Early family risk, school context, and children's joint trajectories of cognitive ability and mental health

Lead Research Organisation: University College London
Department Name: Psychology and Human Development


Cognitive ability and mental health are both important aspects of child functioning, each shows gradients between advantaged and disadvantaged families, and each has long-term effects on a range of outcomes. They are also inter-twined, although there may be some children who fare better on one rather than the other. This project will 1) explore the hitherto uncharted patterns of their parallel unfolding, in the general population, from the early years to the end of primary school; 2) relate these patterns to the resources and risks in the family setting in early childhood; 3) link them to later (adolescent) outcomes, and 4) explore the role of primary school in this parallel unfolding and in reinforcing or compensating for the roles of individual characteristics and early family risk in this parallel unfolding. The project will use state-of-the-art statistical tools to exploit data from the Millennium Cohort Study (MCS) and the schools, in England, which the children attended. We will follow more than 19,000 children born in 2000/01 and surveyed at ages 9 months, and 3, 5, 7, 11 and 14 years.

We will take information on cognitive ability (measured, primarily, with the British Ability Scales) and mental health (measured with the Strengths and Difficulties Questionnaire) from MCS at ages 3, 5, 7 and 11. Early family risk (i.e., infancy to age 3) will be summarized by factors such as socio-economic disadvantage, maternal depression, low parental involvement, household chaos, poor parent-child interaction, single parenthood and low parental education. We will look at age 14 adolescent outcomes, such as academic performance, substance use, sexual behaviour, antisocial behaviour, bullying, peer victimisation and subjective well-being. The primary school context will reflect school composition (the demographic and social make-up of the student body), its 'quality' (measured by the school compositional variables of school-level achievement and school-level pupil absenteeism) and whether lessons are organized into ability groups. To preserve confidentiality, special arrangements will be made to access and analyse the data from schools.

In the first part of our work, we will show the average time trend (growth trajectory) of cognitive ability and mental health and the overall longitudinal association between these two outcomes from ages 3 to 11. This will also allow us to investigate how cognitive ability and mental health in childhood may affect each other. We will also look for any specific groups with distinct patterns of change or growth. Secondly, we will explore the role of early family risk in these trajectories. A third part of the study will be on the role of these trajectories in adolescent outcomes. Fourth, we will explore the role of the school context both in these trajectories and in closing or, conversely, widening the gaps between higher and lower risk families.

The results will contribute to the debate about whether failure to address children's mental health difficulties limits their making the best of intellectual abilities; will contribute evidence on the relative importance of cognitive ability and mental health for children's school achievement, and about how far schools redress or widen differences in children's life chances. Our project will create knowledge but also capacity. We will enhance the capacity to analyse the MCS and similar data sources through the involvement of graduate students and the training courses offered. We will also liaise with the Centre for Longitudinal Studies (the owner of MCS) to enhance MCS through adding data on children's schools. We will strive to communicate our findings to a wide range of non-academic audiences by actively engaging with the media, offering free training to non-academic users of research, and publishing non-technical research briefings and overview papers.

Planned Impact

The main aim of this project is to explore the patterns of the developmental association among cognitive ability and mental health from the early years until the end of primary school, and relate these to early family risk and later (adolescent) outcomes. As such, it will provide evidence for the extent and type of the hitherto neglected developmental association of two of the most important aspects of child functioning, and for the prediction and consequences of this two-track development. Our project findings will be of interest and, we hope, use to a number of groups. The first group are those making decisions about interventions in the childhood years. Our project findings should assist them in effectively targeting prevention efforts and interventions. The second main audience is clinicians and educators who can be guided on how to best distinguish normative from non-normative patterns of behaviour and cognitive functioning in children (e.g., problems which are likely to be 'outgrown' and those which tend to worsen). The third audience is national, local and devolved governments who have an interest in the extent and type of school 'effects' on children's affective, behavioural and cognitive functioning and resilience over time. A fourth group to whom results will be addressed are the general public, especially parents, grandparents and caregivers. Academic researchers are a fifth category of users, including those with a substantive interest in child cognitive and behavioural development and those interested in advanced longitudinal modelling. Future users of MCS are a specific part of these beneficiaries as they will have access to school-level data which we will link to this resource (see Data Management Plan). Finally, we hope to inform those commissioning research in child development. It is conceivable that mental health professionals have underestimated or neglected the centrality of cognitive ability in the progression of mental health symptoms, or educators the converse, because it does not fall directly under their purview. Our project will show if compartmentalizing the domains of child functioning in training, funding, research and social services programmes may be contraindicated.

To reach these groups, we will follow our current practice and publish research briefings and press release project findings. The press releases on project findings attract significant media and government interest. Our briefings will be available on the UCL website to download at no cost, will be targeted not only at academics but also policy makers and the public, and will summarise research findings in non-technical language. We will also offer two free training events, using our data and presenting our findings, targeted at academic and non-academic audiences. The first will be on the role of early family risk in children's (separate and joint) trajectories of cognitive ability and mental health. The second will be on the role of early family risk in typical and atypical trajectories of cognitive ability and mental health. We will also build capacity by offering research supervision of student projects related to our aims and objectives and using our dataset. These will be UCL postgraduate students in psychology, education and longitudinal research. We have a strong record of successfully linking master's, doctoral and postdoctoral research to our funded grants. For example, we have supervised some 25 master's dissertations attached to our current ESRC grant (Flouri et al., 2012-15). Eight of these postgraduate research projects are already published as journal articles, and some have received prizes. Finally, we will seek the help of our advisory group in reaching non-academic audiences, and we will organise a half day seminar to reach these audiences (see also Pathways to Impact).


