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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]

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. [ABSTRACT FROM AUTHOR]

Aim: Many children start school with additional health and developmental needs (AHDN), yet how best to support these children for optimal outcomes in the school setting is a complex challenge. This study aims to determine the views of education experts on what differentiates the most effective primary schools. Methods: Qualitative interviews were conducted with nine senior leaders across the education system responsible for managing or improving practice across a range of schools or school regions in Victoria. Using a positive deviance approach, which investigates strategies already implemented in organizations achieving desired outcomes, the semi‐structured interviews aimed to elicit instances of perceived good practice that already exists within the school system. Interviews were analysed using inductive content analysis. Results: All education experts reported high variability across schools and suggested a number of factors differentiating those that were most effective at supporting children with AHDN. They included the presence of strong teacher support by the school leadership team; explicit and documented processes to guide the practice of teachers and ensure consistency at a whole school level; inclusive relationships and environments; participation and knowledge sharing between medical, allied health and other stakeholders in the care team; and an evidenced‐based approach to allocating resources to programmes and strategies. Conclusion: This exploration of instances of good practice can generate novel insights into a complex problem. Current findings suggest a number of potential opportunities for enhancing practice that can be tested in future research. Improving outcomes for this vulnerable and significant group of children will require collaboration across health and education. [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]

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

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]

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. [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]

The present study examined the longer-term implications of adolescent positive mental health for successful young adult transitions. Positive mental health in adolescence was defined by indicators roughly corresponding to Seligman's positive psychology PERMA framework (positive emotional experiences, engagement, relationships, purpose, and accomplishment), with the addition of health. Data were drawn from one of Australia's longest running studies of social and emotional development (Australian Temperament Project, est. 1983, N = 2443), which has followed a large representative community sample from infancy to 27-28 years of age. In the analyzed sample of n = 999, positive mental health at 15-16 years was associated with indicators of career progression (educational attainment and perceived competence) and taking on citizenship responsibilities (volunteering and civic activities) over a decade later at 27-28 years. Mental health problems in adolescence were more relevant to establishing romantic partnerships in young adulthood: adolescent antisocial behaviors predicted higher likelihood of being in a relationship, while depressive symptoms predicted lower quality partnerships. The results suggest that successful transitions into young adult roles and responsibilities may be facilitated by targeted mental health promotion interventions designed to both foster positive mental health and address mental health difficulties in adolescence. [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]

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]

Growing concern about the global burden of child mental health disorders has generated an increased interest in population-level efforts to improve child mental health. This in turn has led to a shift in emphasis away from treatment of established disorders and towards prevention and promotion. Prevention efforts are able to draw on a substantial epidemiological literature describing the prevalence and determinants of child mental health disorders. However, there is a striking lack of clearly conceptualised and measurable positive outcomes for child mental health, which may result in missed opportunities to identify optimal policy and intervention strategies. In this paper, we propose an epidemiological approach to child mental health which is in keeping with public health principles and with the WHO definition of health, and which is grounded in current thinking about child development. Constructs such as competence offer the opportunity to develop rigorous outcome measures for epidemiological research, while broader ideas about ‘the good life’ and ‘the good society’ derived from philosophical thinking can enable us to shape policy initiatives based on normative ideas of optimal child mental health that extend beyond individuals and undoubtedly beyond the traditional boundaries of the health sector. [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 < .001, to OR = 7.49, p < .001), whereas English-proficient bilingual children had equal or slightly lower odds (OR = .84, p < .001, to OR = .97, ns). Future research with longitudinal data is now needed to establish causal pathways and explore long term outcomes. [ABSTRACT FROM AUTHOR]

Abstract: 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. [Copyright &y& Elsevier]

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. [ABSTRACT FROM AUTHOR]

Abstract: 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. [Copyright &y& Elsevier]

Relatively high levels of depression are observed during the transition to adulthood. Hence, it is important to identify the factors that can reduce the incidence of depression at this time. Social capital is theorised to protect against depression by providing greater access to support and psychological resources. Social capital incorporates both interpersonal relationships and broader community-level factors. However, most research has focused on the influence of relationships with parents and peers in the development of depression in young people, with little attention given to the role of broader social capital factors relating to perceptions of and engagement with the wider community. Drawing on longitudinal data from the Australian Temperament Project (ATP), this article examines the effects of close interpersonal relationships (with parents and peers) and broader, community-level aspects of social capital (trust and civic engagement) on depression during the transition to adulthood. Using hierarchical multiple regression, alienation from peers was found to predict higher depression, whereas good communication with peers was associated with a reduction of depressive symptoms. After controlling for the effects of close interpersonal relationships, trust in authorities and organisations made a significant contribution to the prediction of lower depression. Implications for intervention are discussed. [ABSTRACT FROM AUTHOR]

