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Schools are often seen as a key setting for the provision of mental health support for children. This study aimed to explore the professional perspectives of primary school educators in Victoria, Australia, regarding how schools can support the mental health of their students. Semi-structured interviews and focus groups were conducted with 17 primary school educators, from four schools. Thematic analysis was used to generate themes from the data. This study indicates that educators report significant concerns about the complexities of their role and their capacity to support children's mental health due to a lack of resources, overwhelming demands, and inadequate training. Educators highlighted the importance of partnership and communication with families and of a school culture that prioritises mental health. This study provides insights into external factors that can undermine effective support of children's mental health within primary schools and indicates a need for a more integrated approach to supporting children's mental health across education and healthcare.

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 sample 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.

There is increasing acknowledgement of the importance of the early years of school in laying the foundations for children's learning pathways, and interest in the role of mental health in promoting positive early learning experiences. Understanding child mental health requires consideration of both mental health competence and mental health difficulties. The aim of this paper was to determine how profiles of competence and difficulties relate to children's early learning skills in their first year of school. Cross-sectional data from a population census was used to explore whether children's mental health profile (the combination of competence and difficulties) predicted key domains of early learning. In 2015, the Australian Early Development Census (a teacher-rated measure of child development) was completed for 96.5% of Australian children in their first year of schooling (N = 302,003; M = 5 years, 7 months of age). Logistic regression analyses revealed that mental health profiles were strongly related to two key domains of early learning: language and cognitive skills, and communication skills and general knowledge. Anything less than the optimal high competence with low difficulties profile was associated with substantially poorer early learning skills (OR 2.17, p < 0.001 to OR 67.75, p < 0.001). These results suggest that profiles of mental health competence and difficulties are a salient factor as children begin school, and illustrate the importance of recognising both competence and difficulties when considering the mental health of young children.

Racism and discrimination are fundamental determinants of health inequities, with young people particularly vulnerable. Since the onset of the global COVID‐19 pandemic in 2020, reports of racism and discrimination rose sharply. This study examined direct discrimination, vicarious racial discrimination, heightened vigilance, worries about experiencing racial discrimination, COVID‐19‐related stressors and their associations with young people's mental health during COVID‐19 lockdown in 2020. A community‐based, cross‐sectional online survey collected data from 363 young people aged 16–24 years living in Victoria, Australia, of whom 45.3% self‐identified as being from a multicultural background and 3.7% as Aboriginal and/or Torres Strait Islander. 73.7% reported direct discrimination, 88.9% reported vicarious racial discrimination, 84.3% reported heightened vigilance, and 62.8% reported worries about experiencing racial discrimination. Half (51.3%) of the participants experienced one or two COVID‐19‐related stressors. 53.1% of participants reported moderate‐to‐high levels of distress or negative mood state. Experiences of direct discrimination, vicarious racial discrimination, heightened vigilance, worries about experiencing racial discrimination and multiple COVID‐19‐related stressors (3+) were associated with negative mood state, after adjusting for ethnicity, age, gender and socioeconomic position. Addressing racism and discrimination is critical to addressing health inequities for young people. [ABSTRACT FROM AUTHOR]

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" < 0.001, to "OR" = 7.49, p < 0.001), whereas English-proficient bilingual children had equal or slightly lower odds ("OR" = 0.84, "p" < 0.001, to "OR" = 0.97, "ns"). Future research with longitudinal data is now needed to establish causal pathways and explore long term outcomes.

The transition to adulthood is characterised by potential for both positive development and problem outcomes such as psychopathology, yet little is known about relationships between the two. Given the diversity of pathways observed during this transition period, there is likely to be significant heterogeneity in young people's experiences of these outcomes. Drawing on data from 1158 19-20 year olds in the Australian Temperament Project and using latent profile analysis, we identified six subgroups. For most, higher positive development was associated with lower psychopathology and vice versa. One group (33.6%) was high across all positive development measures and low on psychopathology, and another (47.7%) average in both areas. The remaining four groups were low on positive development but differentiated by average psychopathology (4.7%), high internalising (5.5%), and moderate (7.2%) and severe (1.3%) externalising problems. Tailored intervention strategies that address both the promotion of competence and prevention of problem outcomes are needed. (Contains 4 tables and 2 figures.)

