Louise Marryat

Associations between social isolation, pro-social behaviour and emotional development in preschool aged children: a population based survey of kindergarten staff

BackgroundThe impact of peer relationships has been extensively reported during adolescence, when peer influence is generally considered to be at its greatest. Research on social isolation during childhood has found associations with school achievement, future relationships and adult mental health. Much of the evidence is derived from either parent or child-rated assessment of peer relationships, each of which have their limitations.MethodsWe report findings from Goodmans Strengths and Difficulties Questionnaire (SDQ), completed by staff in preschool establishments for over 10,000 children in their preschool year (aged 4–5), linked with routine demographic data. Correlations between scores and demographics were explored. Regression models examined the independent relationships between three social isolation variables, taken from the SDQ Peer Relationship Problems, Pro-social Behaviour and Emotional Symptoms subscales, controlling for demographics.ResultsThere were substantial overlaps between problem scores. Regression models found all social isolation variables to be significantly correlated with social and emotional functioning. Different types of social isolation appeared to relate to different psychological domains, with unpopularity having a stronger relationship with poor pro-social skills, whereas being solitary was more strongly linked to poorer emotional functioning.ConclusionsSocial isolation does have a significant association with reported child social and emotional difficulties, independent of demographic characteristics. The analysis highlights the complexity of measuring social isolation in young children. Different types of social isolation were found to have relationships with specific areas of social and emotional functioning.

No evidence of whole population mental health impact of the Triple P parenting programme: findings from a routine dataset

BackgroundThe Triple P parenting programme has been reported to improve child mental health at population level, but it consumes substantial resources. Previous published work has suggested improvements in whole population scores in the Strengths and Difficulties Questionnaire (SDQ) Total Difficulties Scale among samples of children following introduction of the programme. This paper aims to explore whether Triple P had an impact on child mental health problems using routinely collected data over 6 years before and during the implementation of the multilevel Triple P programme in Glasgow City.MethodsAnnual monitoring of teacher-rated SDQ Total Difficulties Scale scores among children in their pre-school year in Glasgow City.ResultsNo significant or consistent changes in SDQ Total Difficulties Scale scores were seen during or after the implementation of Triple P programme on a whole population level.ConclusionTriple P in Glasgow City appears to have had no impact on early child mental health problems over a 6 year period. The Triple P programme, implemented on a whole population level, is unlikely to produce measurable benefits in terms of child mental health.

Mapping area variability in social and behavioural difficulties among Glasgow pre-schoolers: linkage of a survey of pre-school staff with routine monitoring data

BACKGROUND Social, emotional and behavioural development in early to middle childhood impact upon many outcomes in future life and are influenced by home, neighbourhood and school environments. We used linked data to investigate differences between areas in Glasgow City in level of difficulties in pre-school age children, after consideration of demographics, including area-level deprivation. METHODS Pre-school education staff completed Strengths and Difficulties Questionnaires (SDQ) on all children progressing to school from a local authority or partnership (local authority-funded private) pre-school in Glasgow City between 2010 and 2012. These data were linked to individual (age, gender) and area-level (deprivation) demographics from the City Council Education Services Department. Statistical models were fitted to the SDQ scores, adjusting for age, gender, area deprivation, year of school entry, pre-school establishment attended and electoral ward of residence. Correlation between neighbouring wards was incorporated to allow for clustering of scores. RESULTS Boys and those living in more deprived areas had higher levels of difficulties. Children aged 5.0-5.5 years had fewest difficulties, while the oldest and youngest children had similar levels of difficulties. There were no significant secular trends by year of school entry. There remained differences among areas after adjusting for these variables, with children living in some areas having fewer difficulties than would be expected based on their socio-demographic characteristics. CONCLUSIONS There remained differences in childrens levels of difficulties between areas after adjusting for age, gender, area deprivation and year of school entry. Children in some very deprived areas had fewer difficulties than might be expected, while those in relatively affluent areas had more difficulties than expected based on their deprivation level. There may be other, unmeasured, individual- and area-level reasons for childrens level of difficulties, and these require further exploration.

