Dafna E. Kohen

Neighborhood Disadvantage: Pathways of Effects for Young Children

The present study used Canadian National Longitudinal data to examine a model of the mechanisms through which the effects of neighborhood socioeconomic conditions impact young childrens verbal and behavioral outcomes (N= 3,528; M age = 5.05 years, SD= 0.86). Integrating elements of social disorganization theory and family stress models, and results from structural equation models suggest that both neighborhood and family mechanisms played an important role in the transmission of neighborhood socioeconomic effects. Neighborhood disadvantage manifested its effect via lower neighborhood cohesion, which was associated with maternal depression and family dysfunction. These processes were, in turn, related to less consistent, less stimulating, and more punitive parenting behaviors, and ultimately, poorer child outcomes.

School Readiness and Later Achievement: Replication and Extension Using a Nationwide Canadian Survey

In this article we replicate and extend findings from Duncan et al. (2007). The 1st study used Canada-wide data on 1,521 children from the National Longitudinal Survey of Children and Youth (NLSCY) to examine the influence of kindergarten literacy and math skills, mother-reported attention, and mother-reported socioemotional behaviors on 3rd-grade math and reading outcomes. Similar to Duncan et al., (a) math skills were the strongest predictor of later achievement, (b) literacy and attention skills predicted later achievement, and (c) socioemotional behaviors did not significantly predict later school achievement. As part of extending the findings, we incorporated a multiple imputation approach to handle missing predictor variable data. Results paralleled those from the original study in that kindergarten math skills and Peabody Picture Vocabulary Test-Revised scores continued to predict later achievement. However, we also found that kindergarten socioemotional behaviors, specifically hyperactivity/impulsivity, prosocial behavior, and anxiety/depression, were significant predictors of 3rd-grade math and reading. In the 2nd study, we used data from the NLSCY and the Montreal Longitudinal-Experimental Preschool Study (MLEPS), which was included in Duncan et al., to extend previous findings by examining the influence of kindergarten achievement, attention, and socioemotional behaviors on 3rd-grade socioemotional outcomes. Both NLSCY and MLEPS findings indicated that kindergarten math significantly predicted socioemotional behaviors. There were also a number of significant relationships between early and later socioemotional behaviors. Findings support the importance of socioemotional behaviors both as predictors of later school success and as indicators of school success.

The health and psychosocial functioning of caregivers of children with neurodevelopmental disorders

Purpose. Children with neurodevelopmental disorders (Neuro) pose complex parenting challenges, particularly if the condition co-occurs with behaviour problems. Such challenges are likely to impact caregiver health and well-being. This study explores the extent to which caregivers of children with both Neuro and behaviour problems differ in their physical and psychosocial outcomes from caregivers of children with either condition or neither condition. Method. The first wave of data collected in the National Longitudinal Survey of Children and Youth in Canada (1994) was used to identify four groups of caregivers of 4-to 11-year-old children: caregivers of children with a Neuro disorder and externalising behaviour problems (Both; n = 414), caregivers of children with a Neuro disorder only (Neuro Only; n = 750), caregivers of children with an externalising behaviour problem only (Ext Only; n = 1067), and caregivers of children with neither health condition (Neither; n = 7236). Results. Caregivers in the Both group were least likely to report excellent or very good health, and more frequently reported chronic conditions such as asthma, arthritis, back problems, migraine headaches, and limitations in activities as compared to the Neither group. This group also exhibited higher depression scores, experienced more problematic family functioning and reported lower social support than the Neither group. Scores for caregivers in the Ext Only and Neuro Only groups tended to lie between the Both and Neither group scores and often did not differ from one another. Conclusions. Caregivers of children with both neurovelopmental disorders and behaviour problems exhibited a greater number of health and psychosocial problems. While addressing childrens behaviour problems, health care professionals should also consider caregiver physical and psychosocial health, as this may also have an impact on childrens well-being.