Calls have been made for a greater focus on successful development and how positive functioning can be conceptualized in theory and empirical research. Drawing on a large Australian community sample (N = 890; 61.7% female), this article examines the structure and stability of positive development at two time points during young adulthood. Previously, we developed and empirically tested a model of positive development at 19-20 years comprised of five first-order constructs (civic action and engagement, trust and tolerance of others, trust in authorities and organisations, social competence, and life satisfaction) and a second-order positive development construct. In the current study, we replicated this model at 23-24 years and found that it was again a good fit for the data, and was equally applicable for young men and women. Hence, positive development can be conceptualized according to five important dimensions at both ages. While variable-oriented tests suggested continuity in levels of positive development, person-oriented analyses revealed four distinct patterns of positive development over time--two reflecting stability (stable high [34.5%] and stable very low [11.6%]) and two characterized by change (low/average increasing [30.4%] and average decreasing [23.5%]). There were significant differences in the gender composition of these groups, with young women overrepresented in the more favourable groups. Thus, despite mean level stability, positive development is characterized by change for many young people, suggesting the importance of identifying factors that support young people's capacity for positive functioning over this transitional period. The current findings contribute to our understanding of the nature and course of positive development over this important period.

This article responds to recent calls for a focus on successful development in young people and examination of its developmental precursors, in order to identify potentially modifiable targets for interventions. The current study examined child and adolescent precursors of positive functioning in emerging adulthood, including individual characteristics, relationship factors, and connections to the community, using a multidimensional positive development measure at 19-20 years. The sample consisted of 511 males and 647 females who were participants in the Australian Temperament Project, a population based longitudinal study that has followed young people's psychosocial adjustment from infancy to early adulthood. Higher levels of positive development in emerging adulthood were associated with stronger family and peer relationships, better adjustment to the school setting, higher family socioeconomic status, and better emotional control. Some significant gender differences were observed, with emotional control, family relationships, and community orientation all being stronger predictors of males' than of females' positive development. The findings provide possible targets for child and adolescent interventions to promote positive development in early adulthood.

The transition to adulthood is characterised by both great potential for positive change and a relatively high incidence of problem outcomes. A multidimensional model of positive development during the transition to adulthood (at 19-20 years) has recently been proposed. However, an unresolved question regarding the nature of positive development during this time is how best to conceptualise its relationship to psychopathology. We drew on data from 1158 participants in the Australian Temperament Project, a large longitudinal community-based study that has followed young people's psychosocial adjustment from infancy to early adulthood. Using structural equation modelling, we compared three models reflecting different conceptualisations of the relationship between positive development and psychopathology. The results suggest that positive development and psychopathology are best modelled as separate but correlated constructs. Hence, development in one domain is likely to influence the other, although separate and specific developmental pathways are also likely to be operating.

Background: 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 amplified this risk. Method: 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. Results: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of direct and vicarious racial discrimination experiences from peer, school and societal sources, and examine associations between these experiences and socioemotional and sleep outcomes.Methods: Data were analysed from a population representative cross-sectional study of n=4664 school students in years 5-9 (10-15 years of age) in Australia. Students reported direct experiences of racial discrimination from peers, school and societal sources; vicarious discrimination was measured according to the frequency of witnessing other students experiences of racial discrimination. Students self-reported on the Strengths and Difficulties Questionnaire, with the total difficulties, conduct, emotional and prosocial behaviour subscales examined. Sleep problems included duration, latency, and disruption.Results: 41.56% (95% CI 36.18 to 47.15) of students reported experiences of direct racial discrimination; Indigenous and ethnic minority students reported the highest levels. 70.15% (95% CI 63.83 to 75.78) of students reported vicarious racial discrimination. Direct and vicarious experiences of racial discrimination were associated with socioemotional adjustment (eg, for total difficulties, total direct racism: beta=3.77, 95% CI 3.11 to 4.44; vicarious racism: beta=2.51, 95% CI 2.00 to 3.03). Strong evidence was also found for an effect of direct and vicarious discrimination on sleep (eg, for sleep duration, total direct: beta=-21.04, 95% CI -37.67 to -4.40; vicarious: beta=-9.82, 95% CI -13.78 to -5.86).Conclusions: Experiences of direct and vicarious racial discrimination are common for students from Indigenous and ethnic minority backgrounds, and are associated with socioemotional and sleep problems in adolescence. Racism and racial discrimination are critically important to tackle as social determinants of health for children and adolescents. [ABSTRACT FROM AUTHOR]

