Prevalence of breakfast skipping among children and adolescents: a cross-sectional population level study.

BACKGROUND: Interventions to promote breakfast consumption are a popular strategy to address early life inequalities. It is important to understand the epidemiology of children and adolescents who skip breakfast so that interventions and policy can be appropriately considered. This study investigated the prevalence of breakfast skipping among a contemporary, population-wide sample of children and adolescents in Australia. METHODS: Participants were grade 4-12 students (n = 71,390, 8-18 years) in South Australian government (public) schools who took part in the 2019 Wellbeing and Engagement Collection. The prevalence of breakfast skipping (never, sometimes, often, or always) was calculated for the overall sample and stratified by gender, school grade, socioeconomic status and geographical remoteness. Multinomial logistic regression analyses were conducted to determine the relative risk ratio of sometimes, often, and always skippers compared with never skippers, according to demographic characteristics. RESULTS: Overall, 55.0% of students reported never skipping breakfast, 17.4% reported sometimes skipping, 18.0% reported often skipping, and 9.5% reported always skipping breakfast. Skipping breakfast was more prevalent among females, students in senior grades, and those living in socioeconomically disadvantaged and regional and remote areas. Analyses disaggregated by gender revealed that grade level gradients in breakfast skipping were more marked among females compared to males. CONCLUSIONS: Breakfast skipping among children and adolescents appears considerably more prevalent than previous research suggests. Drivers of breakfast skipping across population sub-groups need to be explored to better inform strategies to promote breakfast consumption.

The education word gap emerges by 18 months: findings from an Australian prospective study.

BACKGROUND: The idea of the '30 million word gap' suggests families from more socioeconomically advantaged backgrounds engage in more verbal interactions with their child than disadvantaged families. Initial findings from the Language in Little Ones (LiLO) study up to 12 months showed no word gap between maternal education groups. METHODS: Families with either high or low maternal education were purposively recruited into a five-year prospective study. We report results from the first three waves of LiLO when children were 6, 12 and 18 months old. Day-long audio recordings, obtained using the Language Environment Analysis software, provided counts of adult words spoken to the child, child vocalizations and conversational turns. RESULTS: By the time children were 18 months old all three measures of talk were 0.5 to 0.7 SD higher among families with more education, but with large variation within education groups. Changes in talk from 6 to 18 months highlighted that families from low educated backgrounds were decreasing the amount they spoke to their children (- 4219.54, 95% CI -6054.13, - 2384.95), compared to families from high educated backgrounds who remained relatively stable across this age period (- 369.13, 95% CI - 2344.57, 1606.30). CONCLUSIONS: The socioeconomic word gap emerges between 12 and 18 months of age. Interventions to enhance maternal communication, child vocalisations and vocabulary development should begin prior to 18 months.

How many words are Australian children hearing in the first year of life?

BACKGROUND: There is evidence that parents from more socioeconomically disadvantaged backgrounds engage in fewer verbal interactions with their child than more advantaged parents. This leads to the so-called, '30 million-word gap'. This study aims to investigate the number of words children hear and the number of vocalizations children produce in their first year of life and examines whether these aspects of the early language home environment differ by maternal education. METHODS: Mothers were recruited into a five-year prospective cohort study and categorized into either high or low maternal education groups. Data was derived from the first two waves of the study, when the children were six and twelve months old. At both waves, children were involved in day-long audio recordings using the Language Environment Analysis software that provided automatic counts of adult words spoken to the child, child vocalizations and conversational turns. Descriptive results are presented by maternal education groups. RESULTS: There was large variation within each maternal education group, with the number of adult words spoken to the child ranging from 2958 to 39,583 at six months and 4389 to 45,849 at twelve months. There were no meaningful differences between adult words, child vocalizations or conversational turns across maternal education groups at either wave of data collection. CONCLUSIONS: These results show that a word gap related to maternal education is not apparent up to twelve months of age. The large variability among both maternal education groups suggests that universal interventions that encourage all parents to talk more to their child may be more appropriate than interventions targeted towards disadvantaged families during the first year of life.

Early developmental risk for subsequent childhood mental disorders in an Australian population cohort.

