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Background: The Early Learning Outcomes Measure (ELOM) assesses early learning programme outcomes in children aged 50-69 months. ELOM assesses gross motor development (GMD), fine motor coordination and visual motor integration (FMC & VMI), emergent numeracy and mathematics (ENM), cognition and executive functioning (CEF), and emergent literacy and language (ELL). Content and construct validity, reliability and cross-cultural fairness have been established. Aim: To establish the test-retest reliability and concurrent validity of the ELOM. Setting: Low income preschool and Grade R children. Methods: In study one, Test-retest reliability was investigated in a convenience sample of 49 English and isiXhosa speaking preschool children (Mean age = 60.77 months, SD = 3.70) tested and retested one week apart. In study two, concurrent validity was investigated in a convenience sample of 62 children (Mean age = 75.05 months, SD = 0.75). ELOM performance was compared with that on the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI-IV). Results: Test-retest reliability was established for ELOM Total score (r = 0.90, p < 0.001). The concurrent validity of ELOM Total and the WPPSI-IV Full Scale Composite scores was established (r = 0.64, p < 0.001). FMC & VMI, CEF, and ELL domains correlated significantly with their corresponding WPPSI-IV indices: visual spatial, fluid reasoning, processing speed, working memory, and verbal comprehension. Conclusion: The findings of both psychometric studies contribute further to the reliability and validity of the ELOM.

Research Findings: Community-based playgroups in low-and-middle-income countries increase access to early learning at lower cost than centers. However, evidence of effectiveness is limited. The effects of one, two, or three playgroup sessions per week on children's performance on the Early Learning Outcome Measure (ELOM) (n = 112; baseline M = 55.32 months) were investigated using a quasi-experimental design. Data on children's home learning environments was obtained from primary caregivers, and program staff provided information on playgroup characteristics. Multilevel modeling demonstrated significant differences between programs in ELOM score improvement over eight months participation (F = 6.48; p = 0.01); Fisher LSD Post Hoc pairwise comparisons indicated that three session playgroups produced significantly greater gains than two and one session models (p < 0.01). ELOM Total scores at baseline, and the quality of children's interactions with adults and peers, predicted growth in ELOM Total scores by endline. Baseline age, height-for-age, child-practitioner ratio, and caregiver time for activities with their children, predicted growth in certain ELOM domains at endline. Practice or Policy: Until provision of quality center-based provision is realized, our findings indicate that well-designed community-based playgroups of sufficient dose, have the potential to improve learning outcomes and school readiness in children from poor households.

In 2015, Innovation Edge commissioned the development of South Africa's first national-level preschool child assessment tool. The project's key innovations were that the tool should fairly assess children from across the cultural and socio-economic spectrum, be inexpensive in terms of equipment and administration costs, and be administered in about 45 minutes. Rather than professional evaluators, well-trained persons with a background in early childhood education would serve as assessors. Finalized in 2016, the primary purpose of the Early Learning Outcomes Measure (ELOM) (www.elom.org.za) is to provide the country with a national instrument to fairly assess children age 50-69 months from all socioeconomic and cultural backgrounds. This brief article describes the program's early learning development standards and how to effectively interpret ELOM data.

