Bristol Social Adjustment Guide Research Articles

Estimating the late-life effects of social and emotional skills in childhood using midlife mediators

Social and emotional skills are known to affect health and non-health outcomes, but there is limited evidence on whether these skills in childhood affect late life outcomes because of a shortage of long-running datasets containing this information. We develop a three-stage procedure and use it to estimate the effect of childhood social and emotional skills on health and labour market outcomes in late-life. This procedure makes use of mediators in midlife which are shown to be predicted by childhood skills in one dataset and to predict late-life outcomes in another dataset. We use this method to combine estimates from the National Child Development Survey and the British Household Panel Survey. We find that childhood skills predict marital status, education, home ownership, income and health at age 46 years and these midlife variables predict levels of quality-adjusted life years and labour income accumulated by age 63 years. The combined estimates suggest a standard deviation increase in average Bristol Social Adjustment Guide total score at ages 7 and 11 is associated with 4.2% (standard error = 0.6%) additional quality-adjusted life years and more than 9.9% (£14,539, standard error = £2072) additional accumulated pre-tax earnings by age 63 years. Therefore, childhood interventions to increase social and emotional skills would be expected to reduce future healthcare costs and increase wealth. Our three-stage methodology can be used to predict the life-course effects of investments in childhood skills by combining results from datasets across population cohorts.

Physical Inactivity From Childhood to Adolescence and Incident Depression

The long-term impact of physical activity during early life on the risk of depression in later stages of adulthood remains unclear. This study examines the association between physical activity during childhood and adolescence and the incidence of depressive symptoms in early, middle, and late adulthood. Data from a birth cohort (the 1958 National Child Development Survey), including births (N=17,415) in England, Wales, and Scotland, were used. After birth, 11 more follow-ups were carried out between ages 7 and 62 years (2020). Leisure-time physical activity was assessed through a self-reported questionnaire. Psychological measures were assessed with the teacher-rated Bristol Social Adjustment Guide, the teacher-rated Rutter scale, and the self-rated Malaise Inventory. Leisure-time physical activity and psychological symptoms were examined in all the 11 follow-up assessments included in this study. Best-fit model was used to obtain hazard ratios and 95% CIs of depression symptoms by physical activity status in different ages, including demographic, behavioral, and health-related variables as potential confounders. After multivariate analysis, being physically active at age 16 years reduced the risk of incident elevated depressive symptoms (hazard ratio=0.73, 95% CI=0.62, 0.85) throughout adulthood. The long-term impacts of physical activity practiced at age 16 years persisted throughout adulthood up to age 62 years. Adolescence is a critical early-life period to promote physical activity for reducing the incidence of elevated depressive symptoms throughout adulthood. Public health policies should promote healthy lifestyles during the lifespan to reduce both the burden of physical inactivity and depressive symptoms at the population level.

Absence of Association between Behavior Problems in Childhood and Hypertension in Midlife.

BackgroundIt is known that behavior in childhood is associated with certain physical and mental health problems in midlife. However, there is limited evidence on the role of childhood behavior problems in the development of hypertension in adulthood. The present study aimed to examine whether behavior problems in childhood influenced the risk of hypertension in midlife in the United Kingdom 1958 birth cohort.MethodsThe 1958 British birth cohort comprised 17,638 individuals born in the first week of March 1958 in the United Kingdom. Behavior problems were assessed at 7, 11, and 16 years of age by parents and teachers. At age 45, blood pressure was measured and hypertension was recorded if blood pressure was ≥140/90 mm Hg or if the participants were informed by their health professionals that they had high blood pressure. Behavioral information was reported according to the Rutter Children’s Behaviour Questionnaire (RCBQ) and the Bristol Social Adjustment Guide (BSAG). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine behavior problems in childhood in relation to hypertension at 45 years of age according to logistic regression analysis, with adjustment for sex, social class in childhood and adulthood, childhood cognition, birth weight, gestational age at birth, body mass index (BMI), smoking, alcohol consumption, and physical activity.ResultsBehavior problems reported by parents at 7, 11, and 16 years were not associated with hypertension in midlife (OR, 0.93; 95% CI, 0.81, 1.07; OR, 0.95; 95% CI, 0.81, 1.11; OR, 0.98; 95% CI, 0.85, 1.12, respectively). Similarly, teacher-reported behavior problems at 7, 11, and 16 years were not associated with hypertension in midlife (OR, 0.92; 95% CI, 0.72, 1.18; OR, 0.92; 95% CI, 0.84, 1.02; OR, 1.03; 95% CI, 0.92, 1.15, respectively). Further separate analyses showed similar results for males and females.ConclusionThere is no association between behavior problems in childhood and hypertension in midlife.

P22 Childhood socioeconomic position and adult smoking: are childhood cognitive ability, psychosocial adjustment and parental involvement important?

BackgroundStudies have shown that childhood socioeconomic position (SEP) is related to smoking in adulthood, independent of adult SEP. Educational attainment partially mediates this association; however, previous studies suggest three childhood...

Health and social precursors of unemployment in young men in Great Britain.

