Publication - Research and analysis

The Impact of Disability on the Lives of Young Children: Analysis of Growing Up in Scotland Data

Published: 18 September 2013
Topic: Health and social care
ISBN: 9781782569077

This research project was commissioned by Scottish Government Children and Families Analysis with the objective of undertaking an in-depth analysis of data from the Growing Up in Scotland study (GUS) to examine the circumstances and outcomes of children living with a disability in Scotland. The overall aim of this analysis was to explore the impact of disability on the child, their parents and the wider family unit

Supporting documents

2 Findings

Demographics

2.1 13% of children had a disability at 10 months of age. By age six, this had increased to 19% (Figure 2‑A). The largest increase (4 percentage points) occurred between ages 2 and 3. However, at age 2, respondents were not asked whether their child still had the longstanding illness or disability which had been identified at the previous sweep. This may explain the drop in the proportion identifying their child as having a disability at age 2 compared with age 1^[4]. If we discount this sweep, the largest increase was between 10 months and age 3, with a 3 percentage point increase.

Figure 2‑A % of children with a disability by age

Figure 2‑A % of children with a disability by age

2.2 There was no difference in age of the mother when the child was born between disabled and non-disabled children, nor in the proportion of children who were of non-white ethnic background (Table 2.1, Table 2.2).

2.3 A higher proportion of children with a disability had mothers who were looking after the home or family rather than working or looking for a job, compared with children who did not have a disability (this was only significant at the 10% level at 10 months, Table 2.3).

2.4 There was a significantly higher proportion of disabled children living in the most deprived areas of Scotland compared with non-disabled children in all three sweeps examined. Twenty nine percent of disabled children lived in areas that fell in the most deprived quintile compared with 24% of non-disabled children at 10 months (Table 2.4). In addition, a higher proportion of children living in deprived areas had a disability than children living in non-deprived areas (Table 2.5).

2.5 At 10 months there was no significant difference between the proportion of disabled children and non-disabled children in the bottom quintile for equivalised household income. However, at ages three and five disabled children were more likely than non-disabled children to be living in households in the lowest income quintile. For example, at age 5, 31% of disabled children lived in a household in the lowest income quintile compared with 22% of non-disabled children (Table 2.6).

2.6 There was a significant difference at all sweeps in the proportion of disabled children whose mother's partner was not in paid work compared with children with no disability (Table 2.7).

2.7 At all sweeps children with a disability were less likely to be living in owner-occupied accommodation than children without a disability (Table 2.8).

Table 2.1 Disability by mother's age at child's birth

Age of natural mother at birth of cohort child	Non-disabled children	Disabled children
	%	%
Under 20	8	9
20 to 29	42	44
30 to 39	47	45
40 or older	3	2
Bases
Unweighted	4518	680
Weighted	4510	687

Table 2.2 Disability by ethnicity

Age of natural mother at birth of cohort child	Non-disabled children	Disabled children
	%	%
White	95	96
Other ethnic background	5	4
Bases
Unweighted	4524	683
Weighted	4516	690

Table 2.3 Disability by mother's employment status

Mothers employment status	Non-disabled children	Disabled children
	%	%
*Age 1*
In full-time paid employment or self-employed, over 30hrs a week	15	16
In part-time paid employment or self-employed, under 30hrs a week	38	32
On maternity/parental leave	5	4
Looking after the home or family	38	41
Not in paid work	5	7
*Age 3*
In full-time paid employment or self-employed, over 30hrs a week	18	17
In part-time paid employment or self-employed, under 30hrs a week	41	35
On maternity/parental leave	4	1
Looking after the home or family	30	37
Not in paid work	6	10
*Age 5*
In full-time paid employment or self-employed, over 30hrs a week	23	17
In part-time paid employment or self-employed, under 30hrs a week	40	38
On maternity/parental leave	3	3
Looking after the home or family	28	34
Not in paid work	6	9
Bases
Age 1
Unweighted	4527	683
Weighted	4519	690
Age 3
Unweighted	3589	599
Weighted	3580	607
Age 5
Unweighted	3181	648
Weighted	3148	681

Table 2.4 Disability by Scottish Index of Multiple Deprivation Quintiles (i)

Scottish IMD quintiles	Non-disabled children	Disabled children
	%	%
*Age 1*
1 Least deprived	18	18
2	20	16
3	20	18
4	18	19
5 Most deprived	24	29
*Age 3*
1 Least deprived	19	16
2	20	17
3	20	17
4	18	19
5 Most deprived	23	30
*Age 5*
1 Least deprived	20	14
2	21	16
3	19	18
4	19	23
5 Most deprived	22	29
Bases
Age 1
Unweighted	4528	683
Weighted	4520	690
Age 3
Unweighted	3590	599
Weighted	3581	607
Age 5
Unweighted	3184	648
Weighted	3151	681

Table 2.5 Disability by Scottish Index of Multiple Deprivation Quintiles (ii)

	Scottish IMD quintiles
	1 Least deprived	2	3	4	5 Most deprived
	%	%	%	%	%
*Age 1*
Non-disabled children	87	89	88	86	84
Disabled children	13	11	12	14	16
*Age 3*
Non-disabled children	87	87	87	85	82
Disabled children	13	13	13	15	18
*Age 5*
Non-disabled children	86	86	83	79	78
Disabled children	14	14	17	21	22
Bases
Age 1
Unweighted	1015	1056	1042	929	1169
Weighted	936	1002	1010	968	1295
Age 3
Unweighted	904	882	873	698	832
Weighted	783	808	822	758	1016
Age 5
Unweighted	838	838	752	671	647
Weighted	730	757	708	712	790

Table 2.6 Disability by Equivalised Household Income Quintiles

Equivalised household income quintiles	Non-disabled children	Disabled children
	%	%
*Age 1*
Bottom Quintile (<£8,410)	19	21
2nd Quintile (>=£8,410< £13,750)	18	20
3rd Quintile (>=£13,750< £21,785)	16	17
4th Quintile (>=£21,785< £33,571)	19	18
Top Quintile (>=£33,571)	17	15
Missing	11	9
*Age 3*
Bottom Quintile (<£11,250)	22	27
2nd Quintile (>=£11,250< £17,916)	20	19
3rd Quintile (>=£17,916< £25,000)	17	18
4th Quintile (>=£25,000< £37,500)	19	16
Top Quintile (>=£37,500)	15	13
Missing	6	6
*Age 5*
Bottom Quintile (<£12,217)	22	31
2nd Quintile (>=£12,217< £19,643)	21	23
3rd Quintile (>=£19,643< £29,126)	16	17
4th Quintile (>=£29,126< £37,857)	21	14
Top Quintile (>=£37,857)	14	10
Missing	6	6
Bases
Age 1
Unweighted	4528	683
Weighted	4520	690
Age 3
Unweighted	3590	599
Weighted	3581	607
Age 5
Unweighted	3184	648
Weighted	3151	681

Table 2.7 Disability by partner's employment status

Partner's employment status	Non-disabled children	Disabled children
	%	%
*Age 1*
In paid work	91	85
Does not currently have a paid job	9	15
*Age 3*
In full-time paid employment or self-employed, over 30 hours a week	89	85
In part-time paid employment or self-employed, under 30 hours a week	4	2
Not in paid work	7	13
*Age 5*
In full-time paid employment or self-employed, over 30 hours a week	86	82
In part-time paid employment or self-employed, under 30 hours a week	4	5
Not in paid work	9	13
Bases
Age 1
Unweighted	3700	531
Weighted	3625	525
Age 3
Unweighted	3045	478
Weighted	2908	463
Age 5
Unweighted	2712	521
Weighted	2571	517

Table 2.8 Disability by tenure

Tenure	Non-disabled children	Disabled children
	%	%
*Age 1*
Owner occupied	27	33
Social rented	6	7
Private rented	4	3
Other	63	57
*Age 3*
Owner occupied	64	56
Social rented	27	35
Private rented	6	7
Other	3	2
*Age 5*
Owner occupied	66	53
Social rented	26	38
Private rented	7	8
Other	2	1
Bases
Age 1
Unweighted	4523	683
Weighted	4515	690
Age 3
Unweighted	3589	599
Weighted	3580	607
Age 5
Unweighted	3180	647
Weighted	3147	680

Mother's experience of pregnancy and birth

2.8 A lower proportion of mothers with a disabled child were very happy about the prospect of having their child while they were pregnant (65% compared with 71% of mothers with a non-disabled child, Table 2.9).

2.9 A higher proportion of mothers with disabled chil§dren had an illness or other problem during pregnancy that required medical attention or treatment (49% compared with 37%). Similarly, a lower proportion reported that they kept 'very well' during pregnancy compared with mothers with non-disabled children (Table 2.10, Table 2.11).

2.10 29% of mothers with disabled children reported having smoked cigarettes (occasionally or most days) during pregnancy compared with 25% of mothers with non-disabled children. However, there was no difference between mothers with disabled children and mothers with non-disabled children in alcohol consumption during pregnancy (Table 2.12, Table 2.13).

2.11 There was no significant difference between mothers with a child with a disability and mothers with a child without a disability in the proportion who used two or more sources of information during pregnancy^[5]. There was also no difference between these two groups of mothers in the proportion who found the information they received from health professionals during pregnancy very useful (Table 2.14, Table 2.15).

2.12 A lower proportion of disabled children were born on time compared with non-disabled children. 31% of disabled children were born weeks early compared with 22% of non-disabled children, while 39% were born late compared with 46% of non-disabled children (Figure 2‑B). There was no significant difference, however, between disabled and non-disabled children in the proportion who were born through a normal delivery. There was also no difference in the proportion born as singletons (96% of children with a disability were single births and 98% of children without a disability; Table 2.16, Table 2.17, Table 2.18).

2.13 A higher proportion of children with a disability at 10 months had spent any time in a special care baby unit or neonatal unit after they were born compared with children without a disability at 10 months. 11% of children with a disability had spent seven or more days in such a unit compared with 4% of children without a disability (Table 2.19).

Figure 2‑B Timing of birth in relation to due date and time spent in neonatal unit after birth by disability

Figure 2‑B Timing of birth in relation to due date and time spent in neonatal unit after birth by disability

2.14 Multivariate analysis of disability at 10 months was conducted to examine which variables were associated with disability once other covariates were controlled for. A summary of the statistically significant factors is provided below. Time spent in a special care unit or neonatal unit, how well the mother kept during pregnancy and whether she had any illnesses during pregnancy, the sex of the child, and the timing of the birth all remained significantly associated with disability at 10 months in the multivariate setting. The odds of children who spent seven or more days in a special care unit or neonatal unit having a disability at 10 months were about 2.5 times than for those who had not spent any time in such a unit. Children with mothers who reported not keeping well during pregnancy or who had any illness during pregnancy were more likely to have a disability, as were those who were born early. Female children were less likely to have a disability (Table 2.20).

