ORCID Profile
0000-0003-2440-3667
Current Organisations
University of Western Australia
,
University of South Australia
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Public Health and Health Services | Epidemiology | Social Program Evaluation | Social Work | Health and Community Services | Family Care | Social work not elsewhere classified | Counselling, Welfare and Community Services | Aboriginal and Torres Strait Islander Health | Population Trends and Policies | Health and community services | Social epidemiology | Epidemiology | Social Policy | Mental Health | Public Health and Health Services not elsewhere classified |
ANZSRC Socio-Economic Objective (SEO)
Aboriginal and Torres Strait Islander Development and Welfare | Social Structure and Health | Families and Family Services | Public Health (excl. Specific Population Health) not elsewhere classified | Preventive Medicine | Mental Health | Children's/Youth Services and Childcare | Child Health | Structure, Delivery and Financing of Community Services | Disease Distribution and Transmission (incl. Surveillance and Response)
Related Links
Publications
Infant removals: The need to address the over-representation of Aboriginal infants and community concerns of another ‘stolen generation’
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.CHIABU.2019.01.017
Abstract: The removal of a child from their parents is traumatising, particularly in Aboriginal communities where a history of child removals has led to intergenerational trauma. This study will determine where disparities in child protection involvement exist among Aboriginal and non-Aboriginal children and characteristics associated with infant removals. Challenges faced by child protection and other agencies, and opportunities for overcoming these, are discussed. Data from both the Australian Institute of Health and Welfare and linked Western Australian government data was used to examine disparities between Aboriginal and non-Aboriginal children in the child protection and out-of-home care system. Nationally, Aboriginal children are ten times more likely to be placed in out-of-home care than non-Aboriginal children and this disparity starts in infancy. Infants were removed from parents with high levels of risk. Aboriginal infants were at increased risk of being removed from women with substance-use problems and had greater proportions removed from remote, disadvantaged communities than were non-Aboriginal infants. Aboriginal infants have a high rate of removal. Although there are many complexities to be understood and challenges to overcome, there are also potential strategies. The disparity between Aboriginal and non-Aboriginal infant removals needs to be seen as a priority requiring urgent action to prevent further intergenerational trauma.
Data Linkage: Canadian and Australian Perspectives on a Valuable Methodology for Intellectual and Developmental Disability Research
Publisher: American Association on Intellectual and Developmental Disabilities (AAIDD)
Date: 10-2019
DOI: 10.1352/1934-9556-57.5.439
Abstract: Data linkage holds great promise for generating new information about people with intellectual and developmental disabilities (IDD) as a population, yet few centers have developed the infrastructure to utilize this methodology. Two ex les, from Canada and Australia, describe their efforts in building data linkage capabilities, and how linked databases can be used to identify persons with IDD and used for population-based research. The value of data linkage is illustrated through new estimates of prevalence of IDD health service utilization patterns associations with sociodemographic characteristics, and with physical and mental health conditions (e.g., chronic diseases, injury, fertility, and depression) and findings on equity in medical treatments. Ex les are provided of findings used for governmental policy and program planning.
The lasting impact of family and domestic violence on neonatal health outcomes.
Publisher: Wiley
Date: 03-10-2022
DOI: 10.1111/BIRT.12682
Abstract: To compare the health of neonates born to women who experienced family and domestic violence (FDV) 12 months prior to birth, with the health of neonates born to women with an earlier history of FDV and women with no history of FDV. A retrospective cohort of women who experienced FDV within 12 months of birth (antenatal FDV [AFDV]) (n = 1230) was identified using data from the Western Australia (WA) Police Force Incident Management System and WA Hospital Morbidity Data Collection. Two comparison cohorts were used, the first including women with a history of FDV (HFDV) 12-60 months prior to birth (n = 1549) and the second with no history of FDV (NFDV) recorded (n = 3690). Hospital, birth, mortality, and congenital anomaly data were used in generalized linear models to examine and compare neonatal health outcomes. Women in the AFDV group had higher proportions of factors associated with poor neonatal outcomes including smoking (42.4%), substance use (23.0%), and mental health disorders (34.8%). Neonates born to AFDV mothers had significantly higher odds of congenital anomalies (OR: 1.51, 95% CI: 1.18-1.94), low birth weight (1.74, 1.45-2.10), and preterm birth (1.48, 1.22-1.79) compared with neonates born to NFDV mother. Neonatal health outcomes in those born to AFDV women were not significantly different from those born to HFDV women. Antenatal and historical FDV were associated with poor neonatal health outcomes. Additional pregnancy and social support should be offered to women who have experienced FDV during or prior to pregnancy.
Patterns of participation in year 9 academic testing and factors predicting absence on the day of test
Publisher: Springer Science and Business Media LLC
Date: 21-06-2016
Young people with prior health service contacts have increased risk of repeated alcohol-related harm hospitalisations
Publisher: Wiley
Date: 06-04-2022
DOI: 10.1111/DAR.13467
Abstract: After a first alcohol‐related hospitalisation in youth, subsequent hospitalisations may demonstrate an increased risk of further alcohol‐related hospitalisations, but there is no existing data on this. A retrospective longitudinal study between July 1992 and June 2017 using linked hospital administrative data identified 23 464 Western Australian young people [9009 (38.4%) females and 14 455 (61.6%) males], aged 12–24 years hospitalised for at least one alcohol‐related harm (ARH) episode of care. Cox regression was used to estimate hazard ratios (HR) between risk factors and repeated alcohol‐related hospitalisation after the first discharge for ARH. Of those admitted for an alcohol‐related hospitalisation ( n = 23 464), 21% ( n = 4996) were readmitted for ARH. This high‐risk sub‐group comprised 46% ( n = 16 017) of the total alcohol‐related admissions ( n = 34 485). After the first discharge for ARH, 16% (804) of people who experienced an alcohol‐related readmission were readmitted within 1 month, and 51.8% (2589) were readmitted within 12 months. At increased risk of readmission were Aboriginal people and those with prior health service contacts occurring before their first alcohol‐related hospitalisation, including illicit drug hospitalisations, mental health contacts and, in a sub‐analysis, emergency department presentations. The probability of a repeated ARH hospitalisation was highest in the first month after initial discharge. There is a high‐risk sub‐group of young people more likely to have a repeat ARH hospitalisation. This represents an opportunity to provide interventions to those most at risk of repeated ARH.
What Are the Risks and Obstacles in Implementing a Public Health Approach to the Well-Being and Protection of Children?
Publisher: Springer International Publishing
Date: 2019
‘He Has Problems; He Is Not the Problem . . .’ A Qualitative Study of Non-Custodial Staff Providing Services for Young Offenders Assessed for Foetal Alcohol Spectrum Disorder in an Australian Youth Detention Centre
Publisher: SAGE Publications
Date: 08-2019
Abstract: Little is known about the challenges non-custodial youth detention centre staff face supporting young people with foetal alcohol spectrum disorder (FASD). We undertook qualitative inquiry to identify and describe the perspectives of non-custodial staff detention staff regarding the value of an FASD prevalence study. Data were collected using semi-structured interviews and focus groups and analysed using thematic network analysis. Staff held few concerns about the prevalence study and its impact on participating young people however, they identified barriers related to study processes, and practices and culture within their workplace, which hindered gaining maximum benefit from the research and its findings.
Patterns of homelessness and housing instability and the relationship with mental health disorders among young people transitioning from out-of-home care: Retrospective cohort study using linked admin
Publisher: Public Library of Science (PLoS)
Date: 02-09-2022
DOI: 10.1371/JOURNAL.PONE.0274196
Abstract: The study examined the relationship between mental health, homelessness and housing instability among young people aged 15–18 years old who transitioned from out-of-home in 2013 to 2014 in the state of Victoria, Australia with follow-up to 2018. We determined the various mental health disorders and other predictors that were associated with different levels of homelessness risk, including identifying the impact of dual diagnosis of mental health and substance use disorder on homelessness. Using retrospective de-identified linked administrative data from various government departments we identified various dimensions of homelessness which were mapped from the European Topology of Homelessness (ETHOS) framework and associated mental health variables which were determined from the WHO ICD-10 codes. We used ordered logistic regression and Poisson regression analysis to estimate the impact of homelessness and housing instability respectively. A total homelessness prevalence of 60% was determined in the care-leaving population. After adjustment, high risk of homelessness was associated with dual diagnosis of mental health and substance use disorder, intentional self-harm, anxiety, psychotic disorders, assault and maltreatment, history of involvement with the justice system, substance use prior to leaving care, residential and home-based OHC placement and a history of staying in public housing. There is clearly a need for policy makers and service providers to work together to find effective housing pathways and integrated health services for this heterogeneous group of vulnerable young people with complex health and social needs. Future research should determine longitudinally the bidirectional relationship between mental health disorders and homelessness.
