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Objectives: Early childhood education and care (ECEC) services are attended by most children before school entry, reaching many living in circumstances of poverty and providing opportunity to support their nutrition. In this study, we examine the extent to which this opportunity is being met, comparing two common types of service provision: centre- versus family- provided food. Methods: Intensive in-situ observations were undertaken across 10 ECEC services in highly disadvantaged Australian communities. All meals provided to children aged 3.5–5 years across an ECEC day (N = 48), of which 11% were experiencing severe food insecurity, were photographed and analysed to assess nutritional adequacy with reference to national dietary standards. Results: Meals provided did not meet national dietary recommendations for quality or quantity. Nutrition was least adequate in services with policies of family-provided food. These services were also those that served families experiencing the highest levels of severe food insecurity (29%). Conclusions: In the absence of policies for the provision of food in ECEC, services are not realising their potential to support child nutrition in the context of poverty presenting increased risk to lifetime trajectories of health and wellbeing. System level policy interventions are required to facilitate equitable access to nutritious food and attendant life chances. Significance: ECEC services present an important opportunity to address social inequities, including inequities associated with experiences of poverty. Yet, to date knowledge of the extent to which ECEC services are meeting the nutritional needs of children remains unclear. This study provides evidence from an intensive data collection in ECEC services located in areas at high risk of poverty. Our findings suggest that the nutritional needs of children are not being met within these services, but particularly where provision of food is the responsibility of families. This article highlights the need for system level policies for food provision to overcome perpetuation of poverty for these children. [ABSTRACT FROM AUTHOR]

Background: In developed economies, most children attend Early Childhood Education and Care (ECEC) services before school entry, many from early life and across long days. For this reason, ECEC services present significant potential to provide food environments that positively influence eating behaviours and food preferences with attendant effect on life course trajectories of health and wellbeing. Yet there is evidence that feeding practices that limit optimal ongoing nutrition, such as pressure and restriction, are amplified in ECEC services serving disadvantaged communities. We sought to identify underlying explanatory mechanisms through observation of children's feeding experiences and educator explanations comparing, family‐provided and service‐provided meals. Method: This study used qualitative analyses of educator interviews and observation records from 55 mealtimes in 10 ECEC services: 5 providing food and 5 requiring family food provision. Results: High levels of concern drove educator's controlling feeding practices at mealtimes but presented differently across meal provision modes. In centres that provided food, educators' concern focused on food variety, manifesting in pressure to 'try' foods. In centres requiring family‐provided food, concern focused on nutrition quantity and quality and manifested as control of order of food consumption and pacing of intake to ensure food lasted across the day. Interview data suggested that conflict aversion limited optimal nutrition. In centres providing food, this was seen in menus that prioritized child food preferences. In centres requiring family meal provision, conflict aversion was seen as reticence to discuss lunchbox contents with families. Conclusion: The findings direct attention to public health intervention. Currently, ECEC face significant barriers to realizing their potential to support child nutrition and establish positive life course trajectories of nutrition. To do so requires targeted supports that enable sufficient supply and quality of food in the context of poverty. [ABSTRACT FROM AUTHOR]

Observational studies comparing child outcomes in early care and education classrooms of differing quality are often confounded by between‐child differences. A within‐child design, tracking children across contexts, can identify the effects of quality with less confounding. An analysis of Australian children (N = 1128, mean age 5 years, 48% female, 2.9% Indigenous, ethnicity data unavailable) tracked across pre‐K, K, and year 1 (2010–2012) was conducted to assess how changes in observed quality (Classroom Assessment Scoring System) were associated with changes in cognitive development (Woodcock–Johnson III). Thresholds of quality were also investigated. Increases in Emotional Support were associated with improved language development (β = 0.54, 95% CI [0.1–0.99], approximating 2.6 weeks development). Results highlight that emotional quality is an integral and potent component of early learning. [ABSTRACT FROM AUTHOR]

