Family Socioeconomic Disadvantage Research Articles

Maternal and paternal overprotection of children born preterm: Relations to child and parental factors.

The purpose of this study was to investigate the correlates of observed overprotective behaviors of mothers and fathers of preterm-born preschoolers. Participants included 85 children born prematurely (gestational age <37 weeks) and their parents, assessed when children were 12, 24, and 42 months old. Observed overprotection was measured through the standardized observation of a parent-child interaction. The examined correlates included parent-reported perception of their protective behavior, parental gender, child neonatal risk, child development, parent-reported perception of child vulnerability, parent-reported psychological distress, and family's socioeconomic disadvantage. Results revealed that the correlation between parent-reported and observed parental overprotection was not significant for mothers and fathers. There was a significant positive association between maternal and paternal observed overprotection and no significant differences between mothers' and fathers' overprotection levels. Lower child developmental level and more socioeconomic disadvantage at child's 12 months of age were significant predictors of observed overprotective behaviors. Findings suggest the importance of targeting parents of preterm-born children with socioeconomic disadvantages and whose children have a lower developmental level for providing support to both mothers and fathers in the development of more adaptive parenting strategies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Increased Risk of Parental Instability for Children Born Very Preterm and Impacts on Neurodevelopmental Outcomes at Age 12.

Caring for a child born preterm places significant emotional and financial burdens on family relationships. This paper examines (a) the extent to which children born very and extremely preterm are more likely to experience parental change/caregiver instability than children born full term, (b) predictors of parental change/s for preterm infants, and (c) whether exposure to parental change/caregiver instability increases child neurodevelopmental risk. Data were collected as part of a prospective longitudinal study of 110 very preterm and 113 full-term born infants and their parents studied from birth to corrected age 12 years. At ages 2, 4, 6, 9 and 12 years, detailed information was collected about the frequency and nature of all parent/caregiver changes for 3–6 monthly intervals of each child’s life. At age 12, all children completed a comprehensive neurodevelopmental evaluation of their emotional and behavioural adjustment, cognition, and educational achievement. Results showed that children born very preterm were at increased risk of experiencing parental/caregiver changes, with this risk being greatest for those born extremely preterm. Neonatal medical complexity, family socioeconomic disadvantage, maternal psychological wellbeing, and child neurodevelopmental impairment were associated with a higher risk of parental change. Preterm birth and exposure to parental change/instability contributed additively to poorer child outcomes. Findings support the need for family-focused neonatal and postnatal care strategies for high-risk infants, to support parents as well as their infants to optimize child health and developmental outcomes.

Predictors in Infancy for Language and Academic Outcomes at 11 Years.

To examine the contribution of early life factors and preschool- and school-aged language abilities to children's 11-year language and academic outcomes. Participants (N = 839) were from a prospective community cohort study of 1910 infants recruited at 8 to 10 months of age. Early life factors included a combination of child (prematurity, birth weight), family (socioeconomic disadvantage, family history of language difficulties), and maternal factors (education, vocabulary, and age). Language (standardized assessment of receptive and expressive skills) and academic (national assessment) outcomes at 11 years were predicted by using a series of multivariable regression models. Early life factors explained 11% to 12% of variance in language scores at 11 years. The variance explained increased to 47% to 64% when language scores from 2 to 7 years were included. The largest increase in variance explained was with 4-year language scores. The same early life factors explained 13% to 14% of academic scores at 11 years, with increases to 43% to 54% when language scores from 2 to 11 years were included. Early life factors adequately discriminated between children with typical and low language scores but were much better discriminators of children with typical and low academic scores. When earlier language scores were added to models then the area under the curve increased to 0.9 and above. Children's language outcomes at 11 years are accurately predicted by their 4-year language ability and their academic outcomes at 11 years are predicted by early family and home environment factors. Children with low language abilities at 11 years consistently performed more poorly on national assessments of literacy and numeracy.

Multilevel prenatal socioeconomic determinants of Mexican American children's weight: Mediation by breastfeeding.