Summary of multivariate analysis results: factors associated with child having a disability at 10 months

Spent 7+ days in a special care baby unit or neo-natal unit more likely to have a disability

Child is a male

Mother kept less than 'very well' during pregnancy

Mother had any illnesses or other problems during pregnancy

Child was born days or weeks early

Table 2.9 Disability by mother's feelings about the prospect of having the study child

Mother's feelings about the prospect of having study child	Non-disabled children	Disabled children
	%	%
Very happy	71	65
Fairly happy	16	16
Neither happy nor unhappy	9	11
Fairly unhappy or very unhappy	5	7
Bases
Unweighted	4461	666
Weighted	4454	673

Table 2.10 Disability by whether mother had any illnesses or other problems during pregnancy that required medical attention or treatment

Mother had any illnesses or other problems during pregnancy	Non-disabled children	Disabled children
	%	%
Yes	37	49
No	63	51
Bases
Unweighted	4467	667
Weighted	4461	674

Table 2.11 Disability by how mother kept during pregnancy

How mother kept during pregnancy	Non-disabled children	Disabled children
	%	%
Very well	52	38
Fairly well	35	42
Not very well	9	14
Not at all well	3	7
Bases
Unweighted	4466	667
Weighted	4460	674

Table 2.12 Disability by whether mother smoked during pregnancy

Mother smoked cigarettes during pregnancy	Non-disabled children	Disabled children
	%	%
Yes, occasionally	12	12
Yes, most days	13	17
No	75	71
Bases
Unweighted	4440	663
Weighted	4434	670

Table 2.13 Disability by mother's alcohol consumption during pregnancy

Mother's alcohol consumption during pregnancy	Non-disabled children	Disabled children
	%	%
1-2 times per week plus	4	4
2-3 times a month	5	4
Less than once a month	18	16
Never - did not drink at all	74	76
Bases
Unweighted	4408	655
Weighted	4401	661

Table 2.14 Disability by number of sources of information used during pregnancy

Number of sources of information used by the mother during pregnancy	Non-disabled children	Disabled children
	%	%
0	0	0
1	12	13
2	22	21
3	25	27
4	20	16
5	12	12
6	7	7
7	3	4
Bases
Unweighted	4389	660
Weighted	4383	668

Table 2.15 Disability by how useful found information received from health professionals while pregnant

How useful the mother found information received from health professionals during pregnancy	Non-disabled children	Disabled children
	%	%
Very useful	59	56
Fairly useful	36	39
Not very useful or not at all useful	4	5
Bases
Unweighted	4444	665
Weighted	4436	672

Table 2.16 Disability by timing of birth

Timing of birth	Non-disabled children	Disabled children
	%	%
Early - days	18	20
Early - weeks	22	31
Late	46	39
On time	14	10
Bases
Unweighted	4517	682
Weighted	4509	689

Table 2.17 Disability by type of delivery

Type of delivery	Non-disabled children	Disabled children
	%	%
Normal delivery	62	59
Forceps	7	8
Ventouse Suction	4	5
Forceps and Ventouse, or other	2	2
Caesarean Section … before labour began	11	15
Caesarean Section … after labour began	13	11
Bases
Unweighted	4515	680
Weighted	4507	687

Table 2.18 Disability by single or multiple pregnancy

Single or multiple pregnancy	Non-disabled children	Disabled children
	%	%
Single	98	96
Multiple	2	4
Bases
Unweighted	4527	682
Weighted	4519	689

Table 2.19 Disability by time spent in a neo-natal unit

Time spent in a special care baby unit or neo-natal unit	Non-disabled children	Disabled children
	%	%
Did not spend any time	90	80
0-2 days	4	5
3-6 days	3	4
7+ days	3	11
Bases
Unweighted	4524	682
Weighted	4516	689

Table 2.20 Multivariate analysis of disability at 10 months

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Time spent in a special care baby unit or neo-natal unit (p<0.001)
Did not spend any time	1	4,532
0-2 days	1.42 (0.99,2.02)	207
3-6 days	1.52 (0.97,2.38)	141
7+ days	2.51 (1.88,3.36)	240
Sex (p<0.001)
Male	1	2,631
Female	0.72 (0.61,0.84)	2,489
How mother kept during pregnancy (p<0.001)
Very well	1	2,613
Fairly well	1.49 (1.21,1.83)	1,829
Not very well	1.55 (1.11,2.15)	505
Not at all well	2.22 (1.52,3.24)	173
Mother had any illnesses or other problems during pregnancy (p=0.035)
Yes	1.27 (1.02,1.58)	1,942
No	1	3,178
Timing of birth (p=0.046)
Early - days	1.59 (1.06,2.40)	937
Early - weeks	1.52 (1.07,2.16)	1,178
Late	1.24 (0.89,1.73)	2,301
On time	1	704

Child-parent relationship

2.15 Parents were asked about a number of different aspects, or dimensions, of the day-to-day parenting of their child. To explore differences in this domain, we draw largely on the parenting measures defined by Parkes and Wight^[6]. Three domains were explored: connection, negativity and control.

Connection

2.16 Mother-infant attachment was measured at 10 months using an abbreviated six-item version of the Condon mother-infant attachment scale^[7]. Mothers were asked about their feelings for their child, with four different possible responses for each item. The scale had a low reliability (Cronbach alpha=0.52), and this should be borne in mind when interpreting the results. Mean scores were divided into tertiles indicating low, medium and high mother-infant attachment.

2.17 The warmth of mother-child relationship was measured at age five using seven items from the Pianta scale (reliability acceptable, Cronbach alpha=0.67). Each item was scored as 1 definitely does not apply, 2 not really, 3 neutral, 4 applies sometimes, or 5 definitely applies. 'Can't say' responses were considered as missing. Scores were summed for parents who had completed all warmth items. A high number of parents scored the maximum of 35, and so the lowest third of parents (with scores between 7 and 33) were contrasted with the remainder (referred to as 'high warmth').

2.18 Information on each mother's activities with their child was measured at sweeps two, three and four. A count of the number of activities that the mother had carried out with the child in the past week was made for sweeps two and four (from a list of six: books/stories, played outdoors, painting or drawing, nursery rhymes or songs, letters or shape recognition, used a computer or games console). For the multivariate analysis the counts were divided into a binary outcome: low (1 to 2 activities mentioned) and high (3 to 6 activities mentioned).

2.19 There was no significant difference between mothers of non-disabled children and mothers of disabled children in the proportion scoring low on the mother-infant attachment scale. There was, however, a difference in the proportion scoring 'high warmth'. 67% of mothers with non-disabled children scored as high for the warmth of mother-child relationship compared with 59% of mothers with disabled children (Table 2.21, Table 2.22, Figure 2‑C).

Figure 2‑C Parent-child warmth at age five and parent-child activities by disability

Figure 2‑C Parent-child warmth at age five and parent-child activities by disability

2.20 At age two, mothers with a disabled child reported carrying out fewer activities with their child than mothers with non-disabled children. 26% of mothers with disabled children carried out 1 or 2 activities with their child compared with 20% of mothers with non-disabled children. However, by age four the distribution over the number of activities carried out was approximately the same for mothers with non-disabled children and mothers with disabled children (Table 2.23).

2.21 Multivariate analysis of the warmth of the mother-child relationship revealed that the sex of the child, housing tenure, parental stress, and mental wellbeing were related to this outcome (see the summary of the statistically significant factors below). Mothers were more likely to score as low warmth if their child was a boy, if they were renting compared with being an owner-occupier, if they reported high stress levels as a parent, and if they scored as having poorer levels of mental health on the medical outcomes Short-Form (SF-12) mental wellbeing subscale. Whether their child had a disability or not was not related to warmth of the mother-child relationship once these other variables were taken into consideration (Table 2.24).

Summary of multivariate analysis results: factors associated with low mother-child warmth

Child is a male

Accommodation is rented - social or private

High parenting stress

Main carer has lower mental wellbeing

2.22 The variables that were related to the level of activities carried out with the child in the multivariate analysis (summarised below) were sex of the child, equivalised household income, employment status, and mental wellbeing of the mother. The mother was more likely to have only carried out 1 or 2 activities at age four if their child was a boy, if they were in lower income quintiles for their household income, if they were staying at home to look after the home or family rather than being in full-time employment, or if they had a lower mental wellbeing score. Again, whether the child had a disability or not was not related to the level of parent-child activities once these other variables were taken into consideration (Table 2.25).

Summary of multivariate analysis results: factors associated with low parent-child activities

Child is a male

Having a lower income

Main carer not in paid employment

Main carer has lower mental wellbeing

Table 2.21 Disability by tertiles of the Condon mother-infant attachment scale (total score)

Condon mother-infant attachment scale total score - tertiles (Age 1)	Non-disabled children	Disabled children
	%	%
Low	35	36
Medium	30	29
High	35	35
Bases
Unweighted	4027	611
Weighted	4019	616

Table 2.22 Disability by warmth of parent-child relationship

Warmth of parent-child relationship - total score of 7 items on the Pianta scale (Age 5)	Non-disabled children	Disabled children
	%	%
Low warmth	33	41
High warmth	67	59
Bases
Unweighted	3108	609
Weighted	3066	636

Table 2.23 Disability by level of mother-child activities

Count of the number of activities the mother carried out with her child in the past week	Non-disabled children	Disabled children
	%	%
*Age 2*
1	6	8
2	14	18
3	21	24
4	30	25
5	27	23
6	2	2
*Age 4*
1	6	5
2	12	12
3	19	20
4	28	26
5	27	27
6	9	10
Bases
Age 1
Unweighted	3942	471
Weighted	3920	476
Age 4
Unweighted	3289	633
Weighted	3260	645

Table 2.24 Multivariate analysis of warmth of parent-child relationship at age five

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Sex (p<0.001)
Male	1	1,890
Female	0.72 (0.62,0.84)	1,824
Tenure (p<0.001)
Owner occupied	1	2,665
Social rented	1.63 (1.33,1.99)	771
Private rented	1.55 (1.17,2.05)	212
Other	1.06 (0.52,2.16)	66
Parental stress (p<0.001)
High stress	1	1,374
Medium stress	0.83 (0.68,1.01)	1,092
Low stress	0.62 (0.52,0.74)	1,248
Medical outcomes Short-Form (SF-12) mental wellbeing subscale score (p=0.003)	0.99 (0.98,1.00)	3,714

Note: Other than the standard independent variables (see appendix), the following variables were also included in the model: whether smoked cigarettes during pregnancy; whether drank alcohol during pregnancy; level of parenting stress; family type (couple or lone parent); whether used childcare; main carer's general health; whether main carer has long-standing illness; score on SF-12 mental wellbeing component

Table 2.25 Multivariate analysis of level of mother-child activities at age 4

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Sex (p<0.003)
Male	1	1,950
Female	0.74 (0.61,0.90)	1,860
Equivalised household income (p<0.001)
Bottom Quintile (<_11,250)	1	652
2nd Quintile (>=_11,250< _17,916)	1.06 (0.81,1.4)	735
3rd Quintile (>=_17,916< _25,000)	0.63 (0.47,0.84)	712
4th Quintile (>=_25,000< _37,500)	0.52 (0.39,0.71)	809
Top Quintile (>=_37,500)	0.37 (0.26,0.51)	674
missing	0.89 (0.57,1.39)	228
Employment status (p=0.042)
In full-time paid employment or self-employment	1	710
In part-time paid employment or self-employment	1.18 (0.87,1.6)	1,653
On Maternity / parental leave from an employment	0.83 (0.47,1.45)	177
Looking after home or family	1.46 (1.09,1.96)	1,059
Not in paid work	0.95 (0.59,1.54)	211
Medical outcomes Short-Form (SF-12) mental wellbeing subscale score (p=0.015)	0.99 (0.98,1.00)	3,810

Negativity

2.23 Mother-child conflict was measured at age five using eight questions from the Pianta scale. Items were scored on a 4-point scale as for the Pianta warmth items (see above). Cronbach's alpha indicated good reliability (0.80). Scores were summed for parents who had completed all conflict items and grouped into thirds as 8-12 (lowest conflict), 13-18 (medium conflict), or 19-40 (high conflict).

2.24 Harsh discipline was measured at ages two and four from parents' replies to questions about whether they had ever smacked their child at age two, and whether they had ever smacked, or smacked in the last year, at age four. Any report of smacking was contrasted with no mention of smacking.

2.25 Mothers of disabled children were more likely to score in the 'high conflict' tertile than mothers with non-disabled children; 30% of mothers with disabled children scored in the highest tertile compared with 23% of those with non-disabled children (Table 2.26).

2.26 At both sweeps two and four there was no significant difference between mothers of disabled children and mothers of non-disabled children in the proportion who had ever smacked their child (Table 2.27).

Table 2.26 Disability by mother-child conflict

Mother-child confilct - total score of 7 items on the Pianta scale (Age 5)	Non-disabled children	Disabled children
	%	%
Low conflict	41	37
Medium conflict	36	32
High conflict	23	30
Bases
Unweighted	3122	632
Weighted	3078	661

Table 2.27 Disability by whether mother ever smacked child

Whether mother ever smacked child	Non-disabled children	Disabled children
	%	%
Age 2
No	84	86
Yes	16	14
Age 4
No	55	55
Yes	45	45
Bases
Age 2
Unweighted	4022	485
Weighted	4015	491
Age 4
Unweighted	3336	655
Weighted	3318	672

Control

2.27 Parental supervision was measured at age four using an abbreviated version of the Parent Supervision Attributes Profile Questionnaire^[8]. Mothers were asked about their agreement with statements covering protectiveness ("I feel very protective of my child"; "I think of all the dangerous things that could happen"; "I keep my child from playing rough games or doing things where he/she might get hurt") and supervision while the child plays outdoors ("I can trust my child to play by (him/herself) without constant supervision"; "I stay close enough to my child so that I can get to him/her quickly"; "I make sure I know where my child is and what he/she is doing"). Answers were coded on a 5-point scale from 1 strongly agree to 5 strongly disagree. Item 4 was reverse-coded, and a mean score of the six items (Cronbach's alpha=0.67, indicating acceptable reliability) was computed and divided into thirds of low, medium and high parental supervision.

2.28 Parental supervision was also measured at age six using questions where the parent indicated where, amongst a list of places, the child was permitted to go on his/her own without constant adult supervision (but with siblings or friends). The list ranged from the child's own garden and street, to a local shop or play area. A count of the number of places the child was allowed to go on his/her own was computed from these questions.

