Sharon Goldfeld

Nurse Home Visiting for Families Experiencing Adversity: A Randomized Trial

Publisher: American Academy of Pediatrics (AAP)

Date: 2019

DOI: 10.1542/PEDS.2018-1206

Abstract: Nurse home visiting (NHV) may redress inequities in children’s health and development evident by school entry. We tested the effectiveness of an Australian NHV program (right@home), offered to pregnant women experiencing adversity, hypothesizing improvements in (1) parent care, (2) responsivity, and (3) the home learning environment at child age 2 years. A randomized controlled trial of NHV delivered via universal child and family health services was conducted. Pregnant women experiencing adversity (≥2 of 10 risk factors) with sufficient English proficiency were recruited from antenatal clinics at 10 hospitals across 2 states. The intervention comprised 25 nurse visits to child age 2 years. Researchers blinded to randomization assessed 13 primary outcomes, including Home Observation of the Environment (HOME) Inventory (6 subscales) and 25 secondary outcomes. Of 1427 eligible women, 722 (50.6%) were randomly assigned 306 of 363 (84%) women in the intervention and 290 of 359 (81%) women in the control group provided 2-year data. Compared with women in the control group, those in the intervention reported more regular child bedtimes (adjusted odds ratio 1.76 95% confidence interval [CI] 1.25 to 2.48), increased safety (adjusted mean difference [AMD] 0.22 95% CI 0.07 to 0.37), increased warm parenting (AMD 0.09 95% CI 0.02 to 0.16), less hostile parenting (reverse scored AMD 0.29 95% CI 0.16 to 0.41), increased HOME parental involvement (AMD 0.26 95% CI 0.14 to 0.38), and increased HOME variety in experience (AMD 0.20 95% CI 0.07 to 0.34). The right@home program improved parenting and home environment determinants of children’s health and development. With replicability possible at scale, it could be integrated into Australian child and family health services or trialed in countries with similar child health services.

Designing, testing, and implementing a sustainable nurse home visiting program: right@home

Publisher: Wiley

Date: 05-2018

DOI: 10.1111/NYAS.13688

Abstract: Nurse home visiting (NHV) offers a potential platform to both address the factors that limit access to services for families experiencing adversity and provide effective interventions. Currently, the ability to examine program implementation is h ered by a lack of detailed description of actual, rather than expected, program development and delivery in published studies. Home visiting implementation remains a black box in relation to quality and sustainability. However, previous literature would suggest that efforts to both report and improve program implementation are vital for NHV to have population impact and policy sustainability. In this paper, we provide a case study of the design, testing, and implementation of the right@home program, an Australian NHV program and randomized controlled trial. We address existing gaps related to implementation of NHV programs by describing the processes used to develop the program to be trialed, summarizing its effectiveness, and detailing the quality processes and implementation evaluation. The weight of our evidence suggests that NHV can be a powerful and sustainable platform for addressing inequitable outcomes, particularly when the program focuses on parent engagement and partnership, delivers evidence‐based strategies shown to improve outcomes, includes fidelity monitoring, and is adapted to and embedded within existing service delivery systems.

Inequities in Children's Reading Skills: The Role of Home Reading and Preschool Attendance

Publisher: Elsevier BV

Date: 08-2021

DOI: 10.1016/J.ACAP.2021.04.019

Predictive validity of verbal and non‐verbal communication and mother–child turn‐taking at 12 months on language outcomes at 24 and 36 months in a cohort of infants experiencing adversity: a prelimina

Publisher: Wiley

Date: 12-07-2018

DOI: 10.1111/1460-6984.12408

Abstract: Parent-reported measures of early communication have limitations for use with infants experiencing adversity. Observational measures of early non-verbal and verbal communicative behaviours and mother-child turn-taking may provide a complementary method of capturing early communication skills for these children. To explore the predictive validity of verbal and non-verbal behaviours and mother-child conversational turn-taking (fluency and connectedness) at child age 12 months in relation to language measures at 24 and 36 months in a cohort of infants experiencing adversity. Pregnant women experiencing adversity were recruited from maternity hospitals in Australia. At 12 months, 190 infants were videoed during mother-child free-play. Verbal and non-verbal communicative behaviours and fluency and connectedness were measured from the 12-month videos. Predictive validity of 12-month behaviours was calculated in relation to mean length of utterance and number of unique words at 24 months and Clinical Evaluation of Language Fundamentals Preschool-Second Edition (CELF-P2) Core Language scores at 36 months. All 12-month behaviours had adequate specificity but poor sensitivity when compared with other predictive validity studies using published early language measures. However, in adjusted regression models, fluency and connectedness and verbal behaviours at 12 months predicted unique words at 24 months. Fluency and connectedness also predicted CELF-P2 scores at 36 months. Findings reconfirm the difficulty in early identification of children at risk of later language difficulties. All 12-month measures were more accurate at identifying those children who will have better language than those children who will not. As fluency and connectedness was the only measure to predict 24- and 36-month language in adjusted regression models, it may be an important factor to consider when measuring early language skills for infants experiencing adversity. Future research could combine observational measures of early communication and fluency and connectedness with other predictors of language to try to increase prediction accuracy.

Hair cortisol as a measure of the stress response to social adversity in young children

Publisher: Wiley

Date: 04-03-2019

DOI: 10.1002/DEV.21840

Abstract: Hair cortisol has the potential to provide insight into young children's long-term stress response to social adversity. This study investigated associations between children's exposure to adversity from pregnancy to 2 years of age and their hair cortisol at 2 years, using a longitudinal cohort of children enriched for adversity risk, whose mothers were recruited during pregnancy through the "right@home" trial. Exposures were 18 maternal socioeconomic and psychosocial indicators of adversity, examined as concurrent, cumulative, and longitudinal exposure from pregnancy to 2 years. Hair s les were analyzed from 319/603 (53%) children participating at 2 years. Multivariable regression analyses for concurrent exposure showed three indicators of adversity were associated with higher hair cortisol (housing tenure of public rental, paying board or living rent free not living in a safe place higher maternal stress symptoms), one with lower hair cortisol (housing problems), and 14 indicators with no evidence of association. There was no evidence of association for the cumulative adversity count. Longitudinal exposure showed "intermittent" and "persistent" high maternal stress symptoms were associated with higher hair cortisol. The small number of associations identified suggests that hair cortisol is limited as a measure of stress response to social adversity in children at 2 years.

The feasibility of a Child and Family Hub within Victorian Community Health Services: a qualitative study

Publisher: Elsevier BV

Date: 12-2022

DOI: 10.1111/1753-6405.13292

Abstract: Explore the feasibility of an integrated Child and Family Hub within Victorian Community Health Services (CHS) to identify and respond to family adversities as preventable determinants of child mental health problems. Thirteen Victorian CHS staff and government policy makers (PMs), recruited via snowball s ling, participated in semi-structured interviews exploring: 1) barriers and facilitators for implementing a hub 2) feasibility of a proposed integrated hub and 3) resources needed to scale and sustain a hub. Transcripts were analysed employing framework analysis. 1) Barriers included inadequate and activity-based funding, inability to fund community paediatricians and inadequate workforce competencies. Facilitators included CHS engagement with vulnerable communities and readiness to act. 2) The proposed hub model was identified as feasible to implement. Local co-design, co-location, and virtual delivery would support hub implementation. 3) To sustainably scale a hub, clear policy leadership and workforce and funding model reviews are needed. A hub was perceived as feasible when based in CHS however, local and system-wide issues need consideration to support its sustainable scaling. Findings will inform the scaling of hub models of care across Victoria and other states to potentially optimise broader child and family health outcomes.

A comparison of two measures to screen for mental health symptoms in pregnancy and early postpartum: the Matthey Generic Mood Questionnaire and the Depression, Anxiety, Stress Scales short-form

Publisher: Elsevier BV

Date: 02-2021

DOI: 10.1016/J.JAD.2020.11.055

Language and reading instruction in early years’ classrooms: the knowledge and self-rated ability of Australian teachers

Publisher: Springer Science and Business Media LLC

Date: 23-09-2015

DOI: 10.1007/S11881-015-0112-0

Abstract: This study sought to investigate the level of knowledge of language constructs in a cohort of Australian teachers and to examine their self-rated ability and confidence in that knowledge. Seventy-eight teachers from schools across the Australian state of Victoria completed a questionnaire which included items from existing measures, as well as newly developed items. Consistent with a number of earlier Australian and international studies, teachers' explicit and implicit knowledge of basic linguistic constructs was limited and highly variable. A statistically significant correlation was found between (1) total self-rated ability and (2) years since qualification and experience teaching the early years of primary school however, no relationship was found between self-rated ability and overall performance on knowledge items. Self-rated ability to teach phonemic awareness and phonics had no relationship with demonstrated knowledge in these areas. Teachers were most likely to rate their ability to teach skills including spelling, phonics, comprehension or vocabulary as either moderate or very good. This was despite most respondents demonstrating limited knowledge and stating that they did not feel confident answering questions about their knowledge in these areas. The findings from this study confirm that in the field of language and literacy instruction, there is a gap between the knowledge that is theoretically requisite, and therefore expected, and the actual knowledge of many teachers. This finding challenges current pre-service teacher education and in-service professional learning.

Tier 2 oral language and early reading interventions for preschool to grade 2 children: a restricted systematic review

Publisher: Informa UK Limited

Date: 30-12-2021

DOI: 10.1080/19404158.2021.2011754

Connecting Healthcare with Income Maximisation Services: A Systematic Review on the Health, Wellbeing and Financial Impacts for Families with Young Children

Publisher: MDPI AG

Date: 25-05-2022

DOI: 10.3390/IJERPH19116425

Abstract: Financial counselling and income-maximisation services have the potential to reduce financial hardship and its associated burdens on health and wellbeing in High Income Countries. However, referrals to financial counselling services are not systematically integrated into existing health service platforms, thus limiting our ability to identify and link families who might be experiencing financial hardship. Review evidence on this is scarce. The purpose of this study is to review “healthcare-income maximisation” models of care in high-income countries for families of children aged between 0 and 5 years experiencing financial difficulties, and their impacts on family finances and the health and wellbeing of parent(s)/caregiver(s) or children. A systematic review of the MEDLINE, EMBase, PsycInfo, CINAHL, ProQuest, Family & Society Studies Worldwide, Cochrane Library, and Informit Online databases was conducted according to the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) statement. A total of six studies (five unique s les) met inclusion criteria, which reported a total of 11,603 families exposed to a healthcare-income maximisation model. An average annual gain per person of £1661 and £1919 was reported in two studies reporting one Scottish before–after study, whereby health visitors/midwives referred 4805 clients to money advice services. In another UK before–after study, financial counsellors were attached to urban primary healthcare centres and reported an average annual gain per person of £1058. The randomized controlled trial included in the review reported no evidence of impacts on financial or non-financial outcomes, or maternal health outcomes, but did observe small to moderate effects on child health and well-being. Small to moderate benefits were seen in areas relating to child health, preschool education, parenting, child abuse, and early behavioral adjustment. There was a high level of bias in most studies, and insufficient evidence to evaluate the effectiveness of healthcare-income maximisation models of care. Rigorous (RCT-level) studies with clear evaluations are needed to assess efficacy and effectiveness.

Improving Cohort-Hospital Matching Accuracy through Standardization and Validation of Participant Identifiable Information

Publisher: MDPI AG

Date: 07-12-2022

DOI: 10.3390/CHILDREN9121916

Abstract: Linking very large, consented birth cohorts to birthing hospitals clinical data could elucidate the lifecourse outcomes of health care and exposures during the pregnancy, birth and newborn periods. Unfortunately, cohort personally identifiable information (PII) often does not include unique identifier numbers, presenting matching challenges. To develop optimized cohort matching to birthing hospital clinical records, this pilot drew on a one-year (December 2020–December 2021) cohort for a single Australian birthing hospital participating in the whole-of-state Generation Victoria (GenV) study. For 1819 consented mother-baby pairs and 58 additional babies (whose mothers were not themselves participating), we tested the accuracy and effort of various approaches to matching. We selected demographic variables drawn from names, DOB, sex, telephone, address (and birth order for multiple births). After variable standardization and validation, accuracy rose from 10% to 99% using a deterministic-rule-based approach in 10 steps. Using cohort-specific modifications of the Australian Statistical Linkage Key (SLK-581), it took only 3 steps to reach 97% (SLK-5881) and 98% (SLK-5881.1) accuracy. We conclude that our SLK-5881 process could safely and efficiently achieve high accuracy at the population level for future birth cohort-birth hospital matching in the absence of unique identifier numbers.

Exposure to adversity and inflammatory outcomes in mid and late childhood

Publisher: Elsevier BV

Date: 12-2020

DOI: 10.1016/J.BBIH.2020.100146

Study protocol for the Healthier Wealthier Families (HWF) pilot randomised controlled trial: testing the feasibility of delivering financial counselling to families with young children who are identif

Publisher: BMJ

Date: 05-2021

DOI: 10.1136/BMJOPEN-2020-044488

Abstract: Poverty and deprivation can harm children’s future health, learning, economic productivity and societal participation. The Australian Healthier Wealthier Families project seeks to reduce the childhood inequities caused by poverty and deprivation by creating a systematic referral pathway between two free, community-based services: universal, well-child nursing services, which provide health and development support to families with children from birth to school entry, and financial counselling. By adapting the successful Scottish ‘Healthier Wealthier Children’ model, the objectives of this Australian pilot are to test the (1) feasibility of systematising the referral pathway, and (2) short-term impacts on household finances, caregiver health, parenting efficacy and financial service use. This pilot randomised controlled trial will run in three sites across two Australian states (Victoria and New South Wales), recruiting a total of 180 participants. Nurses identify eligible caregivers with a 6-item, study-designed screening survey for financial hardship. Caregivers who report one or more risk factors and consent are randomised. The intervention is financial counselling. The comparator is usual care plus information from a government money advice website. Feasibility will be evaluated using the number roportion of caregivers who complete screening, consent and research measures, and access financial counselling. Though powered to assess feasibility, impacts will be measured 6 months post-enrolment with qualitative interviews and questionnaires about caregiver-reported income, loans and costs (adapted from national surveys, for ex le, the Household, Income and Labour Dynamics in Australia Survey) health (General Health Questionnaire 1, EuroQol five-dimensional questionnaire, Depression, Anxiety, Stress Scale short-form) efficacy (from the Longitudinal Study of Australian Children) and financial service use (study-designed) compared between arms. Ethics committees of the Royal Children’s Hospital (HREC/57372/RCHM-2019) and South West Sydney Local Health District (2019/ETH13455) have approved the study. Participants and stakeholders will receive results through regular communication channels comprising meetings, presentations and publications. ACTRN12620000154909 prospectively registered. Pre-results.

The potential of intervening on childhood adversity to reduce socioeconomic inequities in body mass index and inflammation among Australian and UK children: A causal mediation analysis

Publisher: BMJ

Date: 03-08-2023

DOI: 10.1136/JECH-2022-219617

Abstract: Lower maternal education is associated with higher body mass index (BMI) and higher chronic inflammation in offspring. Childhood adversity potentially mediates these associations. We examined the extent to which addressing childhood adversity could reduce socioeconomic inequities in these outcomes. We analysed data from two early-life longitudinal cohorts: the Longitudinal Study of Australian Children (LSAC n=1873) and the UK Avon Longitudinal Study of Parents and Children (ALSPAC n=7085). Exposure: low/medium (below university degree) versus high maternal education, as a key indicator of family socioeconomic position (0–1 year). Outcomes: BMI and log-transformed glycoprotein acetyls (GlycA) (LSAC: 11–12 years ALSPAC: 15.5 years). Mediator: multiple adversities (≥2/ ) indicated by family violence, mental illness, substance abuse and harsh parenting (LSAC: 2–11 years ALSPAC: 1–12 years). A causal mediation analysis was conducted. Low/medium maternal education was associated with up to 1.03 kg/m 2 higher BMI (95% CI: 0.95 to 1.10) and up to 1.69% higher GlycA (95% CI: 1.68 to 1.71) compared with high maternal education, adjusting for confounders. Causal mediation analysis estimated that decreasing the levels of multiple adversities in children with low/medium maternal education to be like their high maternal education peers could reduce BMI inequalities by up to 1.8% and up to 3.3% in GlycA. Our findings in both cohorts suggest that slight reductions in socioeconomic inequities in children’s BMI and inflammation could be achieved by addressing childhood adversities. Public health and social policy efforts should help those affected by childhood adversity, but also consider underlying socioeconomic conditions that drive health inequities.

