Do twins differ from single-born children on rates of behavioral difficulty in early childhood? A study of sibling relationship risk factors.

The hypothesis that twinning raises risk for behavioral difficulties in childhood is persistent, yet there is limited and inconsistent empirical evidence. Simple mean comparison without control for confounders provides data on prevalence rates but cannot provide knowledge about risk or etiology. To assess the effect of twin relationship on behavior, comparison of patterns of association with single-born siblings may be informative. Analyses of data from an Australian sample of twins and single-born children (N = 305, mean age 4 years 9 months, and a follow-up 12 months later) were undertaken. The outcome measure was the Strengths and Difficulties Questionnaire. Predictor and control measures were obtained from parent report on the sibling/co-twin relationship behavior, family demographics, and obstetric history. We assessed difference between twins and single-born children in two respects: (a) mean behavioral difficulties, and (b) patterns of association between sibling relationship and behavioral difficulties, controlling for confounders. Results showed no differences in mean levels of behavioral difficulties between twins and single-born siblings identifying the importance of statistical control for family and obstetric adversity. Differences in patterns of association were found; for twin children, conflict in their co-twin relationship predicted externalizing behaviors, while for single-born children conflict predicted internalizing behaviors. The findings of mean differences between twin and single-born children in social background, but not in behavioral difficulties, underscore the necessity of statistical control to identify risk associated with twinning compared with risk associated with family and obstetric background factors.

Associations between young children's emotion attributions and prediction of outcome in differing social situations.

Associations between young children's attributions of emotion at different points in a story, and with regard to their own prediction about the story's outcome, were investigated using two hypothetical scenarios of social and emotional challenge (social entry and negative event). First grade children (N = 250) showed an understanding that emotions are tied to situational cues by varying the emotions they attributed both between and within scenarios. Furthermore, emotions attributed to the main protagonist at the beginning of the scenarios were differentially associated with children's prediction of a positive or negative outcome and with the valence of the emotion attributed at the end of the scenario. Gender differences in responses to some items were also found.

Re-examining the link between prenatal maternal anxiety and child emotional difficulties, using a sibling design.

Background: Prenatal exposure to maternal anxiety has been associated with child emotional difficulties in a number of epidemiological studies. One key concern, however, is that this link is vulnerable to confounding by pleiotropic genes or environmental family factors. Methods: Data on 82 383 mothers and children from the population-based Mother and Child Cohort Study and data on 21 980 siblings were used in this study. Mothers filled out questionnaires for each unique pregnancy, for infant difficulties at 6 months and for emotional difficulties at 36 months. The link between prenatal maternal anxiety and child difficulties were examined using logistic regression analyses and multiple linear regression analyses for the full study sample and the sibling sample. Results: In the conventional full-cohort analyses, prenatal exposure to maternal anxiety was associated with child difficulties at both 6 months [odds ratio (OR) = 2.1 (1.94-2.27)] and 36 months [OR = 2.72 (2.47-2.99)]. The findings were essentially the same whether we examined difficulties at 6 months or at 36 months. However, these associations were no longer present once we controlled for potential social and genetic confounders in the sibling comparison analyses, either at 6 months [OR = 1.32 (0.91-1.90)] or at 36 months [OR = 1.28 (0.63-2.60)]. Findings from multiple regression analyses with continuous measures were essentially the same. Conclusions: Our finding lends little support for there being an independent prenatal effect on child emotional difficulties; rather, our findings suggest that the link between prenatal maternal anxiety and child difficulties could be confounded by pleiotropic genes or environmental family factors.

The role of pre- and postnatal timing of family risk factors on child behavior at 36 months.