Reproductive and sexual health of Australian adolescents exposed to family and domestic violence
Publisher: BMJ
Date: 08-03-2023
DOI: 10.1136/BMJSRH-2022-201684
Abstract: There is a dearth of research investigating sexually transmitted infections (STIs) in children exposed to family and domestic violence (FDV). Further, there is no research on terminations of pregnancy in children exposed to FDV. This retrospective cohort study used linked administrative data from Western Australia to investigate whether exposure to FDV is associated with a risk of hospitalisations for STIs and terminations of pregnancy in adolescents. This study involved children born from 1987 to 2010 whose mother was a victim of FDV. Identification of family and domestic violence was from two sources: police and hospital records. This approach provided an exposed cohort of 16 356 and a non-exposed cohort of 41 996. Dependant variables were hospitalisations for pregnancy terminations and STIs in children aged from 13 up to 18 years of age. The primary explanatory variable was exposure to FDV. Multivariable Cox regression was used to investigate the association of FDV exposure and the outcomes. Following adjustment for sociodemographic and clinical factors, children exposed to FDV had an increased risk of hospitalisations for STIs (HR 1.49, 95% CI 1.15 to 1.92) and terminations of pregnancy (HR 1.34, 95% CI 1.09 to 1.63) as an adolescent than non-exposed peers. Children exposed to FDV are at an increased risk of hospitalisation for STI and termination of pregnancy as an adolescent. Effective interventions are needed to support children exposed to FDV.
Child maltreatment: variation in trends and policies in six developed countries
Publisher: Elsevier BV
Date: 02-2012
Maternal mental health and risk of child protection involvement: mental health diagnoses associated with increased risk
Publisher: BMJ
Date: 16-07-2015
Abstract: Previous research shows that maternal mental illness is an important risk factor for child maltreatment. This study aims to quantify the relationship between maternal mental health and risk of child maltreatment according to the different types of mental health diagnoses. The study used a retrospective cohort of children born in Western Australia between 1990 and 2005, with deidentified linked data from routine health and child protection collections. Nearly 1 in 10 children (9.2%) of mothers with a prior mental health contact had a maltreatment allegation. Alternatively, almost half the children with a maltreatment allegation had a mother with a mental health contact. After adjusting for other risk factors, a history of mental health contacts was associated with a more than doubled risk of allegations (HR=2.64, 95% CI 2.50 to 2.80). Overall, all mental health diagnostic groups were associated with an increased risk of allegations. The greatest risk was found for maternal intellectual disability, followed by disorders of childhood and psychological development, personality disorders, substance-related disorders, and organic disorders. Maltreatment allegations were substantiated at a slightly higher rate than for the general population. Our study shows that maternal mental health is an important factor in child protection involvement. The level of risk varies across diagnostic groups. It is important that mothers with mental health issues are offered appropriate support and services. Adult mental health services should also be aware and discuss the impact of maternal mental health on the family and children's safety and well-being.
Pregnancy and birth outcomes of mothers with intellectual disability and their infants: Advocacy needed to improve well-being
Publisher: Elsevier BV
Date: 04-2020
DOI: 10.1016/J.DHJO.2019.100871
Abstract: Pregnancy in women with intellectual disability (ID) is increasingly recognised, along with their increased likelihood of experiencing risk factors for adverse pregnancy and infant outcomes. We aimed to compare risks of socio-demographic, pregnancy and infant outcomes of women with ID to other women. All mothers with children born in Western Australia from 1983 to 2012 were linked to the population-based Intellectual Disability Exploring Answers database. Mothers with ID were matched by age and Aboriginality to a population s le of mothers without ID. Pregnancy and birth outcomes were compared for both groups and logistic regression was used to compare outcome risks. Compared to non-Aboriginal mothers without ID, non-Aboriginal mothers with ID were more likely to be of low socio-economic status, be without partner, smoke antenatally and have pre-existing asthma. They had a 1.5 times increased risk of pregnancy complications, specifically pre-ecl sia, urinary tract infection, threatened preterm labour and post-partum haemorrhage. After adjustment for maternal medical conditions and pregnancy complications, infants of Aboriginal mothers with ID had twice the risk of preterm birth and 1.6 times the risk of having percentage of optimal head circumference <95% compared to infants of Aboriginal mothers without ID. Infants of both Aboriginal and non-Aboriginal mothers with ID were more likely to have percentage of optimal birth weight <85% compared to those without ID. For mothers with ID, modifiable risk factors for adverse outcomes need addressing. They may require additional assistance during pregnancy, including more frequent consultations and support to assist with pregnancy management.
Tailoring service and system design for families known to child protection: a rapid exploratory analysis of the characteristics of families
Publisher: Wiley
Date: 05-2022
DOI: 10.1002/CAR.2762
Proceedings of The Magnificent CEνNS Workshop 2018
Publisher: Zenodo
Date: 2019
Trends in mental health related contacts among mothers of Aboriginal children in Western Australia (1990-2013)
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-027733
Abstract: This study examines the scale of maternal mental health related contacts among Australian Aboriginal children over time, and associations with socio-economic characteristics, geographical remoteness and maternal age. A retrospective cohort study of the prevalence of maternal mental health related contacts among Aboriginal children born in Western Australia between 1990 and 2013. Population of Western Australia with de-identified linked administrative data from the Western Australian Department of Health. All Aboriginal children born in Western Australia between 1990 and 2013 and their mothers. Prevalence of maternal mental health related contacts among Aboriginal children born between 1990 and 2013. Mental health related contacts were identified using mental health related inpatient hospitalisations and outpatient contacts. Almost 30% of cohort children were born to a mother with at least one mental health contact in the 5 years prior to birth, with 15% reported in the year prior to birth and the year post birth. There was a distinct increase in the prevalence of maternal mental health contacts between 1990 and 2013 (4–5% per year, with a peak in 2007). Maternal mental health contacts were associated with living in more disadvantaged areas and major cities, and having a mother aged over 20 years at birth. The study affirms that mental health issues place a considerable burden on Aboriginal Australia, and suggests that many of the mental health issues that women develop earlier in life are chronic at the time of conception, during pregnancy and at birth. Early intervention and support for women in the earliest stages of family planning are required to alleviate the burden of mental health problems at birth and after birth. There is a clear need for policies on the development of a holistic healthcare model, with a multisector approach, offering culturally appropriate services for Aboriginal people.
Western Australian emergency department presentations related to child maltreatment and intentional injury: Population level study utilising linked health and child protection data
Publisher: Wiley
Date: 12-10-2011
DOI: 10.1111/J.1440-1754.2011.02189.X
Abstract: The aim of this study is to determine the proportion of child maltreatment-related emergency department (ED) presentations in Western Australia (WA) and describe the type of injuries associated with them. It is also to investigate the proportion of maltreatment-related ED presentations resulting in hospitalisation, the proportion referred to the Department for Child Protection and their outcomes. This is a retrospective cohort study of all children aged 0-17 years residing in WA from 2001 to 2005 who had an ED presentation recorded in the ED Data Collection. This study used de-identified administrative data linked across the Departments of Health and Child Protection. Only 0.03% of ED presentations were identified as maltreatment related and 0.2% for all intentional injury presentations. One in five children with maltreatment-related ED presentations was admitted to hospital and a similar proportion had a notification to Department for Child Protection and 87% of these subsequently substantiated. This study showed that there are limitations with ED data for child maltreatment surveillance in WA and raises concerns that there may be missed opportunities for identifying maltreatment and for referring families for further assessment and support. Recommendations are provided to improve maltreatment surveillance and ED data, particularly for the identification of external causes of injury.
Trends in Hospital Admissions for Intimate Partner Violence in Australian Mothers With Children Born From 1990 to 2009.
