Early childhood social-emotional profiles associated with middle childhood internalizing and wellbeing

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Abstract

This study linked data from two large population monitoring surveys in British Columbia, Canada, (N = 17,181) to examine associations between teacher-rated social-emotional functioning at school entry (age 5) and child self-reported internalizing and wellbeing in Grade 4 (age 9). Latent profile analysis identified seven profiles of early childhood social-emotional functioning based on eight subscales from the Early Development Instrument. The largest profile group of children (55.6%) showed strengths across all eight subscales. Four years later, children in this group reported the lowest internalizing (worries and sadness) and highest wellbeing (life satisfaction and optimism), measured using the Middle Years Development Instrument. Comparatively, children in profile groups characterized by relative vulnerabilities on one or more subscales reported higher internalizing and lower wellbeing in Grade 4, but not consistently for all outcomes. Results suggest school entry may be an opportunity to promote children's strengths and address vulnerabilities to support future mental health.

Introduction

Middle childhood, defined as approximately between the ages of 8 and 12, is an important developmental transition when children undergo rapid physical and biological changes including the onset of puberty, social changes including the increasing importance of peers and peer belonging, and academic changes including higher performance expectations and changing evaluations (Eccles, 2004; Eccles & Roeser, 2013). Most research has focused on problematic transitions, in particular mental health difficulties (anxiety and depression) that show a sharp rise in prevalence across middle childhood and into adolescence (Kessler et al., 2005; Merikangas, Nakamura, & Kessler, 2009). Less is known about changes in children's life satisfaction and positive future expectancy (optimism) in middle childhood, in part because of the perceived measurement challenges of asking children to self-reflect on their wellbeing (Rose et al., 2017). However, emerging research using validated child self-report measures similarly suggests that children experience an overall decline in wellbeing across middle childhood (Schonert-Reichl, 2011; Shoshani & Slone, 2013). In response to this, there has been substantial call for investments in school-based interventions that focus on addressing mental health difficulties and promoting social-emotional wellbeing, for example through structured social and emotional learning (SEL) opportunities (Greenberg & Abenavoli, 2017; Greenberg, Domitrovich, Weissberg, & Durlak, 2017). The purpose of the current study was to examine the association between children's social-emotional functioning at school entry and their mental health and wellbeing in middle childhood, with the goal of identifying earlier developmental processes that can be supported to promote future mental health and wellbeing.

The “dual-factor model” of mental health proposes that mental health problems and wellbeing are not opposite ends of the same spectrum, but better understood as two inter-related factors (Greenspoon & Saklofske, 2001; Suldo & Shaffer, 2008). Wellbeing includes components such as life satisfaction, a belief in oneself, a sense of purpose, engagement in community, perceived control over events in one's life, and positive expectations about the future (Diener et al., 2017; Keyes, 2009; Rose et al., 2017; Suldo, Huebner, Freidrich, & Gilman, 2009). Previous studies have identified that 7% to 13% of school-age children self-report low wellbeing even in the absence of mental health problems, and that 9% to 13% of children report concurrent mental health problems and high wellbeing (Antaramian, Huebner, Hills, & Valois, 2010; Greenspoon & Saklofske, 2001; Lyons, Huebner, Hills, & Shinkareva, 2012; Suldo & Shaffer, 2008).

Existing research also suggests that the factors associated with mental health problems and wellbeing may differ (Guhn, Schonert-Reichl, Gadermann, Hymel, & Hertzman, 2013; Patalay & Fitzsimons, 2016). Research from the UK Millienium Cohort Study demonstrated that eleven-year old children's self-reported wellbeing was only weakly correlated with their self-reported internalizing and externalizing symptoms, with wider environmental factors (school connectedness, perceived neighbourhood safety) explaining more of the variance in wellbeing than mental health problems (Patalay & Fitzsimons, 2016). Children's perceived connectedness with adults has also been found to be more strongly associated with wellbeing outcomes (life satisfaction, self-esteem) than with children's internalizing symptoms (Guhn et al., 2013). Based on this evidence we expected that patterns of early childhood social-emotional functioning associated with future internalizing may not be the same as those associated with wellbeing.

