Purpose
This report considers the relationship between the 372 individual factors to test how protective they are for children with high ACE exposure. We do this by looking for statistical evidence that these protective factors significantly reduce the detrimental effects of either the total number of childhood ACEs or an indicator of the physical abuse ACE on the various measures of school readiness. The main reason that the physical abuse ACE was singled out was because it had the highest level of prevalence in the sample.
Methodology
The Growing Up in New Zealand (GUiNZ) cohort consists of 6,790 births. Our sample consists of individuals who responded to the 54-month survey wave and were enrolled before the birth of the child, to ensure that all relevant outcomes were observed. This reduces our sample for this analysis to 5,562 children (81.9% of the original GUiNZ births).
The outcomes of interest for our study were seven school readiness assessments as used previously by the authors (Walsh et al., 2019a, Walsh et al., 2019b) and summarised below in Box 1. Data from antenatal, 9-month, 24-month, and 54-month survey waves were used to estimate the association between school readiness and a multitude of factors in three overarching domains: Health Care, Early Childhood Education, and Social Services. All seven school readiness assessment outcomes were collected during the 54-month GUiNZ survey. As expected, these school readiness measures are positively correlated. We are unaware of any validated composite index of these seven separate indicators.
We extracted a total of 372 variables that were deemed by the authors to be relevant indicators of access to and use of Health Care, Early Childhood Education, and Social Services. These mutable factors were selected after reviewing all available data from GUiNZ from the antenatal, 9-month, 24-month and 54-month datasets that clearly fell into the three domains. These selfreported measures cover the subgroups within the domains of Utilisation, Access, Quality and Preference. Table 1 provides the frequency distribution of the variables (Appendix 2 provides a full list of these factors). The majority of these indicators capture Utilisation (235 of the 372 variables or over 63% of the total). Additional measures of Access, Quality and Preference were extracted for all three domains, except Social Services.
Key Results
- For children who had experienced multiple ACEs, four factors had the largest potential effect on school readiness, all related to a child’s access to a General Practitioner.
- For the subset of children who had experienced the ACE of childhood physical abuse two factors had the largest potential effects related to school readiness: contact with social support agencies when needed, and the use of paid Early Childhood Education (ECE).
The researchers argue that the finding that access to a General Practitioner potentially has a strong effect on school readiness suggests that improving general access to healthcare for children at risk of experiencing multiple ACEs could potentially improve school readiness.
The researchers also note their findings suggest access to good quality, paid ECE may have a role to play in closing the gaps in school readiness for children who experience ACEs.