Publisher: SAGE Publications
Date: 27-02-2021
Abstract: This study aims to determine the prevalence, and trends over time, of Western Australian (WA) mothers who were victims of intimate partner violence (IPV) requiring hospital admission. The study investigated the prevalence of all mothers and the specific prevalence of Aboriginal and non-Aboriginal mothers. A population-based cohort study using de-identified linked health data of mothers of children born from 1990 to 2009 in WA was carried out. The prevalence of hospitalizations for IPV in mothers of children born in the period 1990-2009 (per 1,000 births) was calculated. Results indicate that the overall prevalence of hospital admissions for mothers assaulted 12 months prior to their child's birth month increased in the period 1990-2009, from 2.7 to 7.7 per 1,000 births. There was also an increase in the overall prevalence of hospital admissions of mothers who were assaulted 12 months prior to the birth month and 36 months after the birth month, from 8.9 per 1,000 births in 1990 to 19.4 per 1,000 births in 2009. In addition, being Aboriginal, having a mother <30 years of age, and being of low SES significantly increased the odds of having a mother with an IPV admission. This study highlights that while there has been an increase in the prevalence of IPV admissions for mothers of children born from 1990 to 2009 in WA, the level of prevalence has remained persistent for the last decade for the whole population. However, non-Aboriginal mothers have seen an increase in prevalence in the last decade. This increase is associated with the introduction of the Z63.0 code in
Trends in alcohol-related injury admissions in adolescents in Western Australia and England: population-based cohort study
Publisher: BMJ
Date: 05-2017
Supporting Aboriginal and Torres Strait Islander Families to Stay Together from the Start (SAFeST Start): Urgent call to action to address crisis in infant removals
Publisher: Wiley
Date: 26-01-2022
DOI: 10.1002/AJS4.200
Abstract: Reducing the rate of over‐representation of Aboriginal and Torres Strait Islander children in out‐of‐home care (OOHC) is a key Closing the Gap target committed to by all Australian governments. Current strategies are failing. The “gap” is widening, with the rate of Aboriginal and Torres Strait Islander children in OOHC at 30 June 2020 being 11 times that of non‐Indigenous children. Approximately, one in five Aboriginal and Torres Strait Islander children entering OOHC each year are younger than one year. These figures represent compounding intergenerational trauma and institutional harm to Aboriginal and Torres Strait Islander families and communities. This article outlines systemic failures to address the needs of Aboriginal and Torres Strait Islander parents during pregnancy and following birth, causing cumulative harm and trauma to families, communities and cultures. Major reform to child and family notification and service systems, and significant investment to address this crisis, is urgently needed. The Family Matters Building Blocks and five elements of the Aboriginal and Torres Strait Islander Child Placement Principle (Prevention, Participation, Partnership, Placement and Connection) provide a transformative foundation to address historical, institutional, well‐being and socioeconomic drivers of current catastrophic trajectories. The time for action is now.
Research protocol of a multifaceted prospective mixed-method longitudinal study
Publisher: Springer Science and Business Media LLC
Date: 29-07-2020
DOI: 10.1186/S12889-020-09138-X
Abstract: Developing robust evidence is a challenge for researchers working with disadvantaged or vulnerable populations. For ex le, research shows that young people who have transitioned from out-of-home care (OOHC) to independent adulthood often experience poor long-term outcomes. However, evidence for the aetiology of those outcomes is weak due to methodological limitations such as small s le sizes and a lack of longitudinal data. This paper details the protocol for Navigating Through Life, a study that utilises novel research methods to better understand the pathways and outcomes of young people as they leave OOHC in Western Australia (WA) . Navigating Through Life is a longitudinal, mixed methods, population-based study. A prospective longitudinal study of young people aged 15–25 years will follow participants’ experiences and outcomes over a two-year period. Quantitative and qualitative data is being collected from participants five times over 2 years, using standardised outcome measures and in idual interviews. Outcome measures focus on key dimensions of young people’s lives (e.g., social inclusion, well-being, resilience, self-determination). Interviews examine important influences and the variable contexts into which young people have transitioned from care. In addition, retrospective population-level data for young people transitioning from OOHC will be obtained from linked Western Australian government administrative records. Using a multitude of data sources, analysis will map pathways and outcomes of young people with care experience, and comparisons will be made with other population groups within WA. Navigating Through Life exemplifies a novel utilisation of multiple data sources to research outcomes for vulnerable and difficult to reach populations, and offers insights for other complex mixed-methods longitudinal studies. Results will provide new and more comprehensive data about specific pathways that may be influential to a range of post-care outcomes. Findings will extend evidence to inform better service-delivery models that improve outcomes and reduce disparities for vulnerable young people.
Rates and types of hospitalisations for children who have subsequent contact with the child protection system: a population based case-control study
Publisher: BMJ
Date: 23-09-2009
Abstract: To determine whether children who have child maltreatment allegation or substantiation have a higher rate of general hospital admissions and injury related admissions when compared to other children and to investigate other types of admissions, such as mental health, infections and admissions due to external causes. A prospective matched case-control study of children born in Western Australia between 1990 and 2005 using de-identified record linked Child Protection and Hospital Morbidity data. Rates of prior hospital admissions for cases versus controls were calculated, and conditional logistic regression was used to estimate the effect of hospital admission rate on the risk of child maltreatment allegation and substantiated allegation. Children with child maltreatment allegations and substantiations had higher mean prior admission rates compared to controls. Higher rates of general admissions and admissions for injuries, infections, mental and behavioural disorders, and external causes of morbidity, were associated with a markedly increased risk of child maltreatment allegations and substantiation. The hospital system plays not only an important role both in the surveillance of maltreatment-related injuries and conditions but also in the role of prevention in the referral of families who may need support and assistance in ensuring the health and safety of their children. This research highlights the importance of moving to electronic patient records in identifying children who have high rates of admissions and the types of conditions they have previously presented with, particularly for injuries, mental and behavioural disorders and external causes of admissions.
Child protection involvement of children of mothers with intellectual disability
Publisher: Elsevier BV
Date: 04-2022
DOI: 10.1016/J.CHIABU.2022.105515
Abstract: Children born to parents with intellectual disability (ID) have been shown as disproportionally represented in child protection services however with limited population-based research. To investigate child protection involvement for children born to mothers with ID in Western Australia using linked administrative data. A cohort of 1106 children born to a mother with ID and a comparison group of 9796 children of mothers without ID were identified in Western Australia. Cox regression analyses stratified by maternal Aboriginal status were conducted to investigate risk of child involvement with child protection services and care placement. Interaction with child age, intellectual disability status, and maternal mental health and substance use was investigated. Children born to a mother with ID were both at higher risk of having contact with child protection services (HR: 4.35 (3.70-5.12)) and placement in out-of-home care (HR: 6.21 (4.73-8.17)). For non-Aboriginal children, the risks of child protection involvement and placement for those born to mothers with ID were 7 times and 12 times higher than those of mothers without ID. The risk was lower for Aboriginal children, at 1.8 and 1.9 times, respectively. Infants born to mothers with ID were at higher risk of child protection involvement compared to other age groups. Maternal mental health and substance use moderated the increased risk. Intellectual disability alone is not sufficient justification for removal of children from their parents. The challenge for family services is ensuring that resources are adequate to meet the family's needs.
Maltreatment risk among children with disabilities
Publisher: American Academy of Pediatrics (AAP)
Date: 04-2017
Abstract: Children with disabilities are at increased risk of child maltreatment however, there is a gap in the evidence about whether all disabilities are at equal risk and whether risk factors vary according to the type of disability. A population-based record-linkage study of all children born in Western Australia between 1990 and 2010. Children with disabilities were identified by using population-based registers and risk of maltreatment determined by allegations reported to the Department for Child Protection and Family Support. Although children with disabilities make up 10.4% of the population, they represent 25.9% of children with a maltreatment allegation and 29.0% of those with a substantiated allegation however, increased risk of maltreatment was not consistent across all disability types. Children with intellectual disability, mental/behavioral problems, and conduct disorder continued to have increased risk of an allegation and substantiated allegation after adjusting for child, family, and neighborhood risk factors. In contrast, adjusting for these factors resulted in children with autism having a lower risk, and children with Down syndrome and birth defects/cerebral palsy having the same risk as children without disability. The prevalence of disabilities in the child protection system suggests a need for awareness of the scope of issues faced by these children and the need for interagency collaboration to ensure children’s complex needs are met. Supports are needed for families with children with disabilities to assist in meeting the child’s health and developmental needs, but also to support the parents in managing the often more complex parenting environment.
