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Don’t let the kids get jet-lag: why regular bedtimes are key to a happy healthy childhood

The very best of sleep medicine and research is being presented at the World Sleep Congress in Prague this week. Among that research are findings from work by Child of our Time Editor, Professor Yvonne Kelly and colleagues at the ESRC International Centre for Lifecourse Studies. They have been trying to find out what it is about sleep that matters most when it comes to giving children the best possible start in life. Here Yvonne explains what they have found to date and why regular bedtimes are key to a healthy happy childhood.

What happens in the early years has profound implications for what happens later on in life. Thousands of research papers, many of them using the wonderful rich data in the British Birth Cohort studies, have documented the enduring impacts of the way we live our lives as children on how we fare later on. Children who get a poor start in life are much more likely to experience poor outcomes as adults, whether that’s to do with poor health or their ability to enjoy work and family life later on.

So what has all that got to do with getting enough sleep as a toddler you might ask? Well our research shows it is one of a number of important factors related to getting children off to the best possible start in life and here’s why.

Recommended sleep

The National Sleep Foundation recommends that toddlers should get around 11 to 14 hours sleep every day. For 3-5 year-olds, the recommendation is 10-13 hours and it suggests 9-11 hours for children once they’re at primary school. But is it all about the number of hours sleep children get, or is there more to it than that? Those are the questions we have been addressing in our research into children’s sleep and how it ties in with how they get on at home and at school across the first decade of their life.

Digging into one of those studies mentioned earlier, the Millennium Cohort Study, which has followed the lives of some 20,000 children since the turn of the century, we found that it’s not just the number of hours a child sleeps that matters, but also having consistent or regular bedtimes.

First we looked at the relationship between regular and irregular bedtimes and how the children got on in a range of cognitive tests. The results were striking. Children with irregular bedtimes had lower scores on maths, reading and spatial awareness tests.

Parents who took part in the MCS were asked whether their children went to bed at a regular time on weekdays. Those who answered “always” or “usually” were put in the regular bedtime group, while those who answered “sometimes” or “never” were put in the irregular bedtime group.

Interestingly, the time that children went to bed had little or no effect on their basic number skills, and ability to work with shapes. But having no set bedtime often led to lower scores, with effects particularly pronounced at age three and the greatest dip in test results seen in girls who had no set bedtime throughout their early life.

The key to understanding all this is circadian rhythms. If I travel from London to New York, when I get to there I’m likely to be slightly ragged because jet lag is not only going to harm my cognitive abilities, but also my appetite and emotions. That’s for me, an adult. If I bring one of my children with me and I want them to do well at a maths test having just jumped across time zones, they will struggle even more than I will. The body is an instrument, and a child’s is especially prone to getting out of tune.

The same thing happens when children go to bed at 8 p.m. one night, 10 p.m. the next and 7 p.m. another — we sometimes call this a “social jet lag effect.” Without ever getting on a plane, a child’s bodily systems get shuffled through time zones and their circadian rhythms and hormonal systems take a hit as a result.

Bedtimes and behaviour

Having established the importance of sleep to a child’s intellectual development, we turned our attention to the relationship between regular bedtimes and their behaviour.

At age 7, according to parents and teachers, children in the MCS who had irregular bedtimes were considerably more likely to have behaviour problems than their peers who had a regular bedtime. In addition, the longer a child had been able to go to bed at different times each night, the worse his or her behaviour problems were. In other words the problems accumulated through childhood.

One really important piece of good news was that we found that those negative effects appeared to be reversible, so children who changed from not having to having regular bedtimes showed improvements in their behaviour. There seems to be a clear message here that it’s never too late to help children back onto a positive path and a small change could make a big difference to how well they get on. Of course, the reverse was also true so the behaviour of children with a regular bedtime who switched to an irregular one, worsened.

Bedtimes and obesity

In a follow up study, which looked at the impact of routines including bedtimes on obesity, we reported that children with irregular bedtimes were more likely to be overweight and have lower self-esteem and satisfaction with their bodies.

In fact, of all the routines we studied, an inconsistent bedtime was most strongly associated with the risk of obesity, supporting other recent findings which showed that young children who skipped breakfast and went to bed at irregular times were more likely to be obese at age 11.

Even children who ‘usually’ had a regular bedtime were 20 per cent more likely to be obese than those who ‘always’ went to bed at around the same time.

