‘Grow­ing up’ sur­vey reaches dou­ble dig­its

Ten-year-old study which tracks progress of 19,000 children is cru­cial for pol­icy mak­ers

The Irish Times - Tuesday - Health - - Parenting Child Development - Sheila Way­man

Aquar­ter of our three-year-olds are over­weight or obese; 50 per cent of Ir­ish-born moth­ers don’t even start to breast­feed their ba­bies; 16 per cent of 13-year-olds have drunk al­co­hol, and one in five ado­les­cent girls has self-harmed.

These are just a few of thou­sands of find­ings by the Grow­ing Up in Ire­land (GUI) study – the big­gest and most com­plex so­cial sci­ence project ever to be un­der­taken in this coun­try.

While me­dia head­lines about GUI’s ob­ser­va­tions of the lives of our children come and go, the con­stant avail­abil­ity of the in­for­ma­tion it gath­ers is cru­cial to re­searchers and pol­icy mak­ers. A joint project be­tween the Eco­nomic So­cial Re­search In­sti­tute (ESRI) and Trin­ity Col­lege, Dublin, its an­nual cost to the Depart­ment of Children and Youth Af­fairs is ¤2.5 mil­lion.

The way the study has been track­ing the progress of the same children through child­hood, ed­u­ca­tion and into the start of adult­hood, gives in­valu­able in­sights into the myr­iad fac­tors and cir­cum­stances that shape the path from the cradle on­wards.

The 10th an­nual Grow­ing Up in Ire­land con­fer­ence this Thursday, Novem­ber 8th, will mark a decade of re­search that has evolved from the min­ing of facts and view­points col­lected from a na­tion­ally rep­re­sen­ta­tive spread of children, along with their par­ents and teach­ers. The fo­cus has been on 19,000 children in two age groups – from nine years old and from nine months old – and af­ter the ini­tial gath­er­ing of data, they have been re­vis­ited at key stages.

Former taoiseach Enda Kenny talked about mak­ing Ire­land “one of the best small coun­tries to grow up in and raise a fam­ily”, at the 2014 launch of 160 pol­icy com­mit­ments in a na­tional ac­tion plan for children and young peo­ple, called Bet­ter Out­comes, Brighter Fu­tures. Both it and the up­com­ing first na­tional early years strat­egy to be launched later this month would have drawn heav­ily on the de­tailed picture of child­hood that GUI pro­vides. The State needs to know what’s ac­tu­ally go­ing on in children’s lives be­fore it can hope to find ways to im­prove them.

“His­tor­i­cally, pol­i­cy­mak­ers have been con­demned for shoot­ing in the dark and act­ing from their own anec­do­tal bi­ases maybe,” says Prof James Wil­liams, GUI’s prin­ci­pal in­ves­ti­ga­tor from the out­set un­til his re­tire­ment from the ESRI last July. Now the ev­i­dence base is there to il­lu­mi­nate cour­ses of ac­tion that should pay off both so­cially and eco­nom­i­cally.

Ire­land was very late in com­ing to a lon­gi­tu­di­nal study of its youngest ci­ti­zens. Most if not all other de­vel­oped coun­tries had ones run­ning long be­fore the new mil­len­nium.

Bri­tain em­barked on its first in 1946 and now has four such, large-scale on­go­ing sur­veys. It was 2002 be­fore the gov­ern­ment here an­nounced the set­ting up of the GUI.

“The ab­sence of re­search about the lives of children in Ire­land has led us to rely on in­ter­na­tional ma­te­rial,” the then min­is­ter for children, Mary Hanafin, pointed out at that an­nounce­ment. “This study means that Ir­ish in­for­ma­tion about Ir­ish children can in­flu­ence Ir­ish poli­cies,” she added.

The plan­ning and de­sign of the study took an­other four years be­fore the first phase (2006-2014) be­gan with 8,500 nine-year-olds be­ing re­cruited ran­domly through the pri­mary school sys­tem in 2006/2007.

Not only were in­ter­views con­ducted with the children and their pri­mary and sec­ondary care-givers (as de­fined by fam­i­lies them­selves), but their school prin­ci­pal and class teacher were also asked to fill in ques­tion­naires about them­selves, school re­sources and the child.

These children were rein­ter­viewed at age 13, 17 and now GUI is just about to meet them again at the age of 20. This group was orig­i­nally called the “child co­hort” but, as be­fits their now adult sta­tus, they are also re­ferred to as the ‘98 co­hort – the year most of them were born.

Ba­bies

Mean­while, a sec­ond co­hort of more than 11,000 nine-month-old ba­bies was ran­domly se­lected through the child ben­e­fit regis­ter for a par­al­lel track­ing study. Ob­vi­ously, at that age their par­ents were the source of in­for­ma­tion, with ret­ro­spec­tive de­tails gath­ered about preg­nancy, labour and de­liv­ery, as well as the first months of the baby’s life. The in­fant was weighed, and length and head cir­cum­fer­ence mea­sure­ments taken.

