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This study investigated patterns of universal health and education service use from birth through Kindergarten (age 4 years) and estimated associations between cumulative risk and service use patterns, and between service use patterns and children's developmental vulnerability in the Preparatory Year (age 5 years). The study used population‐wide linkage of health and education administrative data records for 5168 children who had a 2018 AEDC instrument collected in Tasmania and were born in Tasmania (2011–2013). Latent class analysis (LCA) identified three service use patterns: Regular (72.2 per cent of children; reference group), Low (15.6 per cent of children) and High service use (12.2 per cent of children). The patterns of Regular, Low and High service use were consistent across health and education services used at different ages and stages of child development. Membership of the Low and High service use groups was associated with higher cumulative risk and increased odds of developmental vulnerability, relative to the Regular service use group. This population‐wide view of universal service use can be used by the health and education sectors to explore ways in which their specialist expertise, resources and referral processes can be further integrated within and across services to meet the developmental needs of children and families. [ABSTRACT FROM AUTHOR]

In this paper, we aim to contribute to the understanding of the multidimensional nature of school readiness. In a sample of over 4,000 Australian children in their first year of school, we used latent class analysis to examine patterns of school readiness based on child, family, school and community characteristics, and examine the relationship between these patterns of school readiness and subsequent outcomes (reading comprehension, school absence and emotional and behavioural difficulties). We identified four distinct groups: a Developmentally Enabled group (70 per cent of children), a Parenting Risk group (16 per cent of children), an Emotionally Immature Risk group (7 per cent of children) and a Language and Developmental Risks group (7 per cent of children). The four profiles showed differential patterns of association with low reading comprehension and emotional and behavioural difficulties at age 8, but no association with school absence. The study highlights the importance of family, school and community factors when considering school readiness. [ABSTRACT FROM AUTHOR]

Introduction: There is a global trend towards place-based initiatives (PBIs) to break the cycle of disadvantage and promote positive child development. Co-location is a common element of these initiatives and is intended to deliver more coordinated services for families of young children. This paper examines how co-locating early childhood services (ECS) from health and education in Child and Family Centres (CFCs) has impacted collaboration between services. Methods: This ethnographic study included 130 participant observation sessions in ECS between April 2017 and December 2018 and semi-structured interviews with 45 early childhood service providers and 39 parents/carers with pre-school aged children. Results: Service providers based in CFCs reported that co-location of services was facilitating local cooperation and collaboration between services. However, insufficient information sharing between services, prioritising client contact over collaborative practice and limited shared professional development remained barriers to collaborative practice. For parents, co-location improved access to services, but they experienced services independently of each other. Discussion and Conclusion: Co-location of ECS in CFCs contributed to greater cooperation and collaboration between services. However, for the potential of CFCs to be fully realised there remains a need for governance that better integrates service policies, systems and processes that explicitly support collaborative practice. [ABSTRACT FROM AUTHOR]

• Outreach was occurring in all early childhood services, but varied in practice. • Outreach activities were facilitating engagement with more vulnerable families. • Outreach was characterised by being purposeful and informed by principles of flexibility, consistency, responsiveness and persistence. • Policies and frameworks provided no guidance about outreach and what it entailed. Tasmanian early childhood services (ECS) are attempting to improve their engagement with vulnerable families and increase the uptake of universal health and education services in this population. This paper presents qualitative findings from the Tassie project, focusing on the scope and role of outreach in supporting family engagement in the Tasmanian ECS. Using an ethnographic study design, over 100 naturalistic observations were recorded in health and education ECS settings in Tasmanian communities between April 2017 and February 2018. In addition, 42 ECS providers and 32 parents/guardians with pre-school aged children participated in semi-structured interviews. Interview transcripts and observation field notes were analysed thematically, focusing on family engagement and the role of outreach across three key universal ECS. Outreach was undertaken by all services involved in this study, but varied in practice and scope. Outreach was not directed at specific population groups, but was instigated in response to an identified need with more vulnerable families to address issues of inequity in service access. Policies and strategic frameworks within services provided little or no guidance about outreach beyond procedures for conducting home visits. Attending specialised services alongside parents, a strategy adopted by one service, was particularly effective for facilitating connection to services for vulnerable families. The capacity of services to offer outreach was constrained by structured service systems, individual providers' skills and capability, resource limitations and lack of clarity with respect to policies and procedures. Outreach activities are occurring within the universal ECS system in Tasmania, facilitating engagement with vulnerable Tasmanian families and children. Flexible service systems, building the skills and capacities of service providers and clearer policies and procedures would enable services to more fully embed outreach practices within existing ECS. [ABSTRACT FROM AUTHOR]

The article discusses the proposed changes to the Affordable Care Act (ACA), particularly the Medicare for All and the Medicare for All with a Public Option, and their potential effects to the healthcare sector. Also cited are the issues on healthcare financing under the ACA, the potential impacts of the proposals to nursing organizations and the nurses' personal finances, as well as the coverage of the Medicare for All program like emergency services and pediatrics.