So we have a body of robust evidence now that shows very clearly that regular bedtimes really matter when it comes to a child’s health and development over that important first decade of their life.

Providing that evidence in the form of advice to parents and all those caring for young children alongside recommended hours of sleep could make a real difference, helping protect our children from ‘social jet-lag’ and getting them off to a flying start instead.

Equally protected children: one step closer

In 2015 UCL researchers Anja Heilmann, Yvonne Kelly and Richard Watt produced a report, which showed that there was ample evidence that physical punishment can damage children and escalate into physical abuse. Together with the children’s charities that commissioned the report, they called for urgent action to provide children with the same legal protection against violence that British adults enjoy. The report was at the heart of Scottish MSP John Finnie’s proposed Children (Equal Protection from Assault) Bill which the Scottish Government have just announced that they will support in their programme for the coming year. The Bill would make Scotland the first UK country to outlaw all physical punishment by removing the defence of “justifiable assault” of children, and giving them the same protection as adults. Lead researcher, Anja Heilmann, reflects on the news and what she hopes it might mean for the human rights of children in Scotland and elsewhere.

On 11 May 2017, John Finnie MSP proposed a Bill to the Scottish Parliament to “give children equal protection from assault by prohibiting the physical punishment of children by parents and others caring for or in charge of children”.

After a three month consultation, which received more than 650 responses, the majority positive (75 per cent), that Bill became part of the Scottish Government’s plans for the next year, as Nicola Sturgeon announced she would not oppose it.

If passed, the Bill will prohibit the physical punishment of children by ending the existing common-law position that physical punishment by parents can be defended as reasonable chastisement and therefore be lawful. The Bill will not create a new criminal offence, as the common law offence of assault will apply (with a modification removing the reasonable chastisement defence).

It’s a far cry from similar efforts made in Scotland in 2002 to prohibit the physical punishment of children under the age of three. Back then, not only did a majority of MSPs reject the idea, but it was branded as “ridiculous” and an unwelcome intrusion into family life by many parents and the media.

15 years on it seems attitudes may have changed significantly. In the foreword to the Bill, John Finnie himself said:

“We would no longer consider it acceptable…. to allow our children to roam freely in the back of the car when going on a journey. Neither would we dream of taking them to a cinema if they had to watch a film through a fug of cigarette smoke … Attitudes towards these and many other fundamental societal issues have dramatically changed.”

Those attitudes changed as the result of a clear presentation of the evidence – the hard facts about the damage that those behaviours could cause.

We believe that, in this case, our evidence has made it clear for all to see that hitting children can not only damage them, but it carries the risk of escalation into physical abuse. It is a clear violation of international human rights law and children should and must be afforded the same rights as adults in this respect.

Overwhelming evidence

The evidence for the detrimental effects of physical punishment is vast and consistent. In short, our summary of the available evidence showed that physical punishment was related to increased aggression, delinquency and other anti-social behaviour over time. It also showed the more physical punishment suffered by a child, the worse the subsequent problem behaviour.

There was also a clear link between physical punishment and more serious child maltreatment and negative effects continued into adulthood, including problems of drug and alcohol dependency.

Half-hearted responses to recent human rights rulings condemning the physical punishment of children need to become wholehearted changes to the law, not tinkering that does just enough to meet the minimum requirements of those judgments rather than properly respect the rights of children.

The UN Committee on the Rights of the Child is unequivocal – all forms of corporal punishment of children are unacceptable. Let’s hope the Scottish Parliament can find the courage to make that statement a reality and show the rest of the UK the way.

As Martin Crewe of Barnardo’s Scotland stated:

“This is a huge step forward and sends a very clear message about the kind of Scotland we want to see for our children.”

Personally, I am hoping it’s a kind of Scotland and indeed UK, we WILL see in the not too distant future and I appeal to all MSPs to listen to the evidence and support the Bill.

Equally Protected? A review of the evidence on the physical punishment of children by Dr Anja Heilmann, Professor Yvonne Kelly and Professor Richard G Watt was commissioned by NSPCC Scotland, CHILDREN 1st, Barnardo’s Scotland and the Children and Young People’s Commissioner Scotland.

Why reading is key to giving our kids a great start in life

A growing body of research is pointing to how important and valuable reading is in giving children the best possible start in life, not just for academic success but more broadly including for a child’s mental health and happiness.

