Abstract
BackgroundDifferent configurations of family adversity affect children’s socio-emotional development differently; however, we lack knowledge of moderators amenable to policy intervention. This study explored whether early childhood centre-based childcare moderated the impact of family adversity configurations on socio-emotional development.MethodsData were from the Growing Up in Scotland first birth cohort, born 2004–05. Latent class analysis of 19 early childhood family adversity indicators identified four classes: ‘Low Risk’ (68%), ‘Poor Maternal Health’ (16.5%), ‘Economic Hardship’ (10.0%) and ‘Multiple Adversities’ (5.5%). Latent growth models of externalizing and internalizing symptom trajectories (age 46–152 months, n = 3561) by family adversity controlled for confounding. Moderation by centre-based childcare use was examined through stratification.ResultsCompared to ‘Low Risk’, high-risk classes had more externalizing and internalizing symptoms and internalizing symptoms increased at a faster rate, with ‘Multiple Adversities’ faring worst. The effects of ‘Economic Hardship’ on change in externalizing symptoms over time varied by childcare (P = 0.035): relative to the Low Risk group, symptoms increased (+0.04 points/year) among those not using childcare, and decreased (–0.09 points/year) among those who did. The effect of ‘Multiple Adversities’ on internalizing symptoms also varied (P = 0.034): +0.12 without centre-based childcare; +0.33 with centre-based childcare (patterns were similar for externalizing symptoms but with wide confidence intervals). No moderation was found by ‘Poor Maternal Health’.ConclusionsCentre-based childcare may alleviate disadvantages in socio-emotional wellbeing for children experiencing mainly economic hardship, but may exacerbate them for those experiencing multiple adversities. A better understanding of how early years’ services can support families with complex needs is required.
Highlights
Cumulative childhood adversity including economic stress, disruptive family processes and poor parental mental health is associated with behavioural and emotional difficulties for children and poorer mental health in adulthood. 1-3 Yet despite the compelling evidence base in relation to cumulative adversity, the assumption that risk factors are additive and interchangeable 4 limits our understanding of appropriate policy tools to support families experiencing different combinations of social adversity and reduce inequalities in socio-emotional outcomes
The effect of ‘Multiple Adversities’ on internalising symptoms varied (p=0.034): +0.12 without centre-based childcare; +0.33 with centre-based childcare
Centre-based childcare may alleviate disadvantages in socio-emotional wellbeing for children experiencing mainly economic hardship, but may exacerbate them for those experiencing multiple adversities
Summary
Cumulative childhood adversity including economic stress, disruptive family processes and poor parental mental health is associated with behavioural and emotional difficulties for children and poorer mental health in adulthood. 1-3 Yet despite the compelling evidence base in relation to cumulative adversity, the assumption that risk factors are additive and interchangeable 4 limits our understanding of appropriate policy tools to support families experiencing different combinations of social adversity and reduce inequalities in socio-emotional outcomes. The main aim of this study is to investigate centre-based childcare as a moderator of associations between different patterns of family adversity in early childhood and children’s later socio-emotional outcomes, using a nationally representative population sample. Formal early childhood education and care (ECEC) offered by centre providers such as nurseries, playgroups or family centres may benefit children’s development. Greater clarity is needed on differential benefits and harms of centre-based childcare, especially as family disadvantage is often complex and multidimensional. Different configurations of family adversity affect children’s socio-emotional development differently: we lack knowledge of moderators amenable to policy intervention. This study explored whether early childhood centre-based childcare moderated the impact of family adversity configurations on socio-emotional development
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