Objective: Mexican American (MA) children are more likely to grow up in poverty than their non-Hispanic/Latinx white peers and are at an elevated risk for early onset obesity. The current study evaluated the effects of prenatal family- and neighborhood-level disadvantage on children's weight and weight gain from 12 months through 4.5 years of age. Maternal breastfeeding duration was evaluated as a potential mechanism underlying the relation between multilevel disadvantage and weight. Methods: Data was collected from 322 low-income, MA mother-child dyads. Women reported the degree of family socioeconomic disadvantage and breastfeeding status. Neighborhood disadvantage was evaluated with census-level metrics. Children's weight and height were measured at laboratory visits. Results: Greater prenatal neighborhood disadvantage predicted higher child Body Mass Index (BMI) at 12 months, over and above family-level disadvantage; this effect remained stable through 4.5 years. Breastfeeding duration partially mediated the effect of neighborhood disadvantage on child BMI. Breastfeeding duration predicted child BMI at all timepoints. Conclusions: Maternal prenatal residence in a neighborhood with high concentrated disadvantage may place low-income, MA children at increased risk of elevated weight status during the first few years of life. Breastfeeding duration emerged as potentially modifiable pathway through which the prenatal neighborhood impacts children's early life weight. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Is poverty on young minds? Stereotype endorsement, disadvantage awareness, and social-emotional challenges in socioeconomically disadvantaged children.

Socioeconomic disadvantage is associated with social-emotional difficulties, including internalizing and externalizing problems, as early as toddlerhood. The aim of the current study was to understand whether economically disadvantaged children's beliefs about the consequences and correlates of poverty (poverty stereotypes) and their beliefs about their personal economic disadvantage contribute to their social-emotional functioning. Interviews were conducted with 94 socioeconomically diverse 4- to 9-year-old children, whose parents reported on their social-emotional functioning and family socioeconomic disadvantage. As hypothesized, among relatively socioeconomically disadvantaged children, perceived disadvantage was associated with social-emotional functioning. The same relation was not found for relatively socioeconomically advantaged children. Socioeconomically disadvantaged children who endorsed higher levels of personal disadvantage had more attention problems and more anxious-depressive symptoms than socioeconomically disadvantaged children who endorsed lower levels of personal disadvantage. In addition, only among socioeconomically disadvantaged children (and not among relatively advantaged children) was negative stereotyping associated with attention problems. Socioeconomically disadvantaged children who endorsed more negative stereotypes had higher levels of attention problems. There was no evidence of an association between negative stereotyping and anxious-depressive symptoms and no moderation of this relation by socioeconomic status. Implications and directions for future research are discussed in light of several relevant theoretical frameworks, including stigma consciousness, status anxiety, and critical consciousness. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Learning outcomes of children with teacher-identified emerging health and developmental needs.

Children's additional health and developmental needs are often first identified by teachers when they begin school. This study estimates the Grade 3 literacy and numeracy outcomes of children with teacher-identified additional needs emerging in the first year of school, including the added burden conferred by socioeconomic disadvantage. Population linked data (n = 42,619) were analysed from the Australian Early Development Census, which include teacher reports on children's health and development at school entry, and the National Assessment Program-Literacy and Numeracy, a direct assessment of reading and numeracy skills at Grade 3. Linear regression analyses were used to estimate associations between emerging needs and learning outcomes, adjusted for sociodemographic characteristics. The combined effect of emerging needs and low maternal education (an indicator of socioeconomic disadvantage) on academic outcomes was examined by estimating the relative excess risk due to interaction (RERI). Emerging health and developmental needs at school entry were associated with lower reading (b = -26.86, 95% CI = -29.19, -24.52) and numeracy (b = -24.39, 95% CI = -26.43, -22.35) outcomes at Grade 3. The combined effect of emerging needs and socioeconomic disadvantage was greater than expected when their individual effects are summed (RERI = 0.38, 95% CI 0.22, 0.55 for reading and RERI = 0.27, 95% CI 0.10, 0.43 for numeracy). In the current study, emerging health and developmental needs identified by teachers at the outset of schooling were associated with poorer literacy and numeracy skills at Grade 3, and family socioeconomic disadvantage appeared to further amplify this effect. Meeting the needs of these children will require timely and coordinated supports across the health and education systems, particularly for those children who are also disadvantaged.