Compared with most other Organization for Economic Co‐operation and Development (OECD) countries, information about the patterns of health service use for children from immigrant families in Australia is currently limited, and internationally, data on unmet healthcare needs are scarce. This study aims to examine the distribution of health service utilisation and unmet healthcare needs for immigrant children aged 10–11 years in Australia. We drew on data from the Longitudinal Study of Australian Children Birth (B; n = 5,107) and Kindergarten (K; n = 4,983) cohorts. The exposure was family immigration background collected at 0–1 (B‐cohort) and 4–5 (K‐cohort) years. Outcomes were parent‐reported child health service use and unmet healthcare needs (defined as the difference between services needed and services received) at 10–11 years. Logistic regression analyses were used to examine associations between family immigration background and health service use/unmet healthcare needs, adjusting for potential confounders. Results showed that one‐third of Australian children (B‐cohort: 29.0%; K‐cohort: 33.4%) came from immigrant families. There were similar patterns of health service use and unmet healthcare needs between children from English‐speaking immigrant and Australian‐born families. However, children from non‐English‐speaking immigrant families used fewer health services, including paediatric, dental, mental health and emergency ward services. There was a disparity between the services used when considering children's health needs, particularly for paediatric specialist services (B‐cohort: OR = 2.43, 95% CI 1.11–5.31; K‐cohort: OR = 2.72, 95% CI 1.32–5.58). Findings indicate that Australian children from non‐English‐speaking immigrant families experience more unmet healthcare needs and face more barriers in accessing health services. Further effort is needed to ensure that the healthcare system meets the needs of all families. [ABSTRACT FROM AUTHOR]

Exposure to early adversity carries long term harmful consequences for children's health and development. This study aims to 1) estimate the prevalence of childhood adversity for Australian children from infancy to 10–11 years, and 2) document inequalities in the distribution of adversity according to socioeconomic position (SEP), Indigenous status, and ethnicity. Adversity was assessed every 2 years from 0–1 to 10–11 years in the nationally representative birth cohort of the Longitudinal Study of Australian Children (N = 5107). Adversity included legal problems; family violence; household mental illness; household substance abuse; harsh parenting; parental separation/divorce; unsafe neighborhood; family member death; and bullying (from 4 to 5 years). Adversities were examined individually and summed for a measure of multiple adversity (2+ adverse experiences). By 10–11 years, 52.8% (95% confidence interval [CI] 51.0–54.7) of children had been exposed to 2 or more adversities. When combined with low SEP, children from ethnic minority and from Indigenous backgrounds had 4 to 8 times the odds of exposure to 2 or more adversities than children from higher SEP Anglo-Euro backgrounds, respectively (odds ratio [OR] 4.3, 95% CI 2.8–6.6 and OR 8.1, 95% CI 4.4–14.8). Ethnic minority and Indigenous children from higher SEP backgrounds had increased odds of exposure to multiple adversity than similarly advantaged Anglo-Euro children (OR 1.8, 95% CI 1.4–2.3 and OR 2.3, 95% CI 1.3–4.3, respectively). Addressing early adversity is a significant opportunity to promote health over the life course, and reduce health inequalities experienced by marginalized groups of children. [ABSTRACT FROM AUTHOR]

Major policy reforms were instigated in 2008 in Australia to ensure that all children have access to a preschool program in the year before starting school. The Australian Early Development Census (AEDC) provides a means of monitoring the impact of these reforms at the population level, as teachers of all children in their first year of school retrospectively report on children's preschool experiences every three years. Early indications from AEDC data spanning the preschool years of 2008–2011 indicated that the proportion of children attending preschool remained relatively stable over this period. In this short communication, we update this with analysis of preschool trends from 2008 to 2014. We find evidence of increasing preschool attendance over this longer time frame (80.43% in 2008, compared to 91.30% in 2014; OR 2.53, 99% CI 2.44–2.62). Consistent with earlier data, children from disadvantaged communities had higher odds of non-attendance, compared to those living in the most advantaged communities (OR 2.94, 99% CI 2.74–3.15). In 2014, children who did not attend preschool were also disproportionately Indigenous and from non-English speaking backgrounds. Findings suggest that participation in preschool appears to have increased, concurrent to government efforts to promote participation through universal access. Engaging the most vulnerable families in preschool programs remains a major challenge that requires continued policy focus. [ABSTRACT FROM AUTHOR]

The Australian New Zealand Intergenerational Cohort Consortium (ANZ-ICC) brings together three of the longest running intergenerational cohort studies in Australia and New Zealand to examine the extent to which preconception parental life histories (from infancy to parenthood) predict next generation early health and development. The aims are threefold: (1) to describe pathways of advantage that strengthen emotional health and well-being from one generation to the next, (2) to describe pathways of disadvantage that perpetuate cycles of emotional and behavioural problems across generations, and (3) to identify modifiable factors capable of breaking intergenerational cycles. The Victorian Intergenerational Health Cohort Study has followed 1,943 young Australians from adolescence to adulthood across ten waves since 1992, and 1,030 offspring from pregnancy to early childhood since 2006. The Australian Temperament Project Generation 3 Study has followed 2,443 young Australians from infancy to adulthood across 15 waves since 1983, and 1170 offspring from pregnancy to early childhood since 2012. The Dunedin Multidisciplinary Health and Development Study Parenting Study has followed 1,037 young New Zealanders across 15 waves since 1972, and 730 offspring in early childhood since 1994. Cross-cohort replication analyses will be conducted for common preconception exposures and next generation offspring outcomes, while integrated data analysis of pooled data will be used for rare exposures and outcomes. The ANZ-ICC represents a unique collaboration that bridges the disciplines of lifecourse epidemiology, biostatistics, developmental psychology and psychiatry, to study the role of parental preconception exposures on next generation health and development. [ABSTRACT FROM AUTHOR]