Associations between Maternal Behaviors at 1 Year and Child Language at 2 Years in a Cohort of Women Experiencing Adversity

Publisher: Wiley

Date: 08-2017

DOI: 10.1111/INFA.12200

Early Childhood Education Participation: A Mixed-Methods Study of Parent and Provider Perceived Barriers and Facilitators

Publisher: Springer Science and Business Media LLC

Date: 09-03-2022

DOI: 10.1007/S10826-022-02274-5

The World Health Organization Health Promoting School framework is important for some child health outcomes

Publisher: Wiley

Date: 02-2017

DOI: 10.1111/JPC.13475

More than a snapshot in time: pathways of disadvantage over childhood

Publisher: Oxford University Press (OUP)

Date: 05-06-2018

DOI: 10.1093/IJE/DYY086

Abstract: Disadvantage rarely manifests as a single event, but rather is the enduring context in which a child's development unfolds. We aimed to characterize patterns of stability and change in multiple aspects of disadvantage over the childhood period, in order to inform more precise and nuanced policy development. Participants were from the Longitudinal Study of Australian Children birth cohort (n = 5107). Four lenses of disadvantage (sociodemographic, geographic environment, health conditions and risk factors), and a composite of these representing average exposure across all lenses, were assessed longitudinally from 0 to 9 years of age. Trajectory models identified groups of children with similar patterns of disadvantage over time for each of these lenses and for composite disadvantage. Concurrent validity of these trajectory groups was examined through associations with academic performance at 10-11 years. We found four distinct trajectories of children's exposure to composite disadvantage, which showed high levels of stability over time. In regard to the in idual lenses of disadvantage, three exhibited notable change over time (the sociodemographic lens was the exception). Over a third of children (36.3%) were exposed to the 'most disadvantaged' trajectory in at least one lens. Trajectories of disadvantage were associated with academic performance, providing evidence of concurrent validity. Children's overall level of composite disadvantage was stable over time, whereas geographic environments, health conditions and risk factors changed over time for some children. Measuring disadvantage as uni-dimensional, at a single time point, is likely to understate the true extent and persistence of disadvantage.

The impact of multidimensional disadvantage over childhood on developmental outcomes in Australia

Publisher: Oxford University Press (OUP)

Date: 29-05-2018

DOI: 10.1093/IJE/DYY087

Abstract: Understanding the relationship between different aspects of disadvantage over time and domains of child development will facilitate the formulation of more precise policy responses. We examined the association between exposure to aspects of disadvantage over the childhood period (from 0-9 years) and child development at 10-11 years. We used data from the nationally representative birth cohort of the Longitudinal Study of Australian Children (n = 4979). Generalized linear models with log-Poisson link were used to estimate the association between previously derived disadvantage trajectories (in each of four lenses of sociodemographic, geographic environments, health conditions and risk factors, and a composite of these) and risk of poor child developmental outcomes. Population-attributable fractions were calculated to quantify the potential benefit of providing all children with optimal conditions for each developmental outcome. Trajectories of disadvantage were associated with developmental outcomes: children in the most disadvantaged composite trajectory had seven times higher risk of poor outcomes on two or more developmental domains, compared with those most advantaged. Trajectories of disadvantage in different lenses were varyingly associated with the child development domains of socio-emotional adjustment, physical functioning and learning competencies. Exposure to the most advantaged trajectory across all lenses could reduce poor developmental outcomes by as much as 70%. Exposure to disadvantage over time is associated with adverse child development outcomes. Developmental outcomes varied with the aspects of disadvantage experienced, highlighting potential targets for more precise policy responses. The findings provide evidence to stimulate advocacy and action to reduce child inequities.

Examining longitudinal associations between self-reported depression, anxiety and stress symptoms and hair cortisol among mothers of young children

Publisher: Elsevier BV

Date: 03-2021

DOI: 10.1016/J.JAD.2020.12.144

What is the timeliness and extent of health service use of Victorian (Australia) children in the year after entry to out-of-home care? Protocol for a retrospective cohort study using linked administra

Publisher: BMJ

Date: 2019

DOI: 10.1136/BMJPO-2018-000400

Abstract: Children entering out-of-home care have high rates of health needs across all domains of health. To identify these needs early and optimise long-term outcomes, routine health assessment on entry to care is recommended by child health experts and included in policy in many jurisdictions. If effective, this ought to lead to high rates of health service use as needs are addressed. Victoria (Australia) has no state-wide approach to deliver routine health assessments and no data to describe the timing and use of health service visits for children in out-of-home care. This retrospective cohort data linkage study aims to describe the extent and timeliness of health service use by Victorian children (aged 0–12 years) who entered out-of-home care for the first time between 1 April 2010 and 31 December 2015, in the first 12 months of care. The s le will be identified in the Victorian Child Protection database. Child and placement variables will be extracted. Linked health databases will provide additional data: six state databases that collate data about hospital admissions, emergency department presentations and attendances at dental, mental and community health services and public hospital outpatients. The federal Medicare Benefits Schedule claims dataset will provide information on visits to general practitioners, specialist physicians (including paediatricians), optometrists, audiologists and dentists. The number, type and timing of visits to different health services will be determined and benchmarked to national standards. Multivariable logistic regression will examine the effects of child and system variables on the odds of timely health visits, and proportional-hazards regression will explore the effects on time to first health visits. Ethical and data custodian approval has been obtained for this study. Dissemination will include presentation of findings to policy and service stakeholders in addition to scientific papers.

Better together: Advancing life course research through multi-cohort analytic approaches

Publisher: Elsevier BV

Date: 09-2022

DOI: 10.1016/J.ALCR.2022.100499

Using spatial analysis of the Australian Early Development Index to advance our understanding of ‘neighbourhood effects’ research on child health and develo

Publisher: Wiley

Date: 03-02-2015

DOI: 10.1111/JPC.12822

The feasibility and acceptability of a population‐level antenatal risk factor survey: Cross‐sectional pilot study

Publisher: Wiley

Date: 29-03-2017

DOI: 10.1111/JPC.13510

Abstract: Australian data on the prevalence and distribution of antenatal risk factors are scarce. This study aimed to investigate (i) the feasibility and acceptability of an antenatal risk factor survey collected in public settings and (ii) whether the survey risk factors co-occur with more sensitive risk factors that are privately asked by clinicians. Design and setting: study-designed survey linked with clinician-collected risk factors. pregnant women attending antenatal clinics at two Victorian hospitals. (i) study-designed survey: young pregnancy, no support, poor/fair/good general health, anxious mood, not finishing high school, no income, long-term illness, living without another adult, not employed, never had a job and proxy poverty measures (ii) Clinician-collected data: smoking, alcohol/marijuana/drug use, domestic violence, social issues, history of mental health problems and depression symptoms. (i) feasibility and acceptability were assessed through survey completion. Each item was assessed for whether they discriminated risk dichotomised into risk versus no risk with a total count calculated. (ii) Co-occurrence was assessed by examining how the risk factor count agreed with clinician-collected items. One hundred and sixty-six of 186 (89%) eligible women completed the survey 139 of 166 (84%) consented to linking clinician-collected data. The high response and zero missing data demonstrated feasibility and acceptability. Of women with linked data, 92 of 139 (66%) had ≥1 survey risk factor and 30 of 139 (22%) had ≥3 36 of 139 (26%) had at least one co-occurring clinician-collected risk factor. This survey provides a simple, rapid approach to gathering antenatal risk data publicly. It may be a helpful addition to clinicians' standard history collection.

Profiles of Mental Health Competence and Difficulties as Predictors of Children’s Early Learning

Publisher: Springer Science and Business Media LLC

Date: 21-02-2018

DOI: 10.1007/S12310-018-9252-9

An urban neighbourhood framework for realising progress towards the New Urban Agenda for equitable early childhood development

Publisher: Informa UK Limited

Date: 25-03-2023

DOI: 10.1080/14733285.2023.2192339

‘right@home’: a randomised controlled trial of sustained nurse home visiting from pregnancy to child age 2 years, versus usual care, to improve parent care, parent responsivity and the home learning e

Publisher: BMJ

Date: 03-2017

DOI: 10.1136/BMJOPEN-2016-013307

Reply to Li, D'Angiulli and Kendall: The Early Development Index and children from culturally and linguistically diverse backgrounds

Publisher: Informa UK Limited

Date: 03-2009

DOI: 10.1080/09575140802689125

Developmental relationships between socio-economic disadvantage and mental health across the first 30 years of life

Publisher: Bristol University Press

Date: 07-2022

DOI: 10.1332/175795921X16459587898770

Abstract: Understanding of how socio-economic disadvantage experienced over the life course relates to mental health outcomes in young adulthood has been limited by a lack of long-term, prospective studies. Here we address this limitation by drawing on data from a large Australian population cohort study that has followed the development of more than 2,000 Australians (and their families) from infancy to young adulthood since 1983. Associations were examined between prospective assessments of socio-economic position (SEP) from 4–8 months to 27–28 years and mental health problems (depression, anxiety, stress) and competence (civic engagement, emotional maturity, secure intimate relationship) at 27–28 years. The odds of being socio-economically disadvantaged in young adulthood were elevated eight- to tenfold in those who had experienced disadvantage in the family of origin, compared with those who had not (OR 8.1, 95% CI 4.5–14.5 to 10.1, 95% CI 5.2–19.5). Only concurrent SEP was associated with young adult mental health problems, and this effect was limited to anxiety symptoms (OR 2.0, 95% CI 1.1–3.9). In contrast, SEP had more pervasive impacts on young adult competence, particularly in the civic domain where effects were evident even from early infancy (OR 0.46, 95% CI 0.26–0.81). Findings suggest that one potentially important mechanism through which disadvantage compromises mental health is through limiting the development and consolidation of key psychosocial competencies needed for health and well-being in adulthood.

Classroom Promotion of Oral Language: Outcomes From a Randomized Controlled Trial of a Whole-of-Classroom Intervention to Improve Children’s Reading Achievement

Publisher: SAGE Publications

Date: 2022

DOI: 10.1177/23328584221131530

Abstract: Children need rich language learning experiences in school to build language and reading skills. Research suggests that various effective ways to support teacher provision of these experiences. The Classroom Promotion of Oral Language cluster randomized controlled trial ( n = 1,360 students 687 intervention, 673 control) examined whether a teacher professional learning intervention targeting oral language in the first years of school led to improved student outcomes compared to usual teaching practices. The intervention comprised face-to-face professional learning and ongoing support. The primary outcome was student reading ability at Grade 3 secondary outcomes included oral language, reading, and mental health at Grades 1 and 3. No differences were detected between the intervention and control arms. Implications of results and future directions are explored.

The effect of adverse and positive experiences on inflammatory markers in Australian and UK children

Publisher: Elsevier BV

Date: 12-2022

DOI: 10.1016/J.BBIH.2022.100550

School starting age and child development in a state-wide, population-level cohort of children in their first year of school in New South Wales, Australia

Publisher: Elsevier BV

Date: 2019

DOI: 10.1016/J.ECRESQ.2019.01.008

Nurse home visiting to improve child and maternal outcomes: 5-year follow-up of an Australian randomised controlled trial

Publisher: Public Library of Science (PLoS)

Date: 28-11-2022

DOI: 10.1371/JOURNAL.PONE.0277773

Abstract: Nurse home visiting (NHV) is widely implemented to address inequities in child and maternal health. However, few studies have examined longer-term effectiveness or delivery within universal healthcare systems. We evaluated the benefits of an Australian NHV program (“right@home”) in promoting children’s language and learning, general and mental health, maternal mental health and wellbeing, parenting and family relationships, at child ages 4 and 5 years. Randomised controlled trial of NHV delivered via universal, child and family health services (the comparator). Pregnant women experiencing adversity (≥2 of 10 risk factors) were recruited from 10 antenatal clinics across 2 states (Victoria, Tasmania) in Australia. Mothers in the intervention arm were offered 25 nurse home visits (mean 23·2 home visits [SD 7·4, range 1–43] received) of 60–90 minutes, commencing antenatally and continuing until children’s second birthdays. At 4 and 5 years, outcomes were assessed via parent interview and direct assessment of children’s language and learning (receptive and expressive language, phonological awareness, attention, and executive function). Outcomes were compared between intervention and usual care arms (intention to treat) using adjusted regression with robust estimation to account for nurse/site. Missing data were addressed using multiple imputation and inverse probability weighting. Of 722 women enrolled in the trial, 225 of 363 (62%) intervention and 201 of 359 (56%) usual care women provided data at 5 years. Estimated group differences showed an overall pattern favouring the intervention. Statistical evidence of benefits was found across child and maternal mental health and wellbeing, parenting and family relationships with effect sizes ranging 0·01–0·27. An Australian NHV program promoted longer-term family functioning and wellbeing for women experiencing adversity. NHV can offer an important component of a proportionate universal system that delivers support and intervention relative to need. 2013–2016, registration ISRCTN89962120

Teacher Knowledge of Oral Language and Literacy Constructs: Results of a Randomized Controlled Trial Evaluating the Effectiveness of a Professional Learning Intervention

Publisher: Informa UK Limited

Date: 11-02-2021

DOI: 10.1080/10888438.2020.1714629

P1-151 Establishing the construct and predictive validity of the Australian Early Development Index (AEDI)

Publisher: Elsevier BV

Date: 09-2007

DOI: 10.1016/S0378-3782(07)70321-3

Improving outcomes of preschool language delay in the community: protocol for the Language for Learning randomised controlled trial

Publisher: Springer Science and Business Media LLC

Date: 09-07-2012

DOI: 10.1186/1471-2431-12-96

Economic evaluation of an Australian nurse home visiting programme: a randomised trial at 3 years

Publisher: BMJ

Date: 12-2021

DOI: 10.1136/BMJOPEN-2021-052156

Abstract: To investigate the additional programme cost and cost-effectiveness of ‘right@home’ Nurse Home Visiting (NHV) programme in relation to improving maternal and child outcomes at child age 3 years compared with usual care. A cost–utility analysis from a government-as-payer perspective alongside a randomised trial of NHV over 3-year period. Costs and quality-adjusted life-years (QALYs) were discounted at 5%. Analysis used an intention-to-treat approach with multiple imputation. The right@home was implemented from 2013 in Victoria and Tasmania states of Australia, as a primary care service for pregnant women, delivered until child age 2 years. 722 pregnant Australian women experiencing adversity received NHV (n=363) or usual care (clinic visits) (n=359). First, a cost–consequences analysis to compare the additional costs of NHV over usual care, accounting for any reduced costs of service use, and impacts on all maternal and child outcomes assessed at 3 years. Second, cost–utility analysis from a government-as-payer perspective compared additional costs to maternal QALYs to express cost-effectiveness in terms of additional cost per additional QALY gained. When compared with usual care at child age 3 years, the right@home intervention cost $A7685 extra per woman (95% CI $A7006 to $A8364) and generated 0.01 more QALYs (95% CI −0.01 to 0.02). The probability of right@home being cost-effective by child age 3 years is less than 20%, at a willingness-to-pay threshold of $A50 000 per QALY. Benefits of NHV to parenting at 2 years and maternal health and well-being at 3 years translate into marginal maternal QALY gains. Like previous cost-effectiveness results for NHV programmes, right@home is not cost-effective at 3 years. Given the relatively high up-front costs of NHV, long-term follow-up is needed to assess the accrual of health and economic benefits over time. ISRCTN89962120 .

Children who soil: A review of the assessment and management of faecal incontinence

Publisher: Wiley

Date: 10-2018

DOI: 10.1111/JPC.14173

Abstract: Soiling is a common and distressing condition affecting children. In the vast majority of patients, it is associated with constipation. Most constipation is functional and is best thought of as difficulty achieving adequate bowel emptying. In a small minority of patients, there is no associated constipation, so-called non-retentive faecal incontinence. The aetiology of this latter condition in children remains unclear. The mainstay of management in all cases is a regular toileting programme, together with laxatives as required. This must be in idualised considering the diagnosis, the age of the child and the psychosocial factors affecting the child and family. The diagnosis is made with a thorough history and examination, supplemented in some cases with targeted investigations. Engaging the child and family in a long-term treatment programme (at least 6 months to 2 years) is essential for treatment success. The following clinical practice guideline and algorithm for the assessment and management of children who soil represents consensus opinion using available evidence.

Integrated Child and Family Hub models for detecting and responding to family adversity: protocol for a mixed-methods evaluation in two sites

Publisher: BMJ

Date: 05-2022

DOI: 10.1136/BMJOPEN-2021-055431

Abstract: Integrated community healthcare Hubs may offer a ‘one stop shop’ for service users with complex health and social needs, and more efficiently use service resources. Various policy imperatives exist to implement Hub models of care, however, there is a dearth of research specifically evaluating Hubs targeted at families experiencing adversity. To contribute to building this evidence, we propose to co-design, test and evaluate integrated Hub models of care in two Australian community health services in low socioeconomic areas that serve families experiencing adversity: Wyndham Vale in Victoria and Marrickville in New South Wales. This multisite convergent mixed-methods study will run over three phases to (1) develop the initial Hub programme theory through formative research (2) test and, then, (3) refine the Hub theory using empirical data. Phase 1 involves co-design of each Hub with caregivers, community members and practitioners. Phase 2 uses caregiver and Hub practitioner surveys at baseline, and 6 and 12 months after Hub implementation, and in-depth interviews at 12 months. Two stakeholder groups will be recruited: caregivers (n=100–200 per site) and Hub practitioners (n=20–30 per site). The intervention is a co-located Hub providing health, social, legal and community services with no comparator. The primary outcomes are caregiver-reported: (i) identification of, (ii) interventions received and/or (iii) referrals received for adversity from Hub practitioners. The study also assesses child, caregiver, practitioner and system outcomes including mental health, parenting, quality of life, care experience and service linkages. Primary and secondary outcomes will be assessed by examining change in proportions/means from baseline to 6 months, from 6 to 12 months and from baseline to 12 months. Service linkages will be analysed using social network analysis. Costs of Hub implementation and a health economics analysis of unmet need will be conducted. Thematic analysis will be employed to analyse qualitative data. Royal Children’s Hospital and Sydney Local Health District ethics committees have approved the study (HREC/62866/RCHM-2020). Participants and stakeholders will receive results through meetings, presentations and publications. ISRCTN55495932 .