Parental socioeconomic resources and adverse childhood experiences as predictors of not in education, employment, or training: a Finnish register-based longitudinal study

ABSTRACT Socioeconomic disadvantage in childhood is common among youth not in education, employment or training (NEETs). However, the evidence on other adverse childhood experiences as determinants of NEET remains scarce. We use Finnish longitudinal register data on a 20% random sample of households with 0–14-year-old children in 2000 to assess the childhood determinants of NEET. For an analytical sample of 99,137 children born 1986–1993, family socioeconomic resources, parental psychiatric disorders and substance abuse, parental death, living in a single-parent household and out-of-home placement under age 13 were used to predict NEET at the age of 18. We show that family socioeconomic disadvantage is strongly associated with NEET (e.g. odds ratio for parental basic education 5.33, 95% confidence interval 4.77, 5.95), whereas associations between adverse childhood experiences and NEET are more moderate (e.g. odds ratio for parent hospitalised for psychiatric disorder 1.86, 95% confidence interval 1.63, 2.12) and largely explained by socioeconomic factors. These associations were mostly similar by gender. The results suggest that parental socioeconomic resources are more important than adverse childhood experiences for the educational and employment transitions of young adults. Thus, supportive social policy for socioeconomically disadvantaged families may smooth these transitions.

Responsive Parenting Behaviors and Cognitive Function in Children With Sickle Cell Disease.

Children with sickle cell disease (SCD) are at increased risk for cognitive impairment as a result in part from biological characteristics of the disease; however, limited research has explored possible social and contextual factors associated with risk for cognitive problems. The primary aim of the present study was to examine the relation between children's cognitive functioning and responsive parenting, a potentially important contextual factor in children with SCD, accounting for family socioeconomic disadvantage, child disease severity, and caregivers' perceived stress. Forty-eight children completed standardized cognitive assessments and caregivers provided self-reports of general and disease-related stress. Parent-child dyads completed a video recorded puzzle-solving task and observed parenting was quantified using two coding systems. Bivariate Pearson correlations were used to assess preliminary hypotheses, and linear multiple regression analyses were used to assess the primary hypothesis. Results suggested that increased levels of parental stress were related to fewer observations of responsive parenting and provided evidence of an association between children's cognitive function and responsive parenting. Specifically, increased disease-related parent stress and reduced parental use of expansive language were associated with significantly lower cognitive functioning in children with SCD. Findings suggest that social environmental factors along with disease characteristics are sources of risk for cognitive problems with children with SCD. Further, these findings highlight the need to develop targeted interventions for parents of children with SCD to decrease levels of stress and enhance parenting skills, with the aim improving cognitive functioning in youth.

The role of the physical environment in adolescent mental health.

The existing literature suggests an association between the physical environment and mental health but also complex relationships between the social and the physical environment as well as between objective and subjective measures of the environment. In this study, we attempted to explore the role of the residential neighbourhood's physical environment in adolescent mental health, taking this complexity into account. Using data on 3683 ten- to 15-year-olds from England and Wales who participated in Understanding Society, we investigated the role of neighbourhood greenspace and air pollution in adolescent mental health (measured with the Strengths and Difficulties Questionnaire) while controlling for measures of neighbourhood and family socio-economic disadvantage as well as subjective perceptions of social cohesion, crime, safety, and noise in the neighbourhood. In linear regression models, greenspace and air pollution could not predict mental health. However, fear of being a victim of crime was a consistent predictor of mental health and behaviour, indicating the essential role of young people's subjective experience of their neighbourhoods for their mental health and well-being.

Being a mother of preterm multiples in the context of socioeconomic disadvantage: perceived stress and psychological symptoms

ObjectiveThis study aimed to examine the differences between mothers of preterm multiples and mothers of preterm singletons regarding perceived stress and maternal psychological symptoms, and to explore the putative adverse amplified effect of socioeconomic disadvantage. MethodNinety‐five mothers of 1‐year‐olds born preterm participated in this cross‐sectional study. Data collection was carried out in two public hospitals from Northern Portugal. To assess maternal perceived daily stress and psychological symptoms, mothers completed two questionnaires. Mothers reported on socioeconomic factors, including family poverty, parent unemployment, and low education, and two groups of family socioeconomic disadvantage were created. A child medical risk index was calculated. ResultsResults indicated that mothers of preterm multiples reported higher levels of stress than mothers of preterm singletons. Moreover, and specifically regarding psychological functioning, mothers of preterm multiples reported more symptoms than mothers of preterm singletons, but only when living in a context of socioeconomic adversity. ConclusionsThe results of the present study have important implications for practice. Mothers of preterm multiples are at higher risk to present mental health difficulties, in comparison to mothers of singletons, especially when exposed to socioeconomic adversities. The development of psychosocial intervention programs and public policies are of decisive importance in helping mothers of multiples adjust to parenthood.

