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

3 Conclusion

3.1 It is clear that there are differences between disabled and non-disabled children in their early years, in terms of their characteristics, circumstances and experiences, and those of their families. However, these differences are often small, typically being of the scale of around five to six percentage points.

3.2 Some of the largest differences found were in relation to the socio-economic characteristics of the two groups of children. Children with a disability were significantly more likely than non-disabled children to be in lower income households, live in areas with higher deprivation, and have parents who were not working. It appears that many of the differences observed between disabled and non-disabled children are driven by these key socio-economic distinctions rather than the presence of a disability.

3.3 For example, the higher level of couple separation amongst parents of disabled children reflects a higher prevalence of this amongst families in more disadvantaged circumstances shown in other research^[16]. Indeed, the multivariate analysis applied throughout the report confirms this; after controlling for socio-economic differences between disabled and non-disabled children, only one independent association was found between disability and the various outcomes considered. Instead, most of the models showed a significant relationship between the outcome of interest and measures of socio-economic status such as household income, parental employment and housing tenure.

3.4 Only the child's social, emotional and behavioural development - as measured by the total difficulties scale of the SDQ - was independently associated with disability. This is perhaps unsurprising given that the difficult behaviour and emotional problems identified by the SDQ may themselves be considered disabilities using the definition applied in this report - in that they are conditions which may have an adverse effect on the child's day to day life.

3.5 The definition of disability used in the analysis was very broad, encompassing everything from asthma to mental illness. The nature of each individual illness or disability is quite specific and whilst conditions that are similar may similarly affect the children and families involved, it is perhaps unexpected that on considering, in depth, all children with any sort of disability, we find them to be quite a heterogeneous group. In other words, it is possible that had the analysis compared, for example, children with a more specific physical disability with those who did not, greater - or different - distinctions may have been found. In addition, existence of a physical disability may have been shown to affect certain child and family outcomes independently of socio-economic background.

3.6 One obvious extension to the initial analysis conducted therefore, was to consider a more focussed definition of disability. Unfortunately, the small numbers involved would prevent any such definition from being too focussed. However, it was possible to exclude those children with less serious conditions. The GUS data asks parents whose children have a disability whether that disability is in any way limiting to the child's day to day life. This was a simple way of narrowing the group of interest. However, only around 10-20% of those children with a disability at any single sweep (about 2% of all children) are reported as having a limiting illness making this group relatively small for focussed consideration especially combined with the low numbers of families who achieve the outcomes of interest.

3.7 After running the same multivariate models using the revised definition, limiting disability was found to be independently associated with only a small number of outcomes. The association with the child's social, emotional and behavioural development remained and was stronger for children with a limiting disability compared with those whose disability was not necessarily perceived as being limited. Having a limiting disability was also associated with low warmth in the parent-child relationship and with high parenting stress suggesting that having a child with a limiting disability has a clear impact on the parenting role. No further associations were found.

3.8 The lower warmth in the parent-child relationship may be related to certain conditions which make parent-child interactions more challenging. Higher stress amongst parents of children with limiting disabilities is perhaps unsurprising. These parents face the daily challenges faced by all parents of young children along with those additional challenges presented by a child with a limiting condition.

3.9 Otherwise there is little in the data to distinguish the experiences of parents of disabled and non-disabled children. This does not correspond with research elsewhere which reports clear differences between these two groups. We do not suggest that these differences do not exist but rather that they do not occur here because of the definition of disability used, how differences in experiences were measured and the size of the sample.

3.10 Further alternative, and more precise, definitions of disability are possible using GUS data though some further scoping work would be necessary to consider what other definitions may be possible and useful. It may be reasonable, for example, to draw on additional variables to further define disability. For example, cut-off scores on the SDQ or on the cognitive assessments could be used to identify children with difficulties associated with their social, emotional and behavioural development or cognitive development which may be considered disabilities but are not otherwise reported by parents.

3.11 Not all relationships were tested using multivariate analysis and it is possible that further models may show disability to be independently associated with some of the untested outcomes. However, having already undertaken a large number of multivariate models, by extending the multivariate analysis it is likely, simply by chance, that disability will emerge as statistically significant in at least one model. Therefore, it would be necessary to have a reasonable explanation of why we may expect disability to be associated with the additional outcomes to justify compiling and running these additional multivariate models.

3.12 There are other ways in which disabled children could be further differentiated. GUS is a longitudinal study, following a single group of children over time. However, the analysis undertaken for this report is wholly cross-sectional. That is, it considers each time point individually. It does not, therefore, allow for children who were reported as having a disability at several time points - for example, over several years. Whilst the definition of disability used here requires that the child has had, or is likely to have, the condition 'over a period of time', that period will not always extend to one year. Those children who have a 'persistent' disability are likely to have different experiences (and potentially different characteristics and outcomes) to those whose disability is brief and certainly to those without any disability. It is possible to use GUS data to identify children who were reported as having a disability at multiple ages, either in succession (e.g. at 10 months, age two and age three), or intermittently (e.g. at ages two, four and six). Once defined, these children could be compared with the remainder on the various indicators considered within this report - or a more focussed selection of those indicators.

3.13 In addition, this longitudinal approach could be used to consider whether 'age of onset' of disability affects children's experiences. For example, are children who develop a disability in the earliest period of life (from birth to age three, for example) distinct in characteristics and outcomes from those who develop a disability later (between ages three and five)? Analysis to explore this would consider outcome data at a fixed, later, time point - at age five or six - and make comparisons on those outcomes between children in the two onset groups.

3.14 However disability is further defined, the key factor determining the feasibility of further analysis is the size of the resultant sub-group. With too precise a definition, the disabled sub-group will be too small for separate consideration. With too broad a definition, it appears that disability will not show any relationship with children's experiences and outcomes.

3.15 In addition, the experiences enquired about in the Growing Up in Scotland study are many and varied - designed to capture broad variations in a general population. A survey more focussed on identifying variation between the parents of disabled and non-disabled children would perhaps use questions designed to explore in a more focussed fashion, known differences between these two groups.