Four-year-old outcomes of a universal infant-toddler shared reading intervention: The let's read trial

Publisher: American Medical Association (AMA)

Date: 11-2012

DOI: 10.1001/ARCHPEDIATRICS.2012.1099

Abstract: To determine the emergent literacy and language effects of a low-intensity literacy promotion program (Let's Read) provided via universal well-child services to parents during the first 4 years of their child's life. Population-based, cluster randomized controlled trial performed between March 1, 2006, and December 10, 2010. Maternal and child health centers (clusters) in 5 relatively disadvantaged local government areas in Melbourne, Australia. All parents attending their 4-week well-child appointments in participating centers were invited to take part in the study. The Let's Read program was delivered at 4, 12, 18, and 42 months during universal well-child care visits. Child emergent literacy skills (intrasyllabic, phonemic, and sound/letter knowledge) and language (core, receptive, and expressive), measured at 4 years of age. A total of 630 parents participated, with 365 children in 32 intervention clusters and 265 children in 33 control clusters 563 children (89.4%) were retained in the study to 4 years of age. The adjusted mean differences (intervention minus control) for emergent literacy was 0.2 (95% CI, -0.2 to 0.6 P = .29) for intrasyllabic units, 0.05 (95% CI, -0.4 to 0.5 P = .85) for phonemic awareness, and 0.1 (95% CI, -1.5 to 1.6 P = .92) for letter knowledge. For language, the differences were 1.6 (95% CI, -1.1 to 4.3 P = .25) for core, 0.8 (95% CI, -2.0 to 3.7 P = .56) for receptive, and 1.4 (95% CI, -1.4 to 4.2 P = .32) for expressive scores. This population-wide primary care literacy promotion and book distribution program provided neither the anticipated benefits to literacy and language nor enhanced uptake of literacy activities at 4 years of age, even when targeted to relatively disadvantaged areas. isrctn.org Identifier: ISRCTN04602902.

The unknown citizen: epidemiological challenges in child mental health

Publisher: BMJ

Date: 16-07-2014

DOI: 10.1136/JECH-2013-203712

Abstract: Growing concern about the global burden of child mental health disorders has generated an increased interest in population-level efforts to improve child mental health. This in turn has led to a shift in emphasis away from treatment of established disorders and towards prevention and promotion. Prevention efforts are able to draw on a substantial epidemiological literature describing the prevalence and determinants of child mental health disorders. However, there is a striking lack of clearly conceptualised and measurable positive outcomes for child mental health, which may result in missed opportunities to identify optimal policy and intervention strategies. In this paper, we propose an epidemiological approach to child mental health which is in keeping with public health principles and with the WHO definition of health, and which is grounded in current thinking about child development. Constructs such as competence offer the opportunity to develop rigorous outcome measures for epidemiological research, while broader ideas about 'the good life' and 'the good society' derived from philosophical thinking can enable us to shape policy initiatives based on normative ideas of optimal child mental health that extend beyond in iduals and undoubtedly beyond the traditional boundaries of the health sector.

Support for students with additional health and developmental needs: practices and learnings from exemplar schools

Publisher: Informa UK Limited

Date: 03-07-2022

DOI: 10.1080/19404158.2022.2115091

“A multitude of things”: A qualitative analysis of practitioner perceived barriers to identifying and responding to childhood adversity

Publisher: Elsevier BV

Date: 06-2023

DOI: 10.1016/J.MHP.2023.200276

Considering sociotechnical complexity when designing and developing people-centred digital health interventions: A qualitative study (Preprint)

Publisher: JMIR Publications Inc.

Date: 30-06-2022

DOI: 10.2196/PREPRINTS.40512

Abstract: igital health solutions have the potential to transform health delivery and health outcomes. However, the process of building acceptable and sustainable digital health interventions (DHIs) proves an ongoing challenge in a local landscape with complex and diffuse clinical informatics systems, siloed governance arrangements, and the safety of the ‘known’ for clinicians used to existing, often antiquated information systems. ur paper coalesces existing literature on the development of DHIs in complex environments into three themes to provide a framework to consider lessons learnt in the delivery of an anonymised DHI. We highlight the successes and setbacks involved in the development of a person-centred digital health intervention within a complex health care setting for the benefit of future development of DHIs. e conducted qualitative interviews both in person and via telephone with 22 stakeholders involved in the development of the DHI. Three researchers used a thematic analysis to iteratively code interview transcripts and considered the emerging themes within the context of wider literature. e considered the development of a DHIs around three core themes: creating and sustaining aspirational, yet feasible vision the engagement of decision-makers, service users, and service providers and the use of data and flexibility to solve emerging challenges. Our case ex le underscores the importance of these themes. Specifically, the case ex le demonstrated that the engagement of stakeholders and end-users is important, however equally vital is the alignment between ‘co-design’ and ‘build’ phases of technology development. proved a challenging negotiation for the organisation responsible for the intervention. Additionally, the case ex le showed the necessity of balancing novelty and feasibility of vision, which could have been aided by greater technological competence during co-design phases. ur paper provides an empirical consideration of the complexity of designing and developing digital health interventions, with some practical guidance for mitigating this complexity for future DHI development.

Lessons learnt during the COVID‐19 pandemic: Why Australian schools should be prioritised to stay open

Publisher: Wiley

Date: 08-06-2021

DOI: 10.1111/JPC.15588

Abstract: In 2020, school and early childhood educational centre (ECEC) closures affected over 1.5 billion school‐aged children globally as part of the COVID‐19 pandemic response. Attendance at school and access to ECEC is critical to a child's learning, well‐being and health. School closures increase inequities by disproportionately affecting vulnerable children. Here, we summarise the role of children and adolescents in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) transmission and that of schools and ECECs in community transmission and describe the Australian experience. In Australia, most SARS‐CoV‐2 cases in schools were solitary (77% in NSW and 67% in Victoria) of those that did progress to an outbreak, % involved fewer than 10 cases. Australian and global experience has demonstrated that SARS‐CoV‐2 is predominantly introduced into schools and ECECs during periods of heightened community transmission. Implementation of public health mitigation strategies, including effective testing, tracing and isolation of contacts, means schools and ECECs can be safe, not drivers of transmission. Schools and ECEC are essential services and so they should be prioritised to stay open for face‐to‐face learning. This is particularly critical as we continue to manage the next phase of the COVID‐19 pandemic.

Can a teacher-reported indicator be used for population monitoring of oral language skills at school entry?

Publisher: Informa UK Limited

Date: 14-03-2017

DOI: 10.1080/17549507.2017.1294200

Abstract: Monitoring oral language skills at the population level would provide valuable data to inform policy decisions to better support children's oral language skills in schools. The Australian Early Development Census (AEDC) is a teacher-rated population measure of early child development that includes a rating of children's oral communication in the classroom (OCC). This study evaluates the validity of the OCC indicator for population monitoring of children's oral language skills, capitalising on data from two datasets: the 2012 AEDC cohort (n = 289 973) and a subs le of children from the Longitudinal Study of Australian Children for whom AEDC data were also collected (n = 720). Construct validity was demonstrated by showing significant differences in OCC ratings between subpopulations of children who would be expected to differ in terms of oral language skills at school entry (e.g. children with a diagnosed speech-language impairment compared to those with no impairment). OCC ratings were associated with externally validated measures of language, suggesting convergent validity. No relationship was found between OCC ratings and physical health scores, indicating ergent validity. The findings support the use and interpretation of the OCC indicator as a tool for population-level monitoring of oral language in Australian school entrants.

Screening for Adverse Childhood Experiences in Children: A Systematic Review

Publisher: American Academy of Pediatrics (AAP)

Date: 24-01-2022

DOI: 10.1542/PEDS.2021-051884

Abstract: Adverse childhood experiences (ACEs) are associated with increased risk of poor mental health outcomes. Although there is interest in screening for ACEs for early identification and intervention, it is not known whether screening improves outcomes for children. To systematically review whether screening for ACEs in children leads to an increase in (1) identification of ACEs, (2) referrals to services, (3) increased uptake of services, and (4) improved mental health outcomes for children and parents. Ovid Medline, PsycINFO, CINAHL, and Center for Clinical and Translational Research electronic databases were searched between 2009 and 2021. Studies were included if researchers screened for current ACEs in children aged 0 to 12 years and they had a control comparison. Information was extracted, including study characteristics, s le demographics, screening tool characteristics, referral rates to services, uptake rates, and mental health outcomes. A total of 5816 articles were screened, with 4 articles meeting inclusion criteria. Screening for ACEs increases identification of adversity and may increase referrals to services. There are limited data about whether this leads to an increase in referral uptake by families. There are no reported data addressing mental health outcomes. There are few published control trials of moderate quality. There is limited evidence that screening for ACEs improves identification of childhood adversity and may improve referrals. If we are to realize the hypothesized benefits of ACEs screening on child and parent mental health, it is essential to understand the barriers for families taking up referrals.

Nut allergy prevalence and differences between Asian-born children and Australian-born children of Asian descent: a state-wide survey of children at primary school entry in Victoria, Australia

Publisher: Wiley

Date: 29-03-2016

DOI: 10.1111/CEA.12699

Abstract: Asian infants born in Australia are three times more likely to develop nut allergy than non-Asian infants, and rates of challenge-proven food allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate the risk factors for nut allergy, we assessed the whole-of-state prevalence distribution of parent-reported nut allergy in 5-year-old children entering school. Using the 2010 School Entrant Health Questionnaire administered to all 5-year-old children in Victoria, Australia, we assessed the prevalence of parent-reported nut allergy (tree nut and peanut) and whether this was altered by region of residence, socio-economic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders. Parent-reported nut allergy prevalence was 3.1% (95% CI 2.9-3.2) amongst a cohort of nearly 60 000 children. It was more common amongst children of mothers with higher education and socio-economic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian-born mothers (aOR 2.67, 95% CI 2.28-3.27) were more likely to have nut allergy than non-Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of nut allergy (aOR 0.1, 95% CI 0.03-0.31). Migration from Asia after the early infant period appears protective for the development of nut allergy. Additionally, rural regions have lower rates of nut allergy than urban areas.

Preschool attendance and developmental outcomes at age five in Indigenous and non-Indigenous children: a population-based cohort study of 100 357 Australian childre

Publisher: BMJ

Date: 08-12-2020

DOI: 10.1136/JECH-2020-214672

Abstract: Policies to increase Australian Indigenous children’s participation in preschool aim to reduce developmental inequities between Indigenous and non-Indigenous children. This study aims to understand the benefits of preschool participation by quantifying the association between preschool participation in the year before school and developmental outcomes at age five in Indigenous and non-Indigenous children. We used data from perinatal, hospital, birth registration and school enrolment records, and the Australian Early Development Census (AEDC), for 7384 Indigenous and 95 104 non-Indigenous children who started school in New South Wales, Australia in 2009/2012. Preschool in the year before school was recorded in the AEDC. The outcome was developmental vulnerability on ≥1 of five AEDC domains, including physical health, emotional maturity, social competence, language/cognitive skills and communication skills/general knowledge. 5051 (71%) Indigenous and 68 998 (74%) non-Indigenous children attended preschool. Among Indigenous children, 33% of preschool attenders and 44% of the home-based care group were vulnerable on ≥1 domains, compared with 17% of preschool attenders and 33% in the home-based care group among non-Indigenous children. In the whole population model, the adjusted risk difference for developmental vulnerability among preschool attenders was −7.9 percentage points (95% CI, −9.8 to −6.1) in non-Indigenous children and −2.8 percentage points (95% CI −4.8 to −0.7) in Indigenous children, compared with Indigenous children in home-based care. Our findings suggest a likely beneficial effect of preschool participation on developmental outcomes, although the magnitude of the benefit was less among Indigenous compared with non-Indigenous children.

Selecting life course frameworks to guide and communicate large new cohort studies: Generation Victoria (GenV) case study

Publisher: Cambridge University Press (CUP)

Date: 18-01-2021

DOI: 10.1017/S2040174420001245

Abstract: While birth cohorts are shaped by underpinning life course frameworks, few if any report how they select them. This review aimed to (1) summarise publicly available frameworks relevant to planning and communicating large new early-life cohorts and (2) help select frameworks to guide and communicate Generation Victoria (GenV), a whole-of-state birth and parent cohort in planning in the state of Victoria, Australia. We identified potential frameworks from prior knowledge, networks and a pragmatic literature search in 2019. We considered for inclusion only frameworks with an existing visual graphic. We summarised each framework’s concept, then judged it on a seven-item matrix (Scope, Dimensions, Outcomes, Life course, Mechanisms, Multi-age, and Visual Clarity) to be of high, intermediate or low relevance to GenV. We presented and evaluated 14 life course frameworks across research and policy. Two, nine and three frameworks, respectively, were ranked as high, intermediate and low relevance to GenV, although none totally communicated its scope and intent. Shonkoff’s biodevelopmental framework was selected as GenV’s primary framework, adapted to include ongoing feedback loops through the life course and influence of an in idual’s outcomes on the next generation. Because conceptual simplicity precluded the primary framework from capturing the wide range of relevant exposures, we selected the Australian Institute of Health and Welfare’s person-centred model as a secondary framework. This summary of existing life course frameworks may prove helpful to other cohorts in planning. Our transparent process and focus on visual communication are already assisting in explaining and selecting measures for GenV. The feasibility, comprehension and validity of these frameworks could be further tested at implementation.

Investigating the Validity of the Australian Early Development Index

Publisher: Informa UK Limited

Date: 11-10-2007

DOI: 10.1080/10409280701610812

Clinical, financial and social impacts of COVID-19 and their associations with mental health for mothers and children experiencing adversity in Australia

Publisher: Public Library of Science (PLoS)

Date: 13-09-2021

DOI: 10.1371/JOURNAL.PONE.0257357

Abstract: Australia has maintained low rates of SARS-COV-2 (COVID-19) infection, due to geographic location and strict public health restrictions. However, the financial and social impacts of these restrictions can negatively affect parents’ and children’s mental health. In an existing cohort of mothers recruited for their experience of adversity, this study examined: 1) families’ experiences of the COVID-19 pandemic and public health restrictions in terms of clinical exposure, financial hardship family stress, and family resilience (termed ‘COVID-19 impacts’) and 2) associations between COVID-19 impacts and maternal and child mental health. Participants were mothers recruited during pregnancy (2013–14) across two Australian states (Victoria and Tasmania) for the ‘right@home’ trial. A COVID-19 survey was conducted from May-December 2020, when children were 5.9–7.2 years old. Mothers reported COVID-19 impacts, their own mental health (Depression, Anxiety, Stress Scales short-form) and their child’s mental health (CoRonavIruS Health and Impact Survey subscale). Associations between COVID-19 impacts and mental health were examined using regression models controlling for pre-COVID-19 characteristics. 319/406 (79%) mothers completed the COVID-19 survey. Only one reported having had COVID-19. Rates of self-quarantine (20%), job or income loss (27%) and family stress (e.g., difficulty managing children’s at-home learning (40%)) were high. Many mothers also reported family resilience (e.g., family found good ways of coping (49%)). COVID-19 impacts associated with poorer mental health (standardised coefficients) included self-quarantine (mother: β = 0.46, child: β = 0.46), financial hardship (mother: β = 0.27, child: β = 0.37) and family stress (mother: β = 0.49, child: β = 0.74). Family resilience was associated with better mental health (mother: β = -0.40, child: β = -0.46). The financial and social impacts of Australia’s public health restrictions have substantially affected families experiencing adversity, and their mental health. These impacts are likely to exacerbate inequities arising from adversity. To recover from COVID-19, policy investment should include income support and universal access to family health services.