Quality early care and education (ECE) presents an unparalleled opportunity to avert disadvantage and promote children's development. Mealtimes are essential daily routines, yet are often overlooked in research on ECE quality. This paper crystallises a composite case study of ECE mealtimes in highly disadvantaged communities by combining Departing Radically in Academic Writing (DRAW) methodology with parent surveys, scorings of educator‐child interactions (inCLASS), and field notes. Poverty is perpetuated in these centres: children do not have enough food, and educator‐dictated feeding practices restrict children's opportunities to exercise their agency and learn. Systemic policy action is needed to address poverty in ECE. [ABSTRACT FROM AUTHOR]

• Whole-population analysis of access to high-quality ECE using a national standard. • Inequities of access associated with geographic and socio-economic disadvantage. • Recent immigrants over-represented in poor quality services. • Calls for interrogation and identification of effective thresholds of quality. The United Nations Sustainable Development Goal (4.2) calls for all children to have access to high quality Early Childhood Education (ECE), recognising the potential of ECE to promote children's development and ongoing national prosperity. Yet, in marketized systems both structural features (availability and affordability of services) and social factors (family knowledge and social connection) can drive inequitable access to the highest quality provision. In the current study, we analyse data for N =77,113 children in Australia's new whole-population integrated database to ask: Who accesses high-quality ECE services? Australia's national quality rating of ECE services provided whole-of-country standard measurement of ECE quality. We find that, although Australia provides an income-scaled subsidy to families to enable ECE attendance, inequalities are seen in the quality of service accessed. Families experiencing socio-economic disadvantage and those living in regional and remote locations are under-represented in services rated high-quality. Recent immigrants, regardless of their economic status, are most likely to attend poorer quality services. These findings highlight the need to identify and remediate mechanisms preventing those most likely to benefit from the highest quality ECE from access. Such actions are critical to deliver on the promise of ECE to disrupt intergenerational disadvantage and enable sustainable national development. [ABSTRACT FROM AUTHOR]

Summary This paper describes the longitudinal change in sleep, functional, and behavioural characteristics in a cohort of children with Down syndrome, including the effect of sleep interventions in a subset. A prospective longitudinal cohort study was undertaken in children with Down syndrome aged 3–16 years comparing (1) children referred to a tertiary sleep medicine clinic who received sleep hygiene advice and an additional sleep treatment (DSref_I) with (2) children attending the same clinic who only received sleep hygiene advice (DSref_N) and (3) children recruited from the community who, were not receiving any treatment (DScomm). Data collected included demographic and medical history information, Child Sleep Habits Questionnaire‐Abbreviated (CSHQ‐A), Life‐Habits Questionnaire (Life‐H) and Child Behaviour Checklist (CBCL) at baseline and then 6‐monthly for a total of 18 months. Any sleep interventions during this time were recorded. A total of 57 children were included (DSref_I, n = 16; DSref_N, n = 25; DScomm, n = 16). At recruitment, the median CSHQ‐A total score was high (>41) in all three subgroups, but highest in the DSref_I subgroup (median [interquartile range] Dsref_I score 58 [53–66] versus DSref_N score 49 [43–53], p = 0.019). Although improved, 80% of participants in the DSref_I subgroup still had a CSHQ‐A total score >41 at the last assessment point. The median total Life‐H and total CBCL scores were not significantly different between groups at baseline and there was no significant time, group, or interaction effect seen through the study. Over an 18‐month period, sleep problems were seen to persist in children with Down syndrome. Treatment resulted in only modest improvements in sleep. [ABSTRACT FROM AUTHOR]