OBJECTIVE: We examined associations between developmental vulnerability profiles determined at the age of 5 years and subsequent childhood mental illness between ages 6 and 13 years in an Australian population cohort. METHODS: Intergenerational records from New South Wales (NSW) Government Departments of Health and Child Protection spanning pre-birth to 13 years of age were linked with the 2009 Australian Early Development Census records for 86,668 children. Mental illness indices for children were extracted from health records between 2009 and 2016 (child's age of 6-13 years). Associations between mental disorder diagnoses and membership of early childhood risk groups, including those with established 'special needs' (3777, 4.3%) at school entry, or putative risk classes delineated via latent class analysis of Australian Early Development Census subdomains - referred to as 'pervasive risk' ( N = 3479; 4.0%), 'misconduct risk' ( N = 5773; 6.7%) or 'mild generalised risk' ( N = 9542; 11%) - were estimated using multinomial logistic regression, relative to children showing 'no risk' ( N = 64,097; 74%). Poisson regression models estimated the relative risk of a greater number of days recorded with mental health service contacts among children in each Australian Early Development Census risk group. Adjusted models included child's sex, socioeconomic disadvantage, child protection contacts and parental mental illness as covariates. RESULTS: The crude odds of any mental disorder among children aged 6-13 years was increased approximately threefold in children showing pervasive risk or misconduct risk profiles at the age of 5 years, and approximately sevenfold in children with special needs, relative to children showing no risk; patterns of association largely remained after adjusting for covariates. Children with special needs and the misconduct risk class used mental health services over a greater number of days than the no risk class. CONCLUSION: Patterns of early childhood developmental vulnerability are associated with subsequent onset of mental disorders and have the potential to inform interventions to mitigate the risk for mental disorders in later childhood and adolescence.

Measuring early childhood development in multiple contexts: the internal factor structure and reliability of the early Human Capability Index in seven low and middle income countries.

BACKGROUND: The fourth year of the Sustainable Development Agenda era calls for countries to continue to invest not only in interventions and policies that will promote global equity and sustainability, but also in the monitoring systems required to track progress against these targets. A more pragmatic solution to measuring children's early development in low and middle income countries in particular, is required. This study explores the psychometric properties of the early Human Capability Index (eHCI), a population measure of holistic development for children aged 3-5 years, designed with the vision of being flexible and feasible for use in low resource and capacity settings. METHODS: Utilizing data from seven low and middle income countries: Brazil (n = 1810), China (n = 11,421), Kiribati (n = 8339), Lao People's Democratic Republic (n = 7493), Samoa (n = 12,191), Tonga (n = 6214), and Tuvalu (n = 549), analyses explored the internal factor structure and reliability of scores produced by the tool within each country. RESULTS: Confirmatory factor analyses and internal consistency coefficients demonstrated that after local adaptation, translation, and different implementation methods across countries, the eHCI maintained the same factor structure of nine theoretically-based developmental domains: Physical Health, Verbal Communication, Cultural Knowledge, Social and Emotional Skills, Perseverance, Approaches to Learning, Numeracy, Reading, and Writing. CONCLUSIONS: Findings support the aims of the eHCI in being adaptable and applicable for use within a range of low and middle income countries to facilitate measurement and monitoring of children's early development, as is required for the tracking of progress towards the Sustainable Development Agenda.

Childhood Maltreatment and Early Developmental Vulnerabilities at Age 5 Years.

This study examined associations between maltreatment and early developmental vulnerabilities in a population sample of 68,459 children (Mage  = 5.62 years, SD = .37) drawn from the Australian state of New South Wales, using linked administrative data for the children and their parents (collected 2001-2009). Associations were estimated between (a) any maltreatment, (b) the number of maltreatment types, and (c) the timing of first reported maltreatment and vulnerability and risk status on multiple developmental domains (i.e., physical, social, emotional, cognitive, and communication). Pervasive associations were revealed between maltreatment and all developmental domains; children exposed to two or more maltreatment types, and with first maltreatment reported after 3 years of age, showed greater likelihood of vulnerability on multiple domains, relative to nonmaltreated children.

Latent profiles of early developmental vulnerabilities in a New South Wales child population at age 5 years.

OBJECTIVE: Detecting the early emergence of childhood risk for adult mental disorders may lead to interventions for reducing subsequent burden of these disorders. We set out to determine classes of children who may be at risk for later mental disorder on the basis of early patterns of development in a population cohort, and associated exposures gleaned from linked administrative records obtained within the New South Wales Child Development Study. METHODS: Intergenerational records from government departments of health, education, justice and child protection were linked with the Australian Early Development Census for a state population cohort of 67,353 children approximately 5 years of age. We used binary data from 16 subdomains of the Australian Early Development Census to determine classes of children with shared patterns of Australian Early Development Census-defined vulnerability using latent class analysis. Covariates, which included demographic features (sex, socioeconomic status) and exposure to child maltreatment, parental mental illness, parental criminal offending and perinatal adversities (i.e. birth complications, smoking during pregnancy, low birth weight), were examined hierarchically within latent class analysis models. RESULTS: Four classes were identified, reflecting putative risk states for mental disorders: (1) disrespectful and aggressive/hyperactive behaviour, labelled 'misconduct risk' ( N = 4368; 6.5%); (2) 'pervasive risk' ( N = 2668; 4.0%); (3) 'mild generalised risk' ( N = 7822; 11.6%); and (4) 'no risk' ( N = 52,495; 77.9%). The odds of membership in putative risk groups (relative to the no risk group) were greater among children from backgrounds of child maltreatment, parental history of mental illness, parental history of criminal offending, socioeconomic disadvantage and perinatal adversities, with distinguishable patterns of association for some covariates. CONCLUSION: Patterns of early childhood developmental vulnerabilities may provide useful indicators for particular mental disorder outcomes in later life, although their predictive utility in this respect remains to be established in longitudinal follow-up of the cohort.