Socioeconomic disadvantage and psychological deficits: Pathways from early cumulative risk to late-adolescent criminal conviction

Early exposure to multiple risk factors has been shown to predict criminal offending, but the mechanisms responsible for this association are poorly understood. Integrating social-environmental and dispositional theories of crime this research investigated the capacity of family socioeconomic disadvantage and individual psychological deficits to mediate the association between childhood cumulative risk and late adolescent criminal convictions. Male participants in the 1986 Northern Finland Birth Cohort Study (n = 3414) were followed from the prenatal period through age 19–20. The data were analyzed by estimating a structural equation model of the hypothesized pathways. The results found support for both processes of influence, and the model sustained a statistically significant direct effect of cumulative risk on crime. Socioeconomic disadvantage and psychological deficits contribute to criminal offending independently and with roughly equal magnitude. The results point to the utility of both environmental and psychological interventions to prevent criminality among children at risk.

John Henryism Coping and Metabolic Syndrome Among Young Black Adults.

The aim of the study was to test the novel hypothesis that, among black Americans who used John Henryism coping, those from low socioeconomic status backgrounds would be more likely to develop metabolic syndrome than those from higher socioeconomic backgrounds. This is an ancillary analysis of Strong African American Families Healthy Adult Program, a longitudinal cohort of 391 black youths and their caregivers. From ages 11 to 18 years, family socioeconomic status was assessed. At age 25 years, John Henryism was assessed, blood samples were drawn, and measurements were taken of blood pressure and waist circumference. Metabolic syndrome status was based on International Diabetes Federation guidelines. A significant interaction emerged between family socioeconomic disadvantage and John Henryism coping in predicting metabolic syndrome diagnosis (odds ratio = 1.047, 95% confidence interval = 1.004-1.091). Participants who were high in John Henryism coping were more likely to display metabolic syndrome if they were from disadvantaged backgrounds (predicted prevalence of 26.7%) than if they were from more privileged backgrounds (predicted prevalence of 9.6%). These patterns illustrate for the first time that John Henryism coping can undermine cardiometabolic health among black youths from disadvantaged backgrounds.

Being a mother of preterm multiples in the context of socioeconomic disadvantage: perceived stress and psychological symptoms

ObjectiveThis study aimed to examine the differences between mothers of preterm multiples and mothers of preterm singletons regarding perceived stress and maternal psychological symptoms, and to explore the putative adverse amplified effect of socioeconomic disadvantage. MethodNinety-five mothers of 1-year-olds born preterm participated in this cross-sectional study. Data collection was carried out in two public hospitals from Northern Portugal. To assess maternal perceived daily stress and psychological symptoms, mothers completed two questionnaires. Mothers reported on socioeconomic factors, including family poverty, parent unemployment, and low education, and two groups of family socioeconomic disadvantage were created. A child medical risk index was calculated. ResultsResults indicated that mothers of preterm multiples reported higher levels of stress than mothers of preterm singletons. Moreover, and specifically regarding psychological functioning, mothers of preterm multiples reported more symptoms than mothers of preterm singletons, but only when living in a context of socioeconomic adversity. ConclusionsThe results of the present study have important implications for practice. Mothers of preterm multiples are at higher risk to present mental health difficulties, in comparison to mothers of singletons, especially when exposed to socioeconomic adversities. The development of psychosocial intervention programs and public policies are of decisive importance in helping mothers of multiples adjust to parenthood.

Role of Positive Parenting in the Association Between Neighborhood Social Disadvantage and Brain Development Across Adolescence

