Seminar

Prof Johan Eriksson, Executive Director, A*STAR Singapore Institute for Clinical Sciences, shared Key Insights from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study, launched in 2009, including:

• Poor maternal mental health negatively influences children’s brain development and function. 
• Positive maternal attitudes during pregnancy influences school readiness and performance. 
• 13% of the children in the GUSTO study were overweight by 6 years old, and at risk for hypertension and insulin resistance – including an important “late-onset” group with obesogenic eating behaviours. 
• Singaporean children are falling asleep later than children in other countries and sleeping less than recommended.
• Only 5.5% of 5- to 6-year-old children in Singapore meet the 24-hour integrated movement behaviour guidelines (encompassing sleep, screen time and physical activity), and children whose parents are more active with them are more likely to be physically active themselves.

Prof Eriksson highlighted how these insights provide pathways for translation, leading to preventive approaches that target potentially modifiable behaviour.  For example, the Appetite Toolbox for preschool children (4 to 6 years old) includes interventions targeting appetite awareness and self-regulation. He emphasized how interventions should be implemented in the first few years of life when children’s brains are more malleable.

Mr Lim Zhong Hao, Assistant Director and Senior Research Specialist, National Council of Social Service (NCSS) spoke on Quality of Life (QoL) of Caregivers and Children and Youths in Singapore. He presented a wealth of data from >10,000 surveys of wellbeing of children and youth and >4,500 caregivers, research designed to understand the ecosystem and to help design and deliver a person-centred approach in the social services sector. Key insights included:

• QoL of children and youth under 18 years old in Singapore was comparable to their peers in other countries. 
• Positive family function (family’s problem-solving abilities and time spent together) is important for children and youth’s QoL. 
• Children’s psychological well-being is a crucial determinant of their QoL, highlighting the importance of preventing or detecting mental health issues early.
• Fostering children’s social inclusion (i.e. feeling competent and accepted by their peers) is especially important for QoL in children with health conditions or special needs. 

Caregivers’ QoL is a key factor to children’s QoL. The two most prominent influences on caregivers’ overall QoL include self-efficacy and health problems. Findings suggested that a significant proportion of caregivers had to provide care alone. Half of the respondents indicated that more support would be useful and 13% felt “burdened” and experienced difficulties coping with caregiving. While only 3 in 10 caregivers had used social services to help them cope with the demands of caregiving, 1 in 4 caregivers desired more services, especially therapy, and felt that current services were either unaffordable or unavailable. 

Assoc Prof Leher Singh, Department of Psychology, Faculty of Arts and Social Sciences, NUS, spoke on Child Language Development in Socioeconomically and Culturally Diverse Families in Singapore, drawing on her research in the NUS Infant and Child Language Centre and her work in the SG LEADS cohort led by Prof Jean Yeung.  Previous research in Western samples has shown that socioeconomic status (SES) is associated with huge disparities in language exposure.  Prof Singh’s work has demonstrated:

• Infants from higher SES families are better adapted to discriminating sound differences (phonemes) that differentiate words and convey meaning.
• SES proxies such as maternal education are associated with child vocabulary in Singapore.
• Shared reading between parents and young children is also strongly associated with language acquisition.

While there is a persistent association between maternal SES and child language development, the evidence points to book-sharing activities as a potential avenue of intervention in buffering the adverse effects of low SES.  Since pathways to language development can diverge as early as age one year, we should intervene early—and that can be as simple as the serve-and-return interactions of book-sharing.

Assoc Prof Esther Goh, Department of Social Work, Faculty of Arts and Social Sciences, NUS, presented Towards a Holistic Health-Social Care for Children: Utilising Local Success Evidence from Vulnerable Families. Her strengths-focused work provides important practice-based insights on the experience of economic hardship, why some children from poor families do so well, and how family relationships influence children’s trajectories.  She introduced the important resiliency concept of a family’s hardiness—their ability to work together cohesively as they navigate stress.  Her work shows:

• Individual characteristics, such as mothers’ self-esteem, function as important and potentially modifiable protective factors when the family is experiencing economic hardship.
• Family hardiness—their commitment, adaptability, and sense of control—can increase over time and protect against mental health consequences of economic hardship 
• Family hardiness promotes positive family well-being and prevents the depletion of a child’s feelings of hope.

The implications for policy and practice include the need for financial assistance for families facing economic hardship.  Moreover, targeted and accessible supports should be focused on promoting family hardiness and supporting parents’ self-esteem. 

Our Panellists Ms Rahayu Buang, Ms Elaine Loo, Ms Ong Pei Ni and Mr Kitson Leonard Lee, and Moderator Ms Ang Bee Lian, together addressed the hard questions about what to do with this science, and how to translate it effectively in Singapore to bridge gaps and improve outcomes.  Families face challenges in providing nurturing care and ensuring their children’s well-being. Balancing work, family, and other responsibilities leads to time constraints for parents that may impact parent-child interaction and child development. Growing evidence emphasizes the importance of responsive caregiving. Yet parents and caregivers, feeling great pressure to get ahead in Singapore with limited time and resources, make decisions and trade-offs in how they allocate their time. How do we help parents find time and mental space to have quality interaction with their children?  The findings from local research provide good knowledge that when disseminated to the appropriate persons can support good decisions in the use of time.