by British Medical Journal

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The combination of poorly developed social and cognitive skills during childhood is linked to poor exam results by the age of 16, with those for whom these issues persist throughout their childhood more than four times as likely not to pass at least five GCSEs, finds research published online in the Archives of Disease in Childhood.

The findings, which are based on a large set of nationally representative data, suggest that childhood cognitive and behavioral issues may be behind 17% of GCSE (General Certificate of Secondary Education) exam fails among 16-year-olds, conclude the researchers.

"Years in school matter, not just for exam results, but for skills and capacity development. It is this development which informs employment, economic well-being, social support and health behaviors, all of which ultimately affect health," they point out.

"Additionally, exam results at age 16 improve financial, occupational, and social-emotional outcomes in early adulthood, independent of later educational attainment, further supporting the importance of skills development in school," they explain.

While the development of cognitive skills, such as thinking, learning, memory, and reasoning, and socioemotional behaviors, such as social skills and self control, during childhood have independently been associated with educational outcomes, the potential impact of their co-development isn't clear.

To explore this further, the researchers analyzed long term data from 9084 children participating in the large nationally representative UK Millennium Cohort Study.

Childhood cognitive and behavioral problems were categorized into four previously identified patterns: no problems (76.5%); late emergence of socioemotional problems, from the age of 7 (10%); early emergence of cognitive and socioemotional problems between the ages of 3 and 7 (just over 8.5%); and persistent cognitive and socioemotional problems, from the ages of 3 to 14 (5%).

Cognitive development was measured using standard cognition tests and socioemotional behavior was described by parents in questionnaires when their children were aged 3, 5, 7, 11 and 14.

The researchers then looked at which of these children achieved a standard pass (grade 4) in five or more GCSE subjects at the age of 16, adjusting for potentially influential factors, such as the child's gender, mother's ethnicity and educational attainment, and household income.

The odds of achieving a standard pass in at least five GCSEs were higher in girls than in boys, and rose in tandem with the mother's educational attainment and household income level. But childhood behaviors were strongly linked to exam results.

Compared with the "no problem" group, the odds of not achieving a standard GCSE pass was two and a half times higher for the "late socioemotional problems" group and four times higher for the "early cognitive and socioemotional problems" group.

And those with persistent cognitive and socioemotional problems throughout their childhood were nearly 4.5 times more likely not to achieve a standard pass in at least five GCSE subjects.

Extrapolating these findings to the population as a whole, the researchers estimated that around 17% of poor exam results in adolescence might be attributable to cognitive and socioemotional behavioral problems in childhood.

This is an observational study, and as such, no firm conclusions can be drawn about causality. And further research is needed to better understand the associations found, emphasize the researchers.

But the findings prompt them to suggest that: "Rather than focus on getting the highest ability children out of poverty through harnessing that ability to reach the highest levels of educational attainment, such as university degrees, our results support reducing adverse development in all children regardless of level of ability."

They add, "Another policy implication is the need to move away from siloed child health and education policy to cross sector policy development, recognizing the interdependent and interconnected nature of these two major determinants of children's futures."

The inequalities in educational outcomes for children in England are "stark and increasing" they point out, highlighting that the difference in average English and Math GCSE passes among 16-year-olds, between children who are eligible for free school meals and those who aren't, is the highest it's been in over a decade.

More information: Impact of child socioemotional and cognitive development on exam results in adolescence: findings from the UK Millennium Cohort Study, Archives of Disease in Childhood (2025). DOI: 10.1136/archdischild-2024-327963

Journal information: Archives of Disease in Childhood 

Provided by British Medical Journal