2.29 Rules and routines were measured at ages two and five. A count of the number of 'rules' or routines at sweeps two and five were derived from the following: 'always' responses to a question on regular meals at age two and a question on regular bedtime at age five, and four questions at age five on whether the child had to tidy up toys, brush teeth, stay in room, and turn off TV or music in room (using 4-point scale - always/usually/sometimes/never or almost never).

2.30 Home chaos was measured at age five using an abbreviated version of the Confusion, Hubbub, and Order scale^[9]. This was devised as a measure of household disorganisation that captures noise, crowding, home 'traffic' (people coming and going) and a lack of routine or regularity. A number of studies suggest that household disorganisation may impair effective parenting

2.31 For the chaos scale, mothers were asked for their agreement with four items (Cronbach alpha=0.63, indicating acceptable reliability): "It's really disorganised in our home", "You can't hear yourself think in our home", "The atmosphere in our home is calm" and "First thing in the day, we have a regular routine at home". The first two items were reverse coded. Mean scores were divided into three groups, indicating low, medium and high levels of chaos. Because of large numbers of tied scores these groups were unequal in size, with 49% in low, 16% in medium and 35% in high chaos homes.

2.32 Mothers with disabled children exhibited a higher level of parental supervision than mothers with non-disabled children. At age four, a higher proportion of mothers with disabled children scored in the highest group for parental supervision score (46% compared with 40% of mothers with non-disabled children, Figure 2‑D). At age six, mothers with disabled children were more likely to allow their child to go to fewer places on their own than mothers with non-disabled children - 53% of mothers with disabled children allowed them to go to two or more places on their own compared with 63% of mothers with non-disabled children. Similarly, 11% of mothers with disabled children did not allow their child outdoors without an adult compared with 6% of mothers with non-disabled children (Table 2.28, Table 2.29, Table 2.30).

Figure 2‑D Level of parental supervision at age four by disability

Figure 2‑D Level of parental supervision at age four by disability

2.33 For rules and routines, there appeared to be no difference between mothers of disabled children and mothers of non-disabled children. 72% of both groups always had regular meals for their child at age two, while at age five the number of rules and routines always followed were similar for both groups (Table 2.32).

2.34 Mothers with disabled children were more likely to score in the highest tertile for home chaos, with 44% doing so compared with 33% of mothers with non-disabled children (Table 2.33).

Table 2.28 Disability by tertiles of the parental supervision mean score

Tertiles of parental supervision mean score (Age 4)	Non-disabled children	Disabled children
	%	%
High	40	46
Medium	26	25
Low	34	30
Bases
Unweighted	3336	653
Weighted	3318	670

Table 2.29 Disability by the number of places the child was allowed to go on their own

Number of places child allowed to go on own (Age 6)	Non-disabled children	Disabled children
	%	%
0	6	11
1	31	36
2	21	18
3	17	15
4	13	11
5+	12	9
Bases
Unweighted	2994	661
Weighted	2975	680

Table 2.30 Disability by whether child allowed outdoors without adult

Whether child allowed outdoors without an adult (Age 6)	Non-disabled children	Disabled children
	%	%
Yes	94	89
No	6	11
Bases
Unweighted	2994	661
Weighted	2975	680

Table 2.31 Disability by how often child has regular meals

How often child has regular meals (Age 2)	Non-disabled children	Disabled children
	%	%
Always	72	72
Usually	24	25
Sometimes, never, or almost never	3	4
Bases
Unweighted	4023	485
Weighted	4016	491

Table 2.32 Disability by rules and routines

Number of rules or routines always followed out of 5 items (Age 5)	Non-disabled children	Disabled children
	%	%
0	3	2
1	12	13
2	23	23
3	33	31
4	22	24
5	6	6
Bases
Unweighted	3181	648
Weighted	3146	681

Table 2.33 Disability by home chaos score

Tertiles of home chaos mean score (Age 5)	Non-disabled children	Disabled children
	%	%
Low	27	21
Medium	40	35
High	33	44
Bases
Unweighted	3184	648
Weighted	3151	681

Child development

2.35 Physical, cognitive and social, emotional and behavioural development are measured at repeated points throughout the first six sweeps of GUS. Here, we restrict analysis to sweeps one, three and five.

2.36 Developmental milestones were assessed by the main respondents' reports on their child's developmental status at ages 10 months and three years, using 14 items derived from the Denver Development Screening Test^[10]. At 10 months, these items covered gross (e.g. has the child sat up without being supported) and fine (e.g. had the child grabbed objects using his/her whole hand) motor skills plus early communicative gestures (e.g. has the child waved bye-bye on his/her own when someone leaves). At age three, items on gross and fine motor skills were again included, plus items on independence (e.g. can the child get dressed alone). The items used differ at each age reflecting the child's expected developmental stage. For each item, the respondent was asked to indicate whether or not the child could perform the action. A measure was constructed for each sub-set indicating the number of milestones missed.

2.37 Cognitive development was measured by expressive vocabulary (knowledge of words) and non-verbal reasoning (problem solving) ability. Assessments of cognitive ability were included at sweeps three and five. Comparisons are made of average scores between disabled and non-disabled children.

2.38 Social, emotional and behavioural development was measured at all sweeps from four to six using parent's reports on the Strength and Difficulties Questionnaire (SDQ), a brief behavioural screening questionnaire designed for use with 3-16 year olds^[11]. The scale includes 25 questions which are used to measure five aspects of the child's development: emotional symptoms, conduct problems, hyperactivity/ inattention, peer relationship problems and pro-social behaviour. A score is calculated for each of these domains, as well as an overall 'difficulties' score which is generated by summing the scores from all the scales except pro-social. The scores at sweeps four and five were banded into normal, moderate and severe ranges.

2.39 There were significant differences between disabled and non-disabled children in the number of developmental milestones missed (Figure 2‑E). For gross motor skills, disabled children were more likely to miss more milestones at both sweeps, with 9% missing three or more milestones at 10 months compared with 2% of non-disabled children, and 13% missing two or more milestones at age three compared with 6% of non-disabled children. For fine motor skills, 11% of disabled children missed one or more milestones at 10 months compared with 6% of non-disabled children, while at age three 15% missed three or more milestones compared with 8% of non-disabled children. At age three however, approximately the same proportion of disabled children and non-disabled children missed no fine motor skills milestones (32% and 33% respectively; Table 2.34, Table 2.35).

Figure 2‑E % of children who missed gross and fine motor developmental milestones missed at 10 months and age three by disability

Figure 2‑E % of children who missed gross and fine motor developmental milestones missed at 10 months and age three by disability

2.40 At 10 months, disabled children were more likely to miss three or more communicative gestures milestones - though only a small proportion did so. 7% missed this many compared with 4% of non-disabled children, however 18% of both groups missed no communicative gestures milestones. At age three, 40% of both groups missed no independence milestones, but 5% of disabled children missed three of these milestones compared with 2% of non-disabled children.

2.41 Disabled children had a lower average problem solving ability score than non-disabled children at both ages three and five. They also had a lower mean vocabulary ability score at both sweeps (Table 2.36).

2.42 Disabled children were more likely to score in the severe band for the total SDQ score, as well as for each of the five subscales, at both ages four and five (Figure 2‑F). 12% of disabled children at age four and 11% at age five scored in the severe band for the total score, compared with 4% of non-disabled children at both sweeps. The most marked difference occurred for the hyperactivity subscale, with a percentage point difference in the severe band of 11 between disabled and non-disabled children at age four and a percentage point difference of nine at age five (Table 2.37).

Figure 2‑F % of children with a score on the SDQ total difficulties scale in the normal, moderate or severe range at ages four and five by disability

Figure 2‑F % of children with a score on the SDQ total difficulties scale in the normal, moderate or severe range at ages four and five by disability

2.43 Multivariate analysis was conducted using developmental milestones at sweeps one and three as the dependent variables. A total count of milestones missed over the three domains at each age (gross motor skills, fine motor skills and communicative gestures at 10 months, and gross motor skills, fine motor skills and independence at age three) was constructed and then banded into binary outcomes indicating whether the child had missed 2 or more milestones versus one or none.

2.44 At 10 months, children were more likely to have missed two or more developmental milestones if:

They had been born weeks early compared with on time (but less likely if they had been born late);
Their mother was aged 30 or over when they were born;
They lived in less deprived areas;
Their mother had consumed any alcohol during her pregnancy;
They had spent seven or more days in a special care baby unit or neonatal unit;
Their mother was not employed full-time (in the past seven days);
Their mother was living with a spouse or partner.

2.45 Having a disability at 10 months was not itself associated with having missed two or more developmental milestones. However, it is notable that some of the factors which are associated with having missed milestones were also shown to be associated with having a disability at 10 months (Table 2.38).

2.46 At age three, the variables found to be associated with an increased likelihood of missing two or more developmental milestones (summarised below) were living in less deprived areas, being a male child, and being born as part of a multiple birth. Again, having a disability was not independently associated (Table 2.39).

Summary of multivariate analysis results: factors associated with child missing two or more developmental milestones at age three

Child is a male

Multiple birth

Live in an area with lower deprivation

2.47 A further model was run to examine whether disability was associated with having a score in the moderate or severe range on the total difficulties scale of the SDQ at age five. The results are summarised below. In this instance, the results show a significant relationship between disability and total difficulties score. After controlling for key socio-economic characteristics, the odds of disabled children having a score in the moderate or severe range were 1.8 times higher than those for non-disabled children. Other than disability, having a moderate or severe total difficulties score was associated with a range of other factors including the child's sex, ethnicity, area deprivation, household income and parental employment (Table 2.40).

Summary of multivariate analysis results: factors associated with child scoring in the moderate or severe range of SDQ total difficulties at age five

Child has a disability

Child is a male

Live in an area with lower deprivation

Live in rented accommodation

Lower household income

Mother did not keep well during pregnancy

Child is from minority ethnic background

Mother is not in employment

Child spent 7+ days in a neonatal unit after birth

Table 2.34 Disability by number of milestones missed at 10 months

Number of milestones missed (age 1)	Non-disabled children	Disabled children
	%	%
Gross motor coordination
0	24	19
1	63	57
2	11	15
3+	2	9
Fine motor coordination
0	94	89
1+	6	11
Communication/gestures
0	18	18
1	61	58
2	17	17
3+	4	7
Bases*
Unweighted	4514	681
Weighted	4507	688

*Bases vary for each set of items. Those shown are the smallest.

Table 2.35 Disability by number of milestones missed at age 3

Number of milestones missed (age 3)	Non-disabled children	Disabled children
	%	%
Gross motor coordination
0	70	64
1	24	23
2+	6	13
Fine motor coordination
0	33	32
1	37	30
2	22	24
3+	8	15
Independence
0	40	40
1	33	30
2	25	26
3	2	5
Bases*
Unweighted	3492	576
Weighted	3484	586

*Bases vary for each set of items. Those shown are the smallest.

Table 2.36 Disability by cognitive development

Cognitive development	Non-disabled children	Disabled children
Picture similarities ability mean score
Age 3	54.1	50.6
Age 5	83.0	80.7
Naming vocabulary ability mean score
Age 3	72.0	67.2
Age 5	109.6	104.9
Bases*
Age 3
Unweighted	3395	531
Weighted	3358	534
Age 5
Unweighted	3115	607
Weighted	3072	633

*Bases vary for each set of items. Those shown are the smallest.

Table 2.37 Disability by social, emotional and behavioural development

Cognitive development	Non-disabled children	Disabled children
	%	%
SDQ conduct problems banded score
Age 4
Normal	71	59
Moderate	16	22
Severe	13	20
Age 5
Normal	75	65
Moderate	14	17
Severe	11	17
SDQ emotional symptoms banded score
Age 4
Normal	94	87
Moderate	4	6
Severe	2	7
Age 5
Normal	92	86
Moderate	4	8
Severe	4	7
SDQ hyperactivity banded score
Age 4
Normal	83	70
Moderate	7	9
Severe	10	21
Age 5
Normal	80	72
Moderate	9	8
Severe	11	20
SDQ peer problems banded score
Age 4
Normal	85	79
Moderate	8	10
Severe	7	11
Age 5
Normal	87	75
Moderate	7	11
Severe	6	14
SDQ pro-social banded score
Age 4
Normal	90	85
Moderate	7	8
Severe	3	8
Age 5
Normal	93	87
Moderate	5	8
Severe	1	5
SDQ total difficulties banded score
Age 4
Normal	91	76
Moderate	6	12
Severe	4	12
Age 5
Normal	89	78
Moderate	6	11
Severe	4	11
Bases*
Age 4
Unweighted	3298	640
Weighted	3275	656
Age 5
Unweighted	3149	636
Weighted	3111	666

*Bases vary for each set of items. Those shown are the smallest.