Fit to WHO weight standard of European infants over time

Objectives The 2006 WHO growth charts were created to provide an international standard for optimal growth, based on healthy, breastfed populations, but it has been suggested that Northern European children fit them poorly. This study uses infant weight data spanning 50 years to determine how well-nourished preschool children from different eras fit the WHO standard, and discuss the implications of deviations. Design Four longitudinal datasets from the UK and one from Finland were used comprising over 8000 children born between1959 and 2003. Weights from birth to 2 years were converted to age–sex-adjusted Z scores using the WHO standard and summarised using Generalized Additive Models for Location, Scale and Shape. Results Weights showed a variable fit to the WHO standard. Mean weights for all cohorts were above the WHO median at birth, but dipped by up to 0.5 SD to a nadir at 8 weeks before rising again. Birth weights increased in successive cohorts and the initial dip became slightly shallower. By age 1 year, cohorts were up to 0.75 SD above the WHO median, but there was no consistent pattern by era. Conclusions The WHO standard shows an acceptable, but variable fit for Northern European infants. While birth weights increased over time, there was, unexpectedly, no consistent variation by cohort beyond this initial period. Discrepancies in weight from the standard may reflect differences in measurement protocol and trends in infant feeding practice.

Primary schools and the amplification of social differences in child mental health : a population based cohort study

Background This paper examines socioeconomic inequalities in mental health at school entry and explores changes in these inequalities over the first 3 years of school. Methods The study utilises routinely collected mental health data from education records and demographic data at ages 4 and 7 years, along with administrative school-level data. The study was set in preschool establishments and schools in Glasgow City, Scotland. Data were available on 4011 children (59.4%)at age 4 years, and 3166 of these children were followed at age 7 years (46.9% of the population). The main outcome measure was the teacher-rated Goodman’s Strengths and Difficulties Questionnaire (4–16 version) at age 7 years, which measures social, emotional and behavioural difficulties. Results Children living in the most deprived area had higher levels of mental health difficulties at age 4 years, compared with their most affluent counterparts (7.3%vs4.1% with abnormal range scores). There was a more than threefold widening of this disparity over time, so that by the age of 7 years, children from the most deprived area quintile had rates of difficulties 3.5 times higher than their more affluent peers. Children’s demographic backgrounds strongly predicted their age 7 scores, although schools appeared to make a significant contribution to mental health trajectories. Conclusions Additional support to help children from disadvantaged backgrounds at preschool and in early primary school may help narrow inequalities. Children from disadvantaged backgrounds started school with a higher prevalence of mental health difficulties, compared with their more advantaged peers, and this disparity widened markedly over the first 3 years of school.

Credibility of subgroup analyses by socioeconomic status in public health intervention evaluations: An underappreciated problem?

There is increasing interest amongst researchers and policy makers in identifying the effect of public health interventions on health inequalities by socioeconomic status (SES). This issue is typically addressed in evaluation studies through subgroup analyses, where researchers test whether the effect of an intervention differs according to the socioeconomic status of participants. The credibility of such analyses is therefore crucial when making judgements about how an intervention is likely to affect health inequalities, although this issue appears to be rarely considered within public health. The aim of this study was therefore to assess the credibility of subgroup analyses in published evaluations of public health interventions. An established set of 10 credibility criteria for subgroup analyses was applied to a purposively sampled set of 21 evaluation studies, the majority of which focussed on healthy eating interventions, which reported differential intervention effects by SES. While the majority of these studies were found to be otherwise of relatively high quality methodologically, only 8 of the 21 studies met at least 6 of the 10 credibility criteria for subgroup analysis. These findings suggest that the credibility of subgroup analyses conducted within evaluations of public health interventions’ impact on health inequalities may be an underappreciated problem.

Pathways into and out of overweight and obesity from infancy to mid-childhood: Pathways to obesity from infancy to childhood

To investigate whether high weight in infancy predicts obesity in childhood.