Children growing up in disharmonious families with anxious/depressed mothers are at risk for emotional and behavioral difficulties, however whether these associations reflect postnatal environment, prenatal exposure, or an overall liability is still unclear. This study used prospectively collected data from 24,259 participants of the Norwegian Mother and Child Cohort Study (MoBa). Mothers reported on anxiety/depression and family disharmony twice in pregnancy and twice post pregnancy, as well as on their child's physical aggression and crying behavior at age 36 months. First, results from an autoregressive cross-lagged model showed a substantial stability in both maternal anxiety/depression and family disharmony from pregnancy to 18 months postnatal, but there was no indication that family disharmony led to maternal anxiety/depression, or the other way around. Second, structural equation models further suggests that the main risk derived from an overall liability, that is, a lasting effect of family risks that spanned the two time periods.

Peer harassment and satisfaction with appearance in children with and without a facial difference.

This study investigated associations between perceived peer harassment and satisfaction with appearance in the presence or absence of a facial difference. A cross-sectional sample of 661 children aged 10 or 16, with a cleft lip and/or palate, completed measures of satisfaction with appearance and peer harassment. Results indicated that the presence of a visible versus a nonvisible cleft was not associated with appearance dissatisfaction or higher levels of peer harassment for children aged 10 or for adolescent boys. Peer harassment was related to dissatisfaction with appearance in both age groups. In the adolescent group, there was an interaction between cleft visibility and gender, girls with a visible cleft being least satisfied with appearance. However, the association between cleft visibility and satisfaction with appearance was fully mediated by experiences of peer harassment. The results highlight the need to further explore the role of social interactions for subjective perceptions of appearance.

Adolescents with and without a facial difference: The role of friendships and social acceptance in perceptions of appearance and emotional resilience.

This study investigated the role of friendships and social acceptance in self-perceptions of appearance and depressive symptoms, comparing adolescents with and without a facial difference. Adolescents with a visible cleft (n=196) were compared with adolescents with a non-visible cleft (n=93), and with a comparison group (n=1832). Boys with a visible difference reported significantly more positive perceptions of friendships and less depressive symptoms than the comparison group. These results were interpreted in the context of indicators of emotional resilience. The objective measure of facial difference did not explain levels of depressive symptoms, while subjective measures did. Subjective ratings of appearance mediated the association between social acceptance and depressive symptoms in all samples. Gender did not contribute in explaining the paths between friendships, appearance, and depressive symptoms. The associations between perceptions of social acceptance, appearance, and emotional distress, support the possible utility of strengthening social experiences in preventing and treating appearance-concerns.

Social experience in 10-year-old children born with a cleft: exploring psychosocial resilience.

OBJECTIVE: The purposes of this study were to investigate self-reported social experience in 10-year-old children born with a cleft lip and/or palate and to gain a better understanding of variables implicated in psychosocial resilience. DESIGN: Cross-sectional study of 10-year-old children from five consecutive birth cohorts, born from 1992 to 1997. PARTICIPANTS: A total of 268 children treated by the Oslo cleft team (Norway) participated in the study. The children's cleft conditions included cleft lip and palate, cleft lip alveolus, cleft palate, and submucous cleft palate. OUTCOME MEASURES: Psychosocial resilience was measured with the Child Experience Questionnaire (CEQ). Other variables were obtained during a clinical interview with the child. Cognitive, emotional, and psychosocial functioning was measured with the Personality Inventory for Children (PIC). Satisfaction with appearance was assessed through the use of the Satisfaction with Appearance Scales (SWA). Informants were both children and parents. RESULTS: Cleft types differed significantly with respect to subtype and frequency of additional difficulties. Psychosocial resilience was associated with adequate emotional functioning, high satisfaction with appearance, and a lower frequency of reported teasing. Child characteristics such as visibility of cleft, gender, and additional diagnosis did not contribute to explain psychosocial resilience. CONCLUSIONS: Results reported here emphasise the importance of assessing the child's subjective report of satisfaction with appearance and psychosocial experience.

Maternal smoking in pregnancy and externalizing behavior in 18-month-old children: results from a population-based prospective study.