In line with United Nations Sustainable Development Goal (SDG) 4.2, South Africa's National Development Plan commits to providing high-quality early childhood education to all children by 2030 to drive improved child outcomes. Prior to 2016, South Africa lacked reliable, locally standardised, valid, and cross-culturally fair assessment tools for measuring preschool quality and child outcomes, suitable for use at scale within a resource-constrained context. In this paper we detail the development and evolution of a suite of early learning measurement (ELOM) tools designed to address this measurement gap. The development process included reviews of literature and other relevant assessment tools; a review of local curriculum standards and expected child outcomes; extensive consultation with government officials, child development experts, and early learning practitioners, iterative user testing; and assessment of linguistic, cultural, functional, and metric equivalence across all 11 official South African languages. To support use of the ELOM tools at scale, and by users with varying levels of research expertise, administration is digitised and embedded within an end-to-end data value chain. ELOM data collected since 2016 quantify the striking socio-economic gradient in early childhood development in South Africa, demonstrate the relationship between physical stunting, socio-emotional functioning and learning outcomes, and provide evidence of the positive impact of high-quality early learning programmes on preschool child outcomes. To promote secondary analyses, data from multiple studies are regularly collated into a shared dataset, which is made open access via an online data portal. We describe the services and support that make up the ELOM data value chain, noting several key challenges and enablers of data-driven change within this context. These include deep technical expertise within a multidisciplinary and collaborative team, patient and flexible capital from mission-aligned investors, a fit-for-purpose institutional home, the appropriate use of technology, a user-centred approach to development and testing, sensitivity to children's diverse linguistic and socio-economic circumstances, careful consideration of requirements for scale, appropriate training and support for a non-professional assessor base, and a commitment to ongoing learning and continuous enhancement. Practical examples are provided of ways in which the ELOM tools and data are used for programme monitoring and enhancement purposes, to evaluate the relative effectiveness of early learning interventions, to motivate for greater budget and inform more effective resource allocation, to support the development of enabling Government systems, and to track progress towards the attainment of national and global development goals. We share lessons learnt during the development of the tools and discuss the factors that have driven their uptake in South Africa. [ABSTRACT FROM AUTHOR]

Background: Children and adolescents with mental health problems have poor service cover in low- and middle-income countries. Little is known about the resources that would be required to provide child and adolescent mental health services (CAMHS) in these countries. The purpose of this study was to calculate the human resources and associated costs required to scale up CAMHS in South Africa. Methods: A spreadsheet model was developed to calculate mental health service resources, based on an estimation of the need for services in a given population. The model can be adapted to specific settings by adjusting population size, age distribution, prevalence, comorbidity, levels of coverage, service utilisation rates, workloads, length of consultations and staff profile. Steps in the modelling include population identification; estimates of prevalence, service utilisation and staffing; and costing. Results: Using a nominal total population of 100,000 (of which 43,170 would be children and adolescents under 20 years of age), the following full-time equivalent staff are required at minimum coverage level: 5.8 in PHC facilities, 0.6 in general hospital outpatient departments (OPDs), 0.1 in general hospital inpatient facilities, 1.1 in specialist CAMHS OPDs, 0.6 in specialist CAMHS inpatient facilities, 0.5 in specialist CAMHS day services, and 0.8 in regional CAMHS teams. This translates into roughly $21.50 and $5.99 per child or adolescent per annum nationally for the full coverage and minimum coverage scenarios respectively. When comparing the results of this model with current realities in South Africa, there remains a substantial shortfall in existing levels of CAMHS provision. Conclusions: The model can be used as an advocacy tool to engage with planners and policy makers on a rational basis. It can also be adapted for use in other countries, and is intended to support wider calls for a global scaling up of mental health services.

South Africa has alarmingly high crime rates and a significant proportion of offences are committed by juveniles. Recent legislation seeks to protect children by providing for their diversion out of the criminal justice system. The primary objective of this paper is to describe research undertaken to develop minimum standards for diversion interventions. The focus is on the development of standards for pre-referral assessment and diversion program design and delivery. The preliminary standards were presented to twenty-five key informants with experience in child justice and diversion. Eleven of the minimum pre-referral assessment standards and 18 of the 19 minimum standards for diversion program design and delivery were perceived as both appropriate and feasible, but most were regarded as challenging to implement in low-resource contexts. (Contains 2 figures.)