In this special episode of the Child of our Time Podcast, Professor Yvonne Kelly is joined by Jonathan Douglas, CEO of the National Literacy Trust and researcher Christina Clark, also from the  Trust. They discuss important new evidence about the benefits of reading for individual children and in addressing social inequalities.

Useful links

Tackling the childhood obesity epidemic: Can regular bedtimes help?

Nearly one in five 10 and 11-year-olds in England is obese, according to NHS figures. With childhood obesity posing not just a nationwide, but a worldwide health threat, public health researchers around the globe are striving to establish which aspects of a young child’s life might set them on a path to being obese later on. Associate Professor Sarah Anderson from The Ohio State University College of Public Health and colleagues from University College London outline the first research to try to disentangle the role of children’s routines and behaviour at age 3 on obesity at age 11 and show that bedtime routines and learning to manage emotions really do matter.

The UK’s Chief Medical Officer Professor Dame Sally Davies has warned that the health of millions of children is in jeopardy and is concerned that being overweight is becoming the norm. She fears half the population could be obese by 2050 at a cost of billions of pounds to the health service and wider economy.

The latest statistics highlight a stark contrast between the wealthiest and poorest families, with childhood obesity rates in the most deprived areas more than double those in the most affluent areas.

Despite the publication in August 2016 of the Government’s long-awaited childhood obesity strategy, charities and health organisations remain highly critical, describing it as a watered-down effort that puts business interests ahead of those of public health. Even the recent introduction of the so-called ‘sugar-tax’ on soft drinks has been met with scepticism in some quarters.

To help inform public health strategies going forward, our researchers looked at the bedtime, mealtime and tv/video routines of very young children and their emotional and behavioural development to see if, at this early stage, it is possible to identify those most at risk of becoming obese.

The study includes information on nearly 11,000 children collected through the UK Millennium Cohort Study (MCS). When the children were three, their parents reported whether children always, usually, sometimes, or never or almost never had a regular bedtime and mealtime, and the amount of television and video they watched each day.

They were also asked a series of questions about the child’s behaviour during the previous six months. Questions were about how children cope with emotions and their persistence and independence in play, including how easily the child became frustrated and whether they sought help from adults when faced with a difficult task. This was to get an idea of how well the child was able to ‘self-regulate’ their behaviour in these areas.

Regular routines

Children with regular bed and mealtimes and who watched less television were better able to control their emotions than their peers with less regular and consistent routines.

At 11-years-old, 6.2 per cent (682) of the children in the MCS were obese, with obesity more common in lower income and less educated families.

Of the routines we studied, inconsistent bedtime was most strongly associated with the risk of obesity, supporting recent findings by our UCL colleagues which showed that young children who skipped breakfast and went to bed at irregular times were more likely to be obese at age 11, stressing the importance of adequate sleep for preventing childhood obesity.

Even children who ‘usually’ had a regular bedtime were 20 per cent more likely to be obese than those who ‘always’ went to bed at around the same time.

Regular bedtimes and obesity

Surprisingly, toddlers with irregular meal times had a lower risk of obesity at age 11. Once other routines were factored in, television viewing was not related to obesity, although it is important to note that computer use was not taken into account, and the media environment for young children today is different than it was when children in MCS were young.

There was also a clear link between lower levels of emotional self-control in early childhood and obesity later on. Children with poor emotion regulation at age 3 were over 50 per cent more likely to be obese when studied at age 11.

Children’s level of persistence and independence was not linked to later obesity, however, and it is possible that this could be explained by the relative immaturity of the parts of the brain responsible for a child’s cognitive compared with their emotional development at this young age.

Strongest risk

Our study is the first to look at the relationship between a child’s routines, their ability to regulate their emotions and behaviour and how these factors work together to predict obesity.

The two strongest risk factors for obesity were irregular bedtime and a poor ability to control emotions and these were completely independent of each other. In other words, the link between bedtimes and obesity could not be explained away by a child’s inability to regulate their emotions.

There is a need to look more closely at the timing and regularity of children’s mealtimes and how they impact obesity later on, as we think there may be a lot more factors at play than we have considered here. We also need to better understand how the development of emotional and cognitive self-regulation interacts with metabolic, behavioural and social pathways to obesity.

However, our study supports previous research showing that children’s emotional regulation develops within a family context which includes routines.

One message from our study is crystal clear. To be effective, obesity strategies must target early childhood, and must find a way to support parents, especially those from the most deprived areas, to introduce and maintain consistent bedtimes and other home routines, as well as help children regulate emotions and respond to stress.