Table 2.38 Multivariate analysis of developmental milestones at 10 months

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Time spent in a special care baby unit or neo-natal unit (p<0.0012)
Did not spend any time	1	4,432
0-2 days	1.03 (0.77,1.38)	202
3-6 days	1.00 (0.69,1.44)	138
7+ days	2.24 (1.40,3.58)	235
Timing of birth (p<0.001)
Early - days	0.81 (0.65,1.02)	924
Early - weeks	1.36 (1.06,1.74)	1,145
Late	0.73 (0.61,0.88)	2,251
On time	1	687
Age of mother at birth (p=0.003)
Under 20	1	340
20 to 29	1.19 (0.91,1.54)	2,009
30 to 39	1.51 (1.15,1.98)	2,485
40 or older	1.43 (0.92,2.24)	173
Mother's alcohol consumption during pregnancy (p<0.001)
1-2 times per week plus	1.62 (1.16,2.25)	197
2-3 times a month	1.41 (1.04,1.9)	236
less than once a month	1.39 (1.17,1.65)	900
Never - did not drink at all	1	3,674
Scottish Index of Multiple Deprivation 2006 Quintiles (p=0.002)
0.9449 - 7.7446 - least deprived	1	984
7.7472 - 13.5627	0.81 (0.65,1.00)	1,028
13.5640 - 21.0436	0.71 (0.58,0.87)	1,003
21.0521 - 33.6982	0.69 (0.55,0.85)	884
33.7252 -89.0941 - most deprived	0.62 (0.48,0.79)	1,108
Employment status (p=0.012)
In full-time paid employment or self-employment	1	766
In part-time paid employment or self-employment	1.27 (1.05,1.54)	1,900
On maternity / parental leave from an employer	1.68 (1.16,2.44)	240
Looking after home or family	1.38 (1.14,1.66)	1,868
Not in paid work	1.35 (0.94,1.93)	233
Respondents cohabiting status (p=0.003)
Not living with spouse/partner	1	940
Living with spouse/partner	1.40 (1.13,1.74)	4,067

Table 2.39 Multivariate analysis of developmental milestones at 34 months

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Sex (p<0.001)
Male	1	2,064
Female	0.40 (0.35,0.46)	1,968
Scottish Index of Multiple Deprivation 2006 Quintiles (p=0.002)
0.9449 - 7.7446 - least deprived	1	870
7.7472 - 13.5627	1.02 (0.81,1.29)	834
13.5640 - 21.0436	0.73 (0.57,0.92)	843
21.0521 - 33.6982	0.82 (0.66,1.02)	672
33.7252 -89.0941 - most deprived	0.7 (0.56,0.88)	813
Single or multiple pregnancy (p=0.013)
Single pregnancy	1	3,962
Multiple pregnancy	2.2 (1.19,4.09)	70

Table 2.40 Multivariate analysis of factors associated with child scoring in the moderate or severe range of SDQ total difficulties at age five

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Disability (p < 0.001)
No	1	3,105
Yes	1.82 (1.43, 2.31)	626
Time spent in a special care baby unit or neo-natal unit (p<0.03)
Did not spend any time	1	3,336
0-2 days	0.57 (0.30,1.09)	138
3-6 days	1.54 (0.88,2.86)	97
7+ days	1.64 (1.08,2.51)	160
Scottish Index of Multiple Deprivation 2006 Quintiles (p=0.005)
0.9449 - 7.7446 - least deprived	1	833
7.7472 - 13.5627	1.12 (0.72,0.64)	830
13.5640 - 21.0436	2.05 (1.36,1.77)	751
21.0521 - 33.6982	1.70 (1.11,3.09)	668
33.7252 -89.0941 - most deprived	1.77 (1.15,2.58)	649
Maternal employment status (p=0.03)
In full-time paid employment or self-employment	1	886
In part-time paid employment or self-employment	1.07 (0.72,1.60)	1,560
On maternity / parental leave from an employer	1.10 (0.53,2.31)	125
Looking after home or family	1.52 (1.03,2.24)	957
Not in paid work	1.35 (1.21,3.82)	203
Sex (p<0.001)
Male	1	1,905
Female	0.51 (0.41,0.64)	1,826
Housing tenure (p<0.001)
Owner occupied	1	2,666
Social rented	1.92 (1.43, 2.59)	785
Private rented	1.56 (1.04, 2.34)	212
Other	1.37 (0.65, 2.89)	68
Annual equivalised household income quintile (p=0.006)
Bottom Quintile (<£12,217)	1	694
2nd Quintile (>=£12,217 <£19,643)	0.68 (0.49, 0.96)	782
3rd Quintile (>=£19,643 < £29,126)	0.79 (0.53, 1.18)	634
4th Quintile (>=£29,126 < £37,857)	0.59 (0.39, 0.89)	837
Top Quintile (>=£37,857)	0.41 (0.25, 0.66)	580
Missing	0.82 (0.51, 1.32)	204
How mother kept during pregnancy (p<0.014))
Very well	1	1,949
Fairly well	1.45 (1.12, 1.88)	1,305
Not very well	1.68 (1.18, 2.39)	355
Not at all well	1.79 (0.98, 3.26)	122
Ethnicity of child
White	1	3,603
Other ethnic group	2.23 (1.45, 3.43)	128

Family structure and couple relationships

2.48 Parental separation was measured following the rules applied by Chanfreau et al in their analysis of GUS data on change in early childhood^[12]. Separation is identified when families with two parents living together, whether married or cohabiting, are no longer living together when the interviewer returns a year later. Chanfreau et al found that almost all (98%) of the GUS children whose parents separated went on to live with their mother. Only separations which occur after the first interview were considered. Unlike Chanfreau et al, we will not exclude those cases where the mother re-partnered after the initial separation.

2.49 A set of nine items was included in the self-complete section of the questionnaire at sweeps two and four which measure the relationship between the respondent and his/her partner. Respondents were asked the extent to which they agree or disagree with a series of statements such as: "My husband/wife/partner is usually sensitive to and aware of my needs" and "I suspect we may be on the brink of separation". These items were re-coded and a scale constructed where a higher score indicates a less secure relationship. Scores on the scale were then banded to identify three groups and comparisons made of the proportion of parents of disabled and non-disabled children in each group.

2.50 Parents of disabled children were more likely to be in the least secure band for the strength of couple relationships score, at both sweeps two and four (Figure 2‑G). At age two, 43% of parents of disabled children scored in this band (40% at age four), compared with 37% of parents of non-disabled children (and 32% at age four, Table 2.41).

2.51 Parents of disabled children were less likely to remain as a stable couple throughout all six sweeps (Figure 2‑G). 75% of parents with disabled children remained as a couple (i.e. did not separate at any sweep) compared with 83% of parents with non-disabled children (Table 2.42).

Figure 2‑G Strength of couple relationship at age four and relationship stability from 10 months to age six by disability

Figure 2‑G Strength of couple relationship at age four and relationship stability from 10 months to age six by disability

2.52 Multivariate analysis of the strength of couple relationships was conducted at age two, with a binary outcome variable equal to one if scored in the least secure band and zero otherwise. A summary of the statistically significant factors is provided below. Parents were found to be more likely to be in a less secure relationship if they were in lower income bands for equivalised household income, if the mother was aged 40 or over at the birth of the child, if the respondent reported being in good, fair, or poor health compared with excellent health, and if the respondent had lower mental wellbeing as measured by the medical outcomes Short-Form (SF-12) mental wellbeing subscale. There was no statistically significant relationship between disability and having a less secure couple relationship (Table 2.43).

Summary of multivariate analysis results: factors associated with low score on strength of couple relationship scale

Lower household income

Mother aged 40 or older at child's birth

Main carer had less than 'excellent' health

Lower mental wellbeing

Table 2.41 Disability by strength/nature of couple relationships

Tertiles of score for strength/nature of couple relationships	Non-disabled children	Disabled children
	%	%
Age 2
Most secure	29	27
Moderate	34	30
Least secure	37	43
Age 4
Most secure	38	29
Moderate	30	31
Least secure	32	40
Bases
Age 2
Unweighted	3206	357
Weighted	3064	342
Age 4
Unweighted	2744	502
Weighted	2593	483

Table 2.42 Disability by longitudinal family type

Longitudinal family type: separation event	Non-disabled children	Disabled children
	%	%
Stable couple family throughout	83	75
Parents separated	5	9
Partnered or re-partnered	12	16
Bases
Unweighted	2558	560
Weighted	2433	561

Table 2.43 Multivariate analysis of strength/nature of couple relationships at age two

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Equivalised household income (p<0.001)
Bottom Quintile (<£8,410)	1	295
2nd Quintile (>=£8,410< £13,750)	0.70 (0.51,0.96)	589
3rd Quintile (>=£13,750< £21,785)	0.71 (0.53,0.95)	659
4th Quintile (>=£21,785< £33,571)	0.57 (0.42,0.77)	856
Top Quintile (>=£33,571)	0.47 (0.35,0.63)	811
missing	0.74 (0.51,1.07)	327
Age of mother at birth (p=0.002)
Under 20	1	94
20 to 29	1.20 (0.70,2.04)	1,239
30 to 39	1.46 (0.86,2.46)	2,065
40 or older	2.30 (1.23,4.29)	139
General health status (p<0.001)
Excellent	1	739
Very Good	1.19 (0.98,1.44)	1,537
Good	2.07 (1.67,2.57)	914
Fair or poor	2.87 (2.12,3.88)	347
Medical outcomes Short-Form (SF-12) mental wellbeing subscale score (p=0.015)	0.96 (0.95,0.97)	3,537

Note: Other than the standard independent variables (see appendix), the following variables were also included in the model: how mother kept during pregnancy; whether mother had any illness in pregnancy; whether smoked cigarettes during pregnancy; whether drank alcohol during pregnancy; whether child was born early, late or on time; type of delivery; whether child was single or multiple birth; any time spent in neonatal or special care baby unit; partner's employment status; use of any childcare; main carer's general health; whether main carer has longstanding illness; main carer's score on SF-12 mental wellbeing component

Parents' mental health and emotional wellbeing

2.53 GUS has measured parents' mental health and emotional wellbeing using a range of instruments at different sweeps. The Medical Outcomes Short-Form (SF-12) - which includes a sub-scale covering mental wellbeing - was used at sweeps one, three, five and six, whilst selected items from the Depression, Anxiety and Stress scale were included at sweeps two and four. As the SF-12 data was available at sweeps one, three and five, we here focussed on comparisons of mean scores on the mental wellbeing component between parents of disabled and non-disabled children.

2.54 In addition to these measures of mental health and wellbeing, at age five, a series of questionnaire items were included to measure parenting stress. A variable indicating the reported level of stress related to parenting was created by taking the sum of the parent's response to the following statements (1=strongly disagree, 2=somewhat disagree, 3=somewhat agree, 4=strongly agree): being a parent is harder than I thought it would be; I feel trapped by my responsibilities as a parent; I find that taking care of my child(ren) is much more work than pleasure; I often feel tired, worn out, or exhausted from raising a family. Scores were banded into three groups to show higher and lower levels of stress. The proportion of parents in each band is compared.

2.55 At all three sweeps, parents of disabled children had a lower mean score on the SF-12 mental wellbeing subscale, indicating that they were more likely to have lower mental wellbeing than parents with non-disabled children (Table 2.44).

2.56 Parents of disabled children were also more likely to score in the high stress band for parental stress than parents of non-disabled children. 43% of parents with disabled children scored in this band compared with 37% of parents with non-disabled children (Table 2.45).

2.57 Multivariate analysis of parental stress was conducted by using a binary measure of these three bands, comparing those in the high stress band to those in the moderate or low stress bands. The significant factors are noted below. Respondents were found to be more likely to score in the high stress band if they were not in employment, if their child was a boy, if they scored lower on the SF-12 mental wellbeing subscale, and if they had regular childcare for their child. Disability at age five was not independently associated with higher parental stress (Table 2.46).

