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Different 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. Data 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. Compared 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'. 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. A better understanding of how early years' services can support families with complex needs is required. © The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.


Alison Parkes, Michael Green, Anna Pearce. Can centre-based childcare buffer against the negative effects of family adversity on child socio-emotional wellbeing? European journal of public health. 2021 Jul 13;31(3):474-481

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PMID: 33550396

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