Entering out-of-home care during childhood: Cumulative incidence study in Canada and Australia
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.CHIABU.2016.07.011
Abstract: Cumulative incidence provides a more accurate indicator than annual incidence rates of the number of children who experience out-of-home care during childhood. The study utilises a cohort of all children born in Western Australia (WA) 1994-2005 and Manitoba 1998-2008 using de-identified linked data. Life tables were used to calculate the age-specific cumulative incidence over time and for at-risk groups. Cox regression was used to compare risk factors for entry to care. Manitoba had a larger proportion of children entering care compared to WA (9.4% vs 1.5% by age 12). Over time children entered care at a younger age in both WA (HR=1.5, CI:1.4-1.5) and Manitoba (HR=1.5, CI:1.5-1.6). Similar factors were associated with earlier age care entries in both countries including: socioeconomic disadvantage, young maternal age, maternal hospital admissions for mental health issues, substance misuse and assault. Supplementary analysis for WA showed a time trend with young children (<3years of age) who entered care spending an increasing proportion of their early years in care. Whilst Manitoba had a larger proportion of children entering care, over time in Western Australia children have been entering care at a younger age and spending more time in care. These latter factors contribute to an increased burden on the out-of-home care system. Manitoba had over five times greater cumulative incidence than WA, however risk factors for entry to out-of-home care were consistent in both countries. Knowledge of the risk factors for entry to out-of-home care can inform targeted support and prevention programs.
Hospitalisations for maternal assault are associated with increased risk of child protection involvement
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.CHIABU.2019.05.007
Abstract: Previous research shows a co-occurrence between children's exposure to violence and child maltreatment. This study examined the risk of maltreatment allegations in children whose mothers had been hospitalised due to an assault. The study used a retrospective cohort of children born in Western Australia between 1990-2009 (N = 524,534) using de-identified linked-administrative data. Multivariate Cox regression determined the adjusted and unadjusted hazard ratios for child maltreatment allegation in children with a mother hospitalised for assault. Models were adjusted for a range of sociodemographic characteristics. One in five children had a maltreatment allegation following their mother's hospitalisation for assault. This increased to two in five children when the mother was assaulted in the prenatal period. Aboriginal children accounted for 57.6% of all allegations despite representing only 7.8% of the population. Children whose mother had a hospitalisation for assault were nine-times (HR = 9.20, 95%CI: 8.98-9.43) more likely to have a subsequent maltreatment allegation than children whose mother did not have a hospitalisation for assault. Following adjustment for confounding factors, both Aboriginal and non-Aboriginal children had an almost two-fold increased risk of maltreatment allegation (HR = 1.56, 95%CI: 1.43-1.70 HR = 1.93 95%CI:1.80-2.07). Our study shows that child maltreatment allegation is common in children following a maternal hospitalisation for assault. Targeted early intervention is required for families with young children, and pregnant women experiencing violence. Importantly service staff need awareness of the impact of violence on families and the appropriate services to refer families to.
Exposure to family and domestic violence is associated with lower attendance and higher suspension in school children
Publisher: Elsevier BV
Date: 08-2023
DOI: 10.1016/J.CHIABU.2022.105594
Abstract: Exposure to family and domestic violence (FDV) in childhood can have a detrimental effect on children's health and social outcomes. However, research on the school outcomes of children exposed to FDV is scant. To investigate the impact of FDV exposure on school attendance and suspension in Aboriginal and non-Aboriginal children. A population-based retrospective cohort study of school children, in grade 1 to 10, born from 1993 to 2006 in Western Australia (n = 26,743) using linked administrative data. Multivariate logistic regression analysis was used to calculate odds ratios and 95% confidence intervals to determine the association with school attendance and suspension outcomes for children exposed to FDV compared to non-exposed children. Compared to non-exposed children, children exposed to FDV have an increase of poor school attendance: Aboriginal children adjusted odds ratio (aOR) = 1.91, 95% confidence interval (CI): 1.75-2.07, non-Aboriginal children aOR = 2.42, 95%CI: 2.12-2.75. FDV-exposed children also have an increased risk of school suspension: Aboriginal children aOR = 1.60, 95%CI: 1.47-1.74, non-Aboriginal children aOR = 2.68, 95%CI: 2.35-3.05, compared to non-exposed counterparts. Exposure to FDV is associated with an increased odds of poor school attendance and school suspension. Evidence-based and innovative strategies are needed to support children who are exposed to FDV. This involves responding in ways that does not cause further trauma to children a restorative and trauma-informed approach is vital.
Trends in pre‐existing mental health disorders among parents of infants born in Western Australia from 1990 to 2005
Publisher: AMPCo
Date: 05-2013
DOI: 10.5694/MJA12.11783
Abstract: To determine the prevalence of prior and current mental health disorders in parents, including trends over time. retrospective population cohort study using de-identified linked health data. Population of Western Australia. All parents of infants born in WA between 1990 and 2005. Prevalence of prior mental health disorders in parents by birth 2013 and by parent and child characteristics, including Aboriginality, maternal age, socioeconomic status and diagnostic groups. From 1990 to 2005, there was an increase in prevalence of prior mental health disorders in mothers, from 76 per 1000 births in 1990 to 131 per 1000 births in 2005 (3.7% increase per 2013 in the odds of children being born to mothers with a prior mental health disorder). There was also a 4.7% increase in odds per 2013 in the prevalence of mental health contacts that had taken place in the 12 months before the birth 2013 in mothers. In addition, there was an increase in prevalence of prior mental health disorders in fathers, from 56 per 1000 births in 1990 to 88 per 1000 births in 2005 (3.1% increase in odds per 2013). The diagnostic group with the highest prevalence in both mothers and fathers was substance-related disorders. From 1990 to 2005, there was an increase in prevalence of parents with a prior history of mental health disorders in WA. General practitioners and mental health workers can play an important role in identifying mental illness and in working with families to offer early intervention, referral and support.
To feel belonged: The voices of children and youth with disabilities on the meaning of wellbeing
Publisher: Springer Science and Business Media LLC
Date: 26-02-2012
Out-of-Home Care and the Educational Achievement, Attendance, and Suspensions of Maltreated Children: A Propensity-Matched Study
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.JPEDS.2018.03.027
Abstract: To estimate the influence of out-of-home care on reading scores, attendance, and suspensions by comparing a matched s le of maltreated children who entered out-of-home care and maltreated children who remained at home. Linked administrative data for all children born in Western Australia between 1990 and 2010 was used, focusing on those with substantiated maltreatment before year 9 achievement tests (n = 3297). Propensity score modelling was used to address differences in preexisting risk factors (child, family, neighborhood characteristics, maltreatment history, and reading scores) and compare outcomes for children placed in out-of-home care and those remaining in in-home care. Both groups of maltreated children had poor educational outcomes. After accounting for group differences in risk characteristics, there was no difference in year 9 reading achievement for the out-of-home care and in-home care groups. There was no difference in suspensions for the groups. The only significant difference was children in out-of-home care had fewer school absences than children in in-home care. Out-of-home care was not found to be a significant factor in the adverse educational outcomes of these children however, there is a clear need for further educational support to address poor outcomes for children involved with child protection services.
Harmful drinking is associated with mental health conditions and other risk behaviours in Australian young people
Publisher: Elsevier BV
Date: 06-2020
Is early childhood development impeded by the birth timing of the younger sibling?
Publisher: Public Library of Science (PLoS)
Date: 10-05-2022
DOI: 10.1371/JOURNAL.PONE.0268325
Abstract: This study investigated whether the timing of birth of the younger siblings was associated with the risk of the older siblings’ developmental vulnerability in early childhood. Linkage of population-level birth registration, hospital, and perinatal datasets to Australian Early Development Census (AEDC) records (2009–2015), enabled follow-up of a cohort of 32,324 Western Australia born singletons. Children with scores th percentile on an in idual AEDC domain (Physical Health and Wellbeing Social Competence Emotional Maturity Language and Cognitive Skills (school-based) and Communication Skills and General Knowledge) were classified as developmentally vulnerable. Modified Poisson Regression was used to estimate relative risks (RR) for associations between post-birth interpregnancy intervals (IPIs) and developmental vulnerability. Relative to post-birth IPIs of 18–23 months, post-birth IPIs of and 6–11 months were associated with an increased risk of children being classified as DV1 (aRR 1.21, 95% CI: 1.11–1.31) and DV2 (aRR 1.31, 95% CI: 1.15–1.49) and DV1 (aRR 1.10, 95% CI: 1.03–1.17) and DV2 (aRR 1.21, 95% CI: 1.09–1.34), respectively. Post-birth IPIs of months were associated with an increased risk on four of the five AEDC domains. Post-birth IPIs of 48–60 months were associated with an increased risk of developmental vulnerability however, the risk was statistically significant for DV1, DV2 and the domains of Emotional Maturity and Language and Cognitive Skills (school-based). Developmental vulnerability was associated with having a closely spaced younger sibling ( months post-birth IPIs). Optimising birth spacing should be further investigated as a potential means for improving child development outcomes.