The negative effects of socioeconomic disadvantage on lifelong functioning are pronounced, with some evidence suggesting that these effects are mediated by changes in brain development. To our knowledge, no research has investigated whether parenting might buffer these negative effects. To establish whether positive parenting behaviors moderate the effects of socioeconomic disadvantage on brain development and adaptive functioning in adolescents. In this longitudinal study of adolescents from schools in Melbourne, Australia, data were collected at 3 assessments between 2004 and 2012. Data were analyzed between August 2016 and April 2017. Both family (parental income-to-needs, occupation, and education level) and neighborhood measures of socioeconomic disadvantage were assessed. Positive maternal parenting behaviors were observed during interactions in early adolescence. Structural magnetic resonance imaging scans at 3 times (early, middle, and late adolescence) from ages 11 to 20 years. Global and academic functioning was assessed during late adolescence. We used linear mixed models to examine the effect of family and neighborhood socioeconomic disadvantage as well as the moderating effect of positive parenting on adolescent brain development. We used mediation models to examine whether brain developmental trajectories predicted functional outcomes during late adolescence. Of the included 166 adolescents, 86 (51.8%) were male. We found that neighborhood, but not family, socioeconomic disadvantage was associated with altered brain development from early (mean [SD] age, 12.79 [0.425] years) to late (mean [SD] age, 19.08 [0.460] years) adolescence, predominantly in the temporal lobes (temporal cortex: random field theory corrected; left amygdala: B, -0.237; P < .001; right amygdala: B, -0.209; P = .008). Additionally, positive parenting moderated the effects of neighborhood disadvantage on the development of dorsal frontal and lateral orbitofrontal cortices as well as the effects of family disadvantage on the development of the amygdala (occupation: B, 0.382; P = .004; income-to-needs: B, 27.741; P = .004), with some male-specific findings. The pattern of dorsal frontal cortical development in males from disadvantaged neighborhoods exposed to low maternal positivity predicted increased rates of school noncompletion (indirect effect, -0.018; SE, 0.01; 95% CI, -0.053 to -0.001). Our findings highlight the importance of neighborhood disadvantage in influencing brain developmental trajectories. Further, to our knowledge, we present the first evidence that positive maternal parenting might ameliorate the negative effects of socioeconomic disadvantage on frontal lobe development (with implications for functioning) during adolescence. Results have relevance for designing interventions for children from socioeconomically disadvantaged backgrounds.

Environmental adversity and children's early trajectories of problem behavior: The role of harsh parental discipline.

This study was performed to examine the role of harsh parental discipline in mediating and moderating the effects of environmental adversity (family socioeconomic disadvantage and adverse life events) on emotional and behavioral problems across early-to-middle childhood. The sample included 16,916 children (48% female; 24% non-White) from the U.K.’s Millennium Cohort Study. We analyzed trajectories of conduct, hyperactivity, and emotional problems, measured at ages 3, 5, and 7 years, using growth curve models. Harsh parental discipline was measured at these ages with parent-reported items on the frequency of using the physical and verbal discipline tactics of smacking, shouting at, and “telling off” the child. As expected, family socioeconomic disadvantage and adverse life events were significantly associated with emotional and behavioral problems. Harsh parental discipline was related to children’s trajectories of problems, and it moderated, but did not explain, the effect of environmental risk on these trajectories. High-risk children experiencing harsh parental discipline had the highest levels of conduct problems and hyperactivity across the study period. In addition, harsh parental discipline predicted an increase in emotional symptoms over time in high-risk children, unseen in their counterparts experiencing low levels of harsh parental discipline. However, children in low-risk families were also negatively affected by harsh parental discipline concurrently and over time. In conclusion, harsh parental discipline predicted emotional and behavioral problems in high- and low-risk children and moderated the effects of family poverty and adversity on these problems.

Trajectories of parental involvement in home learning activities across the early years: associations with socio-demographic characteristics and children’s learning outcomes

ABSTRACTThis study examined the socio-demographic factors associated with trajectories of parental involvement in shared book reading and other home activities for children aged 2–6 years. The study uses data from 3836 families participating in Growing up in Australia: The Longitudinal Study of Australian Children. Latent growth curve models were estimated to describe associations between trajectories of parental involvement, socio-demographic factors, and children’s learning outcomes. Higher levels of parental involvement at 2 years were associated with better learning outcomes at 6 years. On average, the frequency of parental involvement in home learning activities decreased over time. Family socio-economic disadvantage and being a male child were associated with lower levels of parental involvement at age 2 years, and more rapid decreases in parental involvement in home activities over time. Continued attention is needed to identify effective strategies that can address inequalities in children’s home learning opportunities before children begin school.