Exposure to liquid sweetness in early childhood: artificially-sweetened and sugar-sweetened beverage consumption at 4-5 years and risk of overweight and obesity at 7-8 years.

A significant gap exists in longitudinal evidence on early exposure to artificially sweetened beverages (ASBs) and weight outcomes for paediatric populations.

Mapping area variability in social and behavioural difficulties among Glasgow pre-schoolers

BACKGROUND Social, emotional and behavioural development in early to middle childhood impact upon many outcomes in future life and are influenced by home, neighbourhood and school environments. We used linked data to investigate differences between areas in Glasgow City in level of difficulties in pre-school age children, after consideration of demographics, including area-level deprivation. METHODS Pre-school education staff completed Strengths and Difficulties Questionnaires (SDQ) on all children progressing to school from a local authority or partnership (local authority-funded private) pre-school in Glasgow City between 2010 and 2012. These data were linked to individual (age, gender) and area-level (deprivation) demographics from the City Council Education Services Department. Statistical models were fitted to the SDQ scores, adjusting for age, gender, area deprivation, year of school entry, pre-school establishment attended and electoral ward of residence. Correlation between neighbouring wards was incorporated to allow for clustering of scores. RESULTS Boys and those living in more deprived areas had higher levels of difficulties. Children aged 5.0-5.5 years had fewest difficulties, while the oldest and youngest children had similar levels of difficulties. There were no significant secular trends by year of school entry. There remained differences among areas after adjusting for these variables, with children living in some areas having fewer difficulties than would be expected based on their socio-demographic characteristics. CONCLUSIONS There remained differences in childrens levels of difficulties between areas after adjusting for age, gender, area deprivation and year of school entry. Children in some very deprived areas had fewer difficulties than might be expected, while those in relatively affluent areas had more difficulties than expected based on their deprivation level. There may be other, unmeasured, individual- and area-level reasons for childrens level of difficulties, and these require further exploration.

OP38 Inequalities in the development of mental health problems in childhood: multilevel analysis of routine teacher-rated individual data in Glasgow City

Background Child mental health problems have been linked to a variety of negative outcomes over the lifecourse. In recent years there has been a focus on exploring the development of mental health problems during childhood and adolescence. However, these analyses often use data from cohort studies, which suffer from differential attrition, and parent-reported data, which is liable to be affected by the parent’s own mental state. The current study used routine data to explore what happened to children’s mental health problems during this time; whether this differed for children from different backgrounds; and whether schools made a difference to the development of these problems over the first three years. Methods This study used data collected through nurseries and primary schools for all children in Local Authority funded nurseries or schools in Glasgow City. The study used Goodman’s Strengths and Difficulties Questionnaire to assess internalising and externalising symptoms. Data were collected for children in their preschool year (age 4–5) in 2010 and then in Primary 3 (P3, age 7–8) in 2013. Data were available for 2131 children. Multilevel binomial models were fitted in MLwiN in order to explore the impact of child and school level characteristics on mental health problems at P3. Results Data were assessed for representativeness. Children from an ethnic minority, as well as affluent children with mental health problems, suffered from greater attrition. Children’s mental health in Glasgow was similar to the UK, though with heightened levels of hyperactivity at P3. Results showed a widening of inequalities in mental health problems by deprivation: levels of difficulties in children from the most affluent quintile of area deprivation stayed level between the two time points, whilst levels for children from the most deprived quintiles started higher and increased over time. Multilevel models showed evidence of school effects. Significant predictors of mental health problems at P3 included being male, having been under supervision of the state in early childhood, having an abnormal score at Preschool and being in a school with higher levels of Free School Meals (p < 0.01). Conclusion In conclusion, children in Glasgow show a similar pattern of difficulties compared with UK norms, though with increased levels of Hyperacitivity/inattention by P3. Patterns differ for children from different backgrounds, with children who have experienced adversity having increased levels of difficulties by P3. There does seem to be an effect of schools in the first few years, though a large proportion of this variance is accounted for by the demographics of the pupils within them.