A Demographic Profile of Mothers and Their Children Who Are Victims of Family and Domestic Violence: Using Linked Police and Hospital Admissions Data.
Publisher: SAGE Publications
Date: 05-05-2022
Abstract: The aim of this study was to examine the key sociodemographic characteristics of Australian mothers and their children who were victims of family and domestic violence (FDV) that resulted in the male perpetrator being criminally charged for the offense or the mother being hospitalized. A population-based retrospective cohort study using de-identified linked health and police data of mothers with children born 1987-2010 who were victims of FDV 2004-2008 was utilized. Results indicate that mothers who were identified in police data are different demographically from those identified in health data and differed again from mothers identified in both health and police data. Within Western Australia, 3% of the population identify as Aboriginal however, 44% of mothers identified as victims in police data and 73% within the health data were Aboriginal. Of the mothers identified in police data, 30% were under 25 years of age at their first assault recorded in police data compared with 21% in those identified in both police and hospital data. Most mothers identified as victims of FDV in police data had children present at their assault (60.6%). Prevalence of FDV exposure, identified in police data, was significantly different in Aboriginal children compared with non-Aboriginal children. Aboriginal children had a 19-fold (
Parents' experiences with child protection during pregnancy and post‐birth
Publisher: Wiley
Date: 15-11-2023
DOI: 10.1111/CFS.12984
Abstract: Limited research has directly sought the input of parents involved in the child protection system during pregnancy and with their infants. As the focus of these policies and practices, parents have a unique and important insight not available to others, so it is vital to obtain their input. As part of a larger Australian study, qualitative interviews were undertaken with 13 parents asking about their views and experiences. Parents predominantly became involved with child protection services during pregnancy through a prenatal report. Parents who previously had their newborn removed from their care described it as sudden and unexpected, leaving them distressed and unsupported post‐removal, with a growing list of requirements for them to see their baby or for restoration to be considered. Domestic violence was a particular issue of concern for some mothers who expressed distress that their partners, perpetrators of violence, were allowed access to their infant with fewer requirements than for them. Improvements recommended by the parents included greater communication and preparation for the removal, better recognition of improvements in their situations and increased supports to be provided to parents both pre‐ and post‐removal. Parental experiences provide an important guide to improving child protection practice with these families.
Alcohol-related harm in emergency departments
Publisher: Wiley
Date: 29-10-2021
DOI: 10.1111/ADD.15284
Abstract: Alcohol‐related harm in emergency departments: linking to subsequent hospitalizations to quantify under‐reporting of presentations. To quantify the proportion of emergency department (ED) presentations that could be identified as alcohol‐related when linking to a patient's subsequent hospitalization, compared with using ED data alone, and to assess that comparison according to the change in alcohol harm rates over time and potential variations within subpopulations. A retrospective study using linked hospital administrative data to identify ED patients who had subsequent alcohol‐related hospitalizations. Western Australia. A total of 533 816 Western Australian young people (246 866 females and 286 950 males), aged 12–24 years. Whether or not presentations of young people to ED could be identified as alcohol‐related, and for those that were not, how many had a subsequent alcohol‐related hospitalization. Rates and proportions of alcohol‐related harm for both methods of ascertainment were estimated by sex and Aboriginality across different age groups. Alcohol‐related hospitalizations that followed an initial presentation at ED allowed the identification of an additional 19 994 alcohol‐related presentations (95% increase). Linking to additional hospitalization information also resulted in significant variation in alcohol‐related harm trends. In particular, trends in alcohol‐related ED presentations for 21–24‐year‐old males were stable to slightly increasing using only ED data, but decreased after linking with hospitalization data ( P 0.05). Similarly, trends among Aboriginal persons aged 21–24 shifted from increasing using only ED data to being stable in comparison to presentations using subsequent hospitalizations ( P 0.05). Among young people in Western Australia, twice as many emergency department presentations could be identified as being alcohol‐related using diagnosis information from subsequent hospitalizations compared with emergency department data alone. When supplemented with hospitalization data, trends in alcohol‐related harm presentations become significantly different within some subpopulations compared with using emergency department presentation data alone.
Identifying families most likely to have missing paternal details in birth registrations using linked data
Publisher: Informa UK Limited
Date: 17-03-2015
Cross-country comparison of victimisation-related injury admission in children and adolescents in England and Western Australia
Publisher: Springer Science and Business Media LLC
Date: 06-07-2013
Abstract: A single, standardised measure of victimisation-related (VR) injury admission in hospital administrative datasets could allow monitoring of preventive and response strategies and international comparisons of policy. Consistency of risk factors and incidence rates for a measure of victimisation-related injury in different countries with similar access to healthcare services would provide indirect evidence for measure validity. Cohorts were derived from hospital administrative data for children aged less than 18 years who were admitted for acute injury to hospitals in England or Western Australia (WA) in 2000 to 2008. We compared the effects of age, sex and deprivation on the annual incidence of acute admission for VR injury defined by a cluster of ICD-10 codes reflecting characteristics that should alert clinicians to consider victimisation as a cause of injury. Four subcategories comprised codes specifically indicating child maltreatment, assault, undetermined cause, or adverse social circumstances. The incidence of VR injury followed a similar ‘J’-shaped association with age in both countries with increasing rates from 10 years onwards and peaks in infancy and in 16–17 year-olds. In both countries, rates increased with deprivation. Girls had lower rates than boys except in the 11–15 age group where girls had higher rates than boys in WA but not in England. Adjusted incidence rates were similar in both countries for children aged 3 to 15 years old, but were higher in WA compared with England in children under 3 years old and in those aged 16–17 years. Higher rates in WA in 16–17 year-olds were explained by more admissions coded for the subcategories of adverse social circumstances, and to a lesser extent, assault, than in England. Children less than 3 years old were more often coded specifically for maltreatment in WA than in England. The similarities in risk factors and in the adjusted rates of victimisation-related injury admission in both countries suggest that the VR cluster of ICD-10 codes is measuring a similar underlying problem. Differential use of coding subcategories highlights the need to use the entire VR cluster for comparisons across settings.
Monitoring child abuse and neglect at a population level: Patterns of hospital admissions for maltreatment and assault
Publisher: Elsevier BV
Date: 11-2010
DOI: 10.1016/J.CHIABU.2010.04.003
Abstract: To investigate the prevalence, trends, and characteristics of maltreatment and assault related hospital admissions and deaths among children and identify common injuries and conditions associated with these admissions using routinely collected morbidity and mortality data. A retrospective cohort study of all children aged 0-17 years in Western Australia from 1980 to 2005 was identified from linked de-identified population level data. Annual trends in prevalence of assault and maltreatment related admissions were calculated and child characteristics were investigated using logistic regression models. Assault admissions more than doubled from 2.8 per 10,000 children in 1981 to 6.1 per 10,000 in 2005 (p<0.0001) and maltreatment admissions rose from 0.7 per 10,000 children in 1981 to 1.3 per 10,000 in 2005 (p<0.0001). Males aged greater than 12 years were at greater risk of an assault, while children aged less than 6 years were more likely to be at risk of maltreatment as well as those from greater disadvantaged backgrounds. Aboriginal children were more likely to be identified with assault and maltreatment compared to non-Aboriginal children. Common indicators of assault admissions included injuries of the skull and facial bones, intracranial, wrist, hand, and abdominal injuries. Children with maltreatment-related admissions were more likely to have superficial head or abdominal injuries and a high proportion had infectious and parasitic diseases, particularly intestinal infections. Many of these cases were associated with factors influencing health status, particularly socioeconomic and psychosocial circumstances. There has been a steady increase in the prevalence of assault and maltreatment related admissions. Specific child characteristics and injuries associated with child assault and maltreatment-related admissions have been identified using routinely collected morbidity data and may be utilized as potential indicators for identifying and monitoring child abuse and neglect. Broadening child maltreatment surveillance to children's admissions for assault and maltreatment is an important public health initiative which can be improved by the increased use of external cause codes. Health data is collected using international coding standards enhancing comparability across states and countries and has clinical implications in highlighting injuries associated with child abuse and neglect.
