Birth order and socioeconomic disadvantage predict behavioural and emotional problems at age 3 years

Child behaviour is a main concern for parents of 3-year-olds

AIM

The aim of this study was to describe parental concerns about child health and behaviour and their sociodemographic predictors in 3-year-olds, in relation to the national guidelines of well-baby clinics.

METHODS

The study included parents of 33 526 children in Stockholm who had completed a questionnaire prior to a routine visit to a well-baby clinic at age 3 years. Multivariate regression was used to analyse predictors for concerns.

RESULTS

Child behaviour problems, defined as defiance and problem with adherence to daily routines, were the most common parental concerns (36.4%), with poor social skills and relations being second (21.8%). Regarding development, 9.6% had concerns about speech and 4.7% about motor development. Screen use (9.5%) and being underweight (6.3%) were other common parental concerns, while lifestyle concerns regarding physical activity and overweight were rare. Parents raised about twice as many concerns for first-born children compared with younger siblings. Child behaviour and developmental concerns were more frequent in families where the mother had primary education only and attended a well-baby clinic with a high Care Need Index.

CONCLUSION

Parents' concerns reflected the national guidelines about child development and behaviour, but not its emphasis on a healthy lifestyle.

The assessment of preschool children with ESSENCE symptoms: concordance between parents, preschool teachers and child psychologists

BACKGROUND

It is important to detect children with Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE) in order to implement early intervention and support for the child and family. Standardized instruments for assessment in different contexts of behaviour problems, engagement and psychosocial health obtain an objective picture of the preschool child's mental health.

AIM

To explore and compare parents', preschool teachers' and child health care psychologists' assessment of behaviour, everyday function, engagement, social interaction and psychosocial health in children with ESSENCE symptoms.

METHOD

Parents of 152 children (114 boys and 38 girls, 4.5 ± 1 years) with ESSENCE symptoms, 155 preschool teachers and 8 child psychologists participated. Parents and preschool teachers assessed externalizing and internalizing behavioural problems using the Strengths and Difficulties Questionnaire (SDQ), including the SDQ supplement for assessing the impact of behavioral problems on daily function. Preschool teachers also assessed engagement and social interaction using the Children's Engagement Questionnaire (CEQ), and the child psychologists assessed psychosocial health with the Child Psychosocial Health Assessment (LillaLAPS) and template in conversations with parents of children with neurodevelopmental problems.

RESULTS

Parents', preschool teachers' and child psychologists' assessment of the child's ESSENCE symptoms overall agreed. Both parents and preschool teachers see a strength in the child's social abilities. Differences in mean values show that parents assess more conduct, emotional symptoms and problems in daily life and more social skills, compared to the preschool teachers rating more peer problems.

CONCLUSION

It is important to consider different contexts to identify the child's need for support in everyday life. Expanded use of validated screening instruments in clinical practice would promote detection of children not already identified as exhibiting neurodevelopmental problems.

Did the choice reform in Stockholm change social disparities in use of outpatient health services for children?

AIM

The aim of this study was to investigate whether the choice reforms in healthcare in Stockholm county in 2008 and 2013 changed the sociodemographic user patterns of outpatient healthcare services for children.

METHODS

The study used regional data on healthcare use linked to sociodemographic data from national registers in the total population of children 0-15 years in the Stockholm county. Change in use of healthcare services was analysed in multiple linear regression in a difference in differences approach of socio-economic indicators.

RESULTS

The choice reform of 2013 increased children's overall use of specialised care by around 30% until 2017 while primary care use decreased by the same degree. The mean number of physician visits in specialised care for children with severe asthma increased from 3.9 to 5.2 per year. Overall, children in families with low maternal education, low disposable income and a non-Western background increased their use of specialised care more than children from families with a more privileged socio-economic situation.

CONCLUSION

There was no indication that the choice reform in Stockholm county increased the social disparities in use of primary and specialised outpatient care for children, rather the opposite.

Systematic review and theoretical comparison of children's outcomes in post-separation living arrangements

The purpose of the systematic review was to synthesize the literature on children's outcomes across different living arrangements (nuclear families, shared physical custody [SPC], lone physical custody [LPC]) by extracting and structuring relevant theoretical hypotheses (selection, instability, fewer resources, and stressful mobility) and comparing the empirical findings against these hypotheses. Following the PRISMA guidelines, the review included 39 studies conducted between January 2010-December 2022 and compared the living arrangements across five domains of children's outcomes: emotional, behavioral, relational, physical, and educational. The results showed that children's outcomes were the best in nuclear families but in 75% of the studies children in SPC arrangements had equal outcomes. Children in LPC tended to report the worst outcomes. When compared with the different theoretical hypotheses, the results were the most consistent with fewer resources hypothesis which suggests that children especially in LPC families have fewer relational and economic resources whereas children in SPC families are better able to maintain resources from both parents.

A Closer Look at the Birth Order Effect on Early Cognitive and School Readiness Development in Diverse Contexts

Using the Early Childhood Longitudinal Study–Birth Cohort data, we examined the effect of birth order (firstborn vs. later-born) on children's cognitive skills at 24 months and school readiness (i.e., math and literacy) skills at age 4 years. Previous research in the U.S. using predominantly English-speaking, low-risk samples suggests that firstborns tend to show better early cognitive and school readiness skills than later-born children. However, results of the current study showed that although there was a firstborn advantage in low-risk or English-speaking families, in high-risk or language minority families, later-born children showed equivalent or even better skills than firstborn children. Our moderated mediation models revealed that children's engagement in home learning activities mediated the relation between birth order and developmental outcomes, and families' cumulative risks and language minority status moderated the mediation pathways. These findings underscore the complex associations between birth order and early development in diverse ecological contexts.