Another key message is that one size does not fit all. There is a lot going on in children’s lives that is important for their health and development. Saying that, it would seem that getting our children to bed at the same time every night could be a simple, cost-effective tool in the tool-kit to get them off to a good start and maybe in the larger battle against obesity.

Self-regulation and household routines at age three and obesity at age 11: Longitudinal analysis of the Millennium Cohort Study is research by Sarah Anderson from The Ohio State University College of Public Health; Amanda Sacker and Yvonne Kelly from University College London and Robert Whitaker of Temple University, Philadelphia.

Better start for children

Giving children the best possible start in life is the topic of a keynote talk today by our editor Yvonne Kelly.

Yvonne will be presenting a range of new evidence from the ESRC International Centre for Lifecourse Studies  to politicians, business leaders, and other professionals and key decision makers at an event discussing how Gothenburg can be made an equal and socially sustainable city.

Yvonne will talk about the factors which are most closely linked with a child’s health and well-being and present findings on children’s verbal skills, behaviour, bedtimes, reading and obesity. She will make the case that signs of social inequalities are evident early in a child’s life and that it is important to intervene early to tackle those inequalities.

Young drinkers: using evidence to prevent alcohol abuse

Research by Child of our Time Editor Yvonne Kelly on 11 year-old drinking has caught the eye of Mentor, a charity working to build resilience among young people to prevent alcohol and drug misuse. The charity’s CEO, Michael O’Toole is now looking to collaborate with Yvonne in future research that will take a look a first look at data from the Millennium Cohort Study in the Autumn. In this episode of the Child of our Time podcast, Michael explains what Mentor is doing, why research based evidence is so important to the charity and how he hopes it will help prevent alcohol abuse among young children in the future.

Photo credit: Joseph Choi

 

Mixed race kids: happier than we might think!

It’s been said and shown over the last few decades that mixed race and mixed ethnicity children tend not to do as well socially and emotionally as their non mixed peers. But new research casts a rather different light on the matter, showing that children both in the UK and US who are from mixed backgrounds are actually doing rather better.  James Nazroo from the University of Manchester has been looking at the issue with colleagues at the ESRC International Centre for Lifecourse Studies, UCL and discusses his surprising findings in our latest podcast episode.

Socioemotional wellbeing among mixed race/ethnicity children in the UK and US: Patterns and underlying mechanisms is due to be published in the Journal of Health and Social Behaviour. It is part of a wider programme of ESRC funded research led by Child of Our Time editor, Yvonne Kelly at ICLS.

Photo credit: Philippe Put

A bedtime story

Reading is key to giving children the best possible start in life. That’s what Child of our Time Editor Professor Yvonne Kelly will be telling representatives of the Swedish Government and European Commission today when she delivers the key note presentation at a seminar highlighting the importance and benefits of early interventions in children’s lives.

The seminar in Brussels has been organised by the City of Gothenburg in Sweden as part of its efforts to achieve the political goal of becoming an equal city and of its commitment to reduce inequalities.

Yvonne will be sharing research by herself and colleagues at the ESRC International Centre for Lifecourse Studies looking at factors associated with children’s poor verbal skills and behaviour problems. The research shows the links between regular bedtimes and reading with children and better outcomes for them in terms of behaviour and how well they get on at school.

Organisers of the event hope their efforts will encourage other cities in Europe to join them in their ambition to create health equality and a good start in life for all.

Photo credit: Lars Plougmann

Can racism towards a mum hurt her children?

Racial discrimination affects people in a range of ways. We know, for instance, that it can lead to poor health. We know, too, that our lives are linked, particularly with those of family members. So, can racism suffered by a parent affect a child? Are the negative effects of social ills transmitted within families? If so, how? And how might we be able to break negative links? A new study reveals some interesting patterns and possible explanations, as Dr Laia Becares from the University of Manchester, explains:

Understanding how our lives are linked is an essential part of understanding how society works. We know that racial discrimination affects the health and life chances of an individual, and it leads to inequalities in health among ethnic minority people, compared to the White majority population.

We know, too, that racial discrimination experienced by one individual impacts not only on that particular person, but on family members of the same generation, and those of previous and future generations. For example, if someone is discriminated against at work in terms of a promotion to a better position, or even in terms of getting hired, this has clear important financial consequences for that person, but also for her/his children, and older family members who may be under their care.