Summary of multivariate analysis results: factors associated with having high parental stress at age five

Child is a male

Main carer was not in employment

Main carer had lower mental wellbeing

Used regular childcare

Table 2.44 Disability by mean scores on the mental wellbeing SF-12 subscale

Medical Outcomes Short-Form (SF-12) mental wellbeing subscale mean score	Non-disabled children	Disabled children
Age 1	50.2	48.2
Age 3	49.9	47.4
Age 5	50.5	48.1
Bases
Age 1
Unweighted	4503	679
Weighted	4495	686
Age 3
Unweighted	3572	594
Weighted	3560	602
Age 5
Unweighted	3163	643
Weighted	3125	675

Table 2.45 Disability by feelings about being a parent

Tertiles of total score from 4 items of feelings about being a parent (age 5)	Non-disabled children	Disabled children
	%	%
High stress	37	43
Medium stress	29	30
Low stress	34	26
Bases
Unweighted	3182	648
Weighted	3149	681

Table 2.46 Multivariate analysis of parental stress when child was aged five

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Employment status (p<0.001)
In full-time paid employment or self-employment	1	902
In part-time paid employment or self-employment	1.29 (1.07,1.55)	1,589
On Maternity / parental leave from an employer	1.12 (0.74,1.68)	126
Looking after home or family	1.67 (1.38,2.02)	979
Not in paid work	1.53 (1.08,2.18)	208
Sex of the child (p=0.045)
Male	1
Female	0.85 (0.73,1)
Respondent uses regular childcare (p=0.014)
Yes	1	3,207
No	0.77 (0.63,0.95)	597
Medical outcomes Short-Form (SF-12) mental wellbeing subscale score (p=0.005)	0.93 (0.92,0.94)	3,804

Note: Other than the standard independent variables (see appendix), the following variables were also included in the model: how mother kept during pregnancy; whether mother had any illness in pregnancy; whether smoked cigarettes during pregnancy; whether drank alcohol during pregnancy; whether child was born early, late or on time; type of delivery; whether child was single or multiple birth; any time spent in neonatal or special care baby unit; family type (couple or lone parent); any use of childcare; main carer's general health; whether main carer had longstanding illness; main carer's consumption of alcohol; score on SF12 mental wellbeing scale

Parents' experiences of support and information services

2.58 GUS has not asked the parents of disabled children directly about their experiences of services designed specifically for them. However, all parents have been asked more generally about their use of various health and support services at different sweeps of the study. These questions have tended to focus on the types of sources used for information and support rather than assessments of usefulness (or satisfaction), accessibility or availability^[13].

2.59 Questions about sources of information and accessing support are grouped into five areas: child health or behaviour, pre-school, primary school, local services and amenities, and parenting.

2.60 Child health and behaviour: a series of questions were included at sweeps one to four which asked parents what sources they had used for information or advice about child health and, separately, child behaviour. Here we examine differences in the number and types of sources used by parents of disabled and non-disabled children at age 10 months and four years for health and ages two and three for behaviour. In addition, at sweeps three and four parents were also asked if, at any point in the last year, they were unable to find the information they were looking for. Comparisons are also made on responses to this item.

2.61 Pre-school: at age four, parents were asked whether, and from whom, they had sought any advice on the child's pre-school enrolment. Sources included pre-school staff, friends and the internet. Again, the number and types of sources are examined.

2.62 Primary school: A range of questions were asked at age five around support sought when the child was starting Primary School. These included: sources used for information about enrolment; whether the parent was unable to find any information about enrolment; and satisfaction with advice and information about starting school.

2.63 Availability and use of local services/amenities: at age three, a series of questions explored the extent to which certain services or amenities - such as a parent/toddler group, community health service or library - were available in the family's local area and whether or not they used it.

2.64 Parenting: questions about parents' satisfaction with the information available to them as a parent and with the services available to support them in their role as a parent were asked at age six. Analysis of these two items was undertaken.

2.65 While parents of disabled children used a similar number of sources of information on their child's health at 10 months as parents of non-disabled children, at age four they were more likely to use more sources of information (Figure 2‑H). 89% of parents of disabled children had used at least one source of information at age four compared with 68% of parents with non-disabled children. In addition, while 11% used six or more sources of information only 5% of parents with non-disabled children had also done so (Table 2.47).

Figure 2‑H % of parents using sources of information on child health and child behaviour at age four by disability

Figure 2‑H % of parents using sources of information on child health and child behaviour at age four by disability

2.66 Parents of disabled children used a higher number of sources of information on their child's behaviour at ages two and three compared with parents of non-disabled children. Just under half (46% at age two and 49% at age three) of parents with disabled children used at least one source of information on their child's behaviour compared with about 40% (38% at age two and 40% at age three) of parents with non-disabled children (Table 2.48).

2.67 The most common source of advice used on the child's health was the family doctor for both parents of disabled children and parents of non-disabled children (at both ages one and four). At 10 months, 89% of parents with disabled children asked their family doctor for advice, while 72% of parents with non-disabled children did. 63% of parents with disabled children said they asked a health visitor for advice and 20% said they used the internet for advice or information. 36% said they used the NHS 24 telephone helpline at age four (Table 2.49).

2.68 For behavioural advice the most common source used by parents of disabled children at age two was a health visitor, with 22% of parents using this source. However, at age three a higher proportion used their own parents or other families for advice; 24% reported using their own parents and 23% said they used other families as a source of advice, compared with 19% using a health visitor. The most used source of information on behavioural advice by parents of non-disabled children was their own parents at both sweeps, with 18% at age two and 21% at age three using this source (Table 2.50).

2.69 4% of parents with disabled children reported being unable to find help on their child's health (at both ages three and four) compared with 1% of parents with non-disabled children (Table 2.51).

2.70 There was no significant difference between parents of disabled children and parents of non-disabled children on the number of sources of information or advice used about pre-school enrolment. In addition, both sets of parents appeared to use similar sources, with 26% of parents with disabled children and 31% of parents with non-disabled children asking friends for advice. 27% and 26% respectively asked pre-school staff for advice (Table 2.52, Table 2.53).

2.71 Similarly, there was no significant difference for the number of sources of information or advice used about primary school enrolment, and the sources used were again very similar. Pre-school staff were the most common source of information followed by friends and primary school staff. Only 1% of parents with disabled children and 2% of parents with non-disabled children were unable to find the help or advice they wanted on primary school enrolment (no significant difference). There was also no difference in the satisfaction with the advice, information or support available about their child's start at primary school. Only 5% of both groups of parents were not satisfied with the information available (Table 2.54 to Table 2.57)

2.72 The two most widely used facilities in the local area for both parents of disabled children and parents of non-disabled children were the family doctor and the playground/park. However, a higher proportion of parents with non-disabled children used both their GP and the playground/park than parents with disabled children.^[14] A higher proportion of parents with non-disabled children also used a local community health service and a local library (Table 2.58).

2.73 There was no difference in the proportion of parents of disabled children and parents of non-disabled children who were not at all satisfied with the information available to them as a parent, with 3% of both groups reporting this. However, a higher proportion of parents with disabled children reported being not at all satisfied with the support services available to them in their role as a parent compared with parents of non-disabled children (6% and 4% respectively reported this; Table 2.59,Table 2.60).

2.74 Multivariate analysis of the number of local leisure facilities used 'often' (results summarised below) revealed that parents were more likely to only use these facilities sometimes or not at all (even though they were available locally) if they lived in more deprived areas, if they were in lower income quintiles, if they did not have regular childcare, and if the respondent had a lower mental wellbeing score (SF-12). Whether their child was disabled or not had no impact on this outcome once these other factors were controlled for (Table 2.61).

2.75 Summary of multivariate analysis results: factors associated with using local facilities less than 'often' at age two

Lower household income

Not using regular childcare

Main carer has lower mental wellbeing

2.76 Multivariate analysis showed that parents were less likely to be satisfied with the information available on parenting if they had equivalised household income in the middle quintile compared with in the lowest quintile, and if they agreed with the statement that 'Nobody can teach you how to be a good parent, you just have to learn for yourself' (Table 2.62).

Summary of multivariate analysis results: factors associated with dissatisfaction with information available about parenting at age six

Household income in the middle 20% of incomes (middle quintile)

Agree that 'Nobody can teach you how to be a good parent, you just have to learn for yourself'

2.77 In considering factors associated with parents being unsatisfied with the support services available to them, the multivariate analysis found less satisfaction if parents were in the middle income quintile compared with the lowest income quintile, and if they currently reported being in fair or poor health compared with being in excellent health. Having a disabled child had no impact on whether they were not satisfied with the support services available once these other factors were taken into account (Table 2.63).

Summary of multivariate analysis results: factors associated with dissatisfaction with support services available to parents

Household income in the middle 20% of incomes (middle quintile)

Main carer has fair or poor health

Table 2.47 Disability by the number of sources of information used by parents on the child's health

Number of sources of information used on child's health	Non-disabled children	Disabled children
	%	%
Age 1
1	17	14
2	24	24
3	24	23
4	16	17
5	10	11
6+	9	12
Age 4
0	32	11
1	19	15
2	18	21
3	14	19
4	8	13
5	5	10
6+	5	11
Bases
Age 1
Unweighted	4061	671
Weighted	4051	679
Age 4
Unweighted	3336	655
Weighted	3318	672

Note: The data from 10 months excludes cases where no sources were used as there was only a very small number of these.

Table 2.48 Disability by the number of sources of information used by parents on the child's behaviour

Number of sources of information used on child's behaviour	Non-disabled children	Disabled children
	%	%
Age 2
0	62	54
1	14	16
2	11	13
3	7	8
4+	5	9
Age 3
0	60	51
1	13	16
2	11	13
3	8	8
4+	8	13
Bases
Age 2
Unweighted	4023	485
Weighted	4016	491
Age 3
Unweighted	3590	599
Weighted	3581	607

Table 2.49 Disability by sources of advice on health used in the last year

Sources of advice used in the last year	Non-disabled children	Disabled children
	%	%
Age 1
Books or leaflets on childcare or family health	19	22
The Internet	12	20
Family doctor	72	89
Telephone helpline	19	22
Own parents	44	46
Partners parents	17	17
Other parents	7	8
Own grandparents	2	3
Partners grandparents	1	2
Other friends or family with children	25	25
Health visitor	58	63
Other	3	9
None of these sources	10	2
Age 4
Books/leaflets	7	10
Internet	15	23
Family doctor/GP	54	76
Own parents	25	31
Partners parents	9	11
Other parents	3	5
Own grandparents	2	3
Partner grandparents	1	1
Other families	15	21
Health visitor	14	29
Practice nurse	6	11
Psychologist	0	3
NHS 24	23	36
Other helpline	0	1
Pre-school staff	6	12
Other carers	1	1
LA staff	0	2
Social workers	0	2
Other professional	4	17
Other	1	3
None	32	11
Bases
Age 1
Unweighted	4527	683
Weighted	4519	690
Age 4
Unweighted	3336	655
Weighted	3318	672

Table 2.50 Disability by sources of behavioural advice used in the last year

Sources of behavioural advice used in the last year	Non-disabled children	Disabled children
	%	%
Age 2
Books/leaflets	7	8
Internet	5	5
Family doctor/GP	4	13
Own parents	18	19
Partners parents	6	6
Other parents	5	3
Own grandparents	1	2
Partners grandparents	0	0
Other families	15	14
Health visitor	13	22
Practice nurse	0	1
Psychologist	0	1
NHS 24	1	4
Other helpline	0	-
Pre-school staff	4	5
Other carers	2	1
LA staff	0	1
Social workers	0	2
Other professionals	1	2
Other	1	2
None	62	54
Age 3
Books/leaflets	6	9
Internet	6	10
Family doctor/GP	7	11
Own parents	21	24
Partners parents	8	5
Other parents	3	5
Own grandparents	1	2
Partners grandparents	0	0
Other families	18	23
Health visitor	13	19
Practice nurse	0	0
Psychologist	0	2
NHS 24	2	4
Other helpline	0	0
Pre-school staff	7	10
Other carers	2	2
LA staff	0	0
Social workers	0	2
Other professionals	1	3
Other	1	2
None	60	51
Bases
Age 2
Unweighted	4021	485
Weighted	4014	491
Age 3
Unweighted	3590	599
Weighted	3581	607

Table 2.51 Disability by unable to find help on health

Unable to find the help, information or advice respondent was looking for (in the past year)	Non-disabled children	Disabled children
	%	%
Age 3
Yes (unable)	1	4
No (able)	99	96
Age 4
Yes (unable)	1	4
No (able)	99	96
Bases
Age 3
Unweighted	2643	546
Weighted	2628	555
Age 4
Unweighted	2304	584
Weighted	2288	598

Table 2.52 Disability by number of sources of information used on pre-school enrolment

Number of sources of information/advice used on pre-school enrolment (age 4)	Non-disabled children	Disabled children
	%	%
0	43	40
1	28	25
2	17	20
3	8	10
4+	4	5
Bases
Unweighted	3102	585
Weighted	3076	595