Psychosocial assessment tools for children and young people aged 5–18 years: A rapid review of the literature

Publisher: Wiley

Date: 12-01-2023

DOI: 10.1111/JPC.16324

Abstract: Schools are a key platform for health promotion and a point of connection to local health‐care services, with an almost universal reach across the child and adolescent population. This study sought to determine whether validated psychosocial assessment tools exist for a school‐based nursing program that would assist in providing an initial health assessment to identify and understand the needs of children and young people referred to the nurse, with the outcome of appropriate connection to external health and wellbeing services. Rapid evidence assessment methodology was utilised to identify validated tools that could identify psychosocial concerns in children and young people aged 5–18 years. We identified articles from peer‐reviewed journals via three electronic bibliographic databases (PubMed, Embase and CINAHL). We then extended the search for evidence through a search of the grey literature. From 3963 peer‐reviewed articles found in the database search, 10 relevant peer‐reviewed publications met inclusion criteria. In combination with 12 grey literature sources, 33 tools were identified. These included self‐report tools (typically for children aged 11 years and older), parent‐report and teacher‐report tools. We identified the six most promising psychosocial assessment tools. However, there was limited description about implementation within school‐based nursing programs. Several tools exist that show promise in assisting school‐based nursing programs to conduct preliminary psychosocial assessments for children and young people. The introduction of any tools into practice would require implementation guidance and evaluation, including how and when they should be used, and when referral and follow‐up is required.

Special Health Care Needs Across the School and Family Contexts: Implications for Service Utilization

Publisher: Elsevier BV

Date: 08-2017

DOI: 10.1016/J.ACAP.2017.02.012

Abstract: A fifth of children enter school with special health care needs (SHCN), many of whom have difficulties that are milder or not yet formally diagnosed (emerging SHCN). This study aimed to investigate how differing perceptions of children's emerging SHCN across the family and school contexts relates to service utilization. S le: The nationally representative birth cohort of the Longitudinal Study of Australian Children, which includes parent reports on the abbreviated Children with Special Health Care Needs Screener. For a subs le of 2459 children teachers also completed the Australian Early Development Census, a measure of early childhood development at school entry that includes SHCN. Logistic regression analyses were conducted adjusting for severity of condition, gender, language background, and disadvantage. Overall 24.1% of children were identified by their parent and/or teacher as experiencing emerging SHCN. Compared with those with consistent reports, children with parent-only identified needs had lower odds of accessing school services (odds ratio [OR], 0.29 95% confidence interval [CI], 0.10-0.81). Similarly, children with parent-only (OR, 0.39 95% CI, 0.20-0.75) and teacher-only (OR, 0.25 95% CI, 0.14-0.46) identified needs had significantly lower odds of accessing services in the community. When parent and teacher perceptions of children's emerging SHCN were inconsistent, service use was lower at school and in the community. Further efforts are needed by health and education providers to ensure that common understandings about a child's needs at school are established early in children's educational careers.

Socioeconomic Disadvantage in Infancy and Academic and Self-Regulation Outcomes

Publisher: American Academy of Pediatrics (AAP)

Date: 05-2019

DOI: 10.1542/PEDS.2018-2640

Abstract: A comprehensive understanding of how timing of exposure to disadvantage affects long-term developmental risk is needed for greater precision in child health policy. We investigated whether socioeconomic disadvantage in infancy (age 0–1 years) directly affects academic and self-regulation problems in late childhood (age 10–12 years), independent of disadvantage at school entry (age 4–6 years). Analyses were replicated in 2 population-based cohorts: the Australian Temperament Project (ATP N = 2443) and the Longitudinal Study of Australian Children (LSAC N = 5107). Generalized linear models were used to estimate the crude and adjusted effects. Marginal structural models were used to estimate the controlled direct effect of socioeconomic disadvantage in infancy on academic and self-regulation outcomes in late childhood, independent of disadvantage at school entry. In both cohorts, socioeconomic disadvantage in infancy and at school entry was associated with poorer academic and self-regulation outcomes. Socioeconomic disadvantage in infancy had a direct effect on academic outcomes not mediated by disadvantage at school entry (ATP: risk ratio [RR] = 1.42 95% confidence interval [CI]: 1.09–1.86 LSAC: RR = 1.87 95% CI: 1.52–2.31). Little evidence was found for a direct effect of disadvantage in infancy on self-regulation (ATP: RR = 1.22 95% CI: 0.89–1.65 LSAC: RR = 1.19 95% CI: 0.95–1.49). Socioeconomic disadvantage in infancy had a direct effect on academic but not self-regulation outcomes in late childhood. More precise public policy responses are needed that consider both the timing of children’s exposure to disadvantage and the specific developmental domain impacted.

Preschool attendance trends in Australia: Evidence from two sequential population cohorts

Publisher: Elsevier BV

Date: 2016

DOI: 10.1016/J.ECRESQ.2015.11.004

Associations between early maternal behaviours and child language at 36 months in a cohort experiencing adversity

Publisher: Wiley

Date: 11-2018

DOI: 10.1111/1460-6984.12435

Abstract: Variations in parenting, more specifically less responsive and more directive parenting, contribute to language difficulties for children experiencing adversity. Further investigation of associations between specific responsive and directive behaviours and child language is required to understand how behaviours shape language over time within different populations. As language is dyadic, further exploration of how mother-child interactions moderate associations is also important. To investigate associations between specific responsive and directive maternal behaviours, the quality of mother-child interaction (fluency and connectedness) and child language in a cohort experiencing adversity. Pregnant women experiencing adversity were recruited from maternity hospitals in Australia. At 12 months, videos of mother-infant free play were collected. Videos were coded for maternal behaviours and fluency and connectedness (n = 249). At 36 months, child language was measured using a standardized language test. Linear regression models were used to examine associations and the moderating role of fluency and connectedness was explored. Responsive yes/no questions were positively associated with language scores. Unsuccessful redirectives were negatively associated with language scores. The moderation effect of fluency and connectedness was equivocal in the current data. Findings reproduce and extend previous research highlighting key features of mother-child interactions associated with child language trajectories. Findings also augment knowledge of risk and protective factors related to language for children experiencing adversity and highlight where targeted interventions might be successful.

Population monitoring of language and cognitive development in Australia: The Australian Early Development Index

Publisher: Informa UK Limited

Date: 2009

DOI: 10.1080/17549500903147552

The relationships between ongoing COVID-19 lockdown and the financial and mental health experiences of Australian families

Publisher: Cold Spring Harbor Laboratory

Date: 20-08-2021

DOI: 10.1101/2021.08.15.21262087

Abstract: In 2020, Australia’s successful COVID-19 public health restrictions comprised a national ‘initial lockdown’ (March-May), and ‘ongoing lockdown’ (July-November) for metropolitan Victorian residents only. We evaluated the relationships between ongoing lockdown and family finances and mental health. In the June and September 2020 Royal Children’s Hospital National Child Health Polls, caregivers of children in Victoria and New South Wales reported: job/income loss material deprivation (inability to pay for essential items) income-poverty mental health (Kessler-6) perceived impact on caregiver/child mental health and caregiver/child coping. Data from N=1207/902 caregivers in June/September were analysed using Difference-in-Difference modelling (New South Wales provided the comparator). During Victoria’s ongoing lockdown, job/income loss increased by 11% (95%CI: 3-18%) Kessler-6 poor mental health by 6% (95%CI: -0.3-12%) and perceived negative mental health impacts by 14% for caregivers (95%CI: 6-23%) and 12% for children (95%CI: 4-20%). Female (versus male) caregivers, metropolitan (versus regional/rural) families, and families with elementary school-aged children (versus pre-/high-school) were most affected. Ongoing lockdown was associated with negative experiences of mental health, employment, and income, but not deprivation or poverty, likely because of government income supplements introduced early in the pandemic. Future lockdowns require planned responses to outbreaks, and evidence-informed financial and mental health supports.

The role of preschool in promoting children’s healthy development: Evidence from an Australian population cohort

Publisher: Elsevier BV

Date: 2016

DOI: 10.1016/J.ECRESQ.2015.11.001

Teacher Talk in Early Years Classrooms following an Oral Language and Literacy Professional Learning Program

Publisher: Informa UK Limited

Date: 09-12-2022

DOI: 10.1080/19345747.2021.1998938

Do Fathers' Home Reading Practices at Age 2 Predict Child Language and Literacy at Age 4?

Publisher: Elsevier BV

Date: 03-2018

DOI: 10.1016/J.ACAP.2017.10.001

Abstract: Maternal shared reading practices predict emergent literacy, but fathers' contributions are less certain. We examined whether fathers' shared home reading activities at 2 years predict language and emergent literacy at age 4 years, when controlling for maternal contributions and whether this differentially benefits these outcomes in disadvantaged children. Two-parent families were recruited from 5 relatively disadvantaged communities for the universal Let's Read literacy promotion population-based trial (ISRCTN 04602902) in Melbourne, Australia. For exposure at 2 years, home reading practices were recorded via self-reported maternal and paternal StimQ-Toddler questionnaires and dichotomized at study median (high vs low). At 4 years, outcomes assessed included receptive and expressive language (Clinical Evaluation of Language Fundamentals 4) and emergent literacy (Sunderland Phonological Awareness Test-Revised). Linear regression, adjusted for mothers' home reading, was performed to assess 2-year-old vocabulary and communication skills and family disadvantage. Interaction of disadvantage (yes vs no) with high home reading by fathers and at least one parent was assessed. Data were available for 405 families (64.3%). High father reading at 2 years (reference: low) predicted better expressive (mean difference, 4.7 95% confidence interval, 1.5 to 8.0) and receptive (mean difference, 5.0 95% confidence interval, 1.8 to 8.2) language at 4 years (both P < .001), but not emergent literacy skills. Similar patterns were observed in families with at least one parent with high home reading. Fathers' reading did not differentially benefit outcomes in disadvantaged children. Fathers' involvement in reading at 2 years predicted better language but not emergent literacy at 4 years, and it did not protect against adverse effects of socioeconomic disadvantage.

Do Integrated Hub Models of Care Improve Mental Health Outcomes for Children Experiencing Adversity? A Systematic Review

Publisher: Ubiquity Press, Ltd.

Date: 17-06-2022

DOI: 10.5334/IJIC.6425

Outcomes of population based language promotion for slow to talk toddlers at ages 2 and 3 years: Let's Learn Language cluster randomised controlled trial

Publisher: BMJ

Date: 18-08-2011

DOI: 10.1136/BMJ.D4741

Local Housing Characteristics Associated with Early Childhood Development Outcomes in Australian Disadvantaged Communities

Publisher: MDPI AG

Date: 16-05-2019

DOI: 10.3390/IJERPH16101719

Abstract: Disadvantaged communities tend to have poorer early childhood development outcomes. Access to safe, secure, and stable housing is a well-known social determinant of health but there is a need to examine key features of neighbourhood housing that reduce early childhood development inequities. The 2012 Australian Early Development Census (AEDC), a population-wide measure of early childhood development, and the Australian Bureau of Statistics Socio-economic Index for Areas Index of Relative Socio-economic Disadvantage were used to select fourteen disadvantaged local communities in five Australian states and territories based on those performing better (off-diagonal), or as expected (on-diagonal) on the AEDC relative to their socio-economic profile. Between 2015–2017, qualitative and quantitative housing data were collected in the local communities. In total, 87 interviews with stakeholders, 30 focus groups with local service providers and parents, and Australian Census dwelling information were analysed. A comparative case study approach was used to examine differences in housing characteristics (e.g., public housing, density, affordability, and tenure) between disadvantaged local communities performing ‘better than expected’ and ‘as expected’ on early childhood development. Perceived better housing affordability, objectively measured housing tenure (ownership) and perceived and objectively measured lower-density public housing were housing characteristics that emerged as points of difference for disadvantaged local communities where children had relatively better early childhood development outcomes. These characteristics are potential modifiable and policy sensitive housing levers for reducing early childhood development inequities.

Family and Community Predictors of Comorbid Language, Socioemotional and Behavior Problems at School Entry

Publisher: Public Library of Science (PLoS)

Date: 05-07-2016

DOI: 10.1371/JOURNAL.PONE.0158802

Neighbourhood Effects Influencing Early Childhood Development: Conceptual Model and Trial Measurement Methodologies from the Kids in Communities Study

Publisher: Springer Science and Business Media LLC

Date: 20-02-2014

DOI: 10.1007/S11205-014-0578-X

A novel method of rapid appraisal of clinical practice guidelines for children with enuresis

Publisher: Elsevier BV

Date: 08-2019

DOI: 10.1016/J.JPUROL.2019.05.015

Abstract: Enuresis (bedwetting) is a common but variably managed pediatric condition. Despite an abundance of published documents which provide recommendations for clinical evaluation and management of enuresis, no formal appraisal of their methodological quality has been undertaken. The objective of the study is to evaluate the quality of current pediatric guidelines for enuresis (bedwetting) using a novel method of appraisal. A comprehensive gray literature search was undertaken to identify guideline documents that provided recommendations for management of enuresis in children and adolescents. The search strategy included guideline databases, targeted websites, Google search engines, and MEDLINE. Guideline documents included clinical practice guidelines, consensus documents, position statements, and other clinical review documents. Each document underwent basic appraisal by two independent assessors using the International Centre for Allied Health Evidence (iCAHE) Guideline Quality Checklist. Those documents which (1) had an iCAHE quality score of ≥10 (2) used a systematic search strategy and (3) linked evidence to their recommendations underwent further detailed appraisal using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Eighteen documents were shortlisted for basic appraisal. The iCAHE highlighted a lack of information regarding underlying evidence and dates (mean score 36% and 41%, respectively). Only three documents met basic quality criteria and progressed to detailed appraisal using the AGREE II. These included guidelines produced by the Paediatric Society of New Zealand and National Clinical Guideline Centre and a position statement from the Canadian Paediatric Society. All three guidelines presented clear and unambiguous recommendations (mean score 80%). However, information regarding stakeholder involvement was lacking (mean score 50%). Several guidelines exist for the evaluation and management of children with enuresis, but many lack appropriate methodological quality standards. The guideline produced by the National Clinical Guideline Centre achieved the highest quality rating and is recommended for future adaptation and implementation in relevant clinical settings.

Academic outcomes of multilingual children in Australia

Publisher: Informa UK Limited

Date: 24-02-2017

DOI: 10.1080/17549507.2017.1292546

Abstract: The Australian educational system is increasingly challenged to meet the needs of multilingual students, who comprise a fifth of the student population. Within the context of a monolingual English curriculum, multilingual children who enter school not yet English proficient may be at risk of experiencing inequitable educational outcomes. We examined the relationship between the timing of multilingual children's acquisition of receptive English vocabulary skills and subsequent reading and numeracy outcomes, as well as factors associated with earlier versus later timing of acquisition. Data were drawn from the Kindergarten-cohort (n = 4983) of the Longitudinal Study of Australian Children - a nationally representative, community s le of Australian children. Linear regression analyses revealed that multilingual children who begin school with proficient receptive English vocabulary skills, or who acquire proficiency early in schooling, are indistinguishable from their monolingual peers in literacy and numeracy outcomes by 10-11 years. However, later acquisition of receptive English vocabulary skills (i.e. after 6-7 years) was associated with poorer literacy outcomes. In turn, socioeconomic disadvantage and broader language or learning problems predicted this later acquisition of receptive English vocabulary skills. All children need to be supported during the early years of school to reach their full educational potential.

Natural history of mental health competence from childhood to adolescence

Publisher: BMJ

Date: 16-08-2021

DOI: 10.1136/JECH-2021-216761

Abstract: Mental health competence (MHC) involves psychosocial capabilities such as regulating emotions, interacting well with peers and caring for others, and predicts a range of health and social outcomes. This study examines the course of MHC from childhood to adolescence and patterning by gender and disadvantage, in Australian and UK contexts. Data: Longitudinal Study of Australian Children (n=4983) and the Millennium Cohort Study (n=18 296). Measures: A measure capturing key aspects of MHC was derived summing items from the parent-reported Strengths and Difficulties Questionnaire, assessed at 4–5 years, 6–7 years, 10–11 years and 14–15 years. Analysis: Proportions of children with high MHC (scores ≥23 of range 8–24) were estimated by age and country. Random-effects models were used to define MHC trajectories according to baseline MHC and change over time. Sociodemographic patterns were described. The prevalence of high MHC steadily increased from 4 years to 15 years (from 13.6% to 15.8% and 20.6% to 26.2% in Australia and the UK, respectively). Examination of trajectories revealed that pathways of some children erge from this normative MHC progression. For ex le, 7% and 9% of children in Australia and the UK, respectively, had a low starting point and decreased further in MHC by mid-adolescence. At all ages, and over time, MHC was lower for boys compared with girls and for children from disadvantaged compared with advantaged family backgrounds. Approaches to promoting MHC require a sustained focus from the early years through to adolescence, with more intensive approaches likely needed to support disadvantaged groups and boys.