OBJECTIVES: 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). METHODS: 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. RESULTS: 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). CONCLUSIONS: Socioeconomic disadvantage in infancy had a direct effect on academic but not selfregulation 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. [ABSTRACT FROM AUTHOR]

Background: 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.Methods: 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.Results: 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%.Conclusions: 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. [ABSTRACT FROM AUTHOR]

Background: 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.Methods: 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.Results: We found four distinct trajectories of children's exposure to composite disadvantage, which showed high levels of stability over time. In regard to the individual 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.Conclusions: 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. [ABSTRACT FROM AUTHOR]

Purpose: 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). Method: 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 subsample of children from the Longitudinal Study of Australian Children for whom AEDC data were also collected (n = 720). Result: 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 divergent validity. Conclusion: 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. [ABSTRACT FROM AUTHOR]

Purpose: 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. Method: 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 sample of Australian children. Result: 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. Conclusion: All children need to be supported during the early years of school to reach their full educational potential. [ABSTRACT FROM AUTHOR]

Aim: 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.Methods: 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 subsample 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.Results: 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).Conclusion: 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. [ABSTRACT FROM AUTHOR]

Participation in a preschool program in the year before starting school can promote children’s healthy development, and has the potential to reduce inequities in developmental outcomes for at-risk subpopulations. In Australia, boosting preschool attendance has emerged as a national policy priority. In this paper, we draw on data from the Australian Early Development Census (AEDC) to describe preschool attendance in two sequential population cohorts, with preschool experiences in 2008 and 2011 reported retrospectively by teachers of children in their first year of school. Overall, findings show that the proportion of children attending preschool remained relatively stable between the two AEDC cohorts (in 2008, preschool attendance ranged from 57.0% to 85.8% across the states and territories, while in 2011, attendance ranged from 49.2% to 93.7%). At a subpopulation level, children from non-English speaking and Indigenous backgrounds and children living in disadvantaged communities all had substantially higher odds of not attending preschool in both 2008 and 2011. These findings highlight the need to maintain policy attention on efforts to further reduce barriers to preschool access for at-risk subpopulations, and the value of monitoring population trends in preschool attendance to better inform policy and service provision. [ABSTRACT FROM AUTHOR]

Purpose: Evidence suggests that early proficiency in the language of school instruction is an important predictor of academic success for bilingual children. This study investigated whether English-proficiency at 4–5 years of age predicts academic language and literacy skills among Australian bilingual children at 10–11 years of age, as part of the Longitudinal Study of Australian Children (LSAC, 2012). Method: The LSAC comprises a nationally representative clustered cross-sequential sample of Australian children. Data were analysed from a sub-sample of 129 bilingual children from the LSAC Kindergarten cohort (n = 4983), for whom teachers completed the Australian Early Development Index (AEDI) checklist (a population measure of early childhood development) and the Academic Rating Scale (ARS) language and literacy subscale. Result: Linear regression analyses revealed that bilingual children who commenced school with stronger English proficiency had higher academic language and literacy scores at the end of primary school (β = 0.45). English proficiency remained a significant predictor, even when accounting for gender and socio-economic disadvantage (β = 0.38). Conclusion: The findings indicate that bilingual children who begin school without English proficiency are at risk of difficulties with academic language and literacy, even after 6 years of schooling. Risk factors need to be identified so early support can be targeted towards the most vulnerable children. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective This study capitalizes on developmental data from an Australian population-based birth cohort to identify developmental markers of abnormal eating attitudes and behaviors in adolescence. The aims were twofold: (1) to develop a comprehensive path model identifying infant and childhood developmental correlates of Abnormal Eating Attitudes and Behaviors in adolescence, and (2) to explore potential gender differences. Method Data were drawn from a 30-year longitudinal study that has followed the health and development of a population based cohort across 15 waves of data collection from infancy since 1983: The Australian Temperament Project. Participants in this analysis were the 1,300 youth who completed the 11th survey at 15-16 years (1998) and who completed the eating disorder inventory at this time point. Results Developmental correlates of Abnormal Eating Attitudes and Behaviors in mid-adolescence were temperamental persistence, early gestational age, persistent high weight, teen depression, stronger peer relationships, maternal dieting behavior, and pubertal timing. Overall, these factors accounted for 28% of the variance in Abnormal Eating Attitudes and Behaviors at 15-16 years of age. Depressive symptoms, maternal dieting behavior, and early puberty were more important factors for girls. Late puberty was a more important factor for boys. Discussion Findings address an important gap in our understanding of the etiology of Abnormal Eating Attitudes and Behaviors in adolescence and suggest multiple targets for preventive intervention. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:813-824) [ABSTRACT FROM AUTHOR]

