OBJECTIVE: This study examined the association between chronic illness and school readiness, by using linked administrative population data.
Children of parents who have been hospitalised with psychiatric disorders are at risk for poor school readiness. These findings add support to recommendations that mental health professionals consider dependent children in discharge and treatment planning for adult psychiatric inpatients. It is also important to ensure that the impact of psychiatric illness in fathers is not overlooked in assessment and intervention. Family-based approaches to adult psychiatric care could meet the dual needs of intervention for parents and preventative measures for children. These findings can inform policy regarding the importance of integrating and coordinating services to meet the needs of families.
BackgroundIdentification of features of the neighbourhood physical environment that have a causal association with positive child development is important for promoting long-term developmental health. Previous research on these associations have been conducted at the neighbourhood level, and do not account for individual variation in exposure to these features.MethodsThis cross-sectional study utilised de-identified linked administrative data. Neighbourhood features were measured with Geographic Information Systems and identified within a 1600 m service area around the child’s home address. The study population included a random selection of 5024 Western Australian children who participated in the 2012 Australian Early Development Census (AEDC; median age 5 years, 5 months). Multi-level logistic regressions modelled the odds of children scoring in the bottom 10% on the physical, social or emotional AEDC domains as an outcome of neighbourhood features.ResultsAfter adjustment for individual and neighbourhood sociodemographic factors, lower odds of physical vulnerability were associated with increased neighbourhood residential density, presence of railway station, and higher counts of playgroups and kindergartens. Larger areas of neighbourhood home-yard space were associated with increased odds of physical and social vulnerability. Presence of high-quality green spaces was associated with lower odds of social vulnerability. Increased road traffic exposure was associated with higher odds of social and emotional vulnerability.ConclusionsThe neighbourhood physical environment has a weak but significant association with early childhood development. Future research should consider the interplay between the neighbourhood environment and proximal influences, including parenting attributes and socioeconomic status, and how they influence early child development.
There is evidence that children of incarcerated parents are at risk of poor developmental and educational outcomes. However, much of this evidence is limited by biased samples, as studies must rely on opt-in recruitment. Administrative data present an opportunity to overcome this challenge, as they capture information on all incarcerated individuals. This study used administrative data on convictions of the parents of 19,071 children aged 5-6 years in Western Australia. Records of parental convictions (starting from 1 year prior to the child's birth) were linked to children's scores on the Australian Early Development Census, which is a teacher-reported measure of children's physical, social, emotional, communicative, and cognitive development. Logistic regression models estimated the odds of children of convicted parents being developmentally vulnerable. Models were adjusted for child, parent, and neighborhood sociodemographic factors. Compared to children in the comparison group, children whose parent had either served a community order or been incarcerated were at risk of poor development across all developmental domains, even after adjusting for sociodemographic factors. Furthermore, children of incarcerated parents had higher odds of developmental vulnerability on multiple domains compared to children of parents who had served community orders only. The results suggest that, although children of convicted parents experience a higher incidence of sociodemographic risk, their parents' criminal activity constitutes an independent risk factor for their development. Intervention to support the early development of children of convicted parents is therefore essential, and should consider the family context. (PsycINFO Database Record
BackgroundCurrently, there is mixed evidence regarding the effects on children when a parent is chronically ill. Research has also primarily been conducted with adolescent samples. This study investigated developmental vulnerabilities in young children of parents with chronic illness.MethodsThis study used linked administrative data. The study population included children born in Western Australia during 2003–2004 (n=19 071; mean age 5.5 years). The outcome measure was a score in the bottom 25% on any of the five developmental domains (physical, social, emotional, communicative and cognitive) of the Australian Early Development Census (2009 collection). Parental chronic illnesses were identified from hospital and cancer registry records, during the period from 1 year prior to the child’s birth and until the end of 2009.ResultsHigher odds of developmental vulnerabilities in physical, social, emotional and communication domains were observed for daughters of chronically ill mothers. Sons of chronically ill mothers had increased odds of language and cognitive difficulties. Risk level increased with each additional year of exposure to maternal chronic illness. Results also indicated increased odds of developmental vulnerabilities for children of mothers experiencing multiple compared with single chronic conditions; however, results were not statistically significant (all p>0.05). No association between fathers’ chronic illness and children’s developmental outcomes was found.ConclusionsMaternal chronic illness is associated with an increased risk of poor developmental outcomes for children, particularly daughters. Healthcare services have an important role to play in linking families into appropriate family-centred services to best support the needs of chronically ill mothers.
Aim: Glasgow is a city where 80% of the most deprived children in Scotland live within 20% of the overall population. Of 168 000 children in Glasgow, an estimated 5000 aged 5–15 y have primary nocturnal enuresis. The aim of this study was to establish a nocturnal enuresis service for Glasgow. Methods: Needs assessment was performed and the incident cases were documented at school entry healthcare appraisal, at the age of 5 y. A cohort of these children was followed up at 8 y of age and symptom resolution was no better than natural remission. Parents, general practitioners, clinical medical officers and a hospital paediatrician were interviewed face‐to‐face about their need for a service. Results: Ten of 11 general practitioners expressed a need for a specialist service. Ten school nurse‐led local nocturnal enuresis clinics were established. Accommodation, funding, default and managing alarms were major problems. School nurses enjoyed extra training and quickly became skilled therapists. Two research projects highlighted that most children at first attendance did not believe they could ever be dry, which predicted outcome. Deprived families, once motivated, could successfully undertake complex behavioural therapies. Conclusion: A comprehensive nocturnal enuresis service begins when children stop using night nappies at the age of 3–4 y. Appropriate waterproof mattress, duvet and pillow coverings should be advocated until 5 y, when desmopressin may be helpful. For continued wetting at the age of 7 y, a local service should be led by a team of well‐trained nurses using enuretic alarms.
We examined the association between otitis media (OM) and educational attainment in a retrospective population cohort of Western Australian children who participated in the grade 3 National Assessment Program—Literacy and Numeracy in 2012 (N = 19,262). Literacy and numeracy scores were linked to administrative hospital and emergency department data to identify secondary care episodes for OM. Results of multivariate multilevel models showed that children with OM episodes had increased odds of poor performance on literacy and numeracy tests, compared to children without OM episodes (46–79% increase in odds for Aboriginal children; 20–31% increase in odds for non-Aboriginal children). There were no significant effects found for age at the first episode, nor for OM episode frequency (all ps > 0.05). Regardless of the timing or frequency of episodes, children with OM episodes are at risk of poor literacy and numeracy attainment. Aboriginal children with OM appeared to be particularly at risk of poor literacy and numeracy achievement. Intervention to reduce the prevalence of otitis media in young children, and early treatment of OM, are important for limiting the negative effects on academic outcomes.
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