Neonatal drug withdrawal syndrome: cross-country comparison using hospital administrative data in England, the USA, Western Australia and Ontario, Canada
Publisher: BMJ
Date: 19-08-2015
DOI: 10.1136/ARCHDISCHILD-2015-308948
Abstract: We determined trends over time in the prevalence of neonatal drug withdrawal syndrome (NWS) in England compared with that reported in the USA, Western (W) Australia and Ontario, Canada. We also examined variation in prevalence of NWS according to maternal age, birth weight and across the English NHS by hospital trusts. Retrospective study using national hospital administrative data (Hospital Episode Statistics) for the NHS in England between 1997 and 2011. NWS was identified using international classification of disease codes in hospital admission records. We searched the research literature and contacted researchers to identify studies reporting trends in the prevalence of NWS. Prevalence of NWS by calendar year per 1000 live births for each country/state. For births in England, prevalence by maternal age group and birth weight group. Prevalence by NHS trust and region at birth, and funnel plot to show outlying English NHS hospital trusts (>3 SD of mean prevalence). Mean prevalence rates of recorded NWS increased in all four countries. Rates stabilised in England and W. Australia from the early 2000s and rose steeply in the USA and Ontario during the late 2000s. The most recent prevalence rates were 2.7/1000 live births in England (2011 1544 cases) 2.7/1000 in W. Australia (2009) 3.6/1000 in the USA (2009) and 5.1/1000 in Ontario (2011). The highest prevalence in England was among babies born to mothers aged 25-34 years at delivery and among babies born with low birth weight (1500-2500 g). In England in 2011, 8.6% of hospital trusts had a recorded prevalence outside 3 SD of the overall average (7% above, 1% below). The North East region of England had the highest recorded prevalence of NWS. Although recorded NWS is stable in England and W. Australia, rising rates in the USA and Ontario may reflect better recognition and/or increased use of prescribed opiate analgesics and highlight the need for surveillance. The extent to which different prevalence rates by hospital trust reflect variation in occurrence, recognition or recording requires further investigation.
Cumulative incidence of child protection system contacts among a cohort of Western Australian Aboriginal children born 2000 to 2013
Publisher: Elsevier BV
Date: 09-2023
Putting ‘Justice’ in Recovery Capital: Yarning about Hopes and Futures with Young People in Detention
Publisher: Queensland University of Technology
Date: 20-01-2020
Abstract: Aboriginal and Torres Strait Islander young people are over-represented in Australian youth detention centres and the justice system. In contrast to deficit-focused approaches to health and justice research, this article engages with the hopes, relationships and educational experiences of 38 detained youth in Western Australia who participated in a study of screening and diagnosis for fetal alcohol spectrum disorder. We report on a qualitative study that used a ‘social yarning’ approach. While the participants reported lives marred by substance use, crime, trauma and neurodevelopmental disability, they also spoke of strong connections to country and community, their education experiences and their future goals. In line with new efforts for a ‘positive youth justice’ and extending on models of recovery capital, we argue that we must celebrate success and hope through a process of mapping and building recovery capital in the justice context at an in idual and institutional level.
Overcrowded housing: One of a constellation of vulnerabilities for child sexual abuse
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.CHIABU.2019.05.010
Abstract: Effective prevention of child abuse depends on an understanding of factors associated with the abuse. Increased risk of child sexual abuse has been associated with parental substance use and adverse socio-economic factors such as living in poverty and parental unemployment. This study investigated overcrowding as a potential socio-economic risk factor in child sexual abuse taking into account other socio-economic, child and parental factors. This study used de-identified linked data from health and child protection data collections for the cohort of children born in Western Australia from 1990 to 2009 (n = 524,478). Cox regression was used to estimate adjusted and unadjusted hazard ratios and 95% confidence intervals for time to first sexual abuse allegation and first substantiated allegation, relative to the level of overcrowding and controlling for other risk factors. Higher levels of household overcrowding were associated with a 23%-46% increase in the risk of child sexual abuse allegations. Only the highest level of overcrowding was associated with a 40% increased risk of substantiated sexual abuse. The findings suggest that overcrowded living conditions are associated with an increased risk of sexual abuse for some children. This factor needs to be considered alongside other risk factors when assessing and improving child safety.
Relationship between out-of-home care placement history characteristics and educational achievement: A population level linked data study
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.CHIABU.2017.05.013
Abstract: Studies generally show children who have entered out-of-home care have worse educational outcomes than the general population, although recent research suggests maltreatment and other adversities are major contributing factors. Children's out-of-home care experiences vary and may affect their outcomes. This study examined the influence of placement stability, reunification, type of care, time in care and age at entry to care on children's educational outcomes. We conducted a population-based record-linkage study of children born in Western Australia between 1990 and 2010 who sat State or national Year 3 reading achievement tests (N=235,045 children, including 2160 children with a history of out-of-home care). Children's educational outcomes varied with many aspects of their care experience. Children placed in residential care were particularly likely to have low scores, with an unadjusted OR 6.81, 95% CI[4.94, 9.39] for low reading scores, which was partially attenuated after adjusting for background risk factors but remained significant (OR=1.50, 95% CIs [1.08, 2.08]). Reading scores were also lower for children who had experienced changes in care arrangements in the year of the test. A dose-response effect for multiple placements was expected but not found. Older age at entering care was also associated with worse reading scores. Different characteristics of a child's care history were interwoven with each other as well as child, family and neighbourhood characteristics, highlighting a need for caution in attributing causality. Although the level of educational difficulties varied, the findings suggest a widespread need for additional educational support for children who have entered care, including after reunification.
Assessing the utility of night‐time presentations as a proxy for alcohol‐related harm among young emergency department trauma patients
Publisher: Wiley
Date: 14-08-2023
Abstract: To assess the usefulness of night‐time presentations to measure alcohol‐related harm (ARH) in young trauma patients, aged 12–24 years, attending Western Australian EDs. A retrospective longitudinal study examined alcohol‐related ED presentations in Western Australia (WA 2002–2016) among 12‐ to 24‐year‐olds. Data from the Emergency Department Data Collection, WA State Trauma Registry Database and Hospital Morbidity Data Collection were used to identify ARH through specific codes and text searches. These were compared to ARH estimates based on presentation time. Statistical analysis involved sensitivity and specificity calculations and Cox proportional hazards modelling. We identified 2644 (17.8%) night‐time presentations as a proxy measure of ARH among the 14 887 presentations of patients aged 12–24 years. This closely matched the 3064 (20.6%) identified as ARH through coding methods. The highest risk for an ARH presentation occurred during the night hours between 00.00 and 04.59 hours. During these hours, the risk was 4.4–5.1 times higher compared to presentations at midday (between 12.00 and 12.59 hours). However, when looking at in idual patients, we observed that night‐time presentations were not a strong predictor of ARH (sensitivity: 0.39 positive predictive value: 0.46). Implementing targeted interventions during night hours could be beneficial in addressing ARH presentations. However, relying solely on the time of presentation as a proxy for ARH is unlikely to effectively identify ARH in young in iduals. Instead, the present study emphasises the importance of implementing mandatory data collection strategies in EDs to ensure accurate measurement of ARH cases.
Child abuse and neglect — is it time for a public health approach?
Publisher: Elsevier BV
Date: 08-2008
DOI: 10.1111/J.1753-6405.2008.00249.X
Abstract: Australia is seeing an unprecedented increase in the rate of child protection notifications and children being taken into care. The burden of such high levels of notifications and removals impact not only the children and families but also the system which is trying to resource them. The concern is that these increases are unsustainable and overloaded child protection systems can be dangerous for the vulnerable families and children they are trying to protect and support. This paper hopes to raise some alternative thinking as to the overall approaches to child abuse and neglect with a greater focus on prevention. Is it time to consider a public health approach, using population-based measures of child abuse and neglect to accurately describe the epidemiology of population risk and protective factors? Should we investigate the potential of universal health, welfare and education services as platforms for prevention? And should we investigate whether the provision of secondary prevention for vulnerable families which address major contributing factors, such as parental substance dependence and mental health issues are effective in reducing abuse of children in these families?
Maternal alcohol use disorder and subsequent child protection contact: A record-linkage population cohort study
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.CHIABU.2017.08.010
Abstract: We examined the relationship between a maternal alcohol-use diagnosis, and the timing of diagnosis, and child protection outcomes in a Western Australian population cohort. This analysis made use of routinely collected linked administrative health and child protection data. Those in scope for the study were women who had a birth recorded on the Western Australian Midwives Notification System (1983-2007). Women with an alcohol related diagnosis (ICD 9/10) on relevant datasets formed the exposed group. The comparison cohort were frequency matched to the exposed cohort. Generalized linear mixed models and a proportional hazards model were used to examine the relationship between a maternal alcohol-use diagnosis and subsequent child protection contact. Children of women with an alcohol-use diagnosis were at significantly increased risk of a substantiated child protection allegation (OR=2.92, 95%CI=2.71-3.14) and entry into out-of-home care (OR: 3.78, 95% CI=3.46-4.13). The highest risk of child protection contact was associated with diagnoses received during pregnancy, and in the years immediately pre- or post-pregnancy. Children whose mothers have an alcohol-use diagnosis are at increased risk of contact with child protection services. Despite current public health recommendations, some women continue to drink heavily during pregnancy. Additional work is required to identify effective strategies to reduce heavy alcohol use in this population. Further, women who have been identified to have alcohol use issues require additional support, from multiple agencies, to reduce the potential negative impacts on their child.