Maternal reports of child injuries in Canada: trends and patterns by age and gender

Objectives—This study examines gender and age differences in maternal reports of injuries in a cross sectional group of children aged 0–11 years. The cause, nature, body part injured, and location of injury are explored, as are the associations with family socioeconomic indicators and associations with limitations in activities. Methods—Data for 22 831 children and their families come from cycle 1 of the Canadian National Longitudinal Survey of Children and Youth collected in 1995. Descriptive analyses and χ2 tests for trends are used to examine injury variations by child gender and age. Logistic regressions are used to examine the relationship between socioeconomic indicators and injury and the associations between injury and limitations in activities. Results—Consistent with findings from hospital data, boys experience more injuries than girls, and injuries increase with child age. Falls are the most common sources of maternally reported injuries, followed by scalds/poisonings for young children and sports injuries for school aged children. The majority of injuries occur in or around the home for young children, but at school for older children. For maternal reports of childhood injuries, single marital status is a risk factor for boys. Conclusions—Maternally reported injuries occur in 10% of Canadian children and many of these are associated with limitations in activities. Preventative strategies should take both child age and gender into consideration.

Neighborhood, Family, and Child Predictors of Childhood Injury in Canada

OBJECTIVE To examine independent and combined effects of child, family and neighborhood on medically attended childhood injuries. METHODS Logistic modeling of longitudinal data (n=9796) from the Census Linked National Longitudinal Survey of Children and Youth. RESULTS Child age and gender were strong predictors of injuries. Smaller effects were found for parenting, neighborhood cohesion among difficult children less than 2 years old, and neighborhood disadvantage among aggressive children 2-3 years old. CONCLUSION Neighborhood in addition to parenting can affect injury risk. Further research is needed into the influence of neighborhood disadvantage and the processes of neighbors cohesion at different childhood stages.

Do neighbourhoods influence the readiness to learn of kindergarten children in Vancouver? A multilevel analysis of neighbourhood effects

A growing body of literature has examined the effects of neighbourhood characteristics on child health and well-being and the mechanisms through which such effects may operate. Research investigating neighbourhood effects on children is based on the notion that individuals and families who live in a neighbourhood collectively create a social context that influences the developing child. In this paper we investigate the relationship between individual and neighbourhood socioeconomic characteristics and kindergarten childrens readiness to learn in Vancouver, Canada (n = 3736), using multilevel modeling techniques and 1996 census data for Vancouver neighbourhoods (n = 68). Findings suggest that although family-level characteristics carry the most weight in shaping childrens readiness to learn, neighbourhood-level factors are independently associated with early developmental outcomes, particularly physical health and well-being, language and cognitive development, and communications skills and general knowledge. The strongest neighbourhood characteristics associated with readiness to learn were median income and the percentage of single-parent families. Also important were the percentage of the population who had not moved in the previous five years and the percentage of the population whose mother tongue was non-English. The latter neighbourhood characteristic was an especially strong predictor of communication skills and general knowledge. The findings suggest that neighbourhood-based policies to improve physical health and well-being, language and cognitive development, and communications skills may also meet with some success.

Changes Over Time in the Health of Caregivers of Children With Health Problems: Growth-Curve Findings From a 10-Year Canadian Population-Based Study

OBJECTIVES We used Canadian population-based data to examine changes in the health of caregivers of children with complex health problems compared with caregivers of healthy children over a 10-year time period. METHODS The National Longitudinal Survey of Children and Youth collected data biennially from 9401 children and their caregivers in 6 waves from 1994-1995 to 2004-2005. We conducted growth-curve analyses of these data to model self-reported general health and depressive symptoms for 4 groups of caregivers: caregivers of healthy children, and caregivers of children with 1, 2, or at least 3 of 4 conceptually distinct indicators of child health problems. We modeled covariates for children (age, gender, only-child status) and caregivers (age, gender, education, income, marital status). RESULTS After we controlled for covariates, caregiver health outcomes worsened incrementally with increasing complexity of child health problems. Change in self-reported general health and depressive symptoms over the 10-year period was consistent across all groups of caregivers. CONCLUSIONS Poorer health among caregivers of children with health problems can persist for many years and is associated with complexity of child health problems. Attention to parental health should form a component of health care services for children with health problems.