Findings from the Kids in Communities Study (KiCS): A mixed methods study examining community-level influences on early childhood development

Publisher: Public Library of Science (PLoS)

Date: 09-2021

DOI: 10.1371/JOURNAL.PONE.0256431

Abstract: There is increasing international interest in place-based approaches to improve early childhood development (ECD) outcomes. The available data and evidence are limited and precludes well informed policy and practice change. Developing the evidence-base for community-level effects on ECD is one way to facilitate more informed and targeted community action. This paper presents overall final findings from the Kids in Communities Study (KiCS), an Australian mixed methods investigation into community-level effects on ECD in five domains of influence–physical, social, governance, service, and sociodemographic. Twenty five local communities (suburbs) across Australia were selected based on ‘diagonality type’ i.e. whether they performed better (off-diagonal positive), worse (off-diagonal negative), or ‘as expected’ (on-diagonal) on the Australian Early Development Census (AEDC) relative to their socioeconomic profile. The approach was designed to determine replicable and modifiable factors that were separate to socioeconomic status. Between 2015–2017, stakeholder interviews (n = 146), parent and service provider focus groups (n = 51), and existing socio-economic and early childhood education and care administrative data were collected. Qualitative and quantitative data analyses were undertaken to understand differences between 14 paired disadvantaged local communities (i.e. on versus off-diagonal). Further analysis of qualitative data elicited important factors for all 25 local communities. From this, we developed a draft set of ‘Foundational Community Factors’ (FCFs) these are the factors that lay the foundations of a good community for young children.

Effects of a professional development program on emergent literacy-promoting practices and environments in early childhood education and care

Publisher: Informa UK Limited

Date: 14-03-2021

DOI: 10.1080/09575146.2021.1898342

Surveying social adversity in pregnancy: The antenatal risk burden experienced by Australian women

Publisher: Wiley

Date: 14-02-2018

DOI: 10.1111/JPC.13860

Abstract: Many, varied, antenatal risk factors can adversely impact children's health, behaviour and cognition. Understanding the antenatal risk factors experienced by women can help identify which families are most likely to benefit from additional early supports however, there is a dearth of published Australian antenatal risk data. This study aimed to determine the prevalence and co-occurrence of a broad range of risk factors in a community-based s le of pregnant Australian women. A brief risk factor survey (10 items, including age, social support, health, smoking, stress or anxious mood, education, household income, employment) completed by pregnant women attending the antenatal clinic waiting rooms of 10 public maternity hospitals, which were selected for their provision of care to areas with fewer socio-economic resources in the states of Victoria and Tasmania, between May 2013 and August 2014. A total of 5586 women participated, with an average age of 29.0 years and gestation of 26.9 weeks. The most prevalent antenatal risk factors were poorer global health (38.9%), not finishing high school (33.5%) and smoking (14.9%), all proportions higher than the general population. Most women reported at least one risk factor (68.6%), with 21.5% reporting ≥3. There was a high degree of co-occurrence between risk factors, especially the three most prevalent. This study reveals the considerable and varied risk burden experienced by Australian women during pregnancy. By understanding where need is greatest and tailoring support accordingly, risk factor assessment provides an opportunity to address equity through health care, ultimately optimising the future developmental outcomes of all children.

Parent and teacher perceptions of emerging special health care needs

Publisher: Wiley

Date: 11-05-2016

DOI: 10.1111/JPC.13188

Abstract: A fifth of children enter school with special health care needs (SHCN) impacting on their physical, psychosocial or educational development, including many with emerging SHCN who often do not qualify for additional supports. This study aimed to compare the perceptions of parents and teachers on children's emerging SHCN, and explore correlates of conflicting reports. The Longitudinal Study of Australian Children (LSAC) is a nationally representative study of Australian children, which includes the abbreviated Children with Special Health Care Needs Screener. Data were analysed from a subs le of n = 720 children from the LSAC Kindergarten cohort (n = 4983) for whom teachers also completed the Australian Early Development Index checklist, a measure of early childhood development that includes teacher reported SHCN. Teachers (n = 120, 17.34%) identified more emerging SHCN than parents (n = 74, 10.74%), and reports were often discrepant. Children were more likely to have consistent reports of emerging SHCN when their parents had high levels of involvement at school (OR 4.86 95% CI 1.08-21.80 P < 0.05), whereas children who came from disadvantaged family backgrounds were more likely to have teacher-only identified difficulties (OR 3.66 95% CI 1.17-11.50 P < 0.05). Parents and teachers bring different perspectives to children's development and additional support needs, each of which is valuable. Greater attention should be given to ensuring that common understandings about a child's needs at school are established early in children's educational pathways.

Maternal Linguistic Input and Child Language in a Cohort at Risk of Experiencing Social Adversity

Publisher: Informa UK Limited

Date: 31-01-2021

DOI: 10.1080/15475441.2021.1875831

Enhancing Value and Uptake for Whole-Population Cohorts of Children and Parents: Methods to Integrate Registries into the Generation Victoria Cohort

Publisher: MDPI AG

Date: 07-04-2021

DOI: 10.3390/CHILDREN8040285

Abstract: Health registries are critical to understanding, benchmarking and improving quality of care for specific diseases and conditions, but face hurdles including funding, bias towards clinical rather than population s les, lack of pre-morbid and outcomes data, and absent cross-registry harmonisation and coordination. Children are particularly under-represented in registry research. This paper lays out novel principles, methods and governance to integrate erse registries within or alongside a planned children’s mega-cohort to rapidly generate translatable evidence. GenV (Generation Victoria) will approach for recruitment parents of all newborns (estimated 150,000) over two years from mid-2021 in the state of Victoria (population 6.5 million), Australia. Its s le size and population denominator mean it will contain almost all children with uncommon or co-morbid conditions as they emerge over time. By design, it will include linked datasets, bios les (including from pregnancy), phenotypes and participant-reported measures, all of which will span pre-morbid to long-term outcomes. We provide a vignette of a planned new registry for high-risk pregnancies to illustrate the possibilities. To our knowledge, this is the first paper to describe such a methodology designed prospectively to enhance both the clinical relevance of a large multipurpose cohort and the value and inclusivity of registries in a population.

Data Resource Profile: Melbourne Children’s LifeCourse initiative (LifeCourse)

Publisher: Oxford University Press (OUP)

Date: 10-05-2022

DOI: 10.1093/IJE/DYAC086

Paediatric bladder dysfunction: A single centre experience of public hospital wait times

Publisher: Wiley

Date: 06-01-2020

DOI: 10.1111/JPC.14758

Abstract: Paediatric bladder dysfunction, including daytime urinary incontinence and enuresis, is a common and distressing condition. Unfortunately, children with these symptoms are often on waitlists for several months. This treatment delay may significantly impact upon the child and family unit. This study aimed to quantify waiting times for children who had attended hospital outpatient clinics for symptoms of wetting. A retrospective review was undertaken for patients who had been referred to The Royal Children's Hospital, Melbourne outpatient clinics for symptoms of wetting (with/without bowel symptoms). Data regarding the referral and triage pathway, up to the time of the first clinic appointment, were collected. These data were compared to a previous audit conducted in the same setting. A total of 101 clinic attendances were included in this study. The overall waiting time, from receipt of referral to the patient's first clinic attendance, was a median of 181 days (n = 94 valid responses range 7-695). Wait times for patients with isolated symptoms of wetting were similar to patients with mixed bowel and bladder dysfunction (187 and 171.5 days, respectively). Most patients were triaged to the continence clinic (n = 68), whilst smaller proportions of patients were seen in the encopresis (n = 14), urology (n = 13), general medicine (n = 2), gastroenterology (n = 1) and nurse-led enuresis clinic (n = 3). The waiting times for patients with wetting generally exceeded 5 months. Alternative pathways for triage need to be explored to manage demand and improve wait times.

Using Hair Cortisol to Examine the Role of Stress in Children's Health Inequalities at 3 Years

Publisher: Elsevier BV

Date: 03-2020

DOI: 10.1016/J.ACAP.2019.05.008

Abstract: Children exposed to early adversity (eg, financial hardship, family violence, parent mental health difficulties) are at greater risk of poor health outcomes. Physiological stress is one mechanism thought to explain this pathway. We investigated associations between adversity and young children's health and whether child stress (measured using hair cortisol) mediated these associations. This was a cross-sectional study of 3-year-old children whose mothers were recruited during pregnancy, through the right@home trial, for their experience of adversity. Using total counts of 9 sociodemographic and 9 psychosocial indicators of adversity, regression models examined relationships among adversity risk counts, child hair cortisol (potential mediator), and 5 health outcomes: externalizing and internalizing problems, physical and socioemotional wellbeing, and overweight/obesity. Hair cortisol data were available for 297 out of 500 (59%) participating children. When examined separately, sociodemographic adversity risk was associated with higher externalizing problems, and psychosocial adversity risk was associated with higher externalizing problems and poorer physical/socioemotional wellbeing. When examined together in a single model, psychosocial (but not sociodemographic) adversity was associated with higher externalizing problems (unstandardized mean difference [β], 0.53 P = .002) and poorer physical wellbeing (β, 1.19 P = .009) higher hair cortisol was associated with higher externalizing problems (β, 0.76 P = .02). There was no evidence that stress (hair cortisol) mediated associations between adversity and health. In 3-year-old children, we found no evidence that physiological stress (hair cortisol) mediated associations between adversity risk and children's health. Hair cortisol may be limited as a single measure of stress, or physiological stress may not be a mechanism for explaining the effects of adversity on these young children's health.

Patterns of maternal depression, anxiety, and stress symptoms from pregnancy to 5 years postpartum in an Australian cohort experiencing adversity

Publisher: Springer Science and Business Media LLC

Date: 25-05-2021

DOI: 10.1007/S00737-021-01145-0

The Impact of Policy Modifiable Factors on Inequalities in Rates of Child Dental Caries in Australia

Publisher: MDPI AG

Date: 03-06-2019

DOI: 10.3390/IJERPH16111970

Abstract: Background: Poor oral health in childhood can lead to adverse impacts later in life. We aimed to estimate the prevalence and population distribution of childhood dental caries in Australia and investigate factors that might ameliorate inequalities. Methods: Data from the nationally representative birth cohort Longitudinal Study of Australian Children (N = 5107), using questions assessing: The experience of dental caries during each biennial follow-up period (2–3 years to 10–11 years), socioeconomic position (SEP), and policy modifiable oral health factors. Results: The odds of dental caries were higher for children with lowest vs. highest SEP (adjusted OR (adjOR) 1.92, 95% CI 1.49–2.46), and lower where water was fluoridated to recommended levels (adjOR 0.53, 95% CI 0.43–0.64). There was no evidence of an association between caries experience and either reported sugary diet or tooth brushing. When SEP and fluoridation were considered in conjunction, compared to the highest SEP group with water fluoridation children in the lowest SEP with fluoridation had adjOR 1.54 for caries, (95% CI 1.14–2.07), and children in the lowest SEP without fluoridation had adjOR 4.06 (95% CI 2.88–5.42). For patterns of service use: The highest SEP group reported a greater percentage of service use in the absence of caries. Conclusions: Dental caries appears prevalent and is socially distributed in Australia. Policy efforts should consider how to ensure that children with dental caries receive adequate prevention and early care with equitable uptake.

Systematic review: An exploration of core componentry characterizing effective sustained nurse home visiting programs

Publisher: Wiley

Date: 22-01-2021

DOI: 10.1111/JAN.14755

Trends in preschool attendance in Australia following major policy reform: Updated evidence six years following a commitment to universal access

Publisher: Elsevier BV

Date: 2020

DOI: 10.1016/J.ECRESQ.2019.09.002

Use of health services by preschool-aged children who are developmentally vulnerable and socioeconomically disadvantaged: testing the inverse care law

Publisher: BMJ

Date: 13-03-2020

DOI: 10.1136/JECH-2019-213384

Abstract: The inverse care law suggests that those with the greatest need for services are least likely to receive them. Our aim of this study was to test the inverse care law in relation to the use of health services by children aged 4–5 years in Australia who were developmentally vulnerable and socioeconomically disadvantaged. Cross-sectional data were collected from the Longitudinal Study of Australian Children birth cohort when the children were aged 4–5 years. Children were grouped according to the combination of developmental vulnerability (yes, no) and socioeconomic disadvantage (lower, higher), resulting in four groups (reference group: developmentally vulnerable and disadvantaged). Multivariate regression was used to examine the impact of the combination of developmental vulnerability and disadvantage on health service use, adjusting for other sociodemographic characteristics. 3967 (90%) of children had data on developmental vulnerability at 4–5 years. A third of children (32.6%) were classified as developmentally vulnerable, and 10%–25% of these children had used health services. Non-disadvantaged children who were developmentally vulnerable (middle need) had 1.4–2.0 times greater odds of using primary healthcare, specialist and hospital services and non-disadvantaged children who were not developmentally vulnerable (lowest need) had 1.6–1.8 times greater odds of using primary healthcare services, compared with children who were developmentally vulnerable and disadvantaged (highest need). We found some evidence of the inverse care law. Equity in service delivery remains a challenge that is critically important to tackle in ensuring a healthy start for children.

Identifying Off-Diagonal Communities Using the Australian Early Development Census Results

Publisher: Springer Science and Business Media LLC

Date: 22-04-2016

DOI: 10.1007/S11205-016-1333-2

The Process and Policy Challenges of Adapting and Implementing the Early Development Instrument in Australia

Publisher: Informa UK Limited

Date: 08-12-2009

DOI: 10.1080/10409280903375800

Examining the Contribution of the Neighborhood Built Environment to the Relationship Between Neighborhood Disadvantage and Early Childhood Development in 205,000 Australian Children

Publisher: Elsevier BV

Date: 04-2023

DOI: 10.1016/J.ACAP.2022.11.014

Associations between ongoing COVID‐19 lockdown and the financial and mental health experiences of Australian families

Publisher: Wiley

Date: 26-12-2022

DOI: 10.1002/AJS4.252

Abstract: In 2020, Australia's successful COVID‐19 public health restrictions comprised a national “initial lockdown” (March–May) and “ongoing lockdown” (July–November) for metropolitan Victorian residents only. We evaluated associations between ongoing lockdown and family finances and mental health. In the June and September 2020 Royal Children's Hospital National Child Health Polls, caregivers of children in Victoria and New South Wales (NSW) reported the following: job/income loss material deprivation (inability to pay for essential items) income poverty mental health (Kessler‐6) perceived impact on caregiver/child mental health and caregiver/child coping. Data from caregivers ( N = 1207/902) in June/September were analysed using difference‐in‐difference modelling (NSW provided the comparator). During Victoria's ongoing lockdown, job/income loss increased by 11% (95%CI: 3%–18%) Kessler‐6 poor mental health by 6% (95%CI: −0.3%–12%) and perceived negative mental health impacts by 14% for caregivers (95%CI: 6%–23%) and 12% for children (95%CI: 4%–20%). Female (vs. male) caregivers, metropolitan (vs. regional/rural) families, and families with elementary school‐aged children (vs. pre‐/high‐school) were the most affected. The ongoing lockdown was associated with negative experiences of mental health, employment and income, but not deprivation or poverty, likely because of government income supplements introduced early in the pandemic. Future lockdowns require planned responses to outbreaks and evidence‐informed financial and mental health supports.

Kids in Communities Study (KiCS) study protocol: a cross-sectional mixed-methods approach to measuring community-level factors influencing early child development in Australia

Publisher: BMJ

Date: 03-2017

DOI: 10.1136/BMJOPEN-2016-014047

The impact of a sustained oral language professional learning program on Australian early years’ teachers’ knowledge, practice and beliefs: a mixed-methods exploration

Publisher: Informa UK Limited

Date: 19-04-2020

DOI: 10.1080/19415257.2019.1603170

Assessing the capacity of the health services research community in Australia and New Zealand

Publisher: Springer Science and Business Media LLC

Date: 2005

DOI: 10.1186/1743-8462-2-4

Health, development and learning screening and assessment tools for children and young people aged 5–18 years

Publisher: The Sax Institute

Date: 05-2022

DOI: 10.57022/JULF8952

Abstract: This Evidence Check was commissioned by the Ministry of Health to identify validated health assessment tools for physical health, mental health, development, and family violence for the Wellbeing and Health In-reach Nurse (WHIN) Coordinator program. This program is a partnership between NSW Health and the NSW Department of Education which places nurses in NSW schools to identify the health and social needs of students and coordinate early intervention and referral to services and programs. Validated assessment tools will help the nurses to identify children at risk of academic, behavioural, emotional or health-related difficulties. This Evidence Check also aims to describe how they are used in clinical practice and barriers and enablers to their effective use. Seventy-two assessment tools were found, but coverage of the areas affecting children’s wellbeing was uneven. Mental health had several promising tools, as did development for younger children. However, physical health and family violence did not have well-validated tools. There was little information on how they were used in clinical practice. Enablers for use included minimal training requirements, ease of administration and ready availability. Use of parental as well as teacher reports was seen as valuable. There is a need for further work on tools for physical health and family violence. There is also a need for information on the practicalities of the chosen tools (user acceptability, licensing, costs, and training requirements) and for clear practice guidelines.