Authors' response to letter regarding a public health approach to child abuse and neglect
Publisher: Elsevier BV
Date: 04-2009
Pre-existing adversity, level of child protection involvement, and school attendance predict educational outcomes in a longitudinal study
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.CHIABU.2015.10.026
Abstract: Maltreatment largely occurs in a multiple-risk context. The few large studies adjusting for confounding factors have raised doubts about whether low educational achievement results from maltreatment or co-occurring risk factors. This study examined prevalence, risk and protective factors for low educational achievement among children involved with the child protection system compared to other children. We conducted a population-based record-linkage study of children born in Western Australia who sat national Year 3 reading achievement tests between 2008 and 2010 (N=46,838). The longitudinal study linked data from the Western Australian Department of Education, Department of Child Protection and Family Support, Department of Health, and the Disability Services Commission. Children with histories of child protection involvement (unsubstantiated maltreatment reports, substantiations or out-of-home care placement) were at three-fold increased risk of low reading scores. Adjusting for socio-demographic adversity partially attenuated the increased risk, however risk remained elevated overall and for substantiated (OR=1.68) and unsubstantiated maltreatment (OR=1.55). Risk of low reading scores in the out-of-home care group was fully attenuated after adjusting for socio-demographic adversity (OR=1.16). Attendance was significantly higher in the out-of-home care group and served a protective role. Neglect, sexual abuse, and physical abuse were associated with low reading scores. Pre-existing adversity was also significantly associated with achievement. Results support policies and practices to engage children and families in regular school attendance, and highlight a need for further strategies to prevent maltreatment and disadvantage from restricting children's opportunities for success.
Characterizing newborn and older infant entries into care in England between 2006 and 2014
Publisher: Elsevier BV
Date: 11-2020
Characteristics of non-Aboriginal and Aboriginal children and families with substantiated child maltreatment: a population-based study
Publisher: Oxford University Press (OUP)
Date: 22-02-2010
DOI: 10.1093/IJE/DYQ005
Abstract: To investigate specific child and parental factors associated with increased vulnerability to substantiated child maltreatment. A retrospective cohort study of all children born in Western Australia during 1990-2005 using de-identified record linked child protection, disability services and health data. Cox regression was used for univariate and multivariate analysis to determine the risk of substantiated child maltreatment for a number of child and parental factors, including child disability, parental age, socio-economic status, parental mental health, substance use and assault-related hospital admissions. Separate analyses were conducted for Aboriginal and non-Aboriginal children. This study found a number of child and parental factors that increase the risk of substantiated child maltreatment. The strongest factors were child intellectual disability, parental socio-economic status, parental age and parental hospital admissions related to mental health, substance use and assault. Awareness of the factors that make children and families vulnerable may aid the targeting of child maltreatment prevention programmes. To prevent child abuse and neglect it is essential that we have a platform of universal services, which assist parents in their role, as well as targeted services for at-risk families.
Application of Population-Based Linked Data to the Study of Intellectual Disability and Autism
Publisher: Elsevier
Date: 2013
Prioritising Children and Young People with Disability in Research About Domestic and Family Violence: Methodological, Ethical and Pragmatic Reflections
Publisher: Springer Science and Business Media LLC
Date: 28-01-2023
DOI: 10.1007/S10896-023-00496-9
Abstract: The perspectives of children and young people with disability who experience domestic and family violence are under-researched, impeding the development of approaches that meet their needs. Knowledge gaps stem from the layered discursive positioning of disability, childhood/youth, or domestic and family violence in addition to the methodological, ethical and pragmatic complexity of research needed to understand their priorities and be attuned to their lived experience. This article explores methodological, ethical and practical challenges to centring their voices in research about domestic and family violence. A conceptual framework of feminist disability theory and intersectionality informed our co-designed research, across three phases: (1) quantitative large-scale data linkage and case file analysis (2) qualitative research with children and young people, their families and service providers and (3) stakeholder engagement workshops. We reflect on how our research was able to prioritise the contextual agency of children and young people with disability, ways it could not, and other constraints. Children and young people with disability experiencing domestic and family violence hold an expert and unique vantage point on what happens to them. Amplifying their priorities for directing policy and organisational change requires more of researchers in terms of methods, but also more flexibility in how projects are funded to enable creativity and innovation. We call for collective attention to frameworks for supported decision-making and child ethics to progress inclusive research which recognises the importance of participation for children and young people with disability.
Role of pre-existing adversity and child maltreatment on mental health outcomes for children involved in child protection
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2019-029675
Abstract: To determine mental health outcomes for children with a history of child protection system involvement, accounting for pre-existing adversity, and to examine variation in risk across diagnostic groupings and child protection subgroups. A longitudinal, population-based record-linkage study. All children in Western Australia (WA) with birth records between 1990 and 2009. Mental health diagnoses, mental health contacts and any mental health event ascertained from International Classification of Diseases codes within WA’s Hospital Morbidity Data Collection and Mental Health Information System from birth until 2013. Compared with children without child protection contact, children with substantiated maltreatment had higher prevalence of mental health events (37.4% vs 5.9%) and diagnoses (20% vs 3.6%). After adjusting for background risks, all maltreatment types were associated with an almost twofold to almost threefold increased hazard for mental health events. Multivariate analysis also showed mental health events were elevated across all child protection groups, ranging from HR: 3.54 (95% CI 3.28 to 3.82) for children who had entered care to HR: 2.31 (95% CI 2.18 to 2.46) for unsubstantiated allegations. Maternal mental health, aboriginality, young maternal age and living in socially disadvantaged neighbourhoods were all associated with an increased likelihood of mental health events. The increase varied across diagnostic categories, with particularly increased risk for personality disorder, and frequent comorbidity of mental health and substance abuse disorders. Young people who have been involved in the child protection system are at increased risk for mental health events and diagnoses. These findings emphasise the importance of services and supports to improve mental health outcomes in this vulnerable population. Adversities in childhood along with genetic or environmental vulnerabilities resulting from maternal mental health issues also contribute to young people’s mental health outcomes, suggesting a role for broader social supports and early intervention services in addition to targeted mental health programmes.
Disability In-Justice: The Benefits and Challenges of Yarning With Young People Undergoing Diagnostic Assessment for Fetal Alcohol Spectrum Disorder in a Youth Detention Center
Publisher: SAGE Publications
Date: 06-11-2019
Abstract: Undertaking research with young people presents an array of methodological challenges. We report the findings from a qualitative study that took place alongside a fetal alcohol spectrum disorder (FASD) prevalence study among detainees in Australia. Of 38 participants, 27 were Aboriginal youth. Interviews were conducted using “social yarning” and “research topic yarning,” an Indigenous research method which allows for data collection in an exploratory, culturally safe way. A complex interplay emerged between social yarning and research topic yarning which provided a space to explore responsively with participants their experiences of FASD assessments. Flexibility, including language adaptation and visual descriptions about assessments, was utilized to assist participants recall and retell their experiences. There were, however, challenges in gathering data on the assessment experiences of some participants. We describe how employing a “yarning” method for collecting data could benefit children and young people undergoing neurodevelopmental assessments in the future.
School Readiness of Children Exposed to Family and Domestic Violence.
Publisher: SAGE Publications
Date: 20-01-2002
DOI: 10.1177/08862605211050099
Abstract: Children have a universal right to live free from exposure to family and domestic violence (FDV). Children exposed to FDV can experience long-term effects on their physical and psychological health and their social competencies including social, emotional, and cognitive skills and behaviours that underpin successful social adaptation and academic achievement. The aim of this study was to investigate if children exposed to FDV were more likely to be vulnerable on school readiness measures compared to those children who were not exposed. Our cohort study used de-identified in idual-level administrative data of children born during 2002-2010, in Western Australia, who were identified in police and hospital records as being exposed to FDV during 2002-2015. Univariate and multivariate logistic regression was used to estimate the odds of vulnerability in Australian Early Development Census (AEDC) outcomes of children exposed to FDV compared to a non-exposed cohort. After adjusting for demographic characteristics, children exposed to FDV had higher odds than non-exposed children of being vulnerable in all five AEDC domains: physical health and wellbeing, social competence, emotional maturity, language and cognitive skills (school-based) and communication skills and general knowledge. Exposed children have an increased likelihood of vulnerability in all five AEDC domains: physical health and wellbeing, social competence, emotional maturity, language and cognitive skills (school-based) and communication skills and general knowledge. Comprehensive multiagency early intervention for children exposed to FDV is required to mitigate the impact on outcomes, and ultimately the need to prevent FDV is needed.
