Elsevier

The Journal of Pediatrics

Volume 167, Issue 2, August 2015, Pages 442-448.e1
The Journal of Pediatrics

Original Article
The Influence of Social Disadvantage on Children's Emotional and Behavioral Difficulties at Age 4-7 Years

https://doi.org/10.1016/j.jpeds.2015.04.054Get rights and content

Objective

To examine associations between indicators of social disadvantage and emotional and behavioral difficulties in children aged 4-7 years.

Study design

This cross-sectional study was based on data collected in a questionnaire completed by parents of children enrolled in their first year of school in Victoria, Australia, in 2010. Just over 57 000 children participated (86% of children enrolled), of whom complete data were available for 38 955 (68% of the dataset); these children formed the analysis sample. The outcome measure was emotional and behavioral difficulties, assessed by the Strengths and Difficulties Questionnaire Total Difficulties score. Logistic regression analyses were undertaken.

Results

Having a concession card (a government-issued card enabling access to subsidized goods and services, particularly in relation to medical care, primarily for economically vulnerable households) was the strongest predictor of emotional and behavioral difficulties (OR, 2.71; 95% CI, 2.39-3.07), followed by living with 1 parent and the parent's partner or not living with either parent (OR, 1.93; 95% CI, 1.58-2.37) and having a mother who did not complete high school (OR, 1.27; 95% CI, 1.11-1.45).

Conclusion

These findings may assist schools and early childhood practitioners in identifying young children who are at increased risk of emotional and behavioral difficulties, to provide these children, together with their parents and families, with support from appropriate preventive interventions.

Section snippets

Methods

The School Entrant Health Questionnaire (SEHQ) is a paper-based survey undertaken annually in the state of Victoria, Australia, by the Victorian Government Department of Education and Training. Parents of all children enrolled in the first year of primary school in Victoria are invited to complete the questionnaire, which includes questions focusing on family demographics and child development. The present analysis is based on responses to the 2010 SEHQ. Ethics approval for this study was

Results

The process of defining the analysis sample is shown in the Figure (available at www.jpeds.com). In 2010, a total of 66 444 children were enrolled in the first year of formal schooling in Victoria, Australia,37 of whom 57 005 (86%) are represented in the SEHQ 2010 dataset.

Complete information on variables of interest was available for 38 955 children (68% of the SEHQ 2010 dataset), and these children compose the analysis sample. Table I compares the analysis sample with children who were

Discussion

In this study, we identified several indicators of social disadvantage associated with emotional and behavioral difficulties as measured by the SDQ in children aged 4-7 years. Being a concession card holder was the strongest predictor of difficulty, followed by living with 1 parent and the parent's new partner or not living with either parent, and finally having a mother who did not complete high school. The present analysis was based on a larger sample and included a broader array of

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    Study was undertaken under the auspices of a 4-year research partnership between the Melbourne School of Population and Global Health at the University of Melbourne. E.S. is partially funded through a research partnership contract between the Melbourne School of Population Health and Department of Education and Training (DET). K.W. is a senior official within DET. The findings and views reported in this paper are those of the authors and should not be attributed to DET or any other branch of the Victorian government. The authors declare no conflicts of interest.

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