To identify health and socioeconomic factors in childhood that are precursors of unemployment in early adult life and to examine the hypothesis that young men who become unemployed are more likely to have accumulated risks to health during childhood. Longitudinal birth cohort study. The amount of unemployment experienced in early adult life up to age 32 years was the outcome measure used. Exposure measures to indicate vulnerability to future ill health were: height at age 7 years and the Bristol social adjustment guide (BSAG) at age 11 years, a measure of behavioural maladjustment. Socioeconomic measures were: social class at birth, crowding at age 7, qualifications attained before labour market entry, and region of residence. Great Britain. Altogether 2256 men with complete data from the national child development study (NCDS). The NCDS has collected data on all men and women born in one week in 1958 and has followed them up using interviews, self completion questionnaires, and medical examinations at birth and at ages 7, 11, 16, 23 and 33 years. A total of 269 men (11.9%) experienced more than one year of unemployment between ages 22 and 32 years. Poor socioeconomic conditions in childhood and a lack of qualifications were associated with an increased risk of unemployment. Geographical region was also significant in determining the risk of unemployment. Men with short stature and poor social adjustment in childhood were more likely to experience unemployment in adult life, even after controlling for socioeconomic background, education, and parental height. These differences remained when those with chronic childhood illnesses were excluded from the analysis. The adjusted relative odds for experiencing more than one year of unemployment between ages 22 and 32 years for men who were in the top fifth of the BSAG distribution (most maladjusted) compared with those in the bottom fifth were 2.36 (95% CI 1.49, 3.73). The adjusted relative odds for experiencing more than one year of unemployment between ages 22 and 32 years for men who were in the bottom fifth of the distribution of height at age 7 years (indicating slowest growth) compared with those in the top fifth, were 2.41 (95% CI 1.43, 4.04). Adult height was not significantly associated with unemployment. The relationship between unemployment and poor health arises, in part, because men who become unemployed are more likely to have accumulated risks to health during childhood, reflected by slower growth and a greater tendency to behavioural maladjustment. Short stature in childhood is a significant indicator of poor socioeconomic circumstances in childhood and reflects earlier poor development.

Screening for Behaviour Problems in a School for Pupils with Moderate Learning Difficulties

Summary Reference is made to the variety of attempts to identify the nature and seriousness of pupils’ behaviour problems in school. A three‐year study is reported, in which the Bristol Social Adjustment Guide is used for this purpose in a special school for pupils aged 11‐16 years who have moderate learning difficulties. Systematic follow‐up enabled the incidence of reported problems to be significantly reduced. This result suggests that a school with difficulties can be assisted to develop strategies through which teaching staff can increasingly help themselves. This article examines these papers which lay out proposals for future legislation with particular reference to the statementing procedure established by the 1981 Education Act.

The social and emotional adjustment of hearing‐impaired children integrated in primary schools

Summary The Bristol Social Adjustment Guide and the Rutter Children's Behaviour Questionnaire were administered to 23 hearing‐impaired children, with a mean loss of 66.7 dB and aged between 4.3 and 10.9 years, integrated into ordinary schools, and 23 hearing controls. They comprised the entire norvadditionally handicapped, hearing‐impaired primary‐age population of Stockport. High levels of maladjustment were found among the hearing‐impaired (43.5 per cent) on the Bristol and also among the hearing controls (30.4 per cent). No child was found to be maladjusted on the Rutter. The difference in the two tests’ scores suggests that they measure different behaviours, and that the problems are broadly ‘social’ rather than ‘emotional’. There were no significant differences in adjustment between the two groups.

Early influences on the school social adjustment of twins.

The birth of twins is often accompanied by complications which may affect both twins equally (eg, prematurity) or which may establish differences between the twins (eg, one coming home from hospital first). Parents' ratings of behaviour may reflect and even perpetuate the influence of such variables and it is of interest to see if people less familiar with the twins' history can observe any long-term effects. In the La Trobe Twin Study teachers routinely complete the Bristol Social Adjustment Guide, an assessment of social maladjustment in children aged 5-16 years. Extreme prematurity and problems at delivery were generally associated with the Underreaction syndrome--the child who is unforthcoming, withdrawn and depressed. Withdrawal, depression and maladaptive behaviour to classroom peers were much more common among those twins discharged from hospital after the cotwin. A major mediating factor was that the parents admitted to greatly preferring the one to come home first. These raise questions both about the practice of bringing twins home separately (which occurred in 21% of the cases) and about intervening variables in studies of personality and temperament.

Social and emotional adjustment of hearing‐impaired children in ordinary and special schools

Summary Previous studies using teacher questionnaires have found a higher prevalence of maladjustment among hearing‐impaired compared with hearing children. Results from the Bristol Social Adjustment Guide (BSAG) and Rutter Children's Behaviour Questionnaire (RCBQ) are reported for 42 children aged seven to 16 years with sensori‐neural losses (mean 45.64 dBHL) born in Manchester who were attending ordinary schools. Prevalence rates on the BSAG are lower than those reported in previous studies with the hearing‐impaired including their special school peers and compare favourably with rates for hearing children. Although a higher prevalence rate was found on the RCBQ, it is lower than that for their special school peers. The relationship between maladjustment and other measures is discussed. The most frequently marked items on the scales are compared with those for their special school peers. The relevance of such studies to the integration of hearing‐impaired children in ordinary schools is outlined.