Understanding the dynamics of support seeking in women with lived experience of non-physical intimate partner violence (IPV) and the service responses—A qualitative study
Publisher: Wiley
Date: 23-06-2022
DOI: 10.1002/AJS4.227
Abstract: Non‐physical abuse is a form of intimate partner violence (IPV), which negatively impacts physical and mental well‐being. The study objectives were to understand the process of support seeking amongst women who experience non‐physical IPV. Interviews were conducted with women who have experience of non‐physical IPV and support workers. The findings of this study suggest that women generally delay support seeking for non‐physical IPV as they are unable to recognise this form of violence. Increasing awareness about non‐physical IPV can be a prevention strategy to assist women in recognising this and seeking support. The important finding in our study that most of the women initially contacted a healthcare professional regarding the psychological impact of the non‐physical violence offers an opportunity for earlier intervention. Healthcare professionals are in a unique position to address the healthcare needs of women who experience IPV and can therefore assist in facilitating disclosure, offering support and referring to DV services. Training and education for professionals on all forms of IPV is required to improve identification and referral of women.
Out‐of‐Home Care versus In‐home Care for Children Who Have Been Maltreated: A Systematic Review of Health and Wellbeing Outcomes
Publisher: Wiley
Date: 07-2016
DOI: 10.1002/CAR.2437
Epilepsy in children exposed to family and domestic violence in the first 5 years of life.
Publisher: Wiley
Date: 26-08-2022
DOI: 10.1111/JPC.16179
Abstract: To investigate childhood (0-18 years) hospitalisation and emergency department (ED) contacts for epilepsy in Western Australian (WA) children exposed to family and domestic violence (FDV) pre 5 years of age compared to children with no FDV exposure. A retrospective, population-based cohort study included children born 1987-2010 who were identified as being exposed to FDV (n = 7018) from two sources: WA Police Information Management System and WA Hospital Morbidity Data Collection (HMDC) and a non-exposed comparison group (n = 41 996). Epilepsy contact was identified in HMDC and ED Data Collection records. Cox regression was used to estimate the adjusted and unadjusted hazard ratio and 95% confidence interval (CI) for epilepsy contact adjustment was made for a range of demographic characteristics known to impact health outcomes. Analyses were stratified by Aboriginal and Torres Strait Islander status to account for higher rates of FDV and epilepsy hospital admissions in Aboriginal and Torres Strait Islander children. Children exposed to FDV had a 62% (HR 1.62, 95% CI: 1.33-1.98) increased risk of epilepsy contact than non-exposed counterparts. Furthermore, the children exposed to FDV had a 50% longer average hospital stay for epilepsy than non-exposed children (4.7 days vs. 3 days, P = 0.006). When stratified by Aboriginal status, we found that Aboriginal children exposed to FDV stayed (on average) 2 days longer in hospital for epilepsy than their non-exposed counterparts (5.1 days vs. 3.1 days, P = 0.018). FDV exposure in early childhood is associated with increased risk of requiring secondary health care and longer hospital stays for childhood epilepsy.
Gestational age and child development at school entry
Publisher: Springer Science and Business Media LLC
Date: 15-07-2021
DOI: 10.1038/S41598-021-93701-Y
Abstract: Studies have reported a dose-dependent relationship between gestational age and poorer school readiness. The study objective was to quantify the risk of developmental vulnerability for children at school entry, associated with gestational age at birth and to understand the impact of sociodemographic and other modifiable risk factors on these relationships. Linkage of population-level birth registration, hospital, and perinatal datasets to the Australian Early Development Census (AEDC), enabled follow-up of a cohort of 64,810 singleton children, from birth to school entry in either 2009, 2012, or 2015. The study outcome was teacher-reported child development on the AEDC with developmental vulnerability defined as domain scores 10 th percentile of the 2009 AEDC cohort. We used modified Poisson Regression to estimate relative risks (RR) and risk differences (RD) of developmental vulnerability between (i) preterm birth and term-born children, and (ii) across gestational age categories. Compared to term-born children, adjustment for sociodemographic characteristics attenuated RR for all preterm birth categories. Further adjustment for modifiable risk factors such as preschool attendance and reading status at home had some additional impact across all gestational age groups, except for children born extremely preterm. The RR and RD for developmental vulnerability followed a reverse J-shaped relationship with gestational age. The RR of being classified as developmentally vulnerable was highest for children born extremely preterm and lowest for children born late-term. Adjustment for sociodemographic characteristics attenuated RR and RD for all gestational age categories, except for early-term born children. Children born prior to full-term are at a greater risk for developmental vulnerabilities at school entry. Elevated developmental vulnerability was largely explained by sociodemographic disadvantage. Elevated vulnerability in children born post-term is not explained by sociodemographic disadvantage to the same extent as in children born prior to full-term.
Increasing Prevalence of Neonatal Withdrawal Syndrome: Population Study of Maternal Factors and Child Protection Involvement
Publisher: American Academy of Pediatrics (AAP)
Date: 04-2009
Abstract: OBJECTIVES. Illicit drug use during pregnancy is an important public health issue, with adverse effects on the newborn and implications for subsequent parenting. The aim of this study was to measure the birth prevalence of neonatal withdrawal syndrome over time, associated maternal characteristics and child protection involvement. METHODS. This is a retrospective cohort study that used linked health and child protection databases for all live births in Western Australia from 1980 to 2005. Maternal characteristics and mental health–and assault-related medical history were assessed by using logistic regression models. RESULTS. The birth prevalence of neonatal withdrawal syndrome increased from 0.97 to a high of 42.2 per 10 000 live births, plateauing after 2002. Mothers with a previous mental health admission, low skill level, Aboriginal status or who smoked during pregnancy were significantly more likely to have an infant with neonatal withdrawal syndrome. These infants were at greater risk for having a substantiated child maltreatment allegation and entering foster care. Increased risk for maltreatment was associated with mothers who were aged & years, were from socially disadvantaged backgrounds, Aboriginal status, and had a mental health–or assault-related admission. CONCLUSIONS. There has been a marked increase in neonatal withdrawal syndrome in the past 25 years. Specific maternal characteristics identified should facilitate planning for early identification and intervention for these women. Findings demonstrate an important pathway into child maltreatment and highlight the need for well-supported programs for women who use illicit drugs during pregnancy as well as the need for sustained long-term support after birth.
Positive reading achievement outcomes in children who experience out-of-home care: characteristics and predictors
Publisher: Elsevier BV
Date: 06-2023
Infant and Pre-birth Involvement With Child Protection Across Australia
Publisher: SAGE Publications
Date: 29-06-2023
DOI: 10.1177/10775595231186647
Abstract: Infants ( year old) are the age group in Australia with the highest rate of involvement with child protection. Many jurisdictions across Australia and internationally are implementing policies focused on prenatal planning and targeted support. This study investigates Australian trends in prenatal and infant child protection notifications, substantiations and out-of-home care and the extent of over-representation of Aboriginal and Torres Strait Islander infants. Data was provided by the Australian Institute of Health and Welfare for the period 1 July 2012-30 June 2019. Univariate Poisson regression analysis was conducted, reporting the percentage change in the incidence rate ratios. All Australian jurisdictions who collect and approved release of prenatal notification data experienced increases in the rates of children with prenatal notifications, with a 4% (IRR: 1.04(1.04–1.05)) overall increase per year across Australia. Approximately 33% of children had substantiated prenatal notifications. Rates of infant notifications and entry to care in Australia increased overall by 3% (IRR:1.03(1.03–1.04)) and 2% per year (IRR:1.02(1.01–1.03)), respectively. With rising numbers of families reported prenatally and during infancy, greater evidence of the effectiveness of policies, interventions and outcomes for children and families is required.
Victim-Survivors, Family and Domestic Violence Service Providers and Support People: Identification of Priority Issues for Research and Translation into Policy and Practice
Publisher: Springer Science and Business Media LLC
Date: 23-11-2022
Trends in child maltreatment – Authors' reply
Publisher: Elsevier BV
Date: 06-2012
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