Predictors of learning outcomes for children with and without chronic illness: An Australian longitudinal study

Publisher: Wiley

Date: 23-07-2018

DOI: 10.1111/CCH.12597

Abstract: Chronically ill children are at increased risk of poor learning outcomes. Knowledge of the predictors of learning outcomes for this group of people is important to inform the development of education supports that stand the best chance of being effective. This study explored the child, family, and school risk and protective factors during the child's transition to elementary school (aged 6-7 years) that were associated with learning outcomes when children were aged 10-11 years for both children with and without a chronic illness. Data from the Longitudinal Study of Australian Children were used. Predictor variables were entered into separate multivariate regression models for children with and without a chronic illness. The strongest predictors of learning outcomes were the child's approach to learning, a consistent parenting style, and family socioeconomic position and were common for both children with and without a chronic illness but strongest for children with a chronic illness. A child's approach to learning and a consistent parenting style during the period of the child's transition to elementary school are important and potentially modifiable factors that are predictive of academic performance in later childhood. These factors are particularly relevant for children with a chronic illness, their parents/caregivers, teachers both hospital and school based, and pediatricians and can be used to inform interventions.

Data Resource Profile: The Australian Early Development Index (AEDI)

Publisher: Oxford University Press (OUP)

Date: 24-04-2014

DOI: 10.1093/IJE/DYU085

Nurse Home Visiting and Maternal Mental Health: 3-Year Follow-Up of a Randomized Trial

Publisher: American Academy of Pediatrics (AAP)

Date: 22-01-2021

DOI: 10.1542/PEDS.2020-025361

Bridging the Gap: Using an interrupted time series design to evaluate systems reform addressing refugee maternal and child health inequalities

Publisher: Springer Science and Business Media LLC

Date: 30-04-2015

DOI: 10.1186/S13012-015-0251-Z

Building Better Communities for Children: Community Implementation and Evaluation of the Australian Early Development Index

Publisher: Informa UK Limited

Date: 11-10-2007

DOI: 10.1080/10409280701610879

Prevalence of language and pre‐literacy difficulties in an Australian cohort of 5‐year‐old children experiencing adversity

Publisher: Wiley

Date: 03-2021

DOI: 10.1111/1460-6984.12611

The demand for speech pathology services for children: Do we need more or just different?

Publisher: Wiley

Date: 23-09-2016

DOI: 10.1111/JPC.13318

Abstract: An inability or difficulty communicating can have a profound impact on a child's future ability to participate in society as a productive adult. Over the past few years the number of interventions for children with speech and language problems has almost doubled the majority are targeted interventions delivered by speech pathologists. In this paper we examine the distribution of speech pathology services in metropolitan Melbourne and how these are aligned with need as defined by vulnerability in language and social disadvantage. We identified three times as many private sector services compared to public services for the 0-5 year age group. Overall there was poorer availability of services in some of the most vulnerable areas. The profound and long-term impact of impoverished childhood language, coupled with the considerable limitations on public spending, provide a strong impetus to deliver more equitably distributed speech pathology services.

Early development of emerging and English-proficient bilingual children at school entry in an Australian population cohort

Publisher: SAGE Publications

Date: 07-11-2013

DOI: 10.1177/0165025413505945

Abstract: Children who enter school with limited proficiency in the language of instruction face a range of challenges in negotiating this new context, yet limited data have been available to describe the early developmental outcomes of this subpopulation in the Australian context. The Australian Early Development Index (AEDI) is a teacher-rated checklist that measures five important domains of child development: physical health and wellbeing, social competence, emotional maturity, language and cognitive skills, and communication skills and general knowledge. In 2009, the AEDI was completed for 97.5% of Australian children in their first year of schooling ( N = 261,147 M = 5 years, 7 months of age), providing a unique opportunity to explore the cross-sectional associations between language background, proficiency in English, and early developmental outcomes at the population-level. Logistic regression analyses revealed that, compared to their peers from English-speaking backgrounds, bilingual children who were not yet proficient in English had substantially higher odds of being in the “vulnerable” range (bottom 10th percentile) on the AEDI domains ( OR = 2.88, p .001, to OR = 7.49, p .001), whereas English-proficient bilingual children had equal or slightly lower odds ( OR = .84, p .001, to OR = .97, ns). Future research with longitudinal data is now needed to establish causal pathways and explore long term outcomes.

Trends in rates and inequalities in paediatric admissions for Ambulatory Care Sensitive Conditions in Victoria, Australia (2003 to 2013)

Publisher: Wiley

Date: 11-01-2021

DOI: 10.1111/JPC.15338

Abstract: To examine 10‐year trends and inequalities in paediatric admission rates for acute and chronic Ambulatory Care Sensitive Conditions (ACSCs) in Victoria, Australia. Secondary data analysis of the Victorian Admitted Episodes Dataset of children aged 0–17 years and 11 months admitted with a principal diagnosis of acute ACSCs: gastroenteritis/dehydration, dental conditions and urinary tract infections (UTIs) or chronic ACSCs: asthma and diabetic ketoacidosis, from 2003 to 2013. Main outcome measure was trends in paediatric hospital admission rates for ACSCs (per 1000 population). Over the 10 years, hospital admission rates remained consistently high for asthma and dental conditions. Children from socioeconomically disadvantaged areas were more likely to be admitted for all acute conditions over time. Dental conditions were the only ACSC associated with increased rates of admissions in regional areas. Inequalities in paediatric hospital admissions exist for acute conditions and have not changed from 2003 to 2013 disadvantaged Victorian children were more likely to be admitted to hospital at each time point. More equitable access to medical and dental care is needed. Primary care (medical and dental) should be a critical platform to address socio‐economic differences and effectively prevent avoidable hospital admissions in children.

Childhood vaccination coverage in Australia

Publisher: Springer Science and Business Media LLC

Date: 07-07-2021

DOI: 10.1186/S12889-021-11345-Z

Abstract: This study describes trends in social inequities in first dose measles-mumps-rubella (MMR1) vaccination coverage in Western Australia (WA) and New South Wales (NSW). Using probabilistically-linked administrative data for 1.2 million children born between 2002 and 2011, we compared levels and trends in MMR1 vaccination coverage measured at age 24 months by maternal country of birth, Aboriginal status, maternal age at delivery, socio-economic status, and remoteness in two states. Vaccination coverage was 3–4% points lower among children of mothers who gave birth before the age of 20 years, mothers born overseas, mothers with an Aboriginal background, and parents with a low socio-economic status compared to children that did not belong to these social groups. In both states, between 2007 and 2011 there was a decline of 2.1% points in MMR1 vaccination coverage for children whose mothers were born overseas. In 2011, WA had lower coverage among the Aboriginal population (89.5%) and children of young mothers (89.3%) compared to NSW (92.2 and 92.1% respectively). Despite overall high coverage of MMR1 vaccination, coverage inequalities increased especially for children of mothers born overseas. Strategic immunisation plans and policy interventions are important for equitable vaccination levels. Future policy should target children of mothers born overseas and Aboriginal children.

Creating community indicators for early childhood development: challenges and innovations from the kids in communities study

Publisher: Informa UK Limited

Date: 29-04-2019

DOI: 10.1080/23748834.2019.1596525

Positive Mental Health and Academic Achievement in Elementary School: New Evidence From a Matching Analysis

Publisher: American Educational Research Association (AERA)

Date: 05-2019

DOI: 10.3102/0013189X19848724

Abstract: Previous research suggests that gains in positive mental health (often termed flourishing, wellbeing, or competence) is associated with stronger academic achievement. This study examines the relationship between positive mental health at school entry and academic achievement at Grade 3, drawing on a representative s le of Australian children with linkage to results of standardized academic testing. Propensity score analysis was used and small positive associations were found between positive mental health and most academic outcomes. Associations were modest in size but sustained over the 3-year period and were similar across a range of academic skills. Future intervention research should assess the potentially wider ranging impact of targeting positive mental health outcomes in the early years of schooling.

Measuring Positive Childhood Experiences: Testing the Structural and Predictive Validity of the Health Outcomes From Positive Experiences (HOPE) Framework

Publisher: Elsevier BV

Date: 08-2022

DOI: 10.1016/J.ACAP.2021.11.003

Abstract: Positive childhood experiences (PCEs), that occur within secure and nurturing social environments, are fundamental to healthy physical, social-emotional, and cognitive development. However, reliable measures of these experiences are not yet widely available. We used data from the Longitudinal Study of Australian Children (LSAC) to empirically represent and psychometrically evaluate 3 primary domains of PCEs defined within the Health Outcomes from Positive Experiences (HOPE) framework, specifically: 1) nurturing and supportive relationships 2) safe and protective environments and 3) constructive social engagement and connectedness. LSAC is a nationally representative cohort that has followed young Australians from birth since 2004. LSAC data were used to represent the 3 primary HOPE-PCEs domains (birth to 11 years) across 4 inter-related PCEs constructs: 1) positive parenting, 2) trusting and supportive relationships, 3) supportive neighborhood and home learning environments, and 4) social engagement and enjoyment. Confirmatory factor analysis was used to test the proposed 4-factor structure. Predictive validity was examined through associations with mental health problems and academic difficulties at 14 to 15 years. The 4-factor structure was supported by empirical data at each time point. Higher exposure to PCEs across each domain was associated with lower reporting of mental health problems (β = -0.20 to -2.05) and academic difficulties (β = -0.01 to -0.13) in adolescence. The 4 LSAC-based HOPE-PCEs have sufficient internal coherence and predictive validity to offer a potentially useful way of conceptualizing and measuring PCEs in future cohort studies and intervention trials aiming to enhance the understanding of, and mitigate the negative impacts of, adverse childhood experiences.

Do Australian policies enable a primary health care system to identify family adversity and subsequently support these families—A scoping study

Publisher: Wiley

Date: 12-12-2022

DOI: 10.1002/HPJA.684

Abstract: To determine if Australian policies support a primary health care system to identify family adversity and subsequently support these families. Two methodological approaches were used: (i) a scoping review of Australian federal and two states (Victoria and New South Wales) policies related to family adversity (e.g., childhood maltreatment or household dysfunction, such as parental mental illness) (ii) thirteen semi‐structured interviews with Victorian Community Health Service (CHS) staff and government policy makers, recruited via snowball s ling to understand the context of policy making and service implementation. Data collected were subsequently discussed in relation to the Stages Model of policy analysis. One hundred and eighty‐eight policies referenced family adversity. Of these, 37 policies met all eligibility criteria including a focus on early intervention within primary care and were included in the review. Most policies were developed within health departments (78%) and included a wide range of adversities, with the majority based within maternal and child health and CHS platforms. Most policy development included consultation with stakeholders. Although most policies received some level of funding, few included funding details and only a third included evaluation. There are many policies related to family adversity in Australia, with most focused within existing primary care platforms. Given these policies, Australia should be well positioned to identify and respond to family adversity. More work needs to be done to ensure policies are adequately implemented, evaluated and transparently and appropriately funded. The co‐occurrence of adversity should focus policy action and potentially lead to more effective and efficient outcomes.

An Opportunity for Our Little Ones: Findings from an Evaluation of an Aboriginal Early Childhood Learning Centre in Central Australia

Publisher: Springer Science and Business Media LLC

Date: 31-03-2021

DOI: 10.1007/S10643-021-01174-5

Can the Neighborhood Built Environment Make a Difference in Children's Development? Building the Research Agenda to Create Evidence for Place-Based Children's Policy

Publisher: Elsevier BV

Date: 2016

DOI: 10.1016/J.ACAP.2015.09.006

Abstract: Healthy child development is determined by a combination of physical, social, family, in idual, and environmental factors. Thus far, the majority of child development research has focused on the influence of in idual, family, and school environments and has largely ignored the neighborhood context despite the increasing policy interest. Yet given that neighborhoods are the locations where children spend large periods of time outside of home and school, it is plausible the physical design of neighborhoods (built environment), including access to local amenities, can affect child development. The relatively few studies exploring this relationship support associations between child development and neighborhood destinations, green spaces, interaction with nature, traffic exposure, and housing density. These studies emphasize the need to more deeply understand how child development outcomes might be influenced by the neighborhood built environment. Pursuing this research space is well aligned with the current global movements on livable and child-friendly cities. It has direct public policy impact by informing planning policies across a range of sectors (urban design and planning, transport, public health, and pediatrics) to implement place-based interventions and initiatives that target children's health and development at the community level. We argue for the importance of exploring the effect of the neighborhood built environment on child development as a crucial first step toward informing urban design principles to help reduce developmental vulnerability in children and to set optimal child development trajectories early.

Developing indicators of public open space to promote health and wellbeing in communities

Publisher: Elsevier BV

Date: 02-2015

DOI: 10.1016/J.APGEOG.2014.12.003

Understanding child disadvantage from a social determinants perspective

Publisher: BMJ

Date: 20-12-2018

DOI: 10.1136/JECH-2017-209036

Abstract: Child health and developmental inequities exist in all countries. Comprehensive and robust concepts of disadvantage are fundamental to growing an evidence base that can reveal the extent of inequities in childhood, and identify modifiable leverage points for change. We conceptualise and test a multidimensional framework of child disadvantage aligned to a social determinants and bioecological perspective. The Longitudinal Study of Australian Children is a nationally representative s le of two cohorts of Australian children, including the birth cohort of 5107 infants, which commenced in May 2004. The analysis focused on disadvantage indicators collected at age 4–5 years. Confirmatory factor analysis was used to test a theoretically informed model of disadvantage. Concurrent validity was examined through associations with academic performance at 8–9 years. The model comprising four latent factors of sociodemographic (10 indicators), geographical environments (three indicators), health conditions (three indicators) and risk factors (14 indicators) was found to provide a better fit for the data than alternative models. Each factor was associated with academic performance, providing evidence of concurrent validity. The study provides a theoretically informed and empirically tested framework for operationalising relative child disadvantage. Understanding and addressing inequities will be facilitated by capturing the complexity of children’s experiences of disadvantage across the multiple environments in which their development unfolds.

Data resource profile: The Child LAnguage REpository (CLARE)

Publisher: Oxford University Press (OUP)

Date: 19-03-2018

DOI: 10.1093/IJE/DYY034

A brief survey to identify pregnant women experiencing increased psychosocial and socioeconomic risk

Publisher: Elsevier BV

Date: 06-2019

DOI: 10.1016/J.WOMBI.2018.08.162

Abstract: Identifying pregnant women whose children are at risk of poorer development in a rapid, acceptable and feasible way. A range of antenatal psychosocial and socioeconomic risk factors adversely impact children's health, behaviour and cognition. Investigate whether a brief, waiting room survey of risk factors identifies women experiencing increased antenatal psychosocial and socioeconomic risk when asked in a private, in-home interview. Brief 10-item survey (including age, social support, health, smoking, stress/anxious mood, education, household income, employment) collected from pregnant women attending 10 Australian public birthing hospitals, used to determine eligibility (at least 2 adverse items) for the "right@home" trial. 735 eligible women completed a private, in-home interview (including mental health, wellbeing, substance use, domestic violence, housing problems). Regression models tested for dose-response trends between the survey risk factor count and interview measures. 38%, 31%, 15% and 16% of women reported a survey count of 2, 3, 4 and 5 or more adverse risk factors, respectively. Dose-response relationships were evident between the survey count and interview measures, e.g. of women with a survey count of 2, 8% reported ever having a drug problem, 4% experienced domestic violence in the last year and 10% experienced housing problems, contrasting with 31%, 31% and 26%, respectively, for women reporting a survey count of 5 or more. A brief, waiting room survey of psychosocial and socioeconomic risk factors concurs with a private antenatal risk factor interview, and could help health professionals quickly identify which women would benefit from more support.

Audit of enuresis referrals on the waiting list for a tertiary hospital outpatient clinic

Publisher: Wiley

Date: 27-05-2021

DOI: 10.1111/JPC.15582

Abstract: Enuresis, defined as intermittent incontinence occurring exclusively during sleep, affects 4–19% of children, but can be effectively treated using education and alarm‐bell therapies. However, delays in treatment are likely to impact upon the quality of life of the child, parents and carers. Poor quality and incomplete referrals are thought to be a major driver of inefficiencies. The aim of this study was to explore characteristics of enuresis referrals on the waiting list for a general medicine clinic at a tertiary paediatric hospital. An audit was conducted to examine all enuresis referrals on the general medicine outpatient clinic waiting list in February 2019 at The Royal Children's Hospital, Melbourne. Enuresis referrals with an organic cause and those for children less than 5 years of age were excluded. Of the 2613 referrals on the general medicine waiting list, 486 of 2613 (19%) were related to enuresis. The median age of patients on the waiting list was 8 years and 65% (315/486) were male. Sufficient detail was provided to determine temporal and disease stratification in 45% (218/486) of referrals primary versus secondary enuresis, and monosymptomatic versus non‐monosymptomatic enuresis. The mean number of days on the waiting list calculated at the time of data extraction (13 February 2019) was 226 (±179) days. The findings from this study suggest that there are long waiting times for enuresis services and referrals often do not contain complete information.