Purpose: Early language and speech acquisition can be delayed in twin children, a twinning effect that diminishes between 4 and 6 years of age in a population-based sample. The purposes of this study were to examine how twinning effects influence the identification of children with language impairments at 4 and 6 years of age, comparing children with specific language impairment (SLI) and nonspecific language impairment (NLI); the likelihood that affectedness will be shared within monozygotic versus dizygotic twin pairs; and estimated levels of heritability for SLI and NLI. Twinning effects are predicted to result in elevated rates of language impairments in twins. Method: The population-based twin sample included 1,354 children from 677 twin pairs, 214 monozygotic and 463 dizygotic, enrolled in a longitudinal study. Nine phenotypes from the same comprehensive direct behavioral assessment protocol were investigated at 4 and 6 years of age. Twinning effects were estimated for each phenotype at each age using structural equation models estimated via diagonally weighted least squares. Heritabilities were calculated for SLI and NLI. Results: As predicted, the twinning effect increased the percentage of affected children in both groups across multiple language phenotypes, an effect that diminished with age yet was still not aligned to singleton age peers. Substantial heritability estimates replicated across language phenotypes and increased with age, even with the most lenient definition of affectedness, at −1 SD. Patterns of outcomes differed between SLI and NLI groups. Conclusions: Nonverbal IQ is not on the same causal pathway as language impairments. Twinning effects on language acquisition affect classification of 4- and 6-yearold children as SLI and NLI, and heritability is most consistent in the SLI group. Clinical practice requires monitoring language acquisition of twins to avoid misdiagnosis when young or a missed diagnosis of language impairments at school entry. [ABSTRACT FROM AUTHOR]

Children whose parents have mental health disorders are at increased risk for deliberate self-harm (DSH). However, the effect of timing of parental mental health disorders on adolescent DSH risk remains under-researched. The aim of this study was to investigate how parental hospital admissions for mental health disorders and/or DSH in different developmental periods impact on the child’s DSH risk in adolescence. A nested case-control sample was compiled from a total population cohort sample drawn from administrative health records in Western Australia. The sample comprised 7,151 adolescents who had a DSH-related hospital admission (cases), and 143,020 matched controls who hadn’t had a DSH-related hospital admission. The occurrence of parental hospital admissions related to mental health disorders and/or DSH behaviours was then analysed for the cases and controls. The timing of the parental hospital admissions was partitioned into four stages in the child’s life course: (1) pre-pregnancy, (2) pregnancy and infancy, (3) childhood, and (4) adolescence. We found that adolescents of a parent with mental health and/or DSH-related hospital admissions in all developmental periods except pregnancy and infancy were significantly more likely than controls to have a DSH-related hospital admission. Compared to parental hospital admissions that occurred during childhood and adolescence, those that occurred before pregnancy conferred a higher risk for adolescent DSH: adjusted odds ratio (aOR) = 1.25 for having only one parent hospitalised and 1.66 for having both parents hospitalised for mental health disorders; aOR = 1.97 for having any parent hospitalised for DSH, all being significant at the level of p < .001. This study shows that timing is important for understanding intergenerational transmission of DSH risk. The pre-pregnancy period is as critical as period after childbirth for effective intervention targeting adult mental health disorders and DSH, highlighting the important role of adult mental health services in preventing DSH risk in future generations. [ABSTRACT FROM AUTHOR]

Resilience is defined as a dynamic and contextually embedded process of positive development despite exposure to significant adversity. The Australian Aboriginal and Torres Strait Islander population experience significant disadvantage and adversity relative to the non-Aboriginal population, with disproportionate and increasing rates of Aboriginal children in out-of-home care and substantiated child maltreatment seven times the rates for non-Aboriginal children. Despite decades of resilience research there remains a gap in our understanding of the extent to which specific mechanisms and processes support resilient outcomes. This discussion paper synthesizes findings from our four previously published studies which together illustrate the application of a person-based resilience framework of analysis in the context of Western Australian Aboriginal youth. We discuss the implications of this approach for better understanding processes differentially impacting psychosocial functioning of youth depending on level of family-risk exposure. Data for these studies were available for 1021 Aboriginal youth, 12–17 years, drawn from the 2000–2002 Western Australian Aboriginal Child Health Survey (WAACHS), a population representative survey of 5289 Aboriginal children (0–17 years) living in 1999 families. Multivariate logistic regression analyses were used to model the differential influence of individual, family, cultural and community factors on psychosocial outcomes depending on family-risk context. Key findings revealed 56% of high-risk youth as psychosocially resilient; prosocial friendship and living in low SES neighborhoods uniquely protected psychosocial functioning; and exposure to racism was an additional risk factor for low-risk exposed youth. We conclude that a resilience perspective holds potential for exploring diversity within disadvantaged populations, identifying processes uniquely beneficial for those at greatest risk, and provides crucial insights for communities, practitioners and policy-makers. [ABSTRACT FROM AUTHOR]

Tasmania’s child and family centres (Centres) provide a single entry point to early childhood services (ECS) for children and families living in amongst the most disadvantaged communities in Australia. This study investigated the impact of Centres on parents’ use and experiences of ECS using a mixed methods approach. The results showed that Centre users made more use of ECS than did non-users. Centre users also rated their experiences of ECS more positively than non-users. For example, Centre users were more likely to report that ECS were convenient and close, committed to helping, and worked closely with one another. Centre users identified Centres as informal, accessible, responsive, non-judgemental and supportive places where they felt valued, respected and safe. Parents experienced Centres as welcoming places that were helping them to develop positive child, family, school and community connections. These qualities appeared critical for facilitating parental access and engagement in ECS. [ABSTRACT FROM PUBLISHER]

Studies generally show children who have entered out-of-home care have worse educational outcomes than the general population, although recent research suggests maltreatment and other adversities are major contributing factors. Children’s out-of-home care experiences vary and may affect their outcomes. This study examined the influence of placement stability, reunification, type of care, time in care and age at entry to care on children’s educational outcomes. We conducted a population-based record-linkage study of children born in Western Australia between 1990 and 2010 who sat State or national Year 3 reading achievement tests (N = 235,045 children, including 2160 children with a history of out-of-home care). Children’s educational outcomes varied with many aspects of their care experience. Children placed in residential care were particularly likely to have low scores, with an unadjusted OR 6.81, 95% CI[4.94, 9.39] for low reading scores, which was partially attenuated after adjusting for background risk factors but remained significant (OR = 1.50, 95% CIs [1.08, 2.08]). Reading scores were also lower for children who had experienced changes in care arrangements in the year of the test. A dose-response effect for multiple placements was expected but not found. Older age at entering care was also associated with worse reading scores. Different characteristics of a child’s care history were interwoven with each other as well as child, family and neighbourhood characteristics, highlighting a need for caution in attributing causality. Although the level of educational difficulties varied, the findings suggest a widespread need for additional educational support for children who have entered care, including after reunification. [ABSTRACT FROM AUTHOR]