Based on a life course perspective, identifying and addressing social-emotional vulnerabilities from an early age has the potential to support children's mental health and wellbeing through the transitions to middle childhood, adolescence, and adulthood (Elder, 1998; McGorry, Purcell, Goldstone, & Amminger, 2011; Shonkoff & Garner, 2012). Related research that informed the current study found that children's mean scores on the social competence and emotional maturity scales of the Early Development Instrument (EDI) (Janus & Offord, 2007), rated by teachers at school entry, predicted children's future self-reported peer connectedness and emotional wellbeing in middle childhood (Guhn, Gadermann, Almas, Schonert-Reichl, & Hertzman, 2016). Likewise, children's levels of vulnerability as categorized on the EDI social competence and emotional maturity scales were associated with both positive and negative aspects of children's self-reported wellbeing in middle childhood within an Australian cohort (Gregory et al., 2020). These studies importantly identify that children's early social-emotional development sets a foundation for future mental health and wellbeing. However, it is also well established that there is wide variation in children's social-emotional functioning that can be overlooked in variable-centered analyses that create groups based on mean scores or scores beyond a threshold (Nandi, Beard, & Galea, 2009). Variable-centered models that group children according to a single shared characteristic, for example heightened hyperactivity, may miss important differences in children's other social-emotional behaviours that in combination may be associated with different outcomes.

Person-centered analyses, such as latent profile modeling, are useful for identifying combinations of behaviours or indicators that frequently appear together (i.e., profile patterns) (Berlin, Williams, & Parra, 2014). For example, it may be that hyperactivity in early childhood is associated with different outcomes for children depending on its combination with other social-emotional behaviours such as aggression or anxiety. Previous research using the EDI has identified early childhood profiles based on developmental vulnerability across a range of indicators that are predictive of future mental health conditions (Green et al., 2019, Green et al., 2017). However, there still remain knowledge gaps regarding how early childhood social-emotional vulnerabilities typically combine with social-emotional strengths, and how these combinations might predict not only future mental health problems, but wellbeing. These gaps currently limit our ability to advise on developmentally appropriate forms of early intervention that could augment current approaches in middle childhood.

Longitudinal studies suggest a high degree of continuity between early childhood vulnerabilities and later social-emotional problems (i.e., internalizing and externalizing behaviours), with persistent and increasing problem trajectories associated with adolescent risky behaviour, peer rejection, and school drop-out, as well as poor mental health, physical health problems, and economic problems in adulthood (Duchesne, Vitaro, Larose, & Tremblay, 2008; Fanti & Henrich, 2010; Odgers et al., 2008; Pingault et al., 2011). Equally, research from the Project Competence Longitudinal Study has observed continuities in children's strengths across the life course on a range of indicators including openness to new experiences, conscientiousness, cognitive skills, self-worth, close relationships, and socioeconomic advantage (Masten & Tellegen, 2012). Children's prosocial behaviour at school entry has been found to predict wellness in young adulthood across a range of outcomes including education, employment, and mental health (Jones, Greenberg, & Crowley, 2015). In one of the few longitudinal studies on positive development available, early social-emotional competencies including childhood prosocial behaviour and peer social inclusion have also been found to prospectively predict wellbeing more than 20 years later in adulthood (Olsson, McGee, Nada-Raja, & Williams, 2013).

Comparatively fewer studies have examined how social-emotional strengths and vulnerabilities combine together in the early life course or how they predict future outcomes (Denham et al., 2012; Nantel-Vivier, Pihl, Cote, & Tremblay, 2014; Van den Akker, Deković, Asscher, Shiner, & Prinzie, 2013). These few existing studies suggest that many children who share common patterns of problematic behaviours also exhibit characteristics that would be considered relative strengths. For example, children categorized as “under-controlled” (lacking inhibition) have also been found to exhibit high extroversion and imagination whereas children categorized as “over-controlled” (highly inhibited) have been found to demonstrate high levels of agreeableness and conscientiousness (Van den Akker et al., 2013). Children who have been found to exhibit moderate levels of aggression or high anxiety also have been rated as having moderate levels of prosocial behaviour (Nantel-Vivier et al., 2014). Research in this area is still emerging, and it remains unknown how combinations of relative strengths alongside vulnerabilities in early childhood might predict both children's future mental health problems and wellbeing, as related but separate constructs (Greenspoon & Saklofske, 2001).

