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

2. Todays presentation Background to the study Health inequalities in the early years School readiness Formal and informal support for parents Discussion

3. Discussion questions 1.Are these findings useful, or not? 2.Do they confirm your experience, or not? 3.Do the findings have any implications for the way that services are resourced and/or delivered? 4.Who else needs to know about these findings and how should we communicate them?

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

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 Age at interview Year0-11-22-33-44-55-66-77-8 2005BC1 (5217) CC1 (2858) 2006BC1 (4512) CC1 (2500) 2007BC1 (4191) CC1 (2331) 2008BC1 (3994) CC1 (2200) 2009BC1- 2010BC1- 2011BC2- 2012-BC1

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. Study content: Other topics covered in the interview 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

10. 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) Health inequalities in the early years

11. 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 Risk factors for poor health

12. Area deprivation Inequalities in pregnancy

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

14. Total number of negative outcomes

15. Child factors –Being a girl Maternal factors –Not experiencing a long-term condition in childs 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 What might help disadvantaged children avoid negative outcomes?

16. Childrens 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? What is the relationship between early behaviour (at pre-school) and later behaviour? 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)

17. % of children with moderate or severe difficulties

18. Patterns of shared difficulties Cluster 1 – 17%: Low pro-social scores, but average scores for difficulty scales Cluster 2 – 37%: High pro-social scores, low scores on 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 Emotional symptoms Conduct problems Hyper- activity Peer problems Lone parent Lower income Poorer health Harsh discipline Low parent interaction Fewer social visits Less than 2 siblings Lower income Poorer health Develop- mental delay Male Lower income Poorer health Younger mother Low parent interaction Fewer social visits Speech probs age 2 Non-white mother Speech probs age 2

20. Classification at pre-school by classification at primary school entry Row percentages Classification of score at entry to primary school Classification of score at pre-school (age 46 months) NormalBorderlineAbnormal Conduct problems Normal(%) 85114 Borderline(%) 572519 Abnormal(%) 312742 Emotional symptoms Normal(%) 9154 Borderline(%) 651817 Abnormal(%) 461539

21. 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. Summary of findings

22. 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 Childrens 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 ? Conclusions from maternal mental health report

23. Support for parents – formal and informal

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

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

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 dont 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 childs life.

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

28. 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. 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