Adolescents exposed to maltreatment have an elevated risk of deliberate self-harm (DSH). The aim of this study was to investigate longitudinally the effects of the number, timing, and type of maltreatment allegations on adolescent risk of having a DSH-related hospital admission, using linked data in Western Australia. A total of 351,372 children born between 1986 and 2000 were followed from birth up to the year 2010. Cox regression models were utilized, while controlling for a range of psychosocial covariates. Compared to children without allegations of maltreatment, children with unsubstantiated allegations only (aHR = 1.04, 95%CI: 1.00–1.08, p < .01) and children with a substantiated allegation (aHR = 1.10, 95%CI: 1.06–1.15, p < .001) all had significantly increased risk of DSH in adolescence. Among children with a substantiated allegation of maltreatment, the greater the number of allegations, the longer the exposure to maltreatment, and the more types of maltreatment experienced by a child, the higher the child's risk of DSH. However, this dose–response pattern was not found among children with unsubstantiated allegations only. This study calls for the early identification of children who are vulnerable to maltreatment, the better identification of the duration and severity of maltreatment experiences, and the provision of continued care and support, to reduce the child's DSH risk in adolescence. [ABSTRACT FROM AUTHOR]

Risk exposures and predictions of child development outcomes typically estimate the independent effects of individual exposures. As a rule though, children are not exposed piecemeal to individual or single risks but, rather, they are exposed to clusters of risk. Many of these clusters of risks are better thought of as comprising a developmental “circumstance” with a substantial duration, over which period, additional risk exposures also accumulate. In this paper we examined the distribution of 16 single risk exposures for low language ability using latent class analysis across a sample of approximately 4000 children from the Longitudinal Study of Australian Children. The best fitting model identified six distinct classes. 46% of children were in a Developmentally Enabled group, 20% were in a group typified as Working Poor families, 10% of children were in group typified as Overwhelmed group, 9% of children were in a group defined by Child Developmental Delay, 8% of children were in a group defined by Low Human Capital, and 7% of children were in a group defined by Resource Poor non-English Speaking background families. These groups had quantitatively and qualitatively distinct patterns of risk factors and showed different onward trajectories of receptive vocabulary. Our results demonstrate a range of multiple risk profiles in a population-representative sample of Australian children and highlight the mix of risk factors faced by children. Children with distinct patterns of risk factors have different onward trajectories of receptive vocabulary development. [ABSTRACT FROM AUTHOR]

Maltreatment largely occurs in a multiple-risk context. The few large studies adjusting for confounding factors have raised doubts about whether low educational achievement results from maltreatment or co-occurring risk factors. This study examined prevalence, risk and protective factors for low educational achievement among children involved with the child protection system compared to other children. We conducted a population-based record-linkage study of children born in Western Australia who sat national Year 3 reading achievement tests between 2008 and 2010 ( N = 46,838). The longitudinal study linked data from the Western Australian Department of Education, Department of Child Protection and Family Support, Department of Health, and the Disability Services Commission. Children with histories of child protection involvement (unsubstantiated maltreatment reports, substantiations or out-of-home care placement) were at three-fold increased risk of low reading scores. Adjusting for socio-demographic adversity partially attenuated the increased risk, however risk remained elevated overall and for substantiated (OR = 1.68) and unsubstantiated maltreatment (OR = 1.55). Risk of low reading scores in the out-of-home care group was fully attenuated after adjusting for socio-demographic adversity (OR = 1.16). Attendance was significantly higher in the out-of-home care group and served a protective role. Neglect, sexual abuse, and physical abuse were associated with low reading scores. Pre-existing adversity was also significantly associated with achievement. Results support policies and practices to engage children and families in regular school attendance, and highlight a need for further strategies to prevent maltreatment and disadvantage from restricting children's opportunities for success. [ABSTRACT FROM AUTHOR]

Aims: Oral language is the foundation of literacy. Naturally, policies and practices to promote children’s literacy begin in early childhood and have a strong focus on developing children’s oral language, especially for children with known risk factors for low language ability. The underlying assumption is that children’s progress along the oral to literate continuum is stable and predictable, such that low language ability foretells low literacy ability. This study investigated patterns and predictors of children’s oral language and literacy abilities at 4, 6, 8 and 10 years. The study sample comprised 2,316 to 2,792 children from the first nationally representative Longitudinal Study of Australian Children (LSAC). Six developmental patterns were observed, a stable middle-high pattern, a stable low pattern, an improving pattern, a declining pattern, a fluctuating low pattern, and a fluctuating middle-high pattern. Most children (69%) fit a stable middle-high pattern. By contrast, less than 1% of children fit a stable low pattern. These results challenged the view that children’s progress along the oral to literate continuum is stable and predictable. Findings: Multivariate logistic regression was used to investigate risks for low literacy ability at 10 years and sensitivity-specificity analysis was used to examine the predictive utility of the multivariate model. Predictors were modelled as risk variables with the lowest level of risk as the reference category. In the multivariate model, substantial risks for low literacy ability at 10 years, in order of descending magnitude, were: low school readiness, Aboriginal and/or Torres Strait Islander status and low language ability at 8 years. Moderate risks were high temperamental reactivity, low language ability at 4 years, and low language ability at 6 years. The following risk factors were not statistically significant in the multivariate model: Low maternal consistency, low family income, health care card, child not read to at home, maternal smoking, maternal education, family structure, temperamental persistence, and socio-economic area disadvantage. The results of the sensitivity-specificity analysis showed that a well-fitted multivariate model featuring risks of substantive magnitude did not do particularly well in predicting low literacy ability at 10 years. [ABSTRACT FROM AUTHOR]