The current study capitalized on data linkage across two of Canada's most comprehensive population-based monitoring systems in early and middle childhood, the Early Development Instrument (EDI) and Middle Years Development Instrument (MDI), respectively. Building on previous research examining latent profile patterns using the EDI social-emotional subscales (Thomson et al., 2019; Thomson, Guhn, Richardson, Ark, & Shoveller, 2017), this study extended these analyses to meet two objectives: (1) to examine profile patterns of children's social and emotional strengths and vulnerabilities at school entry in a recent population cohort and (2) to investigate how children's social-emotional profile patterns at school entry were associated with children's self-reported internalizing and wellbeing in middle childhood, four years later. We hypothesized that children with more social-emotional vulnerabilities at school entry would report higher internalizing and lower wellbeing in middle childhood. We also hypothesized that these associations would be smaller for children with more strengths alongside social-emotional vulnerabilities. Finally, based on the dual factor model of mental health, we were keen to explore how different combinations of early childhood strengths alongside vulnerabilities might differentially predict internalizing compared to wellbeing outcomes.

Section snippets

Data source

EDI survey data were initially collected for a cohort of 127,647 children attending their first year of school (Kindergarten) in British Columbia (BC), Canada, between 2007 and 2012. A subset of this cohort (N = 17,310 children; 13.6%) participated in the MDI survey four years later (Grade 4) and had linkable data. Linkable data was based on the timing of MDI survey administration within each school district (i.e., whether or not MDI data collection occurred exactly four years after EDI data

Sample characteristics

Children in the analytic dataset had an average age in Kindergarten of 5.65 years (range = 4.86 to 7.43 years, SD = 0.30), and an average age in Grade 4 of 9.24 years (range = 7.93 to 11.85 years, SD = 0.50). At school entry, 51.1% of children were identified as boys, and 19.7% were identified as having ESL status. The three most frequently spoken first languages other than English were Punjabi, Cantonese and Mandarin. As shown in Table 1, sample distributions on the EDI social-emotional

Discussion

In this study, we identified seven profile patterns of children's social-emotional functioning at school entry that were associated with both mental health and wellbeing four years later in middle childhood. The majority of children (55.6%) fit into a profile of overall high social-emotional functioning, consistent with other person-centered studies finding that the majority of children at this age fit into profile groups of high functioning and low developmental risk (Basten et al., 2013;

Funding

This work was supported by a Canadian Institutes of Health Research Doctoral Research Award awarded to KT. CO was supported by an Australian National Health and Medical Research Council Investigator Grant. AG was supported by a Michael Smith Foundation for Health Research Scholar Award. MG was supported by the Lawson Foundation, Canada.

Declaration of Competing Interest

All authors report no competing interests.

Acknowledgements

We would like to thank the children and teachers involved in this study, and the implementation, knowledge translation, and data management teams at the Human Early Learning Partnership and Population Data BC. We would also like to thank our funders including the Canadian Institutes of Health Research, Australian National Health and Medical Research Council, Michael Smith Foundation for Health Research, and the Lawson Foundation, Canada.

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      Fifth, while the validity and reliability of the teacher-rated EDI has been demonstrated in prior studies, we recognize that it will be important to replicate this study with other measures of children’s early development. Furthermore, more longitudinal studies using EDI scores are required to aid in understanding the real-life implications of our findings; though, prior research indicates that teacher-ratings on the EDI are associated with self-reported well-being (Gregory et al., 2021; Guhn et al., 2016a), physician-assessed mental health conditions (Thomson et al., 2021, 2019), and academic achievement in later childhood (Brinkman et al., 2013; Davies et al., 2016; Duncan et al., 2020). Finally, our study cohort was largely comprised of children born into multi-parent households, who spoke English as their first language, and who resided in urbanized neighborhoods.

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