Calls have been made for a greater focus on successful development and how positive functioning can be conceptualized in theory and empirical research. Drawing on a large Australian community sample ( N = 890; 61.7% female), this article examines the structure and stability of positive development at two time points during young adulthood. Previously, we developed and empirically tested a model of positive development at 19-20 years comprised of five first-order constructs (civic action and engagement, trust and tolerance of others, trust in authorities and organisations, social competence, and life satisfaction) and a second-order positive development construct. In the current study, we replicated this model at 23-24 years and found that it was again a good fit for the data, and was equally applicable for young men and women. Hence, positive development can be conceptualized according to five important dimensions at both ages. While variable-oriented tests suggested continuity in levels of positive development, person-oriented analyses revealed four distinct patterns of positive development over time-two reflecting stability (stable high [34.5%] and stable very low [11.6%]) and two characterized by change (low/average increasing [30.4%] and average decreasing [23.5%]). There were significant differences in the gender composition of these groups, with young women overrepresented in the more favourable groups. Thus, despite mean level stability, positive development is characterized by change for many young people, suggesting the importance of identifying factors that support young people's capacity for positive functioning over this transitional period. The current findings contribute to our understanding of the nature and course of positive development over this important period. [ABSTRACT FROM AUTHOR]

Background Mental health inequities are shaped by the environments where children develop, including neighbourhoods. Children living in disadvantaged neighbourhoods tend to have poorer development outcomes, yet little evidence has examined positive mental health outcomes, like competence, in young children. Methods We examined associations between neighbourhood disadvantage and young children's competence, as well as mental health difficulties (internalising and externalising), holding constant demographic characteristics and maternal education using multilevel logistic regression (Markov Chain Monte Carlo estimation). Data were from the 2018 Australian Early Development Census, including over 250,000 children entering their first year of school (age approximately 5 years). Results Children living in Australia's most disadvantaged neighbourhoods had higher odds of externalising difficulties (AOR: 1.34; 95% credible interval 1.29 to 1.38), internalising difficulties (AOR: 1.29; 95% credible interval 1.24 to 1.33), and lower odds of competence (AOR: 0.72; 95% credible interval 0.69 to 0.74) than children in the least disadvantaged neighbourhoods. Conclusions Across both mental health difficulties and competence, neighbourhood-level inequities were evident. Future research should identify specific neighbourhood features that could address these inequities. Availability of population linked geospatial and child development data in Australia offers opportunities to address these gaps and is prioritised as the next step in this research program. Key messages Children in disadvantaged neighbourhoods face lower likelihood of positive mental health (competence) and higher likelihood of mental health difficulties. Identifying specific neighbourhood features that could address these inequities is a priority. [ABSTRACT FROM AUTHOR]

Background Mental health inequities can emerge early in life and are shaped by the daily conditions and environments where children develop, including neighbourhoods. Synthesizing evidence around neighbourhoods, disadvantage, and early childhood mental health can advance understandings of neighbourhood features (e.g. housing, parks) associated with (1) optimal mental health and (2) narrowing inequities. Methods We systematically searched and critically reviewed the international quantitative literature investigating associations between the neighbourhood built environment and young children's (0-8 years) mental health, including positive aspects ('competence') and difficulties. Results Eight of the 14 included studies examined nature or public open space (parks); seven found some association between greater access to neighbourhood nature or parks and better mental health. Significant gaps included few studies investigating: (1) social infrastructure (e.g. services, childcare), (2) competence, (3) the extent to which the neighbourhood built environment closed the gap (versus benefiting children generally), and (4) pathways between neighbourhoods, disadvantage, and mental health. Conclusions Emerging evidence suggests that features of the neighbourhood are associated with young children's mental health. Future research should unpack the neighbourhood's role in narrowing inequities in early childhood. Availability of population linked geospatial and child development data in Australia offers opportunities to address these gaps and is prioritized as the next step in this research program. Key messages The neighbourhood built environment holds potential for promoting young children's mental health. Future research should examine its potential to reduce inequities during early childhood. [ABSTRACT FROM AUTHOR]