These fam­i­lies were re­vis­ited for in­ten­sive face-to-face in­ter­views when the child was aged three years and again at five years. A postal sur­vey was con­ducted with the main care-givers at ages seven/eight and the GUI’s 180-strong field-work team has just fin­ished in­ter­view­ing them again at nine years of age.

The children have been ac­tively in­volved since age three, when they did cog­ni­tive tests us­ing the in­ter­na­tion­ally recog­nised Bri­tish Abil­ity Scales. At five years, where the children had started school, the prin­ci­pal and class teach­ers par­tic­i­pated in the same way as de­scribed above for the nine-year-olds. This was re­peated at the age of nine, when the GUI also car­ried out the stan­dard­ised Drum­con­dra tests with them.

Prof Wil­liams praises the “tremen­dous com­mit­ment on part of teach­ers and prin­ci­pals” that all this in­volved, along with the “phe­nom­e­nal com­mit­ment” by all the fam­i­lies tak­ing part in GUI. There is no fi­nan­cial renu­mer­a­tion for their par­tic­i­pa­tion, only the sat­is­fac­tion that they are con­tribut­ing to a greater un­der­stand­ing of how to make children’s lives as happy, healthy and re­ward­ing as pos­si­ble.

In ex­plor­ing three do­mains of children’s lives: phys­i­cal de­vel­op­ment and health, ed­u­ca­tion and so­cio-emo­tional be­hav­iour, GUI is try­ing to un­der­stand what dif­fer­en­ti­ates a child in terms of good out­comes and those that are less than pos­i­tive, he ex­plains.

“You take two kids at nine months of age, who start more or less the same length, same weight and maybe by and large the same fam­ily cir­cum­stances. Why is it one kid has gone this way and the other has gone that way?” says Wil­liams, us­ing his arms to in­di­cate di­verg­ing paths, as he sits in the ESRI of­fices off Sir John Roger­son’s Quay in Dublin.

Go­ing back to the same fam­i­lies en­ables anal­y­sis of the children’s de­vel­op­men­tal paths, to iden­tify the turn­ing points. Was there a key fac­tor in maybe their fam­ily cir­cum­stances or ed­u­ca­tion, that would ex­plain sub­se­quent choices and events?

This can in­form pol­i­cy­mak­ers, he ex­plains, about the crit­i­cal pres­sure points in a child’s life, and what to look out for. This is where you might have to put a safety net to catch the kids who are fall­ing – or, prefer­ably, do it be­fore they start fall­ing. “It is bet­ter to put a no­tice at the top of the cliff ‘Warn­ing: Dan­ger’ than to put an am­bu­lance at the bot­tom of the cliff,” he says.

‘In­ter­na­tional pan­demic’

The data has flagged, for in­stance, Ire­land’s place in the “in­ter­na­tional pan­demic” of child­hood obe­sity. Some 26 per cent of children here are ei­ther over­weight or obese.

Wil­liams re­mem­bers be­ing very sur­prised at the level of obe­sity among the three-year-olds – 24 per cent were classed as over­weight or obese. It is only since GUI started do­ing this work that the pro­file of high BMI (body mass index) and obe­sity has re­ally been raised in this coun­try, he sug­gests.

A large part of ap­plied pol­icy re­search like this is to start to make peo­ple aware of is­sues. “Then you have a pub­lic dis­course, it is raised on to the pub­lic agenda; it gets into the pol­icy space and you start to do some­thing about it. It is a slow, it­er­a­tive process.”

With prob­lems such as child­hood obe­sity, you be­gin to see so­cial in­equal­i­ties, he says. There is a much lower risk among children from wealth­ier fam­i­lies or those with higher ed­u­ca­tion or bet­ter work records. It is clear too, he says, that children from dis­ad­van­taged back­grounds have less chance of par­tic­i­pat­ing in sport.

Take also the tran­si­tion to sec­ondary school. GUI has found that by and large 13-year-old kids set­tle in well to sec­ond-level ed­u­ca­tion. How­ever, “un­for­tu­nately you see these in­equal­i­ties – children from more dis­ad­van­taged fam­i­lies have more tran­si­tion prob­lems, even in terms of lik­ing school and lik­ing teach­ers”.

Look­ing back at the study re­sults for nine-year-olds, the like­li­hood of such prob­lems is clearly in­di­cated.

“What you see is the kids who were find­ing it tough at nine years of age are now the kids find­ing it dif­fi­cult at 13 as well. You might say ‘so what’ but I think that is a big is­sue,” stresses Wil­liams. “It shows that the early ex­pe­ri­ence is crit­i­cal and [it’s] about get­ting some­thing done then.”