Background: Assessment of early childhood development programme effectiveness in South Africa is hampered by a lack of suitable measures that account for variations in cultural and socio‐economic backgrounds and can be administered by non‐professionals. This contribution reports the standardisation of the South African Early Learning Outcomes Measure (ELOM), an instrument designed for population level monitoring of the developmental status of children aged 50–69 months and for evaluation of early learning programmes. Methods: The development of the ELOM was informed by South Africa's National Curriculum Framework from Birth to Four and its National Early Learning and Development Standards. ELOM items were drawn from reliable and valid instruments, particularly those used in Africa and other developing regions and were clustered in five domains: gross motor development, fine motor coordination and visual motor integration, emergent numeracy and mathematics, cognition and executive functioning, emergent literacy and language. The ELOM was standardised on a sample of 1,331 children aged 50–69 months, from five South African official languages and five socio‐economic strata. Item Response Theory techniques were used to establish reliability, validity, and differential item functioning. Results: Confirmatory Factor Analysis established that ELOM domains are unidimensional and internally consistent. Items discriminate reliably between more and less able children and do not discriminate unfairly between children of the same ability from different language backgrounds. Socio‐economic gradients were evident in children's performance. South African Early Learning Development Standards (ELDS) based on standard scores were developed and set at the 60th percentile of the sample standard score distribution. Conclusions: This research produced the first South African, age‐validated population‐level standardised instrument that can be administered relatively cheaply by trained non‐professionals. This will facilitate the assessment of the efficacy of early learning programmes in enabling children to reach ELDS prior to entering Grade R and track progress toward Sustainable Development Goal 4.2. [ABSTRACT FROM AUTHOR]

Mental health problems in childhood and adolescence pose a major threat to public health. Epidemiological studies in high, middle and low income countries indicate that approximately one in five children and adolescents suffer from a mental disorder. In many instances these persist into adulthood. In South Africa, HIV infection, substance use, and exposure to violence increase vulnerability to mental disorders. Child and adolescent mental health services play a key role in reducing the burden of mental disorders in childhood and later in adulthood. This paper focuses on service needs for children and adolescents in South Africa. It commences with a discussion of the prevalence of child and adolescent psychiatric disorders after which the legal and policy context of child and adolescent psychiatric services is described. A framework for child and adolescent mental health service provision is presented, following which steps for reducing the extent of unmet service need are considered. The paper concludes with a call to scale up child and adolescent mental health services in South Africa, based on the stark realities of unmet need and the constitutional rights of children and adolescents to appropriate mental health care. [ABSTRACT FROM PUBLISHER]

In this article the authors discuss the social problem of violence against children in South Africa. They are supportive of having additional research conducted on methods to prevent violence against children and of the positive role that child and adolescent mental health practitioners can play in addressing and preventing violence against children in home settings and in schools.

In the article the author discusses the South African Children's Act, which provides services to protect and enhance the development of children. He notes the history of the Children's Act and describes topics of individual chapters of the Act including interventions for child maltreatment and child protection. He believes that an increase in finance and staffing is required for the Act to be implemented successfully.

In a country in which human rights feature prominently in our discourse about who we are, as well as in the South African constitutional and legal framework, so many wrongs continue to be done to children. One category of wrongs is abuse, but it is not the only one. Poverty, patriarchy and gender violence, as well as the socialised obedience, dependency and silence of women and children, create conditions in which abuse can occur, often with few consequences. South Africa has extremely high rates of both physical and sexual abuse of children. Progressive, rights-based legislation exists to protect children, but it is not adequately supported or resourced by services to fulfil their provisions. Child abuse and neglect will not be significantly reduced in South Africa, without simultaneous improvements in the social and economic conditions in which very large numbers of children live. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper presents a review of theoretical and empirical research on risk factors for: 1) the development of violent and other antisocial behaviour; 2) international interventions targeting antisocial, including violent youths; and 3) outcome evaluations and meta-analyses of interventions targeting antisocial, including violent youths. Taken together, the international literature indicates that interventions which effectively reduce violent and other antisocial behaviours are informed by a number of generic principles which should guide the development and implementation of South African violence-prevention programmes. Common characteristics of interventions which effectively reduce youth violence are presented, with the aim of informing the design and delivery of local interventions. In light of the alarmingly high levels of violence in South Africa, there is an urgent need to develop intensive, multi-modal, evidence-based, structured, cognitive-behavioural programmes for violent adolescents and young adults. Furthermore, it is imperative that efforts are directed at developing a reliable local evidence base of 'what works' for young offenders generally, and violent young offenders specifically. [ABSTRACT FROM AUTHOR]