Table 2.53 Disability by sources of information used on pre-school enrolment

Sources of information/advice used on pre-school enrolment (age 4)	Non-disabled children	Disabled children
	%	%
Pre-school staff	26	27
Other carers	5	6
LA staff	8	12
Social workers	1	3
Other professional	6	14
Own/partner parents	5	8
Own/partner siblings	7	8
Friends	31	26
Internet	4	4
Books etc	1	0
TV/Radio	1	0
Neighbours	6	4
Other	5	5
None	43	40
Bases
Unweighted	3102	585
Weighted	3076	595

Table 2.54 Disability by number of sources of information used on primary school enrolment

Number of sources of information/advice used on primary school enrolment (age 5)	Non-disabled children	Disabled children
	%	%
0	39	36
1	22	21
2	19	21
3	12	13
4+	8	10
Bases
Unweighted	1046	185
Weighted	1046	196

Table 2.55 Disability by sources of information used on primary school enrolment

Sources of information/advice used on primary school enrolment (age 5)	Non-disabled children	Disabled children
	%	%
Primary school staff	21	19
Pre-school staff	37	44
Other childcarer	3	0
Local Authority	7	6
Social workers	1	2
Other professionals	3	7
Own or partner parents/grandparents	12	12
Own or partner siblings	9	10
Friends	28	31
Parentzone website	2	1
Other websites	5	4
Books, etc	1	3
TV/radio	0	-
Other	3	4
None	39	36
Bases
Unweighted	1046	185
Weighted	1046	196

Table 2.56 Disability by unable to find help, information or advice on primary school enrolment

Unable to find help, information or advice on primary school enrolment (age 5)	Non-disabled children	Disabled children
	%	%
Yes (unable)	2	1
No (able)	98	99
Bases
Unweighted	634	117
Weighted	635	125

Table 2.57 Disability by satisfaction with advice, information and support available about starting school

Satisfaction with advice, information and support available about child's start at primary school (age 5)	Non-disabled children	Disabled children
	%	%
Very satisfied	67	66
Quite satisfied	29	29
Neither satisfied or dissatisfied, quite dissatisfied, or very dissatisfied	5	5
Bases
Unweighted	1045	185
Weighted	1046	196

Table 2.58 Disability by facilities used in the local area

Facilities that were used in the local area sometimes or often (age 2)	Non-disabled children	Disabled children
	%	%
Parent & toddler group	42	39
Registered childminder	9	10
Playgroup	13	16
Nursery	25	29
GP (family doctor)	84	80
Community health service	71	66
Library	57	52
Swimming pool etc	56	51
Playground/park	85	79
Credit union	3	4
Advice centre	6	8
None	2	4
Bases
Unweighted	3464	403
Weighted	3399	400

Table 2.59 Disability by satisfaction with information on parenting

How satisfied with information available to them as a parent (age 6)	Non-disabled children	Disabled children
	%	%
Not at all satisfied	3	3
Neither satisfied nor dissatisfied	34	35
Slightly satisfied	9	11
Satisfied	46	42
Very satisfied	8	10
Bases
Unweighted	2874	636
Weighted	2859	654

Table 2.60 Disability by satisfaction with support services available to parents

How satisfied with services available to support them in their role as a parent (age 6)	Non-disabled children	Disabled children
	%	%
Not at all satisfied	4	6
Neither satisfied nor dissatisfied	35	35
Slightly satisfied	11	13
Satisfied	44	38
Very satisfied	6	7
Bases
Unweighted	2861	633
Weighted	2843	652

Table 2.61 Multivariate analysis of use of local leisure facilities

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Scottish Index of Multiple Deprivation 2006 Quintiles (p<0.001)
0.9449 - 7.7446 - least deprived	1	904
7.7472 - 13.5627	1.12 (0.87,1.44)	915
13.5640 - 21.0436	1.13 (0.85,1.5)	914
21.0521 - 33.6982	1.45 (1.12,1.87)	763
33.7252 -89.0941 - most deprived	1.67 (1.27,2.19)	906
Equivalised household income (p<0.001)
Bottom Quintile (<_8,410)	1	710
2nd Quintile (>=_8,410< _13,750)	1.02 (0.83,1.27)	798
3rd Quintile (>=_13,750< _21,785)	0.92 (0.75,1.13)	745
4th Quintile (>=_21,785< _33,571)	0.8 (0.65,0.98)	901
Top Quintile (>=_33,571)	0.66 (0.53,0.83)	836
missing	1.15 (0.87,1.52)	412
Respondent uses regular childcare (p=0.015)
Yes	1	2,696
No	1.16 (1.03,1.31)	1,706
Medical outcomes Short-Form (SF-12) mental wellbeing subscale score (p=0.032)	0.99 (0.99,1.00)	4,402

Note: Other than the standard independent variables (see appendix), the following variables were also included in the model: how mother kept during pregnancy; whether mother had any illness in pregnancy; whether smoked cigarettes during pregnancy; whether drank alcohol during pregnancy; whether child was born early, late or on time; type of delivery; whether child was single or multiple birth; any time spent in neonatal or special care baby unit; family type (couple or lone parent); any use of childcare; main carer's general health; whether main carer had longstanding illness; score on SF12 mental wellbeing scale

Table 2.62 Multivariate analysis of satisfaction with information available on parenting at age six

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Agreement with the statement "Nobody can teach you how to be a good parent, you just have to learn for yourself" (p=0.038)
Strongly agree	1	388
Agree	0.88 (0.67,1.15)	1,361
Neither agree nor disagree	0.94 (0.70,1.27)	609
Disagree or strongly disagree	0.72 (0.55,0.95)	973
Equivalised household income (p=0.007)
Bottom Quintile (<_12,217)	1	597
2nd Quintile (>=_12,217 <_19,643)	1.20 (0.91,1.59)	703
3rd Quintile (>=_19,643 < _29,126)	1.58 (1.23,2.03)	575
4th Quintile (>=_29,126 < _37,857)	1.16 (0.85,1.57)	752
Top Quintile (>=_37,857)	1.34 (1.00,1.80)	519
missing	1.67 (1.18,2.35)	185

Note: Other than the standard independent variables (see appendix), the following variables were also included in the model; whether child was born early, late or on time; type of delivery; whether child was single or multiple birth; any time spent in neonatal or special care baby unit; family type (couple or lone parent); any use of childcare; main carer's general health; whether main carer had longstanding illness; score on SF12 mental wellbeing scale; level of parenting stress; level of home chaos; level of parent-child conflict; level of parent-child warmth; whether agree/disagree with statement "Nobody can teach you how to be a good parent, you just have to learn for yourself'.

Table 2.63 Multivariate analysis of satisfaction with support services as a parent at age six

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Equivalised household income (p=0.021)
Bottom Quintile (<_12,217)	1	608
2nd Quintile (>=_12,217 <_19,643)	1.11 (0.84,1.45)	699
3rd Quintile (>=_19,643 < _29,126)	1.36 (1.11,1.68)	585
4th Quintile (>=_29,126 < _37,857)	1.14 (0.88,1.49)	758
Top Quintile (>=_37,857)	1.25 (0.95,1.65)	522
missing	1.50 (1.06,2.14)	185
General health status (p=0.006)
Excellent	1	546
Very Good	1.10 (0.87,1.39)	1,272
Good	0.98 (0.80,1.19)	1,047
Fair or poor	1.52 (1.17,1.96)	492

Attitudes toward support

2.78 At sweeps one and four, parents were asked the extent to which they agreed or disagreed with a range of statements about help-seeking behaviour and accessing support:

"Nobody can teach you how to be a good parent - you just have to learn for yourself".
"If you ask for help or advice on parenting from professionals like doctors or social workers, they start interfering to take over".
"It's difficult to ask people for help or advice unless you know them really well".
"It's hard to know who to ask for help or advice about being a parent".

2.79 Five categories of response were available for each statement: strongly agree, agree, neither agree nor disagree, disagree, or disagree strongly. Agreement with the statements suggests reluctance to engage with formal services. For example, if the respondent agreed that when asking for help or advice from professionals they start interfering and trying to take over, this would suggest they are more likely to feel uncomfortable seeking help and advice from these formal sources.

2.80 Parents of disabled children were similar to those with non-disabled children in relation to the first two statements (Figure 2‑I). The proportion agreeing or strongly agreeing with these statements were quite similar in each group. However, parents of disabled children were more likely than those with non-disabled children to 'strongly' agree with the first statement. 25% at 10 months and 18% at age four answered in this category compared with 21% of parents of non-disabled children at 10 months and 13% at age four (Table 2.64).

2.81 They were also slightly more likely than parents of non-disabled children to strongly agree or agree that professionals will try to interfere if asked for help or advice. This was true at 10 months and at age four. For example, at age four, 12% of parents with disabled children strongly agreed or agreed with the statement compared with 9% of parents with non-disabled children (Table 2.65).

Figure 2‑I % of parents agreeing with statements on help-seeking behaviour at age four by disability

Figure 2‑I % of parents agreeing with statements on help-seeking behaviour at age four by disability

2.82 Few parents found it difficult to ask for help or advice but a higher proportion of parents with disabled children than those with non-disabled children strongly agreed with this statement. Though again, differences were small. 4% strongly agreed at 10 months and 5% at age four compared with 2% of parents with non-disabled children at both ages (Table 2.66).

2.83 Finally, a higher proportion of parents with disabled children than parents of non-disabled children strongly agreed or agreed that it is hard to know who to ask for help or advice. 27% at 10 months and 32% at age four answered this compared with 22% of parents of non-disabled children at 10 months and 24% at age four (Table 2.67).

2.84 Multivariate analysis of the statement "It's hard to know who to ask for help or advice about being a parent" at 10 months was undertaken, comparing those who answered strongly agree or agree to those who neither agreed or disagreed, disagreed, or strongly disagreed. Parents were more likely to strongly agree or agree with this statement if:

They were in lower income quintiles;
They did not have any regular childcare;
They were social renting instead of living in owner-occupied accommodation;
Their child was of non-white ethnic background; and
They had a lower score for mental wellbeing (SF-12).

Having a child with a disability was not independently associated with agreeing with this statement (Table 2.68).

Table 2.64 Disability by whether agreed with the statement that nobody can teach you to be a good parent

Nobody can teach you to be a good parent - you just have to learn for yourself	Non-disabled children	Disabled children
	%	%
*Age 1*
Strongly agree	21	25
Agree	42	39
Neither agree nor disagree	15	16
Disagree or strongly disagree	22	20
*Age 4*
Strongly agree	13	18
Agree	43	39
Neither agree nor disagree	18	17
Disagree or strongly disagree	26	26
Bases
Age 1
Unweighted	4526	683
Weighted	4518	690
Age 4
Unweighted	3336	655
Weighted	3318	672

Table 2.65 Disability by whether agreed with the statement that professionals start interfering or trying to take over when asked for advice

If you ask for help or advice on parenting from professionals like doctors or social workers, they start interfering or trying to take over	Non-disabled children	Disabled children
	%	%
*Age 1*
Strongly agree or agree	9	14
Neither agree nor disagree	23	21
Disagree	60	58
Strongly disagree	8	7
Age 4
Strongly agree	3	2
Agree	6	10
Neither agree nor disagree	30	30
Disagree	51	47
Strongly disagree	9	10
Bases
Age 1
Unweighted	4436	669
Weighted	4429	676
Age 4
Unweighted	3234	642
Weighted	3213	658

Table 2.66 Disability by whether agreed with the statement that it is difficult to ask people for help or advice unless you know them really well

It's difficult to ask people for help or advice unless you know them really well	Non-disabled children	Disabled children
	%	%
Age 1
Strongly agree	2	4
Agree	23	26
Neither agree nor disagree	12	12
Disagree	58	54
Strongly disagree	5	4
Age 4
Strongly agree	2	5
Agree	29	36
Neither agree nor disagree	17	17
Disagree	48	40
Strongly disagree	4	3
Bases
Age 1
Unweighted	4521	683
Weighted	4514	690
Age 4
Unweighted	3329	655
Weighted	3311	672

Table 2.67 Disability by whether agreed with the statement that it is hard to know who to ask for help or advice about being a parent

It's hard to know who to ask for help or advice about being a parent	Non-disabled children	Disabled children
	%	%
Age 1
Strongly agree or agree	22	27
Neither agree nor disagree	14	15
Disagree	60	55
Strongly disagree	5	3
Age 4
Strongly agree	2	3
Agree	22	29
Neither agree nor disagree	18	18
Disagree	54	46
Strongly disagree	4	4
Bases
Age 1
Unweighted	4513	677
Weighted	4505	684
Age 4
Unweighted	3327	654
Weighted	3309	669