Look­ing right back to nine months, you may see some­thing that hap­pens, which sends that child’s life into a cu­mu­la­tive spi­ral, he says.

Com­par­i­son of data from nine years and 13 years also highlights the per­sis­tence in over­weight and obe­sity is­sues. “Once that be­hav­iour pat­tern sets in at nine, it is dif­fi­cult to change it.”

For Wil­liams, the most sur­pris­ing set of sta­tis­tics pro­duced by GUI so far was around the breast­feed­ing ini­ti­a­tion rate in the nine-month-old co­hort. They were not only way out of step with sim­i­lar in­ter­na­tional stud­ies but they also il­lu­mi­nated a stark dif­fer­ence be­tween the prac­tices of Ir­ish moth­ers and those not born here but giv­ing birth in Ir­ish ma­ter­nity hospi­tals.

Wil­liams is not sure whether he should ad­mit that be­cause the huge dis­crep­ancy jumped out at him, he asked for a recheck of the data, just to make sure. How­ever, the ev­i­dence was in­con­tro­vert­ible – “if you are a mother born in Ire­land, about 50 per cent of you will ini­ti­ate breast­feed­ing, [if you are a] non-Ir­ish-born mother, 84 per cent of you will breast feed”.

It is also clear that the longer non-Ir­ish-born women live here, the less likely they are to ini­ti­ate breast­feed­ing. “What­ever it is, we seem to en­cul­tur­ate them out of it.”

Breast­feed­ing

This is one trend, says Wil­liams, which marks us out as very dif­fer­ent from, say, New Zealand, Aus­tralia and Bri­tain, where ini­ti­a­tion rates are in the 80s or 90s. In­deed, a Unicef re­port re­leased last May showed that among 123 coun­tries, Ire­land had the low­est rate of “ever breast­feed­ing” – at 55 per cent.

Two years ago, Wil­liams and a number of other GUI col­leagues edited a col­lec­tion of es­says en­ti­tled Cher­ish­ing All the Children Equally? to mark 100 years since the Easter Rising. The book ex­plored the ex­tent to which the prin­ci­ples of equal­ity es­poused by Pa­trick Pearse in the Procla­ma­tion out­side the GPO were re­flected in the out­comes and well­be­ing of all groups of children in 2016.

The an­swer to its ti­tle, on the ba­sis of ev­i­dence pre­sented by GUI, must be “no”, its edi­tors con­cluded. Al­though they ac­knowl­edged that a huge amount of progress had been made, par­tic­u­larly since the 1970s, in health, ed­u­ca­tion, sup­ports for fam­i­lies and children’s rights.

Wil­liams is keen to make clear that it’s not a ques­tion of good par­ent­ing or bad par­ent­ing, but rather ac­cess to re­sources that largely drives good and bad out­comes for children, eg their fam­i­lies’ fi­nan­cial cir­cum­stances or the home-learn­ing en­vi­ron­ment. What GUI at­tempts to do is to in­di­cate how the State might be able to help level the play­ing field – and, in the long-term, show the ef­fec­tive­ness of such in­ter­ven­tions.

If, as hoped, fur­ther fund­ing for GUI is se­cured af­ter the end of the sec­ond phase (2014-2019), the older half of it will no longer be a study of children.

But if you want to un­der­stand the im­por­tance of sup­ports in child­hood, you want to track the im­pact into adult­hood, says Wil­liams who, hav­ing given more than a third of his work­ing life to GUI, has handed over the reins to Prof Dorothy Wat­son and Prof Emer Smyth.

Min­is­ter for Children and Youth Af­fairs Kather­ine Zap­pone in a state­ment to The

Ir­ish Times, says she is com­mit­ted to en­sur­ing the fu­ture of the “hugely ben­e­fi­cial” Grow­ing Up in Ire­land study. Work is al­ready un­der way on plan­ning for the next phase, “sub­ject to the nec­es­sary Gov­ern­ment ap­proval and fund­ing”.

GUI has, she adds, “gen­er­ated a com­pre­hen­sive bank of sci­en­tif­i­cally sound and pol­icy-rel­e­vant ev­i­dence to help in­form the de­vel­op­ment and im­ple­men­ta­tion of ef­fec­tive poli­cies, ser­vices and in­ter­ven­tions. This is vi­tal, given my depart­ment’s com­mit­ment to im­prov­ing the lives of children and their fam­i­lies through an ev­i­dence-in­formed ap­proach.”

PHO­TO­GRAPH: ISTOCK

Children from dis­ad­van­taged back­grounds have less chance of par­tic­i­pat­ing in sport.

PHO­TO­GRAPH: ALAN BETSON

Prof James Wil­liams of the ESRI says it’s not good par­ent­ing or bad par­ent­ing, but ac­cess to re­sources that largely drives good and bad out­comes for children.

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