This is one of the ways in which the harm of racial discrimination is perpetuated across generations. Socioeconomic circumstances are strongly linked to health, so this example also shows how racial discrimination leads to poor health indirectly – via socioeconomic inequalities.

Racism and our health

But what about the direct association between racial discrimination and poor health, and the way this harm is transmitted across generations?

The Millennium Cohort Study (MCS), a representative study of children born in the UK between September 2000 and January 2002, offers a quality and quantity of data that, with the right interrogation, offers some important suggestions.

To ask the right questions of the data we needed a hypothesis. Drawing on well-established literature, we chose to focus on two potential mechanisms of transmission.

First we looked at the possible impact of racial discrimination on a mother’s mental health and then at the possible impact on parenting practice, particularly the possibility of it increasing harsh discipline tactics. These two mechanisms are centred on increased stress experienced by the mother following experiences of racial discrimination.

We also looked at three different types of exposure to racial discrimination – that suffered by the mother, that suffered by the family as a whole and that affecting the whole neighbourhood.

Information about the MCS children has been collected at various points since the start of the study. We used data collected when the children were between five and eleven years old.

Measuring discrimination

Racial discrimination was measured in terms of the mother’s experience of racially motivated insults, disrespectful treatment, or unfair treatment. We also used measures of whether family members had been treated unfairly, and whether the family lived in a neighbourhood where racial insults or attacks were common.

Mental health was assessed using the Kessler-6 scale – a well-established scale based on how often an individual has felt such things as depression and nervousness over the past month.

We measured harsh parenting practices by using records of how often parents had smacked or shouted at their children. And we measured the child’s socioemotional development by using another well-established scale – the Strengths and Difficulties Questionnaire developed by Robert Goodman and others.

We adjusted for complicating factors such as mother’s age at time of birth, mother’s educational attainment, household income, whether the mom was born in the UK, and the language most often spoken in the home.

For each factor we used data gathered at relevant stages. So, the measure of racial discrimination is based on data collected when the children were five years old, the mother’s mental health and parenting practices when the children were seven years old and the outcome when the children were aged eleven. The sample was pooled from all UK ethnic minority groups.

Racism and mental health

Around the time of the child’s fifth birthday almost a quarter (23%) of ethnic minority mothers reported having been racially insulted. There was a strong association with less good mental health for the mother two years later.

Both increased maternal psychological distress and increased harsh parenting practices were associated with increased socioemotional difficulties for the child at age 11. A worsening of the mother’s mental health had the most consistent indirect effect on a child’s socioemotional difficulties six years later.

Our results also showed some direct effects of racial discrimination on children. Family experiences of unfair treatment all had a direct effect on a child’s later socioemotional development.

We have to acknowledge some limitations of the study. We restricted ourselves to discrimination faced by mothers and its consequences. There are other things going on in families that affect children’s health. Plus ethnic minority children are likely to experience discrimination directly at school. And, of course, ethnic minority families are more likely to live in deprived areas and to suffer from other social inequalities.

Damage over time underestimated

The study does, however, offer strong support to our hypothesis that a mother’s experience of racial insults, of being treated disrespectfully by shop staff and broader family experience of unfair treatment, harms children over time as a result of the mother’s worsening mental health. This has been underestimated in the past.

If we are to break cycles of deprivation and begin to redress the imbalances in health between the majority and minority populations, policy-makers would do well to put more emphasis on mothers’ mental health.

Whatever is done to reduce a child’s direct experience of racial discrimination – at school, for instance – the mother’s experience and its effect on her is now shown to be important factor in the health of ethnic minority children. That said, the main implication of this study is that racial discrimination is harmful to individuals, families, and societies, and so efforts should be targeted at eliminating it.

A longitudinal examination of maternal, family, and area-level experiences of racism on children’s socioemotional development: Patterns and possible explanations is research by Dr Laia Becares, Professor James Nazroo and Professor Yvonne Kelly and is published in Social Science and Medicine.

Photo credit: moinuddin forhad

Parenting before and after separation

Do more involved dads have more contact with their child in the event of a separation? And does a mother’s confidence in her ability as a parent take a knock on separation? Researchers Professor Lucinda Platt from the London School of Economics and Political Science and Dr Tina Haux from the University of Kent  have been investigating these questions, using the Millennium Cohort Study, in a Nuffield Foundation funded research project looking at parenting before and after separation.

 

Photo credit: Dani Vazquez