Table 2.68 Multivariate analysis of whether feel it is hard to know who to ask for help or advice about being a parent at 10 months

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Equivalised household income (p<0.001)
Bottom Quintile (<_8,410)	1	921
2nd Quintile (>=_8,410< _13,750)	0.82 (0.65,1.02)	944
3rd Quintile (>=_13,750< _21,785)	0.69 (0.52,0.91)	853
4th Quintile (>=_21,785< _33,571)	0.55 (0.41,0.73)	1,009
Top Quintile (>=_33,571)	0.57 (0.44,0.74)	916
missing	0.68 (0.51,0.90)	516
Uses regular childcare (p=0.006)
Yes	1	3,097
No	1.24 (1.06,1.44)	2,062
Tenure (p=0.002)
Owner occupied	1	3,330
Social rented	1.41 (1.17,1.70)	1,316
Private rented	1.08 (0.76,1.54)	326
Other	0.85 (0.57,1.27)	187
Ethnicity of child (p=0.001)
White	1	4,933
Other ethnic background	1.54 (1.19,1.99)	226
Medical outcomes Short-Form (SF-12) mental wellbeing subscale score (p<0.001)	0.97 (0.96,0.97)	5,159

Note: Other than the standard independent variables (see appendix), the following variables were also included in the model: mother's health during pregnancy; whether mother had illness during pregnancy; whether child was born early, late or on time; type of delivery; whether child was single or multiple birth; any time spent in neonatal or special care baby unit; family type (couple or lone parent); any use of childcare; score on SF12 mental wellbeing scale;

Barriers to accessing childcare and pre-school education

2.85 Data on childcare was collected at all sweeps of GUS. This data covers the types of childcare used, perceptions of accessibility and availability, and satisfaction with providers and overall arrangements. Data on pre-school was collected at age 4, towards the end of the child's first year of his/her two years of statutory pre-school education. The questions address similar relevant topics to those described for childcare.

Childcare

2.86 Whether or not the parent was using any regular childcare was asked at all sweeps. Here we compare sweeps one, three and five. Information was collected on both formal (e.g. nursery, childminder) and informal (e.g. grandparents, friends) childcare providers. Comparisons between disabled and non-disabled children were made here on the use of the four key providers: grandparents, nurseries, childminders and 'other informal' at sweeps one, three and five.

2.87 Perceptions of accessibility/availability of childcare and barriers to access were assessed from age two to age five using a question - for those parents who were using childcare - asking how much choice they felt they had when selecting their main provider. They were also asked how easy they had found arranging childcare. For those who said it had been difficult, a follow-up question asked why. Analysis here focuses on sweeps two, three and five.

2.88 Two separate questions on satisfaction with childcare have been included in GUS questionnaires. The first, included at sweeps two, three and four assesses the parent's satisfaction with the care provided by their main childcare provider. The second, included at sweeps five and six, assesses satisfaction with their overall childcare arrangements - that is the types and mix of provision being used.

2.89 Parents who were not using childcare were asked for their reasons why at all sweeps. This data is explored for sweeps one, three and five.

2.90 There was no significant difference at any of sweeps one, three or five in the proportion of parents with disabled children compared with parents with non-disabled children using regular childcare. However, at sweeps one and three a lower proportion of parents with disabled children used grandparents as their main childcare provider. There was no difference in this proportion at age five however, and at this age a nursery or crèche had taken over as the most commonly used childcare provider for both parent groups (Table 2.69, Table 2.70).

2.91 There was no significant difference between parents of disabled children and parents of non-disabled children at sweeps two and five in how much choice parents felt they had in choosing childcare. However, at age three a higher proportion of parents with disabled children felt they had no choice at all about childcare options compared with parents of non-disabled children (24% compared with 15%; Table 2.71).

2.92 There was also no significant difference in the proportion of parents in the two groups who found it very easy to arrange childcare (at sweeps two, three and five). However, at all three sweeps parents with disabled children were more likely to find it fairly or very difficult to arrange childcare (Table 2.72).

2.93 When asked about their current childcare provider at sweeps two, three and four, parents of disabled children were less likely to say they were very satisfied with their provider than parents of non-disabled children. However, at sweeps five and six when asked about their overall childcare arrangements, parents of disabled children were no more or less likely than parents of non-disabled children to be very satisfied with their current arrangements (Table 2.73).

2.94 Parents of disabled children and parents of non-disabled children had similar distributions over the different reasons given for not using any childcare (at sweeps one, three and five). However, parents of disabled children were more likely to give as a reason for not using childcare that their child needed special care (Table 2.74).

2.95 Logistic regression was carried out to examine factors associated with finding it less than very or fairly easy to arrange childcare. The significant factors from the model are summarised below. Parents were more likely to find it less than fairly or very easy to arrange childcare if they had fair or poor general health (compared with those with excellent health) and they had a lower score for mental wellbeing (Table 2.75).

Summary of multivariate analysis results: factors associated with finding it less than fairly/very easy to arrange childcare at age three

Main carer had fair or poor general health

Main carer had lower mental wellbeing

2.96 Multivariate analysis of the satisfaction with their main childcare provider at age three revealed that parents who were in worse health, and parents who lived in areas classified in the middle quintile for IMD (compared with living in areas in the least deprived quintile) were more likely to be less than very satisfied (Table 2.76).

Summary of multivariate analysis results: factors associated with being less than very satisfied with main childcare provider at age three

Main carer had fair or poor general health

Lived in an area in the middle quintile for area deprivation

2.97 Multivariate analysis of satisfaction with overall childcare arrangements at age five only identified one significant factor associated with this outcome. Respondents with a lower score for mental wellbeing (SF-12) were more likely to be less than very satisfied with their overall childcare arrangements. Disability of the child was not a significant factor in any of these regressions (Table 2.77).

Summary of multivariate analysis results: factors associated with being less than very satisfied with overall childcare arrangements at age five

Main carer had lower mental wellbeing

Table 2.69 Disability by whether uses regular childcare

Currently get help with childcare for child on a regular basis	Non-disabled children	Disabled children
	%	%
Age 1
Yes	59	61
No	41	39
Age 3
Yes	76	78
No	24	22
Age 5
Yes	84	83
No	16	17
Bases
Age 1
Unweighted	4528	683
Weighted	4520	690
Age 3
Unweighted	3582	598
Weighted	3573	606
Age 5
Unweighted	3184	648
Weighted	3151	681

Table 2.70 Disability by type of childcare used

Type of regular childcare used	Non-disabled children	Disabled children
	%	%
Age 1
Grandparents	66	60
Childminder	10	12
Nursery or creche	27	27
Other Informal	19	25
Age 3
Grandparents	51	45
Childminder	11	12
Nursery or creche	45	47
Other Informal	14	15
Age 5
Grandparents	45	43
Childminder	9	8
Nursery or creche	73	76
Other Informal	16	19
Bases
Age 1
Unweighted	2701	418
Weighted	2682	424
Age 3
Unweighted	2787	475
Weighted	2729	476
Age 5
Unweighted	2683	543
Weighted	2639	564

Table 2.71 Disability by choice of childcare provider available

How much choice available in selecting main childcare provider	Non-disabled children	Disabled children
	%	%
Age 2
A great deal of choice	16	13
Quite a lot of choice	29	27
Not very much choice	39	39
None at all	16	21
Age 3
A great deal of choice	12	12
Quite a lot of choice	33	21
Not very much choice	40	43
None at all	15	24
Age 5
A great deal of choice	9	8
Quite a lot of choice	37	30
Not very much choice	42	47
None at all	11	15
Bases
Age 2
Unweighted	1143	159
Weighted	1143	162
Age 3
Unweighted	1288	254
Weighted	1289	260
Age 5
Unweighted	1845	376
Weighted	1787	379

Table 2.72 Disability by ease of arranging childcare

How easy/difficult to arrange childchare	Non-disabled children	Disabled children
	%	%
Age 2
Very easy	47	42
Fairly easy	37	37
Neither easy nor difficult	6	7
Fairly difficult	7	8
Very difficult	3	7
Age 3
Very easy	35	33
Fairly easy	45	41
Neither easy nor difficult	11	11
Fairly difficult or very difficult	9	15
Age 5
Very easy	42	38
Fairly easy	42	41
Neither easy nor difficult	9	9
Fairly difficult or very difficult	7	12
Bases
Age 2
Unweighted	2794	324
Weighted	2752	325
Age 3
Unweighted	1315	261
Weighted	1318	268
Age 5
Unweighted	1899	388
Weighted	1840	392

Table 2.73 Disability by satisfaction with childcare

Satisfaction with childcare (main childcare provider for sweeps 2,3 and 4, overall childcare arrangements for sweeps 5 and 6)	Non-disabled children	Disabled children
	%	%
Age 2
Very satisfied	85	81
Fairly satisfied to very dissatisfied	15	19
Age 3
Very satisfied	83	79
Fairly satisfied to very dissatisfied	17	21
Age 4
Very satisfied	83	80
Fairly satisfied to very dissatisfied	17	20
Age 5
Very satisfied	75	77
Fairly satisfied to very dissatisfied	25	23
Age 6
Very satisfied	73	71
Fairly satisfied to very dissatisfied	27	29
Bases
Age 2
Unweighted	2797	324
Weighted	2755	325
Age 3
Unweighted	2785	474
Weighted	2727	475
Age 4
Unweighted	2167	440
Weighted	2103	441
Age 5
Unweighted	1901	389
Weighted	1842	393
Age 6
Unweighted	1728	376
Weighted	1677	386

Table 2.74 Disability by reasons for not using childcare

Reasons for not using childcare	Non-disabled children	Disabled children
	%	%
Age 1
Rather look after him/her myself	68	66
I rarely need to be away from him/her	47	45
There are no childcare providers available that I could trust	4	4
I cannot afford childcare	16	17
The quality of childcare is not good enough	1	1
Child needs special care	0	7
I have had bad experience using childcare in the past	1	0
I would have transport difficulties getting to a provider	2	5
Child too young	1	1
Childcare not required	7	6
Child wouldn't like to be separated from carer	0	0
Lack of availability/choice	1	1
Provider no longer available	0	-
Other reason	1	3
No reason given	2	2
Age 3
Respondent prefers to do it themselves	68	73
Respondent rarely away	42	44
Not trusted providers	2	6
Can't afford it	12	15
Quality not good	0	2
Child needs special care	0	6
Previous bad experience	1	1
Transport difficulties	1	1
Child too young	1	1
Not required	6	4
Child would not like separation	0	2
Lack of choice	1	3
Other reason	2	2
No reason given	6	-
Age 5
Respondent prefers to do it themselves	52	55
Respondent rarely away	46	47
Not trusted providers	1	2
Can't afford it	8	7
Quality not good	1	-
Child needs special care	0	4
Previous bad experience	0	2
Transport difficulties	1	-
Lack of choice	1	-
Child attends school	8	7
Child attends pre-school	1	1
Other	8	4
No reason given	16	14
Bases
Age 1
Unweighted	1827	264
Weighted	1838	265
Age 3
Unweighted	607	99
Weighted	639	105
Age 5
Unweighted	828	160
Weighted	866	182

Table 2.75 Multivariate analysis of satisfaction with main childcare provider at age three

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
General health status (p<0.001)
Excellent	1	752
Very Good	1.60 (1.18,2.16)	1,284
Good	2.32 (1.72,3.12)	823
fair or poor	2.81 (1.97,4.02)	390
Scottish Index of Multiple Deprivation 2006 Quintiles (p=0.022)
0.9449 - 7.7446 - least deprived	1	780
7.7472 - 13.5627	1.25 (0.9,1.72)	715
13.5640 - 21.0436	1.39 (1.07,1.79)	675
21.0521 - 33.6982	0.84 (0.60,1.19)	487
33.7252 -89.0941 - most deprived	1.15 (0.83,1.59)	592

Note: Other than the standard independent variables (see appendix), the following variables were also included in the model: whether child was born early, late or on time; type of delivery; whether child was single or multiple birth; any time spent in neonatal or special care baby unit; family type (couple or lone parent); main carer's general health; whether main carer has long-standing illness

Table 2.76 Multivariate analysis of satisfaction with overall childcare arrangements at age five

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Medical outcomes Short-Form (SF-12) mental wellbeing subscale score (p<0.001)	0.97 (0.96,0.98)	2,280

Note: Other than the standard independent variables (see appendix), the following variables were also included in the model: how mother kept during pregnancy; whether mother had any illness in pregnancy; whether smoked cigarettes during pregnancy; whether drank alcohol during pregnancy; whether child was born early, late or on time; type of delivery; whether child was single or multiple birth; any time spent in neonatal or special care baby unit; family type (couple or lone parent); main carer's general health; whether main carer has long-standing illness; respondent's score on SF12 mental wellbeing scale

Table 2.77 Multivariate analysis of ease of arranging childcare at age three

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
General health status (p=0.019)
Excellent	1	351
Very Good	1.40 (0.89,2.20)	616
Good	1.48 (0.94,2.33)	393
Fair or poor	2.29 (1.35,3.89)	211
Medical outcomes Short-Form (SF-12) mental wellbeing subscale score (p<0.001)	0.97 (0.96,0.99)	1,571

Note: Other than the standard independent variables (see appendix), the following variables were also included in the model: how mother kept during pregnancy; whether mother had any illness in pregnancy; whether smoked cigarettes during pregnancy; whether drank alcohol during pregnancy; whether child was born early, late or on time; type of delivery; whether child was single or multiple birth; any time spent in neonatal or special care baby unit; family type (couple or lone parent); main carer's general health; whether main carer has long-standing illness; respondent's score on SF12 mental wellbeing scale

Pre-school

2.98 Parents were asked if they were using statutory pre-school provision for the cohort child, and also the type of provision attended (e.g. nursery class attached to a primary school, private nursery) at age four.