Systematic review: Effects of sustained nurse home visiting programs for disadvantaged mothers and children

Publisher: Wiley

Date: 10-10-2020

DOI: 10.1111/JAN.14576

Specific language impairment: a convenient label for whom?

Publisher: Wiley

Date: 07-2014

DOI: 10.1111/1460-6984.12102

Population health and wellbeing: Identifying priority areas for Victorian children

Publisher: Springer Science and Business Media LLC

Date: 20-07-2005

DOI: 10.1186/1743-8462-2-16

Abstract: Population health information, collected using soundly-designed methodologies, is essential to inform policy, research, and intervention programs. This study aimed to derive policy-oriented recommendations for the content of a health and wellbeing population survey of children 0–12 years living in Victoria, Australia. Qualitative interviews were conducted with 54 academic and policy stakeholders, selected to encompass a wide breadth of expertise in areas of public health and inter-sectoral organisations relevant to child health outcomes, including universities, government and non-government agencies across Victoria. These stakeholders were asked to provide advice on strategic priorities for child health information (data) using a structured interview technique. Their comments were summarised and the major themes were extracted. The priority areas of health and wellbeing recommended for regular collection include obesity and its determinants, pregnancy and breastfeeding, oral health, injury, social and emotional health and wellbeing, family environment, community, health service utilisation, illness, and socioeconomic position. Population policy questions for each area were identified. In contrast to previous population survey programs nationally and internationally, this study sought to extract contemporary policy-oriented domains for inclusion in a strategic program of child health data collection, using a stakeholder consultation process to identify key domains and policy information needs. The outcomes are a rich and relevant set of recommendations which will now be taken forward into a regular statewide child health survey program.

What factors contribute to positive early childhood health and development in Australian Aboriginal children? Protocol for a population-based cohort study using linked administrative data (The Seeding

Publisher: BMJ

Date: 18-05-2015

DOI: 10.1136/BMJOPEN-2015-007898

Can early childhood education programs support positive outcomes for indigenous children? A systematic review of the international literature

Publisher: Elsevier BV

Date: 11-2020

DOI: 10.1016/J.EDUREV.2020.100363

Potential indirect impacts of the COVID‐19 pandemic on children: a narrative review using a community child health lens

Publisher: Wiley

Date: 23-01-2022

DOI: 10.5694/MJA2.51368

Abstract: ▪In this narrative review, we summarise the vast and burgeoning research on the potential and established indirect impacts on children of the COVID-19 pandemic. We used a community child health lens to organise our findings and to consider how Australia might best respond to the needs of children (aged 0-12 years). ▪We synthesised the literature on previous pandemics, epidemics and natural disasters, and the current COVID-19 pandemic. We found clear evidence of adverse impacts of the COVID-19 pandemic on children that either repeated or extended the findings from previous pandemics. ▪We identified 11 impact areas, under three broad categories: child-level factors (poorer mental health, poorer child health and development, poorer academic achievement) family-level factors that affect children (poorer parent mental health, reduced family income and job losses, increased household stress, increased abuse and neglect, poorer maternal and newborn health) and service-level factors that affect children (school closures, reduced access to health care, increased use of technology for learning, connection and health care). ▪There is increasing global concern about the likely disproportionate impact of the current pandemic on children experiencing adversity, widening existing disparities in child health and developmental outcomes. ▪We suggest five potential strategy areas that could begin to address these inequities: addressing financial instability through parent financial supplements expanding the role of schools to address learning gaps and wellbeing rethinking health care delivery to address reduced access focusing on prevention and early intervention for mental health and using digital solutions to address inequitable service delivery.

Addressing Child Mental Health Inequities Through Parental Mental Health and Preschool Attendance

Publisher: American Academy of Pediatrics (AAP)

Date: 03-04-2023

DOI: 10.1542/PEDS.2022-057101

Abstract: Prevention is key to reducing socioeconomic inequities in children’s mental health problems, especially given limited availability and accessibility of services. We investigated the potential to reduce inequities for disadvantaged children by improving parental mental health and preschool attendance in early childhood. Data from the nationally representative birth cohort, Longitudinal Study of Australian Children (N = 5107, commenced in 2004), were used to examine the impact of socioeconomic disadvantage (0–1 year) on children’s mental health problems (10–11 years). Using an interventional effects approach, we estimated the extent to which inequities could be reduced by improving disadvantaged children’s parental mental health (4–5 years) and their preschool attendance (4–5 years). Disadvantaged children had a higher prevalence of elevated mental health symptoms (32.8%) compared with their nondisadvantaged peers (18.7%): confounder-adjusted difference in prevalence is 11.6% (95% confidence interval: 7.7% to 15.4%). Improving disadvantaged children’s parental mental health and their preschool attendance to the level of their nondisadvantaged peers could reduce 6.5% and 0.3% of socioeconomic differences in children’s mental health problems, respectively (equivalent to 0.8% and 0.04% absolute reductions). If these interventions were delivered in combination, a 10.8% (95% confidence interval: 6.9% to 14.7%) higher prevalence of elevated symptoms would remain for disadvantaged children. Targeted policy interventions that improve parental mental health and preschool attendance for disadvantaged children are potential opportunities to reduce socioeconomic inequities in children’s mental health problems. Such interventions should be considered within a broader, sustained, and multipronged approach that includes addressing socioeconomic disadvantage itself.

The built environment and early childhood development: qualitative evidence from disadvantaged Australian communities

Publisher: Informa UK Limited

Date: 07-04-2022

DOI: 10.1080/14733285.2022.2059651

Timing of paediatric orchidopexy in universal healthcare systems: international administrative data cohort study

Publisher: Oxford University Press (OUP)

Date: 24-07-2020

DOI: 10.1002/BJS5.50329

Abstract: International guidelines in 2008 recommended orchidopexy for undescended testis at 6–12 months of age to reduce the risk of testicular cancer and infertility. Using administrative data from England, Finland, Ontario (Canada), Scotland and Sweden (with data from Victoria (Australia) and Iceland in supplementary analyses), the aim of this study was to investigate compliance with these guidelines and identify potential socioeconomic inequities in the timing of surgery before 1 and 3 years. All boys born in 2003–2011 with a diagnosis code of undescended testis and procedure codes indicating orchidopexy before their fifth birthday were identified from administrative health records. Trends in the proportion of orchidopexies performed before 1 and 3 years of age were investigated, as were socioeconomic inequities in adherence to the guidelines. Across all jurisdictions, the proportion of orchidopexies occurring before the first birthday increased over the study period. By 2011, from 7·6 per cent (Sweden) to 27·9 per cent (Scotland) of boys had undergone orchidopexy by their first birthday and 71·5 per cent (Sweden) to 90·4 per cent (Scotland) by 3 years of age. There was limited evidence of socioeconomic inequities for orchidopexy before the introduction of guidelines (2008). Across all jurisdictions for boys born after 2008, there was consistent evidence of inequities in orchidopexy by the first birthday, favouring higher socioeconomic position. Absolute differences in these proportions between the highest and lowest socioeconomic groups ranged from 2·5 to 5·9 per cent across jurisdictions. Consistent lack of adherence to the guidelines across jurisdictions questions whether the guidelines are appropriate.

Jurisdictional, socioeconomic and gender inequalities in child health and development: analysis of a national census of 5-year-olds in Australia

Publisher: BMJ

Date: 2012

DOI: 10.1136/BMJOPEN-2012-001075

Leveraging research to drive more equitable reading outcomes: an update.

Publisher: Elsevier BV

Date: 09-2022

DOI: 10.1016/J.ACAP.2022.04.001

Learning Trajectories of Children With Special Health Care Needs Across the Severity Spectrum

Publisher: Elsevier BV

Date: 03-2015

DOI: 10.1016/J.ACAP.2014.09.001

Abstract: A significant proportion of school-aged children experience special health care needs (SCHN) and seek care from pediatricians with a wide range of condition types and severity levels. This study examines the learning pathways of children with established (already diagnosed at school entry) and emerging (teacher identified) SHCN from school entry through the elementary school years. The Longitudinal Study of Australian Children (LSAC) is a nationally representative clustered cross-sequential s le of 2 cohorts of Australian children which commenced in May 2004. Data were analyzed from the LSAC kindergarten cohort (n = 4,983), as well as a subs le of 720 children for whom teachers also completed the Australian Early Development Index checklist, a measure of early childhood development at school entry that includes SHCN. Latent class analysis was utilized to establish 3 academic trajectories from 4-5 to 10-11 years: high (24.3%), average (49.8%), and low (23.6%). Descriptive statistics revealed a trend for both children with established and emerging SHCN to fall into weaker performing learning pathways. Multinomial logistic regression focusing on those children with emerging SHCN confirmed this pattern of results, even after adjustment for covariates (relative risk 3.06, 95% confidence interval 1.03-9.10). Children who additionally had low socioeconomic standing were particularly at risk. Even children with less complex SCHN are at risk for academic failure. Early identification, together with integrated health and educational support, may promote stronger pathways of educational attainment for these children. Achieving these better outcomes will require the involvement of both educational and health practitioners.

International research utilizing the Early Development Instrument (EDI) as a measure of early child development: Introduction to the Special Issue

Publisher: Elsevier BV

Date: 2016

DOI: 10.1016/J.ECRESQ.2015.12.007

Foster and kinship carer survey: Accessing health services for children in out‐of‐home care

Publisher: Wiley

Date: 19-09-2020

DOI: 10.1111/JPC.15157

Predictors of mental health competence in a population cohort of Australian children

Publisher: BMJ

Date: 09-01-2014

DOI: 10.1136/JECH-2013-203007

Abstract: The child mental health epidemiology literature focuses almost exclusively on reporting the prevalence and predictors of child mental disorders. However, there is growing recognition of positive mental health or mental health competence as an independent outcome that cannot be inferred from the absence of problems, and requires epidemiological investigation in its own right. We developed a novel measure of child mental health competence within the framework of the Australian Early Development Index, a three-yearly national census of early child development. Predictors of this outcome were investigated by linking these census data at in idual level to detailed background information collected by a large longitudinal cohort study. Predictors of competence were consistent with previously described theoretical and empirical models. Overall, boys were significantly less likely than girls to demonstrate a high level of competence (OR 0.60, 95% CI 0.39 to 0.91). Other strong predictors of competence were parent education and a relative absence of maternal psychological distress these factors also appeared to attenuate the negative effect of family hardship on child competence. This measure of mental health competence shows promise as a population-level indicator with the potential benefit of informing and evaluating evidence-based public health intervention strategies that promote positive mental health.

Data Resource Profile: Seeding Success: a cross-sectoral data resource for early childhood health and development research in Australian Aboriginal and non-Aboriginal children

Publisher: Oxford University Press (OUP)

Date: 11-05-2017

DOI: 10.1093/IJE/DYX051

Testing of a synthetic phonics-based targeted reading intervention for students with reading difficulties in Year 1: protocol for an efficacy randomised controlled trial

Publisher: BMJ

Date: 07-2018

DOI: 10.1136/BMJPO-2018-000301

Two-Year Outcomes of a Population-Based Intervention for Preschool Language Delay: An RCT

Publisher: American Academy of Pediatrics (AAP)

Date: 10-2015

DOI: 10.1542/PEDS.2015-1337

Abstract: We have previously shown short-term benefits to phonology, letter knowledge, and possibly expressive language from systematically ascertaining language delay at age 4 years followed by the Language for Learning intervention. Here, we report the trial’s definitive 6-year outcomes. Randomized trial nested in a population-based ascertainment. Children with language scores & .25 SD below the mean at age 4 were randomized, with intervention children receiving 18 1-hour home-based therapy sessions. Primary outcome was receptive/expressive language. Secondary outcomes were phonological, receptive vocabulary, literacy, and narrative skills parent-reported pragmatic language, behavior, and health-related quality of life costs of intervention and health service use. For intention-to-treat analyses, trial arms were compared using linear regression models. Of 1464 children assessed at age 4, 266 were eligible and 200 randomized 90% and 82% of intervention and control children were retained respectively. By age 6, mean language scores had normalized, but there was little evidence of a treatment effect for receptive (adjusted mean difference 2.3 95% confidence interval [CI] –1.2 to 5.7 P = .20) or expressive (0.8 95% CI –1.6 to 3.2 P = .49) language. Of the secondary outcomes, only phonological awareness skills (effect size 0.36 95% CI 0.08–0.65 P = .01) showed benefit. Costs were higher for intervention families (mean difference AU$4276 95% CI: $3424 to $5128). Population-based intervention targeting 4-year-old language delay was feasible but did not have lasting impacts on language, possibly reflecting resolution in both groups. Long-term literacy benefits remain possible but must be weighed against its cost.

Data to Decisions: Methods to Create Neighbourhood Built Environment Indicators Relevant for Early Childhood Development

Publisher: MDPI AG

Date: 03-05-2022

DOI: 10.3390/IJERPH19095549

Abstract: Healthy development in the early years lays the foundations for children’s ongoing physical, emotional, and social development. Children develop in multiple contexts, including their local neighbourhood. Neighbourhood-built environment characteristics, such as housing, walkability, traffic exposure, availability of services, facilities, and parks, are associated with a range of health and wellbeing outcomes across the life course, but evidence with early years’ outcomes is still emerging. Data linkage techniques were used to assemble a dataset of spatial (objectively-measured) neighbourhood-built environment (BE) measures linked to participant addresses in the 2015 Australian Early Development Census (AEDC) for children living in the 21 most populous urban and regional Australian cities (n = 235,655) to help address this gap. This paper describes the methods used to develop this dataset. This linked dataset (AEDC-BE) is the first of its kind worldwide, enabling opportunities for identifying which features of the built environment are associated with ECD across Australia at scale, allow comparisons between erse contexts, and the identification of where best to intervene. National data coverage provides statistical power to model real-world complexities, such as differences by city, state/territory, and remoteness. The neighbourhood-built environment can be modified by policy and practice at scale, and has been identified as a way to help reduce inequitable early childhood development outcomes.

Child and caregiver mental health during 12 months of the COVID-19 pandemic in Australia: findings from national repeated cross-sectional surveys

Publisher: Cold Spring Harbor Laboratory

Date: 29-08-2021

DOI: 10.1101/2021.08.26.21262708

Abstract: There are calls for research into the mental health consequences of living through the COVID-19 pandemic. Australia’s initial, effective suppression of COVID-19 offers insights into these indirect impacts in the relative absence of the disease. We aimed to describe the mental health experiences of Australian caregivers and children over 12 months, reporting differences related to demographic, socioeconomic and lockdown characteristics. Data were from Australia’s only nationally representative, repeated cross-sectional survey of caregivers with children (0-17 years). N=2020 caregivers participated in June 2020, N=1434 in September 2020, and N=2508 in July 2021. Caregivers reported their mental health (poor versus not, Kessler-6), and perceived impacts of the pandemic on theirs and their children’s mental health (negative versus none ositive). Data were weighted to approximate population distributions of caregiver age, gender, sole-caregiving, number and ages of children, state/territory and neighbourhood-level disadvantage. Perceived impacts on mental health were more frequently negative for female (versus male) caregivers and older (versus younger) children. Poor caregiver mental health (K6) was more common for families experiencing socioeconomic adversity (especially financial), while perceived impacts were more frequently negative for more socially advantaged groups. Caregivers who experienced the least total lockdown reported similar K6 over time. Otherwise, poor mental health and perceived negative impacts increased over time with increasing total length of lockdown. Despite Australia’s low infection rates, the negative mental health experiences of the COVID-19 pandemic are real and concerning. Addressing poor mental health must be central to ongoing pandemic recovery efforts for families and children. - The global evidence shows that, for general adult populations, psychological distress peaked in the first months of the COVID-19 pandemic before appearing to improve. - Less is known about mental health over time of living through the pandemic, especially for caregivers and children. There are urgent calls for research. - Due to low infection rates, Australia’s experience can provide insight into the mental health impacts of lockdown with minimal compounding harms of the virus. - From June 2020 to July 2021, Australia’s lockdowns were detrimental for caregiver and child mental health. - Negative mental health experiences differed by caregiver gender, child age and family socioeconomic characteristics. - Pandemic response and recovery planning must consider both family mental health and socioeconomic security.

The Impact of Nurse Home Visiting on the Use, Dose and Quality of Formal Childcare: 3-Year Follow-Up of a Randomized Trial

Publisher: Elsevier BV

Date: 03-2022

DOI: 10.1016/J.ACAP.2021.07.022

Abstract: We investigated whether nurse home visiting (NHV) affects the uptake and quality of formal early childhood education and care (ECEC) at child ages 2 and 3 years, and reasons for using ECEC at 3 years. Design: Secondary analysis of the "right@home" randomized trial of NHV. 722 pregnant Australian, English-speaking women experiencing adversity recruited from antenatal clinics across 2 states. 25 nurse home visits to 2 years Control: universal well-child nursing service. Parents reported formal ECEC use (government approved and subsidized), comprising long or family day care (LDC), and reasons for use. ECEC quality was classified using the Australian government's national ratings. Eighty-three percent of parents provided data at 2 years (306 intervention/290 control) and 69% at 3 years (255 intervention/240 control). Intention-to-treat analyses were conducted using adjusted regression models, addressing missing data using multiple imputation and inverse probability weighting. There was no evidence of group differences in ECEC uptake or quality, although control families may have used more LDC at 3 years (mean difference 2.8 hours, 95% confidence interval, -0.2 to 5.8 hours). Intervention parents reported using ECEC to support their children's social development more frequently than controls (48% vs 33%) but less for work/study (39% vs 46%). The right@home NHV program did not impact ECEC uptake or quality, although it may influence parents' reasons for using ECEC. If supported by policy and provision, there is an opportunity for NHV programs to promote the transition to high-quality ECEC and evaluate the synergistic benefit on children's development.