Preschool children consume a large proportion of their daily food intake in their childcare settings. These settings, therefore, provide important opportunities for children to experience food socialisation, and related positive nutrition. Yet, the extent to which these opportunities are taken, particularly in socioeconomically disadvantaged areas where risk of poor nutrition is high, is not well documented. This study focused on 10 childcare centres in socially disadvantaged locations and examined daily feeding practices via direct in-situ observation (n = 189 children observed). Centres were randomly selected based on type of food provision: centre-provided (n = 5 centres) or family-provided (n = 5 centres). Analyses showed that where food was family-provided, educators were significantly more likely to use controlling feeding practices, including pressuring children to eat, restricting food choices and rushing children into finishing meals. These practices were particularly evident during mid-morning meals, where pressuring children to eat healthy foods first, was more often observed. Further research and interventions that target feeding practices in childcare are indicated and should consider how source of food provision impacts upon these practices. [ABSTRACT FROM AUTHOR]

Families of children with Down syndrome experience complex lives and needs, yet the few existing studies on these families are written in conventional academic prose that is not optimal for knowledge translation beyond academia, particularly for busy healthcare professionals. In this paper, we Depart Radically in Academic Writing (DRAW) (Mackinlay, 2022) and present data poetry and two case studies that draw upon semi-structured interviews with mothers, fathers, and siblings, who were interviewed separately about their experiences of having a child/sibling with Down syndrome. We introduce our interdisciplinary team that includes academics and clinicians to contextualise our focus on research translation. We demonstrate that writing with creative criticality (i.e. 'DRAWing') contributes an embodied and affective understanding of research participants' stories, which is largely lacking in the academic literature on families of children with Down syndrome and the sociology of health and illness field more broadly. Moreover, DRAWing can impact audiences emotionally as well as intellectually (Richardson, 2003, p. 924), which has important knowledge translation implications for both healthcare professionals and these families. DRAWing can capture healthcare professionals' attention, prompting them to critically reflect on their practices and opportunities for improving care and treatment for these families. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate sleep‐wake behavior and gain insights into perceived impairment (sleep, fatigue, and cognitive function) of athletes competing in two international multi‐day adventure races. Twenty‐four athletes took part across two independent adventure races: Queensland, Australia and Alaska, USA. Individual sleep periods were determined via actigraphy, and racers self‐reported their perceived sleep disturbances, sleep impairment, fatigue and cognitive function. Each of these indices was calculated for pre‐, during‐ and post‐race periods. Sleep was severely restricted during the race period compared to pre‐race (Queensland, 7:46 [0:29] vs. 2:50 [1:01]; Alaska, 7:39 [0:58] vs. 2:45 [2:05]; mean [SD], hh:mm). As a result, there was a large cumulative sleep debt at race completion, which was not ‘reversed’ in the post‐race period (up to 1 week). The deterioration in all four self‐reported scales of perceived impairment during the race period was largely restored in the post‐race period. This is the first study to document objective sleep‐wake behaviors and subjective impairment of adventure racers, in the context of two geographically diverse, multi‐day, international adventure races. Measures of sleep deprivation indicate that sleep debt was extreme and did not recover to pre‐race levels within 1 week following each race. Despite this objective debt continuing, perceived impairment returned to pre‐race levels quickly post‐race. Therefore, further examination of actual and perceived sleep recovery is warranted. Adventure racing presents a unique scenario to examine sleep, performance and recovery. [ABSTRACT FROM AUTHOR]

The international quality-improvement agenda for Early Childhood Education (ECE) directs attention to maximising children's learning experiences. Yet routines, and particularly those relating to sleep-rest provision, are not well conceptualised as learning opportunities. Often children who no longer sleep in the daytime are required to lie down without alternative activity. Educator discourse frames these practices as 'teaching self-regulation', yet these experiences afford little opportunity for child-directed learning, and both observational and cortisol studies suggest the potential for negative learning experiences. Prior studies have examined children's emotional response and identified sleep-rest time as disliked, but have not examined children's accounts of learning. In this study, we analyse accounts of learning from 54 children (mean age = 56 months). Collectively, the children identified three learnings. Most children learned that adults regulate sleep-rest opportunities through instruction, reward, punishment and priveledge. Some children reported learning coping strategies including imagination and subversion. A rare few identitfied learning to self-regulate. The findings identify a discrepancy between policy aspiration and educator intent, that foreground self-regulation and the de facto lessons children draw from their sleep-rest experiences. Our findings identify standard sleep-rest provision as sub-optimal and the imperative to view care routines, such as sleep-rest, as opportunities for learning. [ABSTRACT FROM AUTHOR]