Early childhood interventions have the potential to reduce children's developmental inequities. We aimed to estimate the extent to which household income supplements for lower-income families in early childhood could close the gap in children's developmental outcomes and parental mental health. Data were drawn from a nationally representative birth cohort, the Longitudinal Study of Australian Children (N = 5107), which commenced in 2004 and conducted follow-ups every two years. Exposure was annual household income (0–1 year). Outcomes were children's developmental outcomes, specifically social-emotional, physical functioning, and learning (bottom 15% versus top 85%) at 4–5 years, and an intermediate outcome, parental mental health (poor versus good) at 2–3 years. We modelled hypothetical interventions that provided a fixed-income supplement to lower-income families with a child aged 0–1 year. Considering varying eligibility scenarios and amounts motivated by actual policies in the Australian context, we estimated the risk of poor outcomes for eligible families under no intervention and the hypothetical intervention using marginal structural models. The reduction in risk under intervention relative to no intervention was estimated. A single hypothetical supplement of AU$26,000 (equivalent to ∼USD$17,350) provided to lower-income families (below AU$56,137 (∼USD$37,915) per annum) in a child's first year of life demonstrated an absolute reduction of 2.7%, 1.9% and 2.6% in the risk of poor social-emotional, physical functioning and learning outcomes in children, respectively (equivalent to relative reductions of 12%, 10% and 11%, respectively). The absolute reduction in risk of poor mental health in eligible parents was 1.0%, equivalent to a relative reduction of 7%. Benefits were similar across other income thresholds used to assess eligibility (range, AU$73,329-$99,864). Household income supplements provided to lower-income families may benefit children's development and parental mental health. This intervention should be considered within a social-ecological approach by stacking complementary interventions to eliminate developmental inequities. • Income supplements provided to lower-income households may improve children's development. • Household income supplements may also be beneficial to parental mental health. • The absolute reduction in risk of poor outcomes ranged between 0.8% and 2.8%. • Household income supplements alone are insufficient to eliminate child inequities. • Stacking multiple complementary interventions over the life course is needed. [ABSTRACT FROM AUTHOR]

Background: Limited evidence suggests that positive experiences in childhood may promote cardiovascular health, providing additional opportunities for prevention and early intervention. This study aimed to examine the effects of adverse and positive experiences on cardiovascular health in late childhood., Methods: Data sources: Longitudinal Study of Australian Children (N = 1874)., Exposures: Adverse and positive experiences assessed repeatedly (age 0-11 years)., Outcomes: Cardiovascular health (high versus low or moderate) quantified by four health behaviors (diet, physical activity, cigarette smoking, and sleep) and four health factors (body mass index, non-high-density lipoprotein, blood pressure, and blood glucose) (age 11-12 years) as per the American Heart Association's Life's Essential 8 metrics., Analyses: Separate generalized linear models with log-Poisson links were used to estimate the effects of adverse and positive experiences on cardiovascular health, adjusting for confounders., Results: Children exposed to multiple adverse experiences (≥ 2) were less likely to have high cardiovascular health (RR = 0.82, 95% CI = 0.67 to 1.02) than those not exposed. Children exposed to multiple positive experiences (≥ 2) were more likely to have high cardiovascular health (RR = 1.14, 95% CI = 0.94 to 1.38) than those not exposed. Stratified analyses suggested that exposure to multiple positive experiences might buffer the detrimental effects of multiple adverse experiences on cardiovascular health., Conclusions: Both adverse and positive experiences were found to be modestly associated with cardiovascular health in Australian children. Future research and practice should not only consider addressing childhood adversity but also use a strengths-based approach to promoting positive experiences to improve cardiovascular health., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: An increasing body of evidence supports associations between inflammation and mental health difficulties, but the onset and directionality of these relationships are unclear., Methods: Data sources: Barwon Infant Study (BIS; n = 500 4-year-olds) and Longitudinal Study of Australian Children (LSAC; n = 1099 10-13-year-olds)., Measures: Strengths and Difficulties Questionnaire emotional symptoms at 4, 10-11 and 12-13 years, and circulating levels of two inflammatory biomarkers, high-sensitivity C-reactive protein (hsCRP) and glycoprotein acetyls (GlycA), at 4 and 11-12 years., Analysis: Adjusted quantile regression models examining cross-sectional associations between emotional symptoms and inflammation in 4-year-olds (BIS), and cross-lagged associations in 10-13-year-olds (LSAC)., Results: We identified a small association between higher emotional symptoms at 10-11 years and higher GlycA levels a year later (standardised coefficient β = 0.09; 95%CI: 0.02 to 0.15). Sex-stratified analyses revealed this association was stronger for boys (β = 0.13; 95%CI: 0.04 to 0.21) than girls (β = 0.01; 95%CI: -0.09 to 0.11). These associations were not observed for hsCRP. There was little evidence of an association between higher GlycA or hsCRP at 11-12 years and emotional symptoms a year later, or cross-sectional associations between emotional symptoms and hsCRP or GlycA at 4 years., Limitations: A single time-point of biomarker collection in late childhood precluded adjustment for baseline inflammatory biomarkers., Conclusions: Our results support the direction of association from emotional symptoms to inflammation in late childhood, with potential sex differences. This adds to the body of evidence that addressing emotional symptoms in childhood is a major priority in optimising overall health throughout the life course., Competing Interests: Declaration of competing interest All authors declare no conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: There has been widespread interest in the implications of COVID-19 containment measures on the mental health of parents. Most of this research has focused on risk. Much less is known about resilience; yet such studies are key to protecting populations during major crises. Here we map precursors of resilience using life course data spanning three decades., Methods: The Australian Temperament Project commenced in 1983 and now follows three generations. Parents (N = 574, 59 % mothers) raising young children completed a COVID-19 specific module in the early (May-September 2020) and/or later (October-December, 2021) phases of the pandemic. Decades prior, parents had been assessed across a broad range of individual, relational and contextual risk and promotive factors during childhood (7-8 years to 11-12 years), adolescence (13-14 years to 17-18 years) and young adulthood (19-20 years to 27-28 years). Regressions examined the extent to which these factors predicted mental health resilience, operationalised as lower than expected anxiety and depressive symptoms during the pandemic relative to pre-pandemic symptoms., Results: Parent mental health resilience during the COVID-19 pandemic was consistently predicted by several factors assessed decades before the pandemic. These included lower ratings of internalizing difficulties, less difficult temperament/personality traits and stressful life events, and higher ratings of relational health., Limitations: The study included 37-39-year-old Australian parents with children age between 1 and 10 years., Discussion: Results identified psychosocial indicators across the early life course that, if replicated, could constitute targets for long-term investment to maximise mental health resilience during future pandemics and crises., Competing Interests: Declaration of competing interest None., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: 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., Methods: 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)., Results: 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., Conclusions: 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., (Copyright © 2023 by the American Academy of Pediatrics.)