Efficacy of infant simulator programmes to prevent teenage pregnancy: a school-based cluster randomised controlled trial in Western Australia.

BACKGROUND: Infant simulator-based programmes, which aim to prevent teenage pregnancy, are used in high-income as well as low-income and middle-income countries but, despite growing popularity, no published evidence exists of their long-term effect. The aim of this trial was to investigate the effect of such a programme, the Virtual Infant Parenting (VIP) programme, on pregnancy outcomes of birth and induced abortion in Australia. METHODS: In this school-based pragmatic cluster randomised controlled trial, eligible schools in Perth, Western Australia, were enrolled and randomised 1:1 to the intervention and control groups. Randomisation using a table of random numbers without blocking, stratification, or matching was done by a researcher who was masked to the identity of the schools. Between 2003 and 2006, the VIP programme was administered to girls aged 13-15 years in the intervention schools, while girls of the same age in the control schools received the standard health education curriculum. Participants were followed until they reached 20 years of age via data linkage to hospital medical and abortion clinic records. The primary endpoint was the occurrence of pregnancy during the teenage years. Binomial and Cox proportional hazards regression was used to test for differences in pregnancy rates between study groups. This study is registered as an international randomised controlled trial, number ISRCTN24952438. FINDINGS: 57 (86%) of 66 eligible schools were enrolled into the trial and randomly assigned 1:1 to the intervention (28 schools) or the control group (29 schools). Then, between Feb 1, 2003, and May 31, 2006, 1267 girls in the intervention schools received the VIP programme while 1567 girls in the control schools received the standard health education curriculum. Compared with girls in the control group, a higher proportion of girls in the intervention group recorded at least one birth (97 [8%] of 1267 in the intervention group vs 67 [4%] of 1567 in the control group) or at least one abortion as the first pregnancy event (113 [9%] vs 101 [6%]). After adjustment for potential confounders, the intervention group had a higher overall pregnancy risk than the control group (relative risk 1·36 [95% CI 1·10-1·67], p=0·003). Similar results were obtained with the use of proportional hazard models (hazard ratio 1·35 [95% CI 1·10-1·67], p=0·016). INTERPRETATION: The infant simulator-based VIP programme did not achieve its aim of reducing teenage pregnancy. Girls in the intervention group were more likely to experience a birth or an induced abortion than those in the control group before they reached 20 years of age. FUNDING: Western Australian Health Promotion Foundation (Healthway), Lotteries WA, the Western Australian Department of Education and Training, and the Western Australian Department of Health.

Hospital admission for infection during early childhood influences developmental vulnerabilities at age 5 years.

AIM: Childhood infectious diseases can be associated with later physical and psychological ill health, and the effects of this association may be evident during early childhood development. This study aimed to examine the effects of hospitalisation for early life infection on early childhood development. METHODS: Hospital admission data for infection were obtained from the New South Wales Ministry of Health Admitted Patient Data Collection for 87 026 children, for whom the Australian Early Development Census (AEDC) was completed in their first year of formal schooling (age approximately 5 years). The AEDC provides estimates of each child's level of functioning on five domains of development spanning social and emotional skills, communication skills, numeracy and literacy and physical health. Multinomial logistic regressions were used to determine the relationship between exposure to hospital admissions for infectious disease prior to age 4 years and vulnerability on the AEDC. Models were adjusted for the effects of potential confounding factors related to the perinatal period, exposure to maltreatment and family characteristics. RESULTS: Single and multiple hospitalisation(s) for infections were consistently associated with increased likelihood of being developmentally vulnerable on all AEDC domains, with odds ratios ranging from 1.02 to 1.28, after adjustment for confounding factors. CONCLUSIONS: This study demonstrates a pervasive effect of early life infections that require hospital admission on multiple aspects of early child development, even after adjustment for potential confounding factors. Relatively, severe infection during early childhood constitutes a risk factor for developmental vulnerability by the time of entry to school.