In response to a workforce crisis, Australia's early childhood education and care workforce strategy for the next decade, Shaping our Future, was released in September 2021. This strategy was developed through a three-stage, 'top-down' process in which open consultation on pre-defined strategies was the final stage. Analysing data from the voices of those working at the frontline (N = 794), we take a complementary 'bottom-up' approach, mapping accounts of workforce challenges to Shaping our Future's six focus areas. We identify areas of salience and silence. Recognition, Leadership and Capability, and Wellbeing were salient focus areas while Attraction (and Retention), Qualifications and Career Pathways, and Data and Evidence were not. "Paperwork" and "challenging behaviours" were identified as major impediments to workplace wellbeing and educational effectiveness. Missing strategies identified were review of regulatory burden and redress of place-based inequities for those working with children and families who experience complex and challenging life circumstances. [ABSTRACT FROM AUTHOR]

Sleep disorders are prevalent in children with Down Syndrome (DS). However, sleep treatment is not always readily accessed by this group. This study aims to understand families' experiences of having a child with DS and sleep difficulties, and in particular, their healthcare experiences, with the goal of informing practice improvements. We conducted semi-structured interviews with 34 parents (fathers n = 4 and mothers n = 30) with open-ended questions about parents' experiences of sleep, family dynamics, and healthcare. We operationalized a reflexive Thematic Analysis. Parents normalized their experiences of having a child with DS and sleep problems. Parents acknowledged that sleep disruption has adverse and pervasive impacts on their wellbeing and family dynamics, but also found this difficult to identify as a health problem. They accepted sleep difficulties as a regular part of bringing up any child, particularly one with a disability. When they did seek treatment for their child's sleep difficulties, parents often reported encountering insensitive and inadequate care and described that, at times, healthcare professionals also normalized children's sleep difficulties, resulting in sub-optimal treatment. This included at times failure to refer to tertiary sleep medicine services when required. Parents' and healthcare professionals' normalization of sleeping difficulties denies that they are both deleterious and modifiable. Practice implications include raising healthcare professionals' awareness of the importance of proactively addressing sleep, with sensitivity to families' normalization strategies, recognizing that families may require prompting to report concerns. [ABSTRACT FROM AUTHOR]

Internationally, standard observational measures of Early Childhood Education and Care (ECEC) are used to assess the quality of provision. They are applied as research tools but, significantly, also guide policy decisions, distribution of resources and public opinion. Considerable faith is placed in such measures, yet their validity, reliability and functioning within context should all be considered in interpreting the findings they generate. We examine the case of the Classroom Assessment Scoring System (CLASS) in the Australian study, Effective Early Education for Children (E4Kids). Using this measure Australian educators were identified as "low quality" in provision of instruction (average 2.1 on a scale of 1–7). When these results became public, they attracted negative press coverage and the potential for harm. We interrogate these findings asking three questions relating to sampling, contextual and empirical evidence that define quality and measurement strategies. We conclude that measurement problems, most notably a floor effect, is the most likely explanation for uniformly low CLASS-Instructional scores among Australian ECEC educators, and indeed across international studies. Using a theoretically and empirically informed rescaling strategy we show that there is a diversity of instructional quality across Australian ECEC, and that rescaling might more effectively guide improvement strategies to target those of lowest quality. Beyond, our findings call for a more critical approach in interpretation of standard measures of ECEC quality and their applications in policy and practice, internationally. [ABSTRACT FROM AUTHOR]

