MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
Eur J Public Health. 2021 Jul 13;31(3):474-481. doi: 10.1093/eurpub/ckab006.
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.
不同类型的家庭逆境会对儿童的社会情感发展产生不同的影响；然而，我们缺乏可进行政策干预的调节因素方面的知识。本研究探讨了幼儿中心式儿童保育是否调节了家庭逆境配置对社会情感发展的影响。
数据来自苏格兰首次生育队列研究，2004-05 年出生。通过对 19 个幼儿家庭逆境指标进行潜在类别分析，确定了四个类别：“低风险”（68%）、“产妇健康状况差”（16.5%）、“经济困难”（10.0%）和“多种逆境”（5.5%）。通过对混杂因素进行控制，对外部和内部症状轨迹（年龄 46-152 个月，n=3561）进行潜在增长模型分析。通过分层检验，研究了中心式儿童保育使用对家庭逆境的调节作用。
与“低风险”相比，高风险类别的儿童出现更多的外部和内部症状，内部症状的增长速度更快，“多种逆境”类别的情况最差。“经济困难”对随时间变化的外部症状的影响因儿童保育而异（P=0.035）：与低风险组相比，不使用儿童保育的儿童症状增加（每年增加 0.04 分），而使用儿童保育的儿童症状减少（每年减少 0.09 分）。“多种逆境”对内部症状的影响也存在差异（P=0.034）：没有中心式儿童保育的儿童增加 0.12 分；有中心式儿童保育的儿童增加 0.33 分（外部症状的模式相似，但置信区间较宽）。“产妇健康状况差”没有调节作用。
中心式儿童保育可能会减轻主要面临经济困难的儿童在社会情感福利方面的劣势，但可能会加剧那些面临多种逆境的儿童的劣势。需要更好地了解早期服务如何为有复杂需求的家庭提供支持。