2.99 Questions about the perceptions of accessibility/availability of pre-school and barriers to access were similar to those asked about childcare. Parents were asked how much choice they felt they had when selecting their pre-school provider and whether they would prefer to be using a different provider.

2.100 A question at age four assesses the parent's satisfaction with the standard of care and education provided by their pre-school provider.

2.101 A smaller proportion of disabled children attended pre-school than their non-disabled counterparts at age four (89% compared with 93%). The types of provider used were similar however, with around 60% of disabled children and non-disabled children enrolled in a nursery class attached to a local authority primary school (62% and 61% respectively, difference not significant; Table 2.78, Table 2.79).

2.102 There was no significant difference between parents of disabled children and parents of non-disabled children in the proportion who felt they had no choice at all for pre-school providers, nor in the proportion who felt they had a great deal of choice. There was also no significant difference between the two groups in the proportion who said they would use a different pre-school provider (Table 2.80, Table 2.81).

2.103 Both groups were also equally likely to say they were very satisfied with their pre-school provider (75% of parents of disabled children said this and 79% of parents with non-disabled children, difference not significant; Table 2.82).

2.104 Multivariate analysis of the satisfaction with pre-school provider found that parents were more likely to be less than very satisfied if they were in good, fair or poor health compared with being in excellent heath, they had a lower mental wellbeing score (SF-12), and they were private renting as opposed to being an owner-occupier of their accommodation (Table 2.83).

Summary of multivariate analysis results: factors associated with being less than very satisfied with pre-school provider at age four

Main carer had good, fair or poor health

Main carer had lower mental wellbeing

Accommodation was rented from private landlord

Table 2.78 Disability by whether attends pre-school

Currently attends pre-school (age 4)	Non-disabled children	Disabled children
	%	%
Yes	93	89
No	7	11
Bases
Unweighted	3336	654
Weighted	3318	671

Table 2.79 Disability by type of pre-school used

Type of pre-school used (age 4)	Non-disabled children	Disabled children
	%	%
Nursery class attached to a local authority primary school	61	62
Nursery class attached to an independent school	1	1
Local authority nursery school	15	16
Private day nursery or nursery school	17	15
Community/voluntary nursery	1	1
Community/Voluntary playgroup	1	2
Local authority playgroup	2	2
Private playgroup	1	1
Family Centre	1	-
Bases
Unweighted	3102	585
Weighted	3076	595

Table 2.80 Disability by level of choice for pre-school

Level of choice for pre-school (age 4)	Non-disabled children	Disabled children
	%	%
A great deal of choice	9	9
Quite a lot of choice	39	37
Not very much choice	38	38
None at all	14	16
Bases
Unweighted	3024	574
Weighted	2997	585

Table 2.81 Disability by whether respondent would use a different pre-school provider

Respondent would use a different pre-school provider (age 4)	Non-disabled children	Disabled children
	%	%
Yes	10	12
No	90	88
Bases
Unweighted	3091	583
Weighted	3065	593

Table 2.82 Disability by satisfaction with pre-school

Satisfaction with pre-school (age 4)	Non-disabled children	Disabled children
	%	%
Very satisfied	79	75
Neither satisfied or dissatisfied, fairly dissatisfied, or very dissatisfied	21	25
Bases
Unweighted	3098	584
Weighted	3073	594

Table 2.83 Multivariate analysis of satisfaction with pre-school

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
General health status (p=0.005)
Excellent	1	643
Very Good	1.11 (0.89,1.39)	1,354
Good	1.60 (1.23,2.07)	1,054
Fair or poor	1.50 (1.08,2.07)	512
Tenure (p=0.044)
Owner occupied	1	2,550
Social rented	1.12 (0.89,1.40)	765
Private rented	1.43 (1.00,2.05)	166
Other	1.67 (0.97,2.86)	82
Medical outcomes Short-Form (SF-12) mental wellbeing subscale score (p=0.012)	0.99 (0.98,1.00)	3,563

Note: Other than the standard independent variables (see appendix), the following variables were also included in the model: how mother kept during pregnancy; whether mother had any illness in pregnancy; whether smoked cigarettes during pregnancy; whether drank alcohol during pregnancy; whether child was born early, late or on time; type of delivery; whether child was single or multiple birth; any time spent in neonatal or special care baby unit; family type (couple or lone parent); main carer's general health; whether main carer has long-standing illness; respondent's score on SF12 mental wellbeing scale; agree/disagree with statement 'Nobody can teach you how to be a good parent, you just have to learn for yourself'

The impact of limiting disability

2.105 Further multivariate analysis was undertaken to assess whether or not having a limiting disability was associated with the selected outcomes and characteristics of interest. To do so, those children identified as disabled in the original analysis were further categorised according to whether or not their disability was reported as having a limiting effect on their day to day activities.

2.106 On indicating that the child has a long-standing illness or disability, parents are then asked the following question:

Does this (do these) condition(s) or health problem(s) limit ^him at play or from joining in any other activity normal for a child ^his age?
1 Yes
2 No

2.107 Those children whose parent answered yes to this question were defined as having a limiting disability. The (weighted) number and proportion of children with a disability, using the original definition, and with a limiting disability, at each sweep, are defined in Table 2.84 ^[15].

Table 2.84 Number and percent of children with a disability and with a limiting disability by age

Age	Children with a disability		Children with a limiting disability
Age	n	% of all children*	n	% of all children*
Age 2	491	11	94	2
Age 3	607	15	134	3
Age 4	672	17	144	4
Age 5	681	18	167	4
Age 6	680	19	167	5

2.108 As shown in the table, the number of children with a limiting disability is quite small. This, combined with the often small number of cases having the outcome of interest (e.g. dissatisfaction with pre-school provider), will contribute to the results that follow.

2.109 Outcomes of children with a limiting disability were compared to those of all other children using the same multivariate models utilised in the original analysis shown in the preceding sections.

2.110 Only two 'new' relationships between disability and parent/child outcomes were found:

Parents whose children had a limiting disability at age five were more likely to report low warmth in the parent-child relationship (p< 0.001, Table 2.85)
Parents whose children had a limiting disability at age five were more likely to report high parenting stress. (Note that this finding was borderline significant (p = 0.08). The standard threshold for accepting statistically significant results is p <= 0.05, Table 2.86)

2.111 Disability continued to be associated with the likelihood of the child having moderate or severe social, emotional and behavioural difficulties at age five. The strength of this association increased for children with limiting disability. The odds of children with a limiting disability at age five of having an SDQ total difficulties score in the moderate or severe range were four times higher than those of children who did not have a limiting disability.

2.112 Limiting disability was not significantly associated with any other outcome considered.

Table 2.85 Multivariate analysis of warmth of parent-child relationship at age five with limiting disability included as a covariate

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Limiting disability (p < 0.001)
No	1	3620
Yes	2.20 (1.45, 3.32)	152
Sex (p<0.001)
Male	1	1,890
Female	0.74 (0.63,0.86)	1,824
Tenure (p<0.001)
Owner occupied	1	2,665
Social rented	1.38 (1.11,1.72)	771
Private rented	1.39 (1.01,1.90)	212
Other	0.96 (0.46,2.01)	66
Parental stress (p<0.001)
High stress	1	1,374
Medium stress	0.80 (0.66,0.98)	1,092
Low stress	0.59 (0.49,0.70)	1,248
Scottish Index of Multiple Deprivation 2006 Quintiles (p<0.05)
0.9449 - 7.7446 - least deprived	1	833
7.7472 - 13.5627	0.94 (0.76,1.17)	830
13.5640 - 21.0436	1.24 (0.99,1.56)	751
21.0521 - 33.6982	1.03 (0.81,1.31)	668
33.7252 -89.0941 - most deprived	1.26 (1.01,1.58)	649

Table 2.86 Multivariate analysis of parental stress when child is aged five with limiting disability included as a co-variate

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Limiting disability (p = 0.08)
No	1	3620
Yes	1.39 (0.96, 2.03)	152
Employment status (p<0.001)
In full-time paid employment or self-employment	1	902
In part-time paid employment or self-employment	1.27 (1.05,1.53)	1,589
On Maternity / parental leave from an employer	1.17 (0.77,1.78)	126
Looking after home or family	1.68 (1.39,2.05)	979
Not in paid work	1.57 (1.09,2.27)	208
Sex of the child (p=0.06)
Male	1
Female	0.85 (0.74,1)
Main carer's consumption of alcohol (p = 0.08)
2+ times a week	1	1006
Once a week	0.88 (0.72, 1.08)	753
3 times a month or less	0.77 (0.63, 0.94)	1,542
Do not drink at all	0.81 (0.64, 1.02)	485
Respondent uses regular childcare (p=0.014)
Yes	1	3,207
No	0.78 (0.64,0.96)	597
Medical outcomes Short-Form (SF-12) mental wellbeing subscale score (p=0.005)	0.93 (0.92,0.94)	3,804

Note: Other than the standard independent variables (see appendix), the following variables were also included in the model: how mother kept during pregnancy; whether mother had any illness in pregnancy; whether smoked cigarettes during pregnancy; whether drank alcohol during pregnancy; whether child was born early, late or on time; type of delivery; whether child was single or multiple birth; any time spent in neonatal or special care baby unit; family type (couple or lone parent); any use of childcare; main carer's general health; whether main carer had longstanding illness; main carer's consumption of alcohol; score on SF12 mental wellbeing scale.

Table 2.87 Multivariate analysis of factors associated with child scoring in the moderate or severe range of SDQ total difficulties at age five

Covariates	Odds ratios (95% Confidence limits)	N (unweighted)
Limiting disability (p < 0.001)
No	1	3620
Yes	4.92 (3.33, 7.29)	152
Scottish Index of Multiple Deprivation 2006 Quintiles (p=0.005)
0.9449 - 7.7446 - least deprived (p < 0.001)	1	833
7.7472 - 13.5627	1.19 (0.75,1.88)	830
13.5640 - 21.0436	2.06 (1.34,3.17)	751
21.0521 - 33.6982	1.76 (1.13,2.74)	668
33.7252 -89.0941 - most deprived	1.85 (1.20,2.87)	649
Sex (p<0.001)
Male	1	1,905
Female	0.52 (0.41,0.64)	1,826
Housing tenure (p<0.05)
Owner occupied	1	2,666
Social rented	1.70 (1.25, 2.32)	785
Private rented	1.31 (0.84, 2.03)	212
Other	1.34 (0.63, 2.83)	68
Annual equivalised household income quintile (p<0.05)
Bottom Quintile (<£12,217)	1	694
2nd Quintile (>=£12,217 <£19,643)	0.71 (0.52, 0.99)	782
3rd Quintile (>=£19,643 < £29,126)	0.79 (0.51, 1.24)	634
4th Quintile (>=£29,126 < £37,857)	0.63 (0.42, 0.95)	837
Top Quintile (>=£37,857)	0.46 (0.28, 0.74)	580
Missing	0.91 (0.56, 1.48)	204
How mother kept during pregnancy (p<0.01))
Very well	1	1,949
Fairly well	1.48 (1.13, 1.94)	1,305
Not very well	1.80 (1.25, 2.59)	355
Not at all well	1.86 (1.02, 3.38)	122
Ethnicity of child (p<0.001)
White	1	3,603
Other ethnic group	2.50 (1.57, 3.98)	128
Family type (p = 0.01)
Couple family	1	3236
Lone parent	0.70 (0.53, 0.93)	597

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