Associations among child care, family, and behavior outcomes in a nation-wide sample of preschool-aged children

Canadian data based on maternal reports for a nationally representative sample of 4,521 4—5-year-olds were used to examine associations among child care, family factors, and behaviors in preschool-aged children. Linear regressions testing for direct and moderated associations indicated that regulated home-based care was associated with less physical aggression and less prosocial behavior while high process quality in home-based care was associated with greater prosocial behavior. Among children in home-based settings, being in at least one additional current child care arrangement was linked with greater physical aggression, and low child care stability was linked to greater hyperactivity-inattention, internalizing behavior, and prosocial behaviors. For family factors, parenting behaviors and maternal depression were associated with greater behavioral problems while low household income was linked with greater hyperactivity-inattention among children in home-based care. There was a significant interaction between process quality and household income for physical aggression and internalizing behavior and between structure quality and parenting consistency for prosocial behavior for children in home-based care. Results suggest that child care matters for preschool behavioral outcomes, even after controlling for socio-demographic factors. High quality care appears particularly important for children in home-based care from low-income families so issues around child care quality and regulation should be considered. Findings also underscore the importance of family factors on young children’s behaviors and show that child care and family influences work together to impact child outcomes.

Conceptualizing childhood health problems using survey data: a comparison of key indicators

BackgroundMany definitions are being used to conceptualize child health problems. With survey data, commonly used indicators for identifying children with health problems have included chronic condition checklists, measures of activity limitations, elevated service use, and health utility thresholds. This study compares these different indicators in terms of the prevalence rates elicited, and in terms of how the subgroups identified differ.MethodsSecondary data analyses used data from the National Longitudinal Survey of Children and Youth, which surveyed a nationally representative sample of Canadian children (n = 13,790). Descriptive analyses compared healthy children to those with health problems, as classified by any of the key indicators. Additional analyses examined differences between subgroups of children captured by a single indicator and those described as having health problems by multiple indicators.ResultsThis study demonstrates that children captured by any of the indicators had poorer health than healthy children, despite the fact that over half the sample (52.2%) was characterized as having a health problem by at least one indicator. Rates of child ill health differed by indicator; 5.6% had an activity limitation, 9.2% exhibited a severe health difficulty, 31.7% reported a chronic condition, and 36.6% had elevated service use. Further, the four key indicators captured different types of children. Indicator groupings differed on child and socio-demographic factors. Compared to children identified by more than one indicator, those identified only by the severe health difficulty indicator displayed more cognitive problems (p < 0.0001), those identified only by the chronic condition checklist had a greater likelihood of reporting allergies or asthma (p < 0.0001), and those identified as having elevated service use only were more affluent (p = 0.01) and showed better overall health (p < 0.0001). Children identified by only a single indicator were less likely to have serious health problems than those identified by two or more indicators.ConclusionWe provide information useful to researchers when selecting indicators from survey data to identify children with health problems. Researchers and policy makers need to be aware of the impact of such definitions on prevalence rates as well as on the composition of children classified as being in poor health.

Patterns of Children's Participation in Unorganized Physical Activity

Childrens leisure-time or unorganized physical activity is associated with positive physical and mental health, yet there is little information available on tracking and predicting participation throughout the childhood and adolescent years. The purpose of the current study was to explore patterns of unorganized physical activity participation of children ages 4 through 17 years. Longitudinal data from the Canadian National Longitudinal Survey of Children and Youth were analyzed using semiparametric group-based trajectory modeling. Participation in unorganized physical activity was best represented by two trajectory groups for boys (n = 4,476) and girls (n = 4,502). For boys, these groups were labeled regular participation and infrequent participation. For girls, there was also a regular group and a second group that reflected infrequent and decreasing participation throughout childhood and adolescence. A higher educational level for parents and having two parents in the home predicted regular participation for boys. For girls, none of the examined variables were significant predictors. The results suggest that boys have a relatively stable pattern of unorganized physical activity throughout childhood and adolescence; however, for some girls, participation declines in adolescence.