This study investigated the differential influence of contextual risks for positive psychosocial functioning and participation in education or employment in a representative sample of 12- to 17-year-old Aboriginal youth ( N = 674) using data drawn from the Western Australian Aboriginal Child Health Survey ( WAACHS) 2000-2002. The authors modeled the influence of 3 empirical risk measures (risk factor, cumulative risk, and single risks) on positive psychosocial functioning and participation in education or employment. Results showed different risks for different developmental outcomes. Single sociodemographic risks were associated with reduced likelihood of positive psychosocial functioning, whereas cumulative risk and composite Family Health and Community Risk measures were associated with reduced likelihood of participation in education or employment. Methodological issues and implications for interventions to support young Aboriginal people's adaptation are discussed. [ABSTRACT FROM AUTHOR]

Receptive vocabulary develops rapidly in early childhood and builds the foundation for language acquisition and literacy. Variation in receptive vocabulary ability is associated with variation in children's school achievement, and low receptive vocabulary ability is a risk factor for under-achievement at school. In this study, bivariate and multivariate growth curve modelling was used to estimate trajectories of receptive vocabulary development in relation to a wide range of candidate child, maternal and family level influences on receptive vocabulary development from 4–8 years. The study sample comprised 4332 children from the first nationally representative Longitudinal Study of Australian Children (LSAC). Predictors were modeled as risk variables with the lowest level of risk as the reference category. In the multivariate model, risks for receptive vocabulary delay at 4 years, in order of magnitude, were: Maternal Non- English Speaking Background (NESB), low school readiness, child not read to at home, four or more siblings, low family income, low birthweight, low maternal education, maternal mental health distress, low maternal parenting consistency, and high child temperament reactivity. None of these risks were associated with a lower rate of growth from 4–8 years. Instead, maternal NESB, low school readiness and maternal mental health distress were associated with a higher rate of growth, although not sufficient to close the receptive vocabulary gap for children with and without these risks at 8 years. Socio-economic area disadvantage, was not a risk for low receptive vocabulary ability at 4 years but was the only risk associated with a lower rate of growth in receptive vocabulary ability. At 8 years, the gap between children with and without socio-economic area disadvantage was equivalent to eight months of receptive vocabulary growth. These results are consistent with other studies that have shown that social gradients in children's developmental outcomes increase over time. [ABSTRACT FROM AUTHOR]

Background: Response-contingent time-out has been shown to be an effective technique for enhancing fluency in people who stutter. However, the factors that determine individual responsiveness to time-out are not well understood. Aims: The study investigated the effectiveness of using response-contingent time-out to reduce stuttering frequency in adults who stutter. In addition, it investigated the predictive value of participants' stutter severity, age, previous treatment history, and type of stutter on the responsiveness to time-out conditioning. Methods & Procedures: Sixty people who stutter participated in the study. Half were exposed to time-out following each moment of stuttering over a 40-min period, the remaining participants acted as controls. Outcomes & Results: Results showed that individuals who stutter are highly responsive to time-out, and that the participants with a more severe stutter responded better than those with a mild stutter. To a lesser degree, previous treatment and speech rate also influenced treatment success. Age and type of stutter did not, although the proportion of repetition types of stutters increased over the experiment conditions, with prolongations and blocks decreasing, for the treatment group. Conclusions: This simple operant conditioning treatment method is effective in reducing stuttering. Individuals respond to time-out regardless of their age, type of stutter, stuttering severity or treatment history, thus it is a treatment methodology potentially suitable for all clients. This study investigated initial responsiveness to time-out; therefore, further research is necessary to determine the durability of fluency over time. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the language outcomes of 7-year-old children with and without a history of late language emergence at 24 months. Method: One hundred twenty-eight children with a history of late language emergence (LLE) at 24 months and 109 children with a history of normal language emergence (NLE) at 24 months participated in direct behavioral assessment of multiple dimensions of language at 7 years. The children were recruited from a prospective cohort study of 1,766 epidemiologically ascertained 24-month-old singleton children. Results: The group mean for the LLE children was within the typical range on an omnibus measure of general language ability and measures of specific dimensions of language. However, a greater percentage of LLE children, relative to NLE children, performed below normative expectations on a measure of general language ability (20% versus 11%), speech (7% versus 2%), syntax (18% versus 8%), and morphosyntax (9%-23% versus 2%-14%), but not vocabulary or semantics. Conclusion: The results provide support for growth models of language impairment that predict that late onset of language foretells a protracted growth difference for some LLE children relative to NLE children, particularly for syntax and morphosyntax. [ABSTRACT FROM AUTHOR]

Purpose: The primary objectives of this study were to determine the prevalence of late language emergence (LLE) and to investigate the predictive status of maternal, family, and child variables. Method: This is a prospective cohort study of 1,766 epidemiologically ascertained 24-month-old singleton children. The framework was an ecological model of child development encompassing a wide range of maternal, family, and child variables. Data were obtained using a postal questionnaire. Item analyses of the 6-item Communication scale of the Ages and Stages Questionnaire (ASQ; D. Bricker & J. Squires, 1999; J. Squires & D. Bricker, 1993; J. Squires, D. Bricker, & L. Potter, 1997; J. Squires, L. Potter, & D. Bricker, 1999) yielded a composite score encompassing comprehension as well as production items. One SD below the mean yielded good separation of affected from unaffected children. Analyses of bivariate relationships with maternal, family, and child variables were carried out, followed by multivariate logistic regression to predict LLE group membership. Results: 13.4% of the sample showed LLE via the ASQ criterion, with 19.1% using the single item of "combining words." Risk for LLE at 24 months was not associated with particular strata of parental educational levels, socioeconomic resources, parental mental health, parenting practices, or family functioning. Significant predictors included familial history of LLE, male gender, and early neurobiological growth. Covariates included psychosocial indicators. Conclusion: Results are congruent with models of language emergence and impairment that posit a strong role for neurobiological and genetic mechanisms of onset that operate across a wide variation in maternal and family characteristics. [ABSTRACT FROM AUTHOR]