Possible personality problems among 10-year-old spina bifida children.

Forty-four 10-year-old spina bifida children and 52 non-disabled controls completed the Rogers Personal Adjustment Inventory and their teachers assessed their school behaviour on the Bristol Social Adjustment Guide. Spina bifida children and the controls had similar school adjustment scores but the former appeared to have significantly more emotional problems on the Rogers Inventory suggesting that they have private worries not revealed by characteristic behaviour in school. Factors associated with apparent emotional upset are considered and implications for support discussed.

The social and educational adjustment of abused children

Thirteen 6-year-old children who had been physically abused by their parents were assessed in school for language development, educational attainments and social adjustment, and compared with children from some of the same school classes who served as a comparison group. All the abused children had attended the Family Centre of the National Society for the Prevention of Cruelty to Children (NSPCC) in Manchester before starting school, and they and their parents had received social work support and supervision from the special unit team. Ten of the 13 abused children had made measurable progress in reading. There were no significant differences between the groups in language development or number skills, but the abused group did contain more high (maladjusted) scores on the Bristol Social Adjustment Guide. Monitoring educational progress and social adjustment in school would seem to be a useful method of following the progress of such children. Most of the children in this group are so far making progress within the ordinary school system despite the disturbances which have affected their home life.

Behaviour problems in children followed from 5 to 8 1/2-9 years of age and their relation to educational attainment.

Children from a cohort of consecutive births identified with behaviour problems by the Richman Screening Questionnaire at the age of 5 years continued to have behaviour problems, as assessed by the Rutter parental questionnaire and the Bristol Social Adjustment Guide, more frequently at the age of 8 1/2-9 years than matched control children. No difference between the groups in non-verbal IQ was identified by the Pidgeon Non-Verbal Test BD. The Neale Test of Reading Ability showed delays of 5 months for both accuracy and comprehension for the study group compared with the controls. These results confirm the recent findings of Richman and others (1982) in a different setting.

The Bristol Social Adjustment Guide: comparison between the offspring of alcoholic and non-alcoholic mothers.

A German translation of the BSAG was completed by class-teachers of children whose mothers had a history of alcoholism. These children were judged as showing significantly more over-reactive behaviour in school than a control group of children whose mothers had no previous alcohol abuse. Furthermore, the alcoholic mothers also reported more over-active behaviour in their own childhood. The results are supportive of retrospective studies with adult alcoholics which indicate that childhood hyperactivity may be one precursor of subsequent alcohol abuse.

Children's behaviour and the BSAG: Some theoretical and statistical considerations

The 12 syndromes of the Bristol Social Adjustment Guide were factor analysed using data obtained on some 14000, 11 year olds. Separate analyses carried out for six social class and two sex categories revealed two very stable factors. These were discussed in relation to factors found in other similar analyses.Certain theoretical and empirical limitations and problems were pointed to and it was suggested that within the context of these, the factors provide simple and parsimonious descriptions of classroom behaviour and might be of value in future research.

Inconsequence as a primary type of behaviour disturbance in children.

Summary. In previous studies Stott proposed a type of behaviour disturbance which he named Inconsequence—a failure to reflect upon the consequences of responses resulting in impulsive and often inappropriate behaviour. This article reports (1) an external validation against teacher‐judgment of 30 items of the Bristol Social Adjustment Guide hypothesized as indicating Inconsequence; (2) an item‐analysis of the proposed 30 indications, of which 26 were judged acceptable; (3) a comparison of the performance of Inconsequential and control children on a test of motor impairment, showing them to be significantly inferior.

THE INCIDENCE AND NATURE OF MALADJUSTMENT AMONG CHILDREN IN SCHOOLS FOR THE EDUCATIONALLY SUBNORMAL

Summary. An investigation has been carried out into the incidence, nature and aetiology of maladjustment among children in special schools for E.S.N. children in South Wales. This article discusses the findings of the first stage of the enquiry, in which detailed information was obtained about the incidence and nature of maladjustment, in the school situation, among 169 E.S.N. pupils and the same number of children in ordinary schools, matched for age, sex and socio‐economic background. The E.S.N. pupils were a complete sample of two age groups (9+ to 10+ and 13+ to 14+) in eight special schools.The E.S.N. pupils came predominantly from the lower social strata. They had more physical ailments and defects than the controls. On the basis of the Bristol Social Adjustment Guide, over a third of the E.S.N. children were maladjusted, nearly three times as many as in the control group. The E.S.N. children showed considerably more symptoms of depression, hostility towards adults, inhibition and emotional tension than the controls. There was also a higher incidence of speech defects, unsatisfactory attendance at school, delinquency and behaviour associated with delinquency in the E.S.N. sample. Maladjustment among the E.S.N. children was often associated with low sociometric status.These findings underline the importance of attention to the emotional and social needs of E.S.N. children.