Socioeconomic Disadvantage and Children’s Behaviour Problems: the Role of Early Aspirations

Using data from the UK’s Millennium Cohort Study, we investigated the association of early family socioeconomic disadvantage (measured when cohort children were age three) with children’s aspirations and emotional and behavioural problems at age seven (N = 11,656). Aspirations were gauged by children’s written responses to the question ‘when you grow up, what would you like to be’. Responses were classified to reflect the prestige of the aspired occupation and its sex composition, and the degree of intrinsic/extrinsic motivation inferred from the aspiration. Disadvantage predicted problems both directly and via its association with low prestige and intrinsic aspirations. Children aspiring to more prestigious occupations had fewer emotional and hyperactivity problems, and those with more extrinsic aspirations had fewer emotional symptoms. Both girls and particularly boys with apparently more intrinsic aspirations had more peer problems. The association between hyperactivity and disadvantage was attenuated among children aspiring to more feminised jobs.

Family and neighborhood disadvantage, home environment, and children's school readiness.

The purpose of this study was to examine associations between family socioeconomic risk, neighborhood disadvantage, and children's school readiness. A sample of 420 children from 48 early childcare programs yielded multi-informant data. The average age was 55.3 months (SD = 6.4), with 38% of children being Black, non-Hispanic, Hispanic, or other minority race (American Indian or Alaska Native, Asian, and Native Hawaiian or Pacific Islander). One third (32.4%) of the parents had annual incomes less than $30,000. We used multilevel structural equation modeling to test direct and indirect associations among family socioeconomic risk and neighborhood disadvantage and children's cognitive and social-emotional development through home learning environment and parental depression. Children with a greater number of family socioeconomic risks and a higher level of neighborhood disadvantage demonstrated lower scores on cognitive skills. The degree of family socioeconomic risk was indirectly associated with children's cognitive ability through parents' cognitive stimulation at home. Parents who had more family socioeconomic risks and neighborhood disadvantage reported more depressive symptoms, which, in turn, suggested children's greater probability of having social-emotional problems. In other words, home learning environments explained associations between family socioeconomic disadvantage and children's cognitive skills, while parental depression explained associations between family/neighborhood disadvantages and children's social-emotional problems. Results suggest the importance of intervention or prevention strategies for parents to improve cognitive stimulation at home and to reduce depressive symptoms.

Family Poverty and Trajectories of Children’s Emotional and Behavioural Problems: The Moderating Roles of Self-Regulation and Verbal Cognitive Ability

Socio-economic disadvantage is strongly associated with children's emotional (internalising) and behavioural (externalising) problems. Self-regulation and verbal cognitive ability have been related to children's emotional and behavioural resilience to socio-economic disadvantage. Despite being inter-related, self-regulation and verbal cognitive ability have not been examined jointly as promoting resilience in young children. This study investigated the roles of self-regulation and verbal cognitive ability in children's emotional and behavioural resilience to family socio-economic disadvantage from early to middle childhood (ages 3, 5, and 7 years; N = 16,916; 49 % girls). Using multivariate response growth curve modelling, we found that the relationship between socio-economic disadvantage and internalising problems was stronger for children with lower verbal cognitive ability. Also, poor children with high and low levels of self-regulation showed a widening gap in both emotional and behavioural problems over time. Poor and non-poor children alike benefited from self-regulation, but poor children appeared to be more vulnerable to low self-regulation. Self-regulation and verbal cognitive ability seem to be important protective factors for young children growing up in poor families.

The association of attention deficit hyperactivity disorder with socioeconomic disadvantage: alternative explanations and evidence.

BackgroundStudies throughout Northern Europe, the United States and Australia have found an association between childhood attention deficit hyperactivity disorder (ADHD) and family socioeconomic disadvantage. We report further evidence for the association and review potential causal pathways that might explain the link.MethodSecondary analysis of a UK birth cohort (the Millennium Cohort Study, N = 19,519) was used to model the association of ADHD with socioeconomic disadvantage and assess evidence for several potential explanatory pathways. The case definition of ADHD was a parent-report of whether ADHD had been identified by a medical doctor or health professional when children were 7 years old.ResultsADHD was associated with a range of indicators of social and economic disadvantage including poverty, housing tenure, maternal education, income, lone parenthood and younger motherhood. There was no evidence to suggest childhood ADHD was a causal factor of socioeconomic disadvantage: income did not decrease for parents of children with ADHD compared to controls over the 7-year study period. No clinical bias towards labelling ADHD in low SES groups was detected. There was evidence to suggest that parent attachment/family conflict mediated the relationship between ADHD and SES.ConclusionAlthough genetic and neurological determinants may be the primary predictors of difficulties with activity level and attention, aetiology appears to be influenced by socioeconomic situation.