many providing informal childcare, particularly for younger mothers and those living low-income households. • Strength of social networks – stronger networks associated with more advantaged circumstances – impacts on parents and children. • Mental health - mothers reporting low levels of support from family and/or the local community were more likely to have experienced mental health difficulties during the first four years of their child’s life.

27. Support for parents – the story from GUS Parents who feel supported: Do more ‘home learning’ activities with their children positive impact on child cognitive development Are more open to seeking help and advice when required contributes to ‘school readiness’ ‘resilience’ (avoiding early negative health outcomes) Are less likely to experience mental health difficulties positive impact on child social, emotional & behavioural development

28. For more information about GUS and to download research findings, please visit: www.growingupinscotland.org.uk Or contact: Lesley Kelly, GUS Dissemination Officer CRFR, University of Edinburgh lesley.kelly@ed.ac.uk GUS is funded by the Scottish Government and is being carried out by the Scottish Centre for Social Research (ScotCen) in collaboration with the Centre for Research on Families and Relationships (CRFR) at the University of Edinburgh and the MRC Social & Public Health Sciences Unit at the University of Glasgow.