OBJECTIVE: The relation between prenatal smoking and child behavioral problems has been investigated in children of school age and older, but prospective studies in younger children are lacking. Using the population-based prospective Norwegian Mother and Child Cohort Study, we examined the risk for externalizing behaviors among 18-month-old children after exposure to maternal smoking during pregnancy. METHOD: Participants were 22,545 mothers and their 18-month-old children. Mothers reported their smoking habits at the 17th week of gestation and their child's externalizing behavior at 18 months of age by means of standardized questionnaires. Data were analyzed using logistic regression, with scores of externalizing behavior above the 88.6th percentile as the dependent variable and self-reported smoking as the independent variable. We examined the child's sex as a possible moderator. RESULTS: We documented a threshold effect of smoking 10 cigarettes or more per day during pregnancy on subsequent externalizing behaviors among 18-month-old children, even after adjusting for relevant confounders (odds ratio 1.32, 95% confidence interval 1.03-1.70). The child's sex did not moderate these effects (odds ratio 0.98, 95% confidence interval 0.83-1.16). CONCLUSIONS: Maternal smoking during pregnancy increases offspring's subsequent risk for externalizing behavior problems at 18 months of age. The pattern of risk does not differ between boys and girls. Our findings suggest a population attributable risk of 1.75% [corrected] (i.e., the proportion of externalizing cases that could potentially be avoided if prenatal smoking was eliminated or reduced to fewer than 10 cigarettes per day).

The timing of middle-childhood peer rejection and friendship: linking early behavior to early-adolescent adjustment.

This study used a sample of 551 children surveyed yearly from ages 6 to 13 to examine the longitudinal associations among early behavior, middle-childhood peer rejection and friendedness, and early-adolescent depressive symptoms, loneliness, and delinquency. The study tested a sequential mediation hypothesis in which (a) behavior problems in the early school years are associated with middle-childhood peer rejection and (b) rejection, in turn, leads to lower friendedness and subsequently higher adolescent internalizing--but not externalizing--problems. Results supported this sequential mediation model for internalizing outcomes and revealed an additional path from early disruptiveness to loneliness via peer rejection alone. No evidence of sequential mediation was observed for delinquency.

Association between nonmaternal care in the first year of life and children's receptive language skills prior to school entry: the moderating role of socioeconomic status.

BACKGROUND: Studies have suggested that nonmaternal care (NMC) may either carry risks or be beneficial for children's language development. However, few tested the possibility that NMC may be more or less protective for children with different family backgrounds. This study investigates the role of the family environment, as reflected in the socioeconomic status (SES), in the association between NMC in the first year of life and children's receptive language skills prior to school entry. METHOD: A representative sample of 2,297 Canadian children aged between 0 and 11 months at their first assessment was followed over 4 years. Receptive language skills were assessed with the Peabody Picture Vocabulary Test Revised (PPVT-R) when the child was 4 to 5 years old. RESULTS: After controlling for selection factors, SES was found to moderate the association between NMC and receptive language skills: Full-time NMC in the first year of life was associated with higher PPVT-R scores among children from low SES families (d = .58), but not among children from adequate SES families. CONCLUSION: Full-time NMC in infancy may contribute to reducing the cognitive inequalities between children of low and adequate SES.

Early childcare and physical aggression: differentiating social selection and social causation.

BACKGROUND: Some research findings have suggested that group day-care may be associated with an increased risk for physical aggression. METHODS: Cross-sectional maternal questionnaire data from a representative sample of 3431 Canadian 2- to 3-year-olds were used to compare rates of physical aggression shown by children looked after by their own mothers and those attending group day-care. A family risk index (using occupational level, maternal education, size of sibship, and family functioning) was created to test whether any difference in physical aggression might reflect social selection rather than social causation. RESULTS: Aggression was significantly more common in children looked after by their own mothers than in those attending group day-care. Strong social selection associated with family risk was found, not only in the sample as a whole, but even within the high-risk subsample. However, after taking social selection into account, physical aggression was significantly more common in children from high-risk families looked after by their own parents. No such difference was evident in the majority (84%) of children from low-risk families. CONCLUSION: Insofar as there are any risks for physical aggression associated with homecare they apply only to high-risk families.