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Objectives: Children's additional health and developmental needs are often first identified by teachers when they begin school. This study estimates the Grade 3 literacy and numeracy outcomes of children with teacher‐identified additional needs emerging in the first year of school, including the added burden conferred by socioeconomic disadvantage. Methods: Population linked data (n = 42,619) were analysed from the Australian Early Development Census, which include teacher reports on children's health and development at school entry, and the National Assessment Program–Literacy and Numeracy, a direct assessment of reading and numeracy skills at Grade 3. Linear regression analyses were used to estimate associations between emerging needs and learning outcomes, adjusted for sociodemographic characteristics. The combined effect of emerging needs and low maternal education (an indicator of socioeconomic disadvantage) on academic outcomes was examined by estimating the relative excess risk due to interaction (RERI). Results: Emerging health and developmental needs at school entry were associated with lower reading (b = −26.86, 95% CI = −29.19, −24.52) and numeracy (b = −24.39, 95% CI = −26.43, −22.35) outcomes at Grade 3. The combined effect of emerging needs and socioeconomic disadvantage was greater than expected when their individual effects are summed (RERI = 0.38, 95% CI 0.22, 0.55 for reading and RERI = 0.27, 95% CI 0.10, 0.43 for numeracy). Conclusion: In the current study, emerging health and developmental needs identified by teachers at the outset of schooling were associated with poorer literacy and numeracy skills at Grade 3, and family socioeconomic disadvantage appeared to further amplify this effect. Meeting the needs of these children will require timely and coordinated supports across the health and education systems, particularly for those children who are also disadvantaged. [ABSTRACT FROM AUTHOR]

Abstract: Background: 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. Methods: 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. Results: 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. Conclusion: 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. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: Outcomes for children with special health care needs (SHCN) can vary by their patterns and persistence over time. We aimed to empirically establish typical SHCN trajectories throughout childhood and their predictive relationships with child and parent outcomes. METHODS: The 2 cohorts of the nationally representative Longitudinal Study of Australian Children were recruited in 2004 at ages 0 to 1 (n = 5107, B cohort) and 4 to 5 years (n = 4983, K cohort). The parent-reported Children With SHCN Screener (Short Form) was completed at each of 4 biennial waves. Wave 4 outcomes were parent-reported behavior and health-related quality of life, teacher-reported learning, and directly assessed cognition. Both parents self-reported mental distress. We derived intracohort trajectories by using latent class analysis in Mplus. We compared mean outcome scores across trajectories by using linear regression, adjusting for socioeconomic position. RESULTS: Four distinct SHCN trajectories were replicated in both cohorts: persistent (B 6.8%, K 8.7%), emerging (B 4.1%, K 11.5%), transient (B 7.9%, K 4.2%), and none (B 81.3%, K 75.6%). Every outcome was adversely affected except fathers' mental health. From infancy to age 6 to 7 years, the persistent and emerging groups had similarly poor outcomes. From age 4 and 5 to 10 and 11 years, outcomes were incrementally poorer on moving from none to transient to emerging and to persistent SHCN. Effect sizes were largest for behavior, learning, and psychosocial outcomes. CONCLUSIONS: Adverse outcomes are shaped more by cumulative burden than point prevalence of SHCNs. In addition to providing care according to a child's need at any given time, prioritizing care toward persistent SHCNs may have the biggest benefits for children and parents. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the feasibility of screening for child sleep problems and the efficacy of a behavioral sleep intervention in improving child and parent outcomes in the first year of schooling. METHODS: A randomized controlled trial was nested in a population survey performed at 22 elementary schools in Melbourne, Australia. Intervention involved 2 to 3 consultations that covered behavioral sleep strategies for children whose screening results were positive for a moderate/severe sleep problem. Outcomes were parent-reported child sleep problem (primary outcome), sleep habits, psychosocial health-related quality of life, behavior, and parent mental health (all at 3,6, and 12 months) and blinded, face-to-face learning assessment (at 6 months). RESULTS: The screening survey was completed by 1512 parents; 161 (10.8%) reported a moderate/severe child sleep problem, and 108 of 136 (79.2% of those eligible) entered the trial. Sleep problems tended to resolve more rapidly in intervention children. Sleep problems affected 33% of 54 intervention children versus 43% of 54 control children at 3 months (P = .3), 25.5% vs 46.8% at 6 months (P = .03), and 32% vs 33% at 12 months (P = .8). Sustained sleep-habit improvements were evident at 3,6, and 12 months (effect sizes: 0.33 [P = .03]; 0.51 [P = .003]; and 0.40 [P = .02]; respectively), and there were initial marked improvements in psycho-social scores that diminished overtime (effect sizes: 0.47 [P = .02]; 0.41 [P = .09]; and 0.26 IP = .3]; respectively). Better prosocial behavior was evident at 12 months (effect size: 0.35; P = .03), and learning and parent outcomes were similar between groups. CONCLUSIONS: School-based screening for sleep problems followed by a targeted, brief behavioral sleep intervention is feasible and has benefits relevant to school transition. [ABSTRACT FROM AUTHOR]

BACKGROUND: Early shared reading and literacy promotion benefits have stimulated international interest in the development of early- years literacy-promotion programs despite limited evidence of effectiveness at a broader population level. OBJECTIVE: To determine whether a population-based primary care literacy promotion intervention during the first 2 years of life improves early markers of subsequent literacy by 2 years of age. DESIGN AND METHODS: This cluster randomized controlled trial took place in 5 relatively disadvantaged areas in Melbourne, Australia. Infants attending their maternal and child health centers were recruited at age 1-2 months. The intervention (4-8, 12, and 18 months) comprised maternal and child health nurses modelling shared reading activities to parents, supported by parent information and free books. Outcomes (at 2 years) included expressive vocabulary (MacArthur Bates Communicative Development Inventory), communication (Communication and Symbolic Behavior Scales), and home literacy environment (StimQ-Toddler). We analyzed the outcomes using random-effects (linear regression) models allowing for clustering. RESULTS: A total of 552 families (87.6%; 324 intervention and 228 control families) of 630 recruited families (66.5% response) were retained to outcome. A total of 97.3% of intervention parents received some (93.7% to all) of the intervention. At 2 years, the trial arms had similar vocabulary (adjusted mean difference: -2.0 [95% confidence interval: -6.2 to 2.2]; P = .36), communication (adjusted mean difference: 0.2 [95% confidence interval: -2.3 to 2.7]; P = .87), and home literacy (adjusted mean difference: -0.4 [95% confidence interval: -1.0to 0.2]; P= .21). CONCLUSIONS: This universal literacy-promotion program was not beneficial in relatively disadvantaged communities by the age of 2 years and may be ineffective. Alternative interpretations may relate to program intensity, reach and/or sleeper effects. Definitive outcomes at 4 years are awaited. Pediatrics 2011;127:445-453 [ABSTRACT FROM AUTHOR]