Focus of Presentation Utilising data from multiple cohorts to address causal questions in health research has become increasingly widespread due to a number of advantages. These include improved precision of estimates, in particular to investigate effect heterogeneity as well as rare events and exposures, and the ability to examine the replicability of findings. However, undertaking causal inference in multi-cohort studies also faces several challenges, which makes clear causal thinking even more important than in single-cohort studies. We propose the use of the "target trial" framework for the conduct of causal inference in multi-cohort studies. Findings Using two case studies, the first considering the effect of maternal mental health on emotional reactivity and the second examining the influence of exposure to adversity on inflammatory outcomes in childhood, we describe and demonstrate how the target trial approach enables clear definition of the target estimand and systematic consideration of sources of bias. Considering the target trial as the reference point allows the identification of potential biases within each study, so that analysis can be planned to reduce them. Furthermore, the interpretation of findings is assisted by an understanding of the unavoidable biases that may be compounded when pooling data from multiple cohorts, or that may explain discrepant findings across cohorts. Conclusions/Implications Use of the target trial framework in multi-cohort studies helps strengthen causal inferences through improved analysis design and clarity in the interpretation of findings. Key messages The target trial framework, already well-established for casual inference in single-cohort studies, is recommended for the conduct of causal inference in multi-cohort studies. [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 Methods Results Conclusions We examine precursors of child emotional distress during the COVID‐19 pandemic in a prospective intergenerational Australian cohort study.Parents (N = 549, 60% mothers) of 934 1–9‐year‐old children completed a COVID‐19 specific module in 2020 and/or 2021. Decades prior, a broad range of individual, relational and contextual factors were assessed during parents' own childhood, adolescence and young adulthood (7–8 to 27–28 years old; 1990–2010) and again when their children were 1 year old (2012–2019).After controlling for pre‐pandemic socio‐emotional behaviour problems, COVID‐19 child emotional distress was associated with a range of pre‐pandemic parental life course factors including internalising difficulties, lower conscientiousness, social skills problems, poorer relational health and lower trust and tolerance. Additionally, in the postpartum period, pre‐pandemic parental internalising difficulties, lower parental warmth, lower cooperation and fewer behavioural competencies predicted child COVID‐19 emotional distress.Findings highlight the importance of taking a larger, intergenerational perspective to better equip young populations for future adversities. This involves not only investing in child, adolescent, and young adult emotional and relational health, but also in parents raising young families. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. • Adverse experiences have detrimental effects on cardiovascular health in children. • Children exposed to positive experiences have better cardiovascular health. • Positive experiences may buffer the detrimental effect of adverse experiences. • Promoting positive experiences is needed to improve cardiovascular health. [ABSTRACT FROM AUTHOR]

Co-design and youth participatory action research are promising methodologies for increasing youth engagement in well-being interventions. The current study included 10 recent high school graduates employed as youth advisors to co-design a youth-friendly positive psychology intervention targeting the post-school transition. The youth advisors received foundational training in positive psychology, psychological needs theory and emerging adulthood. They held regular meetings to develop a Positive Transitions programme (PTP) text messaging intervention, informed by discussion of key themes, issues and relevant practical tips. This paper aims to examine the co-design process from the perspective of the youth advisors. Each youth advisor completed a survey, and six of the advisors also participated in a focus group exploring their co-design experiences. Youth advisors noted a range of personal benefits from the co-design experience including learning, enjoyment, teamwork, achievement, and pride. Areas for improvement included clarity of the project scope and the provision of support and feedback. Insights from this process are discussed, with the aim of guiding future work seeking to design youth-friendly well-being interventions. [ABSTRACT FROM AUTHOR]

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]

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. [ABSTRACT FROM AUTHOR]

Aim DNA library preparation for next generation sequencing (NGS) consists of several hundred material transfer and wash steps, which are time consuming, labor intensive, and increase the risk of repetitive strain injury. Robotic liquid handlers can automate and standardize library preparation, but few HLA laboratories have experience with high-complexity robotic platforms. We sought to evaluate the use of robotics for library preparation in conjunction with a NGS based HLA typing assay. Methods A Beckman Coulter Biomek NXp Span-8 robotic liquid handler was acquired along with the vendor supplied robotics method for the Illumina TruSight HLA v2 sequencing panel. The robotics method was first optimized with a series of runs using water, 50% glycerol, 85% ethanol, and AMPure beads. Next, DNA and reagents were run to identify sample viscosity and reagent issues. After each run, issues were communicated to the vendor for method improvement. The finalized method was run on 78 DNA samples over seven runs to assess the quality of normalization, pooling, sequencing, and reproducibility of results. Results Robotic issues were encountered with pipette calibration, labware definitions, proper labware selection, and efficiency. To add complexity, these issues had subtle compounding effects on the overall success of the method, which required that each be addressed individually and in detail. Eleven versions of the method were subsequently produced and tested to ensure robustness and consistency. The finalized method produced consistent high quality sequencing metrics on the NGS typing platform which agreed with the known HLA typing results. Conclusions Detailed documentation of issues by lab staff and clear communication with the vendor allowed for a rapid and iterative improvement of the robotics method. The lessons learned during the implementation process formed a roadmap that allowed for successful implementation of a robotics platform for NGS based HLA typing. [ABSTRACT FROM AUTHOR]