Trends in the prevalence and distribution of teacher‐identified special health‐care needs across three successive population cohorts

Publisher: Wiley

Date: 30-08-2018

DOI: 10.1111/JPC.14192

Abstract: Some children's special health-care needs (SHCN) are formalised at the start of schooling (established SHCN), but a larger proportion start with difficulties that are milder or not yet diagnosed (emerging SHCN). This study explores whether: (i) the prevalence of teacher-identified SHCN (both overall and according to type of needs) and (ii) distribution across disadvantaged communities have changed over three successive population cohorts of Australian children. We draw on repeated cross-sectional data from the Australian Early Development Census, a teacher-reported checklist completed on full populations of Australian school entrants in 2009, 2012 and 2015. It includes a measure of SHCN, as well as demographic information. The proportion of children with emerging and established needs was mostly stable from 2009 to 2015 (emerging needs: 17.1-18.9% established needs: 4.4-4.9%). Change over time was observed in the prevalence of some specific types of impairment. Speech impairment rose by 14.7% for children with emerging needs, and emotional problems rose by 13.7% for children with established needs. Children living in the most disadvantaged neighbourhoods had higher odds of SHCN in all years (e.g. emerging needs relative risk ratio 1.65 (99% confidence interval 1.55-1.75) in 2015 established needs relative risk ratio 1.88 (99% confidence interval 1.71-2.06) in 2015). A large proportion of children starting school each year have SHCN. The types of SHCN that children present with increasingly reflect complex difficulties that require input from both the health and education sectors. Effective responses also need to consider the added impact of disadvantage.

Inequalities in the distribution of COVID‐19‐related financial difficulties for Australian families with young children

Publisher: Wiley

Date: 13-04-2022

DOI: 10.1111/CCH.13010

Abstract: We examine (1) the frequency of financial difficulties in Australian families with young children (0–8 years) in the early and later phases of the pandemic (2) the extent to which parents' pre‐pandemic socio‐economic disadvantage (SED) predicted financial difficulties and (3) whether grandparent intergenerational SED further lified this risk. Data : Australian Temperament Project (ATP established 1983, N = 2443) and ATP Generation 3 study (ATPG3 established 2012 N = 702), of which 74% ( N = 553) completed a COVID‐specific module in the early (May–September 2020) and/or later (October–December 2021) phases of the pandemic. Outcomes : Parent‐reported loss of employment/reduced income, difficulty paying for essentials, and financial strain. Exposures : Pre‐pandemic parent and grandparent education and occupation. Analysis : Logistic regressions, estimated via generalized estimating equations, were used to examine associations between the pre‐pandemic SED of parents and grandparents and their interaction with financial difficulties, adjusting for potential confounders. At both pandemic time points, a third of parents reported adverse financial impacts (early: 34%, 95% confidence interval [CI] = 30–38 later: 32%, 95% CI = 28–36). Each standard deviation increase in the parents' pre‐pandemic SED was associated with a 36% increase in the odds of reporting multiple financial difficulties (odds ratio [OR] = 1.36, 95% CI = 1.04–1.78). There was little evidence of an interaction between the SED of parents and grandparents. Financial impacts related to the COVID‐19 pandemic were common and, irrespective of grandparent SED, disproportionately borne by parents with higher pre‐pandemic SED. Given the well‐established relationship between disadvantage and child health and development, sustained and well‐targeted government supports will be critical to minimizing adverse impacts in years to come.

What's data got to do with it? A scoping review of data used as evidence in policies promoting the health of Aboriginal and Torres Strait Islander children in the Northern Territory, Australia

Publisher: Wiley

Date: 25-10-2023

DOI: 10.1002/HPJA.670

Abstract: Accurate data on the health of Australia's First Nations peoples is critical in determining appropriate public health programs and establishing a baseline against which to measure progress. The effective translation of evidence into practice continues to be a challenge for Australian health departments and policymakers. The objective of this scoping review was to (i) determine the extent and range of policies relevant to the health and well‐being of Aboriginal and Torres Strait Islander children in the Northern Territory (NT) to (ii) identify what data is reported to be used as evidence to reconcile policy goals with outcomes, (iii) to describe issues acknowledged by policy makers relating to data availability and/or limitations, and to (iv) examine how principles of Indigenous inclusion and self‐determination are included in these policies. A search for current policy documents, strategic plans/initiatives or frameworks was conducted across Ovid Medline, PubMed, Informit, Scopus, in addition to a web‐based search for grey literature. Current policy documents for the period 2010‐2021 were included providing at least one of the goals or objectives were relevant to the health and well‐being of Australian Aboriginal and Torres Strait Islander children from the NT. The search located 2610 unique citations. Full‐text screening was conducted on 85 documents, a total of 49 policy documents or strategic plans/frameworks were included in the final synthesis. The source of data being used as evidence was unclear or absent in 10 of the 49 (20.4%) identified policy documents. Limitations of the available data were mentioned to some extent, but detailed information on quality and completeness was largely absent. In mapping the key principles of working in Aboriginal and Torres Strait Islander health contexts, only two policies articulated the need for information sharing and data governance. This review underscores the importance of providing clear information about which data is being used to inform policy decisions so that they may be evaluated and critiqued in meaningful ways that ensure decision makers are accountable. Specific data items and/or indicators should be explicitly referenced as evidence used in the development of policies promoting the health of Aboriginal and Torres Strait Islander children and their communities from the outset so that evaluation is clear and policy makers are held accountable.

The Future Healthy Countdown 2030: holding Australia to account for the health and wellbeing of future generations

Publisher: Wiley

Date: 11-10-2022

DOI: 10.5694/MJA2.51746

Concurrent associations between maternal behaviours and infant communication within a cohort of women and their infants experiencing adversity

Publisher: Informa UK Limited

Date: 06-07-2017

DOI: 10.1080/17549507.2017.1329458

Abstract: Evidence suggests that children living in adversity are at greater risk of poorer language than their peers with the quality of parental interactions potentially mediating this association. Studies typically measure the mediatory impact of generic interaction styles making it difficult to discern which particular aspects of the interaction are facilitating language. This study aims to bridge this gap by identifying specific maternal behaviours associated with concurrent infant communication, in a cohort of 12-month old infants and their mothers experiencing adversity. A total of 249 mother-infant free-play videos were collected from women experiencing adversity in Victoria and Tasmania, Australia. From those videos, specific maternal behaviours, infant communication acts and the interaction quality were coded. Maternal verbal imitations uniquely predicted concurrent use of infant vocalisations, total words and unique words. Furthermore, the more fluent and connected the mother-infant dyad, the stronger the association between imitations and all three infant measures. Frequent use of maternal imitations, within highly connected mother-infant dyads, may help mediate the impact of adversity on early communication. This information is important for early years professionals working with at-risk populations in augmenting current knowledge of risk and protective factors related to early language.

Polyethylene Glycol Dosing for Constipation in Children Younger Than 24 Months: A Systematic Review

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 09-06-2020

DOI: 10.1097/MPG.0000000000002786

Abstract: Evaluate safety and effectiveness of Polyethylene glycol (PEG) for chronic constipation in children aged younger than 24 months. Identify the optimum dose of PEG to manage chronic constipation in children aged younger than 24 months. In this systematic review, Embase, Medline Ovid, Pubmed, and the Cochrane Library were searched between January 1, 2000 and February 1, 2019. Studies investigating functional constipation, in which patients younger than 24 months of age were treated with PEG, were considered as potentially eligible for review. Two authors screened the studies against inclusion/exclusion criteria. Study quality was assessed with the PEDro quality assessment, Cochrane risk of bias tool, and/or the Newcastle-Ottawa Scale. Five studies (2 randomized controlled trials, 3 retrospective chart reviews) satisfied selection criteria (n = 459). All studies employed different dosage categories: mean effective maintenance dose, mean initial dose, mean short-term and long-term dose, and mean daily dose. Dosage regimens were variable, with 0.45 to 1.1 g · kg −1 · day −1 for PEG3350 and 0.48 to 0.65 g · kg −1 · day −1 for PEG4000. Adverse effects were transient across all studies for all types of PEG these included diarrhea and abdominal pain. This systematic review provided evidence for a lack of reported side effects from PEG for children aged younger than 24 months. Evidence to establish appropriate dosage regimens does not exist. An infographic accompanying this article can be found at links.lww.com/MPG/B839.

Inequity in child health: The importance of early childhood development

Publisher: Wiley

Date: 29-03-2013

DOI: 10.1111/JPC.12171

Health needs and timeliness of assessment of Victorian children entering out‐of‐home care: An audit of a multidisciplinary assessment clinic

Publisher: Wiley

Date: 09-04-2019

DOI: 10.1111/JPC.14472

Abstract: To describe the health needs identified in children attending a comprehensive health assessment at a tertiary hospital, multidisciplinary clinic for children following entry to out-of-home care and timeliness of referral and assessment compared with national recommendations. This was a retrospective audit of all the children who attended the Pathway to Good Health clinic at The Royal Children's Hospital, Melbourne from May 2013 until 31 August 2016. A total of 119 children aged 0-12 years attended the clinic during the audit period. Of these children, 17% (including more than 30% of 0-2-year-olds) were not up-to-date with immunisations, and 87% had physical health concerns that were addressed on the day or needed further management. Over 50% had mental health concerns identified (76% of 7-12-year-olds). In children aged 3-6 years, 64% had behavioural problems and 77% had developmental problems identified. Only a third of the children was referred to the Pathway to Good Health clinic within the national standard of 30 days post-entry to care, and 24% of children attended within 3 months of entry to care. Children in out-of-home care within Victoria have high rates of physical, mental and developmental health concerns, consistent with previous studies. Timeliness of attendance at the clinic was low compared with national recommendations, even within a programme designed to facilitate timely health checks. This is the second and largest Australian study exploring timeliness of health checks. Further research would establish whether these results are more systemic.

Understanding the impact of special health care needs on early school functioning: a conceptual model

Publisher: Wiley

Date: 10-06-2014

DOI: 10.1111/CCH.12164

Abstract: Children with special health care needs (SHCN) have or are at increased risk for a chronic condition that necessitates more health and related supports than their peers. While it is generally accepted that these children are at risk for school failure, the mechanisms through which SHCN impact on children's experiences (and therefore opportunities to intervene) at school are still relatively poorly understood. Based on the current literature, this paper provides a conceptual framework to guide further discussion of this issue in research, policy and practice. Evidence from the literature was reviewed and existing frameworks examined. We propose that SHCN impact on four interrelated domains of children's functioning: (1) body functions and structures (2) activities of daily living (3) social participation and (4) educational participation. Children's functioning is further influenced by risk and protective factors that can be identified at the level of the child, family and service systems. Together, these processes contribute to shaping either positive or negative trajectories of school functioning. The mechanisms influencing school experiences for children with special health care needs are complex, with opportunities for positive interventions at a range of levels. The proposed conceptual model provides an accessible tool for guiding discussion of the support needs of this vulnerable population.

Connecting healthcare with income maximisation services, and their financial, health and well-being impacts for families with young children: a systematic review protocol

Publisher: BMJ

Date: 12-2021

DOI: 10.1136/BMJOPEN-2021-056297

Abstract: Poverty has far-reaching and detrimental effects on children’s physical and mental health, across all geographies. Financial advice and income-maximisation services can provide a promising opportunity for shifting the physical and mental health burdens that commonly occur with financial hardship, yet awareness of these services is limited, and referrals are not systematically integrated into existing healthcare service platforms. We aim to map and synthesise evidence on the impact of healthcare-income maximisation models of care for families of children aged 0–5 years in high-income countries on family finances, parent/caregiver(s) or children’s health and well-being. To be included in the review, studies must be families (expectant mothers or parents/caregivers) of children who are aged between 0 and 5 years, accessing a healthcare service, include a referral from healthcare to an income-maximisation service (ie, financial counselling), and examine impacts on child and family health and well-being. A comprehensive electronic search strategy will be used to identify studies written in English, published from inception to January 2021, and indexed in MEDLINE, EMBase, PsycINFO, CINAHL, Proquest, Family & Society Studies Worldwide, Cochrane Library, and Informit Online. Search strategies will include terms for: families, financial hardship and healthcare, in various combinations. Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies, and grey literature will also be searched. Data on objective and self-reported outcomes and study quality will be independently extracted by two review authors any disagreements will be resolved through a third reviewer. The protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Ethical approval is not required. The results will be disseminated widely via peer-reviewed publication and presentations at conferences related to this field. CRD42020195985.

A global perspective of Indigenous child health research: a systematic review of longitudinal studies

Publisher: Oxford University Press (OUP)

Date: 17-04-2021

DOI: 10.1093/IJE/DYAB074

Abstract: Rigorously designed longitudinal studies can inform how best to reduce the widening health gap between Indigenous and non-Indigenous children. A systematic review was performed to identify and present the breadth and depth of longitudinal studies reporting the health and well-being of Indigenous children (aged 0–18 years) globally. Databases were searched up to 23 June 2020. Study characteristics were mapped according to domains of the life course model of health. Risk of bias was assessed using the National Institutes of Health (NIH) Study Quality Assessment Tools. Reported level of Indigenous involvement was also appraised PROSPERO registration CRD42018089950. From 5545 citations, 380 eligible papers were included for analysis, representing 210 in idual studies. Of these, 41% were located in Australia (n = 88), 22.8% in the USA (n = 42), 11.9% in Canada (n = 25) and 10.9% in New Zealand (n = 23). Research tended to focus on either health outcomes (50.9%) or health-risk exposures (43.8%) 55% of studies were graded as ‘good’ quality and 89% of studies made at least one reference to the involvement of Indigenous peoples over the course of their research. We identified gaps in the longitudinal assessment of cultural factors influencing Indigenous child health at the macrosocial level, including connection to culture and country, intergenerational trauma, and racism or discrimination. Future longitudinal research needs to be conducted with strong Indigenous leadership and participation including holistic concepts of health. This is critical if we are to better understand the systematic factors driving health inequities experienced by Indigenous children globally.

Resolving Developmental Inequities For Children

Start Date: 2016

End Date: 2018

Funder: Australian Research Council

Cluster Randomised Control Trial Of An Early Childhood Literacy Intervention To Improve Literacy And Language Outcomes In Preschool Aged Children

Start Date: 2005

End Date: 2010

Funder: Australian Research Council

Addressing Refugee Inequalities Through Primary Health Care Service Reform

Start Date: 2013

End Date: 2017

Funder: National Health and Medical Research Council

Preventing Early Language Delay In Primary Care

Start Date: 2007

End Date: 2009

Funder: National Health and Medical Research Council

Models Of Child Health Appraised

Start Date: 2015

End Date: 2018

Funder: National Health and Medical Research Council

Centre For Research Excellence In Childhood Language

Start Date: 2012

End Date: 2017

Funder: National Health and Medical Research Council

Child Health And Developmental Inequities: Evidence For Precision Policy

Start Date: 2020

End Date: 2023

Funder: Australian Research Council

Improving Outcomes Of Preschool Language Delay In The Community: Randomised Trial

Start Date: 2010

End Date: 2013

Funder: National Health and Medical Research Council

The Kids In Communities Study: National Investigation Of Community Level Effects On Children's Developmental Outcomes

Start Date: 2013

End Date: 2016

Funder: Australian Research Council

Linkage Projects - Grant ID: LP210300558

Start Date: 04-2023

End Date: 04-2027

Amount: $917,285.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP0664429

Start Date: 2006

End Date: 12-2013

Amount: $750,000.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP160101735

Start Date: 06-2016

End Date: 06-2020

Amount: $580,000.00

Funder: Australian Research Council

Research Networks - Grant ID: RN0460314

Start Date: 12-2004

End Date: 12-2010

Amount: $1,750,000.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP130100308

Start Date: 06-2014

End Date: 02-2018

Amount: $570,000.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP100100693

Start Date: 08-2010

End Date: 02-2014

Amount: $240,000.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP190100921

Start Date: 04-2021

End Date: 04-2024

Amount: $475,014.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP130100411

Start Date: 06-2014

End Date: 12-2018

Amount: $568,815.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP0561522

Start Date: 07-2005

End Date: 06-2011

Amount: $272,000.00

Funder: Australian Research Council