Idioms (e.g., go by the book, keep a straight face) are figurative expressions that frequently occur in the English language. Given the pervasiveness of these expressions, it is important that young people can understand their meanings. Developmental studies have shown that idioms that are higher in familiarity and transparency (e.g., blow off some steam) are generally easier for children and adolescents to understand than those that are less familiar and more opaque (e.g., pull up one's socks). In those studies, judgments of idiom familiarity and transparency were based on the perceptions of individuals who were older than the study participants. In the present study, 11-year-old children (n = 50) and 16-year-old adolescents (n = 50) were asked to judge the familiarity and transparency of a set of 20 idioms. Their comprehension of the same expressions was also examined. The results indicated that the children were less familiar with the idioms and had greater difficulty comprehending them than did the adolescents. However, the children's transparency judgments did not differ from those of the adolescents. For the children, the easiest idioms were also more familiar and transparent than the most difficult expressions. For the adolescents, the easiest idioms were more transparent than the most difficult ones, but the two types did not differ in familiarity. Suggestions are offered for conducting future studies of the development of idiom understanding in youth. [ABSTRACT FROM AUTHOR]

Maltreated children are at high risk for low educational achievement, however few studies have accounted for confounding risk factors that commonly co-occur (including child, family and neighbourhood risk factors) and results have been mixed, particularly for adolescents. We aimed to 1) examine the relationship between maltreatment and low educational achievement among Year 9 students, taking into account child, family and neighbourhood risk factors; 2) assess subgroup differences in outcomes based on level of child protection involvement and maltreatment type; and 3) identify prevalence and risk factors for low educational achievement. A population birth cohort of West Australian children (N = 33,866) who sat national reading achievement tests between 2008 and 2010 was used for the main analysis. Linked administrative data from Departments of Health, Communities (Child Protection and Family Support), Education, and the Disability Services Commission was used to conduct a series of logistic regression analyses. Maltreatment was significantly associated with low Year 9 achievement, even after accounting for many child, family and neighbourhood risk factors (aOR 1.51, 95 % CI 1.35–1.69). Educational outcomes were consistently poor across subgroups in the child protection system, including those with different levels of child protection involvement and maltreatment types. Other notable risk factors for low achievement included intellectual disability, attendance, parents' level of education, Aboriginality, and being older (indicating possible grade retention). Adolescents with a history of maltreatment are at risk for poor educational outcomes and need additional support. Multiple contributing risk factors suggest the need for whole-of-government solutions. [ABSTRACT FROM AUTHOR]

Background: To investigate associations between interpregnancy intervals (IPIs) and adverse birth outcomes in twin pregnancies. Methods: This retrospective cohort study of 9,867 twin pregnancies in Western Australia from 1980–2015. Relative Risks (RRs) were estimated for the interval prior to the pregnancy (IPI) as the exposure and after the pregnancy as a negative control exposure for preterm birth (< 37 weeks), early preterm birth (< 34 weeks), small for gestational age (SGA: < 10th percentile of birth weight by sex and gestational age) and low birth weight (LBW: birthweight < 2,500 g). Results: Relative to IPIs of 18–23 months, IPIs of < 6 months were associated with a higher risk of early preterm birth (aRR 1.41, 95% CI 1.08–1.83) and LBW for at least one twin (aRR 1.16, 95% CI 1.06–1.28). IPIs of 6–11 months were associated with a higher risk of SGA (aRR 1.24, 95% CI 1.01–1.54) and LBW for at least one twin (aRR 1.09, 95% CI 1.01–1.19). IPIs of 60–119 months and ≥ 120 months were associated with an increased risk of preterm birth (RR 1.12, 95% CI 1.03–1.22; and (aRR 1.25, 95% CI 1.10–1.41, respectively), and LBW for at least one twin (aRR 1.17, 95% CI 1.08–1.28; and aRR 1.20, 95% CI 1.05–1.36, respectively). IPIs of ≥ 120 months were also associated with an increased risk of early preterm birth (aRR 1.42, 95% CI 1.01–2.00). After negative control analysis, IPIs ≥ 120 months remained associated with early preterm birth and LBW. Conclusion: Evidence for adverse associations with twin birth outcomes was strongest for long IPIs. [ABSTRACT FROM AUTHOR]

Literacy and numeracy are essential for success in life. In Australia, students' academic achievement is monitored using the National Assessment Program – Literacy and Numeracy (NAPLAN). One of the aims of NAPLAN is that results will drive student improvement by identifying which students are underperforming against national minimum standards and who require additional learning support. This study investigated the performance trajectories of students who were identified as "below the national minimum standards", relative to students above the national minimum standards. This study used standardised reading and numeracy test scores for Australian students and regression discontinuity methods to investigate whether students who performed below the national minimum standards showed improved performance in subsequent years compared with similar students above the national minimum standards threshold. On average, achievement gaps between students below the standards and students at or above the standards persisted across year levels. Labelling students below the national minimum standards had no significant effects on later reading or numeracy achievement. The results suggest the NAPLAN national minimum standards labelling is not driving student improvement, highlighting the need for effective early identification and interventions for children who do not meet school year benchmarks for literacy and numeracy. [ABSTRACT FROM AUTHOR]

The article discusses a study carried out for examining the impacts caused by a low-intensity language promotion programme "Let's Learn Language," on the language and behavioral development and specific language impairment (SLL) in children. Research proves that late talking children also catch-up and learn language abilities with time. The association between parental input characteristics and early language acquisition in children is explained.