In early childhood education and care policy, there are two dominant discourses: 'investment and outcomes' and 'children's rights'. There is little research on how these discourses play out in educators' accounts. In this article, the authors examine the case of discourse pertaining to children's relaxation in early childhood education and care. They demonstrate that Australian relaxation policy for children in early childhood education and care constructs children as passive and incompetent subjects. Some educators reproduce early childhood education and care policy tensions by vacillating between investment-outcomes and children's rights discourse in their accounts, while other educators deviate from the policy constructions and adopt children's rights discourse. [ABSTRACT FROM AUTHOR]

School closures across Australia in response to COVID‐19 have persisted since 2020, with rising mental health problems in children and adolescents, alongside rising negative family health and socioeconomic outcomes. Further, some children and young people who were already experiencing disadvantage pre‐pandemic may be at heightened risk of poorer educational outcomes. Therefore, the aim of this study was to conduct a systematic review of the literature to identify the factors for poorer educational outcomes that may be exacerbated by COVID‐19 amongst disadvantaged school students. Key development stages of disadvantage were identified: young children who started school behind, older students already at risk of disengagement from school and children and young people who have had contact with the child protection system. Five databases were systematically searched, across two search periods. A total of 69 Australian, peer‐reviewed articles, published in 2005–2021, examining risk factors for poor educational outcomes for children attending school met the inclusion criteria and were included in final analyses. Our findings provide evidence of key risk factors that make these populations susceptible to worsening outcomes resulting from the COVID‐19 pandemic, and of the critical importance of ongoing research to guide policy and practice support for these at‐risk groups. [ABSTRACT FROM AUTHOR]

Qualitative researchers can discard data that are unsaturated or unrelated to research questions, but what do we do when these data affect us, or 'haunt' us, 'long after collecting "it"' (Taylor 2013, 691)? In this paper, we draw upon Sara Ahmed to guide our engagement with 'discarded data': young children's gendered accounts of violence that unexpectedly arose during interviews about rest-time and relaxation in childcare. We show what it feels like to be affected by children's accounts throughout the non-linear and zig-zagged 'data analysis' processes. Applying Ahmed's conceptualisation of power as 'directionality', we critique the power of qualitative research conventions to define our focus as researchers and pay attention to what children raise: how they are directed towards gendered futures. We find that, in children's accounts of violence, boys have more agency than girls as they participate in – and respond to – violence. [ABSTRACT FROM AUTHOR]

Across developed economies, most children attend early childhood education and care (ECEC) programs attending up to 10,000 h prior to school. These programs present significant opportunity for public health nutrition interventions through provision of healthy food. We sought to identify whether this opportunity is being taken through analysis of population data from Queensland, Australia. Specifically, we asked if meal provision occurs in locations where risk of food insecurity is high and how economic functioning of ECEC services is associated with meal provision. Of ECEC services in Queensland, (N = 1623) administrative data on meal provision (2020) was available for 947 ECEC services (58.4% of cohort). We assessed the association of meal provision in these services with area indices of social disadvantage (geographic location, social disadvantage, proportion of child developmental vulnerability) and ECEC service economic functioning (fee structure, market competition). ECEC services in remote and rural communities were less likely to provide meals. A similar but weaker trend was evident in socio-economically disadvantaged metropolitan communities. In these locations market competition increased likelihood of meal provision but without fee increase. The competitive market works contrary to the potential for ECEC services to support child nutrition and promote public health. Children living in disadvantaged communities, where food insecurity is inevitably higher, are less likely to have meals provided by their ECEC service. Market competition increases the likelihood of meal provision, yet in disadvantaged communities, parents' ability to pay constrains fees that can be charged raising concern about food quality and effects on quality of provision more broadly. Systemic public supports to enable high quality food provision without compromising other aspects of quality, particularly in the most disadvantaged communities, should be a public health priority. • early education centres in disadvantaged locations are less likely to provide meals • market competition increases likelihood of meal provision in disadvantaged areas • Meal provision in disadvantaged areas is not associated with fee increase • Concerns about food quality and broader quality of provision are raised • Mixed-markets do not realise the potential to support child nutrition and health [ABSTRACT FROM AUTHOR]