Later school start time may produce benefits but more evidence is needed

Many studies have been conducted to examine the impact for pupils of later school start times, some of which can be found in previous issues of Best Evidence in Brief. This Campbell systematic review summarises the findings from 17 studies to examine the evidence on the impact of later school start times on pupils’ mental health and academic performance.

The studies included in the review were randomised controlled trials, controlled before-and-after studies and interrupted time series studies with data for pupils aged 13 to 19 and that compared different school start times. The studies reported on 11 interventions in six countries, with a total of almost 300,000 pupils.

The main results of the review suggest that later school starts may be associated with positive academic benefits and psychosocial outcomes. Later school start times also appear to be associated with an increase in the amount of sleep children get. Effect sizes ranged from +0.38 to +2.39, equivalent to an extra 30 minutes to 2 hours of sleep each night. However, the researchers point out that, overall, the quality of the body of evidence is very low, and so the effects of later school start times cannot be determined with any confidence.

Source: Later school start times for supporting the education, health, and well-being of high school students: a systematic review (December 2017), A Campbell Systematic Review 2017:15

Can friendships as a teenager predict later mental health?

Research by Rachel Narr and colleagues at the University of Virginia looked at whether the quality of friendships during adolescence can predict aspects of long-term mental and emotional health.

The study looked at a sample of 169 teenagers over 10 years, from age 15 to 25. They were surveyed annually and asked about who their closest friends were along with questions about those friendships. They were also assessed on anxiety, social acceptance, self-worth and symptoms of depression.

The researchers found that teens who prioritised close friendships at age 15 had lower social anxiety, an increased sense of self-worth and fewer symptoms of depression at age 25 than their peers. However, teens who had lots of friends, rather than a few close friendships, had higher levels of anxiety as young adults.

The study also determined that there was a low relation between teens having high-quality friendships and being more sought after by their peers, suggesting that although some teens manage both popularity and close friendship well, and attract both due to similar characteristics, for the most part, these two types of social success are due to different personal attributes.

Source: Close friendship strength and broader peer group desirability as differential predictors of adult mental health (August 2017), Child Development doi:10.1111/cdev.12905

The world’s largest school-based mental health programmes

School-based mental health programmes are now delivered to millions of children, particularly in high-income countries.

J Michael Murphy and colleagues have published a review of those programmes that reach the largest populations. In an article for the Harvard Review of Psychiatry, they profile eight programmes that have shown their effectiveness using randomised controlled trials or quasi-experimental studies. Most of the programmes focus on primary prevention or target specific vulnerable populations, rather than being aimed at supporting children with diagnosed disorders.

For each of the programmes, there is a description of its approach and a review of the supporting evidence. The eight programmes are:

  • Positive Behavioral Interventions & Supports
  • FRIENDS
  • Positive Action
  • Promoting Alternative Thinking Strategies (PATHS)
  • Skills for Life
  • MindMatters
  • Good Behavior Game
  • Cognitive-Behavioral Intervention for Trauma in Schools

Between them, the programmes have reached more than 25 million children, although the authors point out that these have mainly been in high-income countries. There is limited evidence that these programmes could be implemented at scale in low- and middle-income countries.

The authors suggest that, with the growing availability and diversity of programmes, greater attention can now be paid to assessing the processes and practices of implementation that are associated with successful, widely disseminated and sustainable programmes.

Source: Scope, scale, and dose of the world’s largest school-based mental health programs (August 2017), Harvard Review of Psychiatry

Social media and children’s mental health

In a new report from the Education Policy Institute, Emily Firth has examined the evidence of the impact of using social media on young people’s mental health and emotional well-being.

One of the key findings from the report is evidence of a beneficial impact. This is because young people can connect with others to improve their social skills online, develop their character and resilience and collaborate on school projects. In the recent PISA well-being survey of 15-year-olds, 90.5% of boys and 92.3% of girls in the UK agreed or strongly agreed with the statement “It is very useful to have social networks on the internet”. Also, importantly, those with mental health problems are able to use the internet to seek support, either through social media networks or through the online provision of advice and counseling support. For example, 78% of young people contacting the organisation Childline now do so online.

However, the report also highlights several negative effects on the well-being of young people linked with social media, including cyber-bullying, concerns about excessive use and sharing of private information and harmful content. It also finds that attempts to restrict children’s internet access are likely to be counterproductive as they hinder the development of vital skills needed to counter such risks. Rather than seeking to protect young people from all online risks­, the report calls on policy makers to promote proactive measures that build resilience in children, in order to help them lead safe digital lives.

Source: Social media and children’s mental health: a review of the evidence (June 2017) Education Policy Institute

How much sleep do teenagers need?

In a new study published in Child Development, Andrew J Fuligni and colleagues examined whether there is an “optimal” amount of sleep for peak levels of academic achievement and mental health in teenagers.

A total of 421 pupils (mean age = 15.03 years) with Mexican-American backgrounds from the 9th and 10th grades (Years 10 and 11) of two high schools in the Los Angeles area reported the amount of sleep they had every night for two weeks. Official school records were obtained at the end of the academic year to measure academic achievement. The Youth Self-Report form of the Child Behavior Checklist was used as a measure of mental health. A year later, 80% repeated the same process and a second wave of data was collected.

Pupils who averaged 8.75 – 9 hours of sleep per school night demonstrated peak levels of mental health, whereas those who averaged 7 – 7.5 hours of sleep per night had the highest levels of academic achievement (see also an earlier study reported in Best Evidence in Brief).

While the results showed that the “optimal” amount of sleep needed is different for the two developmental outcomes, the researchers note that reducing sleep for the sake of academic performance may result in a greater decline in mental health than in the decline in academic performance from increasing sleep for the sake of mental health.

Source: Adolescent sleep duration, variability, and peak levels of achievement and mental health (January 2017), Child Development DOI: 10.1111/cdev.12729

Does playing video games harm young children?

A new study has looked at the association between playing video games and young children’s mental health and cognitive and social skills.

Published in Social Psychiatry and Psychiatric Epidemiology, the study used data from the School Children Mental Health Europe project, conducted in six European countries (Germany, The Netherlands, Romania, Lithuania, Bulgaria, and Turkey). More than 3,000 children aged 6-11 took part in the study in 2010. Parents were asked how long their child played video games each week, provided demographic information, and completed a Strengths and Difficulties Questionnaire (SDQ, a measure of mental health status) for the child. Teachers also completed the SDQ for each child, and evaluated the child’s academic performance and motivation at school. Children completed Dominic Interactive, a computerised assessment tool for mental health status.

Results showed that factors associated with video game usage included being older, a boy, and belonging to a medium-sized family. Having a less-educated, single, inactive, or psychologically distressed mother decreased time spent playing video games. The results were adjusted for child age and gender, number of children, mother’s age, marital status, psychological distress, and other demographic characteristics. This showed that high video game usage (more than five hours each week) was significantly associated with higher intellectual functioning, increased academic achievement, a lower prevalence of peer relationship problems, and a lower prevalence of mental health difficulties.

Source: Is Time Spent Playing Video Games Associated with Mental Health, Cognitive and Social Skills in Young Children? (2016), Social Psychiatry and Psychiatric Epidemiology.