The risk factors associated with absenteeism are well known. However, children's exposure to combinations of risks and how these relate to absence patterns remains unclear. Understanding variations in risk profiles among persistently non-attending children will inform the development of absence interventions. Using a longitudinal sample of Australian children (6-11 years), a latent class analysis of 19 risks identified four classes of risk exposure. Most children (56%) were exposed to minimal risk, 20% were exposed to parenting, child development, and mental health risks only, 15% were exposed to a greater extent to financial risks only, and 9% had a higher probability of exposure to all risks. Persistently non-attending children were eight times more likely to be in the high-risk group than regular attenders. However, one-third of persistent non-attenders were classified as low-risk. The heterogeneity of risk profiles is discussed in relation to policies using financial penalties to motivate improved attendance. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates the heritability of language, speech, and nonverbal cognitive development of twins at 4 and 6 years of age. Possible confounding effects of twinning and zygosity, evident at 2 years, were investigated among other possible predictors of outcomes. Method: The population-based twin sample included 627 twin pairs and 1 twin without a co-twin (197 monozygotic and 431 dizygotic), 610 boys and 645 girls, 1,255 children in total. Nine phenotypes from the same comprehensive direct behavioral assessment protocol were investigated at 4 and 6 years of age. Twinning effects were estimated for each phenotype at each age using general linear mixed models using maximum likelihood. Results: Twinning effects decreased from 4 to 6 years; zygosity effects disappeared by 6 years. Heritability increased from 4 to 6 years across all 9 phenotypes, and the heritability estimates were higher than reported previously, in the range of .44-.92 at 6 years. The highest estimate, .92, was for the clinical grammar marker. Conclusions: Across multiple dimensions of speech, language, and nonverbal cognition, heritability estimates are robust. A finiteness marker of grammar shows the highest inherited influences in this early period of children's language acquisition. [ABSTRACT FROM AUTHOR]

There is a large volume of research on the persistence of advantage and disadvantage across generations. Intergenerational studies typically address family resources as independent factors, which ignores how risks cluster together and accumulate over time. Using data from the Longitudinal Study of Australian Children, we conducted two latent class analyses to separately identify latent classes based on grandparent and parent characteristics for study children. We then examined the association between our identified latent classes and grandchild educational outcomes in Years 3 to 9. Five distinct latent classes of grandparent characteristics and four latent classes of parent characteristics were identified. There was association between parent and grandparent latent classes indicating intergenerational multiple disadvantage. Grandchildren in at‐risk parent latent classes tended to have significantly lower literacy and numeracy scores from Years 3 to 9. The effects of grandparent latent classes were inconsistent. The developmental circumstances of children can be defined using the characteristics of both parents and grandparents, and the role of grandparents on children's development extends beyond the influence they have on parent outcomes. This study highlights that addressing intergenerational transfers of disadvantage requires multiple, integrated and coordinated policy approaches that go beyond individual indicators of disadvantage. [ABSTRACT FROM AUTHOR]

Background: Psychosocial processes are implicated as mediators of racial/ethnic health disparities via dysregulation of physiological responses to stress. Our aim was to investigate the extent to which factors previously documented as buffering the impact of high-risk family environments on Aboriginal youths’ psychosocial functioning were similarly beneficial for their physical health status. Method and Results: We examined the relationship between psychosocial resilience and physical health of urban Aboriginal youth (12–17 years, n = 677) drawn from a representative survey of Western Australian Aboriginal children and their families. A composite variable of psychosocial resilient status, derived by cross-classifying youth by high/low family risk exposure and normal/abnormal psychosocial functioning, resulted in four groups- Resilient, Less Resilient, Expected Good and Vulnerable. Separate logistic regression modeling for high and low risk exposed youth revealed that Resilient youth were significantly more likely to have lower self-reported asthma symptoms (OR 3.48, p<.001) and carer reported lifetime health problems (OR 1.76, p<.04) than Less Resilient youth. Conclusion: The findings are consistent with biopsychosocial models and provide a more nuanced understanding of the patterns of risks, resources and adaptation that impact on the physical health of Aboriginal youth. The results support the posited biological pathways between chronic stress and physical health, and identify the protective role of social connections impacting not only psychosocial function but also physical health. Using a resilience framework may identify potent protective factors otherwise undetected in aggregated analyses, offering important insights to augment general public health prevention strategies. [ABSTRACT FROM AUTHOR]