Background: Across the life course, socioeconomic disadvantage disproportionately afflicts those with genetic predispositions to inflammatory diseases. We describe how socioeconomic disadvantage and polygenic risk for high BMI magnify the risk of obesity across childhood, and using causal analyses, explore the hypothetical impact of intervening on socioeconomic disadvantage to reduce adolescent obesity., Methods: Data were drawn from a nationally representative Australian birth cohort, with biennial data collection between 2004 and 2018 (research and ethics committee approved). We generated a polygenic risk score for BMI using published genome-wide association studies. We measured early-childhood disadvantage (age 2-3 years) with a neighbourhood census-based measure and a family-level composite of parent income, occupation, and education. We used generalised linear regression (Poisson-log link) to estimate the risk of overweight or obesity (BMI ≥85th percentile) at age 14-15 years for children with early-childhood disadvantage (quintiles 4-5) versus average (quintile 3) and least disadvantage (quintiles 1-2), for those with high and low polygenic risk separately., Findings: For 1607 children (n=796 female, n=811 male; 31% of the original cohort [N=5107]), polygenic risk and disadvantage were both associated with overweight or obesity; effects of disadvantage were more marked as polygenic risk increased. Of children with polygenic risk higher than the median (n=805), 37% of children living in disadvantage at age 2-3 years had an overweight or obese BMI by adolescence, compared with 26% of those with least disadvantage. For genetically vulnerable children, causal analyses indicated that early neighbourhood intervention to lessen disadvantage (to quintile 1-2) would reduce risk of adolescent overweight or obesity by 23% (risk ratio 0·77; 95% CI 0·57-1·04); estimates for improving family environments were similar (0·59; 0·43-0·80)., Interpretation: Actions addressing socioeconomic disadvantage could mitigate polygenic risk for developing obesity. This study benefits from population-representative longitudinal data but is limited by sample size., Funding: Australian National Health and Medical Research Council., (Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

This study examined whether positive development (PD) in adolescence and young adulthood predicts offspring behavior in two Australasian intergenerational cohorts. The Australian Temperament Project Generation 3 Study assessed PD at age 19-28 (years 2002-2010) and behavior in 1165 infants (12-18 months; 608 girls) of 694 Australian-born parents (age 29-35; 2012-2019; 399 mothers). The Dunedin Multidisciplinary Health and Development Parenting Study assessed PD at age 15-18 (years 1987-1991) and behavior in 695 preschoolers (3-5 years; 349 girls) and their New Zealand born parents (age 21-46; 1994-2018; 363 mothers; 89% European ethnicity). In both cohorts, PD before parenthood predicted more positive offspring behavior (β range  = .11-.16) and fewer behavior problems (β range  = -.09 to -.11). Promoting strengths may secure a healthy start to life., (© 2022 The Authors. Child Development published by Wiley Periodicals LLC on behalf of Society for Research in Child Development.)