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. 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. 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. The study included 37–39-year-old Australian parents with children age between 1 and 10 years. 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. • Prospective, multi-wave studies of parent mental health resilience are rare. • We assessed risk and promotive factors decades before the COVID-19 pandemic. • A range of factors predicted parent mental health resilience during COVID-19. • Findings may assist in long-term preparation for future pandemics or crises. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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 (βrange =.11–.16) and fewer behavior problems (βrange = −.09 to −.11). Promoting strengths may secure a healthy start to life. [ABSTRACT FROM AUTHOR]

A growing body of evidence suggests that engagement with quality early childhood education and care (ECEC) programs such as preschool can enhance children’s early development. The Australian Early Development Census (AEDC) provides a unique opportunity to explore the relationship between ECEC and children’s developmental outcomes in a full population cohort of Australian school entrants. The AEDC is a teacher-rated checklist that provides data on ECEC experiences in the year before starting school, as well as five important domains of child development at school entry: physical health and wellbeing, social competence, emotional maturity, language and cognitive skills, and communication skills and general knowledge. In 2009, the AEDC was completed for 97.5% of Australian children in their first year of formal schooling ( N = 261,147; M = 5 years, 7 months of age). Logistic regression analyses revealed that attendance at preschool was associated with reduced odds (OR = 0.69, p < 0.001 to OR = 0.40, p < 0.001) of being in the vulnerable range (<10th percentile) on four of the five AEDC domains (with the exception of emotional maturity; OR = 0.89, p = 0.002), compared to other ECEC experiences, or care exclusively by parents. Subsequent analyses revealed that this effect was evident for children living in both advantaged and disadvantaged communities. Together, the results suggest that engagement with preschool programs in Australia may present a plausible, equitable, and modifiable approach to improving children's developmental outcomes. [ABSTRACT FROM AUTHOR]

Background Inflammation is one of key mechanisms linking childhood experiences to later chronic disease risk. Childhood adversity is associated with inflammation, but little is known about positive experiences. We examine how adverse and positive experiences are associated with inflammatory markers in late childhood, and whether they have an interaction effect. Methods Data sources: Longitudinal Study of Australian Children (LSAC; N = 1237) and Avon Longitudinal Study of Parents and Children (ALSPAC; N = 3488). Exposures: Adverse and positive experiences assessed from 0 to 11 (LSAC) and 0-14 years (ALSPAC). Adversity indicators included parent legal problems, family violence, mental illness, substance abuse, harsh parenting, parental divorce, neighbourhood violence, family member death, and bullying victimization. Positive experiences included positive parenting practice, trusting and supportive relationships, supportive neighbourhood and home learning environments, social engagement and enjoyment. Outcomes: Inflammation quantified by high-sensitivity C-reactive protein (hsCRP) and glycoprotein acetyls (GlycA). Analyses: Linear regression was used to estimate relative change in inflammatory markers, adjusted for sociodemographics. Outcomes were log-transformed. Results Exposure to adversity was associated with higher levels of inflammation (e.g. CRP: β = 8.8%, 95% CI= -16.5% to 34.2% in LSAC), whereas exposure to positive experiences was associated with lower levels (e.g. CRP: β=-18.9%, 95% CI= -45.8% to 7.9% in LSAC), after adjusting for sociodemographics. There was no interaction effect of adverse and positive experiences on inflammation. Conclusions Adverse and positive experiences have independent and small effects on children's inflammation across two cohorts. Key messages Positive experiences are critical to inform interventions to improve inflammatory outcomes for children who face adversity. [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]

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]

This study explores the longitudinal pathways by which risk and protective factors influence the development of alcohol-related harms in a representative community sample of 941 young adults (19-20 years) from Victoria, Australia, focusing on the role of concurrent risky drinking. Impulsivity at 15-16 years, alcohol-related harms at 15-16 years and 17-18 years, frequency of intoxication at 17-18 years, and antisocial behavior, friends' drinking and living arrangements at 19-20 years were directly related to alcohol-related harms, as well as indirectly related to harms through increased risky drinking. Paternal drinking at 17-18 years was directly related to alcohol-related harms. Friends' drinking at 19-20 years and alcohol-related harms at age 17-18 interacted with risky drinking to increase the likelihood of alcohol-related harms. Implications for intervention efforts are discussed. [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]