We investigate whether the profile of factors protecting psychosocial functioning of high risk exposed Australian Aboriginal youth are the same as those promoting psychosocial functioning in low risk exposed youth. Data on 1,021 youth aged 12–17 years were drawn from the Western Australian Aboriginal Child Health Survey (WAACHS 2000–2002), a population representative survey of the health and well-being of Aboriginal children, their families and community contexts. A person-centered approach was used to define four groups of youth cross-classified according to level of risk exposure (high/low) and psychosocial functioning (good/poor). Multivariate logistic regression was used to model the influence of individual, family, cultural and community factors on psychosocial outcomes separately for youth in high and low family-risk contexts. Results showed that in high family risk contexts, prosocial friendship and low area-level socioeconomic status uniquely protected psychosocial functioning. However, in low family risk contexts the perception of racism increased the likelihood of poor psychosocial functioning. For youth in both high and low risk contexts, higher self-esteem and self-regulation were associated with good psychosocial functioning although the relationship was non-linear. These findings demonstrate that an empirical resilience framework of analysis can identify potent protective processes operating uniquely in contexts of high risk and is the first to describe distinct profiles of risk, protective and promotive factors within high and low risk exposed Australian Aboriginal youth. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the etiology of late language emergence (LLE) in 24-month-old twins, considering possible twinning, zygosity, gender, and heritability effects for vocabulary and grammar phenotypes. Method: A population-based sample of 473 twin pairs participated. Multilevel modeling estimated means and variances of vocabulary and grammar phenotypes, controlling for familiality. Heritability was estimated with DeFries–Fulker regression and variance components models to determine effects of heritability, shared environment, and nonshared environment. Results: Twins had lower average language scores than norms for single-born children, with lower average performance for monozygotic than dizygotic twins and for boys than girls, although gender and zygosity did not interact. Gender did not predict LLE. Significant heritability was detected for vocabulary (0.26) and grammar phenotypes (0.52 and 0.43 for boys and girls, respectively) in the full sample and in the sample selected for LLE (0.42 and 0.44). LLE and the appearance of Word Combinations were also significantly heritable (0.22–0.23). Conclusions: The findings revealed an increased likelihood of LLE in twin toddlers compared with single-born children that is modulated by zygosity and gender differences. Heritability estimates are consistent with previous research for vocabulary and add further suggestion of heritable differences in early grammar acquisition. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the etiology of late language emergence (LLE) in 24-month-old twins, considering possible twinning, zygosity, gender, and heritability effects for vocabulary and grammar phenotypes. Method: A population-based sample of 473 twin pairs participated. Multilevel modeling estimated means and variances of vocabulary and grammar phenotypes, controlling for familiality. Heritability was estimated with DeFries–Fulker regression and variance components models to determine effects of heritability, shared environment, and nonshared environment. Results: Twins had lower average language scores than norms for single-born children, with lower average performance for monozygotic than dizygotic twins and for boys than girls, although gender and zygosity did not interact. Gender did not predict LLE. Significant heritability was detected for vocabulary (0.26) and grammar phenotypes (0.52 and 0.43 for boys and girls, respectively) in the full sample and in the sample selected for LLE (0.42 and 0.44). LLE and the appearance of Word Combinations were also significantly heritable (0.22–0.23). Conclusions: The findings revealed an increased likelihood of LLE in twin toddlers compared with single-born children that is modulated by zygosity and gender differences. Heritability estimates are consistent with previous research for vocabulary and add further suggestion of heritable differences in early grammar acquisition. [ABSTRACT FROM AUTHOR]

School readiness is a construct used by educators and policy makers to describe a range of abilities that are beneficial for children transitioning to school. The association of socioeconomic disadvantage with developmental vulnerability when children start school is well established. Parents play a crucial role in supporting children's transition to school and are acknowledged as their child's first and foremost teacher. The aim of this study was to explore how parents experience and support their children's transition to school. This study presents findings from an ethnographic study with 39 parents living in two Australian communities characterised by high area-level socioeconomic disadvantage. The study reports on how parents experience and support their child for transition to school, specifically through their understanding of the concept of 'readiness'. The role of early childhood services in supporting parents is also explored. Parents conceptualised school readiness as the child's capacity to function effectively and independently in the hitherto unfamiliar physical and social world of school. Parents considered early childhood services supportive of their children's transition to school, particularly the development of social skills. [ABSTRACT FROM AUTHOR]

OBJECTIVE. The aim of this study was to investigate the association of dose and timing of prenatal alcohol exposure with early language acquisition. METHODS. We examined language delay in a randomly selected, population-based sample of Western Australian children born in 1995-1996 whose mothers had agreed to participate in a longitudinal study on health-related behaviors and who had completed the 2-year questionnaire (N = 1739). Information on alcohol consumption was collected at 3 months after birth for four periods; the three months pre-pregnancy and for each trimester separately. Prenatal alcohol exposure was grouped into none, low, moderate-heavy and binge (>5) based on the total quantity consumed per week, quantity consumed per occasion, and frequency of consumption. The communication scale from the Ages & Stages Questionnaire was used to evaluate language delay. Logistic regression analysis was used to generate odds ratios and 95% confidence intervals, adjusted for confounding factors. RESULTS. There was no association between low levels of alcohol consumption and language delay at any time period, although there was a nonsignificant 30% increase in risk when moderate-to-heavy levels of alcohol were consumed in the third trimester. Children exposed to a binge pattern of maternal alcohol consumption in the second trimester had nonsignificant, three-fold increased odds of language delay, with a similar estimate following third trimester alcohol exposure after controlling for covariates. CONCLUSIONS. This study did not detect an association between low levels of prenatal alcohol exposure and language delay when compared with women who abstained from alcohol during pregnancy. A nonsignificant threefold increase in the likelihood of language delay was seen in children whose mothers binged during late pregnancy. However, the small numbers of women with a binge-drinking pattern in late pregnancy limited the power of this study; studies analyzing larger numbers of children exposed to binge drinking in late pregnancy are needed. [ABSTRACT FROM AUTHOR]

This article describes the use of a slightly modified version of the Eating Disorders Examination (EDE) in children. Of the 16 children (10 F 6 M), 11 had a diagnosis of anorexia nervosa, and 5 of eating disorder not otherwise specified (EDNOS). There were interesting differences in responses on items assessing core overvalued ideas, with weight and/or shape concerns emerging as of great importance in terms of self-evaluation in the majority of children with anorexia nervosa. Results suggest that this may be a useful assessment tool in children, with some children obtaining global and subscale scores consistent with adult norms for females with eating disorders. Problems of the administration of the EDE to this patient group are discussed and details of the modifications used are outlined. [ABSTRACT FROM AUTHOR]