There is a lack of research on violence risk assessment in South Africa, particularly on the assessment of risk for violence in children and adolescents. This is problematic, because of the strong association between conducting sound assessments and the appropriate referral of youths to intervention programmes. Considering the very high levels of violence in our country, the effective treatment of violent youths is imperative. International literature on violence risk assessment indicates that although a number of instruments designed to assess youth violence risk exist, many primarily focus on identifying psychopathic tendencies in young people, which has stimulated much debate amongst scholars. In addition to paying careful attention to the content of youth violence risk instruments, their administration should be monitored, to ensure that assessment practice is up to standard. Future research efforts in South Africa should be dedicated towards testing the applicability of instruments developed internationally in local settings, and towards the development and testing of local Instruments. [ABSTRACT FROM AUTHOR]

The authors outline cross-sectional studies (across time and age) of the effects of the political changes in South Africa on the intergroup orientations of adolescents, as well as their orientations to the new democracy. The study was undertaken between 1992 (before the end of apartheid) and 1996 (after apartheid), with 14-year-old and 17-year-old high school students from formerly designated Black, Coloured, White and Indian population groups. Participants completed Duckitt's Subtle Racism Anti-Black Scale, a Repertory Grid following Kelly and measures of adjustment to political change. The results indicate that levels of anti-Black African racism, particularly among Whites previously advantaged under apartheid, were high in both years, and have increased with the emergence of the new state. The study found in addition, that orientations towards the new political dispensation were related to levels of racism. Some evidence of outgroup preference for Whites was evident among Black participants, while a degree of outgroup rejection of other Black groups was also evident among these groups in 1996. [ABSTRACT FROM AUTHOR]

In this article, we explore the effects of the political transformations in South Africa on the orientations of adolescents to these changes. The study was conducted between 1992 and 1996. This period includes the first negotiations toward a new political dispensation for the country, the first democratic elections of April 1994. and the first few years of post-apartheid democratic governance. Informed by generational and life span approaches, this study examined same effects of these changes on 14- and 17-year-old adolescents. These adolescents grew up in racially segregated South African communities, which had different experiences of the transformation process because of their position in the apartheid racial caste system. Results indicate that the separate and differential life circumstances created under apartheid powerfully shaped orientations to the changes in South Africa since 1994. All the adolescents expressed strong concern with the future. White adolescents in particular were alienated from many of the changes that have taken place, while Black African adolescents were generally positive. Those of Indian and mixed racial descent showed a variety of responses, but were also frequently negative or ambivalent. In addition, perceived differences in the society at the two times of measurement generally had more powerful influences on the participants' orientations than did age. [ABSTRACT FROM AUTHOR]

Presents the proceedings of Women's National Coalition (WONCA) conferences for the year 2001. Discussion of the proliferation of HIV/AIDS in South Africa; Principal speaker for 16th WONCA World Conference in Durban, South Africa; Highlights of the 2001 conference of the WONCA European Region and the European Society of General Practice/Family Medicine held in Tampere, Finland.

Violence is a serious problem in South Africa with many effects on health services; it presents complex research problems and requires interdisciplinary collaboration. Two key meta-questions emerge: (i) violence must be understood better to develop effective interventions; and (ii) intervention research (evaluating interventions, assessing efficacy and effectiveness, how best to scale up interventions in resource-poor settings) is necessary. A research agenda to address violence is proposed.

A sample of 355 children with intellectual disability (ID) attending special schools in Cape Town, South Africa, were assessed on the Developmental Behavioural Checklist--Teacher Version (DBC-T). A prevalence rate of 31% for psychopathology was found. Boys manifested more behaviour problems than girls, especially in relation to disruptive, self-absorbed and antisocial behaviours. Children with severe and profound levels of ID showed more behavioural difficulties than those in the mild and moderate categories. Specific behaviour problems were self-absorbed and autistic behaviours in children with profound ID, communication problems and anxiety in those with severe ID and antisocial behaviour in children with mild ID. Epilepsy, but not cerebral palsy was associated with higher total behaviour scores. Ambulant children were more disruptive and antisocial, while non-ambulant children were more anxious. Non-verbal children had higher scores on all of the subscales except for disruptive behaviour.