Objective: 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., Methods: 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., Results: 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., Conclusions: 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., (Copyright © 2021 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

Neighbourhood-level interventions offer a promising opportunity to promote child mental health at a population level; however, neighbourhood effects are still regarded as a 'black box' and a better understanding of the specific design elements, such as public open space, is needed to inform actionable policy interventions., Methods: This study leveraged data from a population linked dataset (Australian Early Development Census-Built Environment) combining information from a national census of children's developmental outcomes with individualised geospatial data. Associations between access to (within 400 m and 800 m from home), and quality of, public open space and child mental health outcomes across eight capital cities were estimated using multilevel logistic regression models, adjusting for demographic and contextual factors. Access was defined based on proximity of public open space to children's home addresses, within distance thresholds (400 m, 800 m) measured along the road network. Effect modification was tested across maternal education groups., Results: Across the eight capital cities, inequities in access to child friendly public open spaces were observed across maternal education groups and neighbourhood disadvantage quintiles. Children with access to any type of public open space within 800 m of home had lower odds of demonstrating difficulties and higher odds of competence. Children with access to child friendly public open spaces within 800 m of home had the highest likelihood of demonstrating competence., Conclusion: Improving access to neighbourhood public open space appears to be a promising strategy for preventing mental health difficulties and promoting competence in early childhood. Action is needed to redress socio-spatial inequities in access to child friendly public open space.

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.

Background: 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., Methods: 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., Results: 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 diverge from this normative MHC progression. For example, 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., Conclusions: 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., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Objective: Children from socioeconomically disadvantaged backgrounds have poorer learning outcomes. These inequities are a significant public health issue, tracking forward to adverse health outcomes in adulthood. We examined the potential to reduce socioeconomic gaps in children's reading skills through increasing home reading and preschool attendance among disadvantaged children., Methods: We drew on data from the nationally representative birth cohort of the Longitudinal Study of Australian Children (N = 5107) to examine the impact of socioeconomic disadvantage (0-1 year) on children's reading skills (8-9 years). An interventional effects approach was applied to estimate the extent to which improving the levels of home reading (2-5 years) and preschool attendance (4-5 years) of socioeconomically disadvantaged children to be commensurate with their advantaged peers, could potentially reduce socioeconomic gaps in children's reading skills., Results: Socioeconomically disadvantaged children had a higher risk of poor reading outcomes compared to more advantaged peers: absolute risk difference = 20.1% (95% confidence interval [CI]: 16.0%-24.2%). Results suggest that improving disadvantaged children's home reading and preschool attendance to the level of their advantaged peers could eliminate 6.5% and 2.1% of socioeconomic gaps in reading skills, respectively. However, large socioeconomic gaps would remain, with disadvantaged children maintaining an 18.3% (95% CI: 14.0%-22.7%) higher risk of poor reading outcomes in absolute terms., Conclusion: There are clear socioeconomic disparities in children's reading skills by late childhood. Findings suggest that interventions that improve home reading and preschool attendance may contribute to reducing these inequities, but alone are unlikely to be sufficient to close the equity gap., (Copyright © 2021 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

Purpose: This study aimed to examine the continuity of internalising difficulties from childhood to adolescence, and determine if the influence of established risk factors on adolescent mental health differed depending on childhood internalising experiences., Methods: Data were used from the Kindergarten cohort of the Longitudinal Study of Australian Children (LSAC, N = 4983, est. 2004). Internalising difficulties were measured via parent report on the Strengths and Difficulties Questionnaire (SDQ) at each wave from 4-5 to 14-15 years of age, and defined as symptoms in the borderline or abnormal range (≥ 4). Logistic generalised estimating equations were used to characterise associations between childhood internalising problems (4-9 years) and previously identified risk factors with adolescent internalising difficulties at three time points (10-11, 12-13 and 14-15 years)., Results: The risk of internalising problems was elevated at each adolescent age for those who previously experienced internalising symptoms in childhood compared to those who did not (10-11 years: OR 3.67, 95% CI 3.01-4.47, 12-13 years: OR 2.84, 95% CI 2.32-3.46, and 14-15 years: OR 2.33, 95% CI 1.90-2.87). Other known risk factors were found to be associated with adolescent internalising problems as expected. We found no statistical evidence that these associations differed for adolescents who previously experienced internalising symptoms in childhood., Conclusion: Findings of this study confirm the continuity of childhood mental health problems and the role of individual and family characteristics in the aetiology of adolescent internalising difficulties. The same risk factors appear relevant to target for adolescents who first experienced internalising symptoms in childhood.

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., (© 2019 John Wiley & Sons Ltd.)

Aim: 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., Methods: 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., Results: 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)., Conclusions: 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., (© 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)