In most English-speaking countries, the children of Asian immigrants have better academic outcomes than other children, yet the underlying causes of their advantages are unclear. Using decade-long time use diaries on two cohorts of children, we present new evidence that children of Asian immigrants spend more time than their peers on educational activities beginning at school entry and that the ethnicity gap in the time allocated to educational activities increases as children age. We can attribute the academic advantage of children of Asian immigrants mainly to their allocating more time to educational activities or their favorable initial cognitive abilities, not to socio-demographics or so-called "tiger parenting" styles. Furthermore, our results show substantial heterogeneity in the contributions of initial cognitive abilities and time allocations by test subjects, children's ages, and points of the test score distribution. [ABSTRACT FROM AUTHOR]

Objective: The risk of repetition of deliberate self-harm peaks in the first 7 days after a deliberate self-harm episode. However, thus far no studies have examined the risk factors for repeating deliberate self-harm during this short-term period. We aimed to investigate the effects of socio-demographic factors, self-harm method and mental health factors in adolescents (10–19 years old) and young adults (20–29 years old). Methods: We used data linkage of population-wide administrative records from hospital inpatients and emergency departments to identify all the deliberate self-harm–related episodes that occurred in adolescents and young adults in Western Australia from 2000 to 2011. Logistic regression with generalised estimating equations was used for the analyses. Results: The incidence of repeating deliberate self-harm within the first 7 days after an index episode was 6% (403/6,768) in adolescents and 8% (842/10,198) in young adults. Socio-demographic risk factors included female gender and socioeconomic disadvantage. Compared with non-poisoning, self-poisoning predicted increased risk of having a repeated deliberate self-harm episode in males, but not in females. Borderline personality, impulse-control and substance use disorders diagnosed within one week before and one week after an index deliberate self-harm episode conferred the highest risk, followed by depressive and anxiety disorders. Having a preceding deliberate self-harm episode up to 7 days before an index episode was a strong predictor for the future repetition of a deliberate self-harm episode. Conclusion: Having a repeated deliberate self-harm episode within the first 7 days was related to a wide range of factors present at an index deliberate self-harm episode including socio-demographic characteristics, deliberate self-harm method and co-existing psychiatric conditions. These factors can inform risk assessments tailored to adolescents and young adults respectively to reduce the repetition of deliberate self-harm within a short but critical period, potentially contributing to reduce the repetition of deliberate self-harm in the long term. [ABSTRACT FROM AUTHOR]

Receptive vocabulary development is a component of the human language system that emerges in the first year of life and is characterised by onward expansion throughout life. Beginning in infancy, children's receptive vocabulary knowledge builds the foundation for oral language and reading skills. The foundations for success at school are built early, hence the public health policy focus on reducing developmental inequalities before children start formal school. The underlying assumption is that children's development is stable, and therefore predictable, over time. This study investigated this assumption in relation to children's receptive vocabulary ability. We investigated the extent to which low receptive vocabulary ability at 4 years was associated with low receptive vocabulary ability at 8 years, and the predictive utility of a multivariate model that included child, maternal and family risk factors measured at 4 years. The study sample comprised 3,847 children from the first nationally representative Longitudinal Study of Australian Children (LSAC). Multivariate logistic regression was used to investigate risks for low receptive vocabulary ability from 4–8 years and sensitivity-specificity analysis was used to examine the predictive utility of the multivariate model. In the multivariate model, substantial risk factors for receptive vocabulary delay from 4–8 years, in order of descending magnitude, were low receptive vocabulary ability at 4 years, low maternal education, and low school readiness. Moderate risk factors, in order of descending magnitude, were low maternal parenting consistency, socio-economic area disadvantage, low temperamental persistence, and NESB status. The following risk factors were not significant: One or more siblings, low family income, not reading to the child, high maternal work hours, and Aboriginal or Torres Strait Islander ethnicity. The results of the sensitivity-specificity analysis showed that a well-fitted multivariate model featuring risks of substantive magnitude does not do particularly well in predicting low receptive vocabulary ability from 4–8 years. [ABSTRACT FROM AUTHOR]

A contingent valuation survey was designed and implemented in 2003 to elicit the willingness to pay for haze reduction in scenic areas of the Eastern United States. This survey updated and enhanced a portion of a 1988 survey, Chestnut and Rowe's Preservation Values Study, which is commonly used to estimate benefits of haze reduction policies. The 2003 survey incorporated features to address criticisms of the 1988 survey regarding its lack of budget constraints and its simplistic descriptions of changes in visibility. In preparing the new survey, we identified a fundamental error in the 1988 survey regarding the amount of visibility change that respondents were asked to value. When corrected, it reduces the estimates in that study of willingness to pay per unit of visibility change by ∼40%. More importantly, we estimate that haze reduction benefits based on that study are overstated by ∼70%. Results from our 2003 survey demonstrate that the distribution of willingness to pay is highly skewed, which implies that a haze reduction policy of which the costs per person are equal to the average willingness to pay would be rejected by between 70% and 80% of the public if subjected to a majority vote. Moreover, estimates of willingness to pay are sensitive to how respondents are reminded of their budget constraints. We find a statistically significant decline in willingness to pay when budgetary reminders are included. Finally, we find evidence that a large portion of the willingness to pay appears to be associated with improvement on the worst condition days. Little additional value appears to be associated with improvements to the majority of days that have haze conditions nearer the average. These survey results have important implications for policy making on haze reduction. [ABSTRACT FROM AUTHOR]

Examines the association between clinical and Doppler echocardiographic characteristics and physicians' recommendation for endocarditis prophylaxis. Use of multiple logistic regression; Doppler evidence of mitral regurgitation; Observations from systolic murmur and systolic click.