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Flouri E (2019) Peer problems, bullying involvement, and affective decision-making in adolescence. in The British journal of developmental psychology

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Flouri E (2018) Maternal depressive symptoms in childhood and risky behaviours in early adolescence. in European child & adolescent psychiatry

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Flouri E (2019) Developmental cascades of internalising symptoms, externalising problems and cognitive ability from early childhood to middle adolescence. in European psychiatry : the journal of the Association of European Psychiatrists

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Flouri E (2019) The role of neighbourhood greenspace in children's spatial working memory. in The British journal of educational psychology

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Flouri E (2017) Maternal psychological distress and child decision-making. in Journal of affective disorders

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Flouri E (2019) Paternal Psychological Distress and Child Problem Behavior From Early Childhood to Middle Adolescence. in Journal of the American Academy of Child and Adolescent Psychiatry

Description We have already published papers and have several others under review or preparation. The key findings for our sample (ages 3-14 years old) thus far are: child mental health and ability develop jointly in most cases although there are some atypical groups too. For example, we identified a typically-developing group (83%) and three atypical groups, all with worse behavior and ability: children with improving behavior and low (but improving in males) ability (6%); children with persistently high levels of problems and low ability (5%); and children with worsening behavior and low ability (6%). Compared to typically-developing children, the latter two groups were more likely to show poor decision-making, be bullies or bully-victims, engage in antisocial behaviors, skip and dislike school, be unhappy and have low self-esteem. By contrast, children (especially males) in the improver group had outcomes that were similar to, or even better than, those of their typically-developing peers. These findings encourage the development of interventions to target children with both cognitive and behavioral difficulties. In terms of causal associations, it seems that cognitive ability and mental health (ie emotional and behavioral problems) in children influence one another but typically only in childhood and not consistently across genders. The consistent bidirectional associations were, in boys, between behavioral problems and low cognitive ability; in girls, between behavior problems and emotional problems. In adolescence, only behavior problems predicted other types of difficulties, such that, in both genders, they reduced cognitive skills and increased emotional problems. It seems that in either childhood or adolescence, reducing behavior problems could have both emotional and cognitive benefits. In childhood, improving cognitive skills could reduce both emotional and behavioral problems.

We have also established the importance of considering the role of poor cognitive skills in the development of, especially, externalising problems, as well as that of externalising problems in the development of cognitive difficulties.

With respect to the role of the broader context, our findings on any school effects are described in papers currently under review. With respect to the role of any neighbourhood effects, our findings point, uniquely, to the vital importance of the physical, alongside the social, context in both child cognition and child behaviour.
Exploitation Route Our findings point to treatment and prevention targets
Sectors Communities and Social Services/Policy,Education,Environment,Healthcare

Description British Academy Small Grants Scheme
Amount £10,000 (GBP)
Organisation The British Academy 
Department British Academy/Leverhulme Trust Senior Research Fellowships
Sector Charity/Non Profit
Country United Kingdom
Start 01/2018 
End 12/2019
Description Leverhulme DTP for the 'Ecological Brain'
Amount £1,000,000 (GBP)
Organisation The Leverhulme Trust 
Sector Academic/University
Country United Kingdom
Start 10/2018 
End 09/2022
Description Norwegian kindergartens 
Organisation University of Oslo
Country Norway 
Sector Academic/University 
PI Contribution This is an ongoing collaboration with BONDS, a large longitudinal study in Norway. The staff I am working with closely are Ane Nærde and Thormod Idsoe. My contributions are: intellectual input and training staff, as well as leadership and expertise.
Collaborator Contribution Following the media coverage and interest in our paper on greenspace and child spatial working memory as well as my close involvement in the 'Leverhulme Doctoral Training Programme for the Ecological Study of the Brain', both outputs related to this ESRC grant, I approached BONDS with whom I collaborated in the past to carry out a project using their data on the outdoor space in the kindergartens their cohort members attended. The project is looking at the role of the outdoor play environment in preschool children's physical aggression. We have some 747 children within 144 kindergartens and the first model results are ready. We expect we will have a manuscript submitted by end of June 2019
Impact For outputs and outcomes, please see above. Yes, it is multidisciplinary involving geography, statistics, education and psychology.
Start Year 2018
Description Scientific advisory network for CLS cohorts 
Organisation University College London
Department Centre for Longitudinal Studies
Country United Kingdom 
Sector Academic/University 
PI Contribution I have been invited to join a new scientific advisory network to support the development of the CLS cohorts. I have joined a small and focussed group on the theme of 'Mental health across the life course'. The overall purpose of the network is as a resource for strategic advice and support for the development of the CLS cohorts.
Collaborator Contribution CLS runs most of the UK cohort studies. This will be a platform for discussions of the development of the cohorts. They will also call on my advice, on an ad hoc basis, for example to support the design of a new study sweep for one of their studies, or when they are developing strategic funding bids. As well as providing strategic advice and support to the cohorts, this will be a forum for developing new ideas, and collaborations.
Impact No outcomes yet. Yes, it will be multidisciplinary. The cohorts are of scientific interest to all the social sciences and most of the medical ones, too.
Start Year 2019
Description The Royal Foundation's Mental Health in Education Conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact This was an event in February 2019, organised by the Royal Foundation. Its aim was to bring the education sector together to focus on how we can work to achieve lasting change
for all young people, and positive mental health in schools. HRH The Duchess of Cambridge attended the events and spoke at it.
Year(s) Of Engagement Activity 2019
URL https://www.youtube.com/watch?v=Mis6bAAGRYs&feature=youtu.be