Mental health profiles and academic achievement in Australian school students.

This study explored mental health profiles in Australian school students using indicators of well-being (i.e., optimism, life satisfaction, and happiness) and psychological distress (i.e., sadness and worries). The sample included 75,757 students (ages 8-18 years) who completed the 2019 South Australian Wellbeing and Engagement Collection. Latent profile analysis identified five mental health profiles consisting of (a) complete mental health (23%), (b) good mental health (33%), (c) moderate mental health (27%), (d) symptomatic but content (9%), and (e) troubled (8%). Findings provide partial support for the dual-factor model of mental health. Distal outcomes analysis on a sub-set of students (n = 24,466) found students with a symptomatic but content, moderate mental health, or troubled profile had poorer academic achievement than students with complete mental health. Implications for schools and education systems are discussed, including the need to pair clinical supports for students with psychological distress with population-level preventative health approaches to build psychological well-being.

Early childhood development strategy for the world's children with disabilities.

Early childhood is foundational for optimal and inclusive lifelong learning, health and well-being. Young children with disabilities face substantial risks of sub-optimal early childhood development (ECD), requiring targeted support to ensure equitable access to lifelong learning opportunities, especially in low- and middle-income countries. Although the Sustainable Development Goals, 2015-2030 (SDGs) emphasise inclusive education for children under 5 years with disabilities, there is no global strategy for achieving this goal since the launch of the SDGs. This paper explores a global ECD framework for children with disabilities based on a review of national ECD programmes from different world regions and relevant global ECD reports published since 2015. Available evidence suggests that any ECD strategy for young children with disabilities should consists of a twin-track approach, strong legislative support, guidelines for early intervention, family involvement, designated coordinating agencies, performance indicators, workforce recruitment and training, as well as explicit funding mechanisms and monitoring systems. This approach reinforces parental rights and liberty to choose appropriate support pathway for their children. We conclude that without a global disability-focussed ECD strategy that incorporates these key features under a dedicated global leadership, the SDGs vision and commitment for the world's children with disabilities are unlikely to be realised.

Objectively measured infant and toddler screen time: Findings from a prospective study.

Objective: Screen time guidelines recommend no screens under two years due to the potential negative impacts on development. While current reports suggest many children exceed this, research relies on parent reports of their children's screen exposure. We objectively assess screen exposure during the first two years and how it differs by maternal education and gender. Methods: This Australian prospective cohort study used speech recognition technology to understand young children's screen exposure over an average day. Data collection occurred every six months when children were 6, 12, 18 and, 24 months old (n = 207). The technology provided automated counts of children's exposure to electronic noise. Audio segments were then coded as screen exposure. Prevalence of screen exposure was quantified, and differences between demographics examined. Results: At six months, children were exposed to an average of 1hr, 16 min (SD = 1hr, 36 min) of screens per day, increasing to an average of 2 h, 28 min (SD = 2 h, 4 min) by 24-months. Some children at six months were exposed to more than 3 h of screen time per day. Inequalities in exposure were evident as early as six months. Children from higher educated families were exposed to 1hr,43 min fewer screens per day, 95%CI (-2hr, 13 min, -1hr, 11 min) compared to lower educated households, with this difference remaining consistent as children age. Girls were exposed to an additional 12 min of screens 95%CI (-20 min, 44 min) per day compared to boys at six months, but this difference reduced to only 5 min by 24-months. Conclusion: Using an objective measure of screen exposure, many families exceed screen time guidelines, the extent increasing with child's age. Furthermore, substantial differences between maternal education groups emerge as young as six months old. This highlights the need for education and supports for parents around screen use in the early years, balanced within the realities of modern life.

Prevalence of electronic device use before bed among Australian children and adolescents: a cross-sectional population level study.

OBJECTIVE: To understand the prevalence of children and adolescents' electronic device use (EDU) in the hour before bed and identify sociodemographic groups that are at increased risk of problematic use. METHOD: A contemporary population wide sample of South Australian school students aged 8-18 years (n = 70,936) was utilised to present descriptive statistics of EDU before bed across sociodemographic groups. Data was collected from the 2019 Wellbeing and Engagement Collection, an annual self-report census of students' health, wellbeing and school engagement. RESULTS: 90% of children used an electronic device in the hour before bed at least one night a week, with 51% using a device every night. Older adolescent females in grades 10-12 were most frequent users and children from the most socioeconomically disadvantaged communities were also more likely to use electronic devices in the hour before bed. CONCLUSION: EDU before bed is highly prevalent among Australian children and adolescents and given the negative health and educational impacts, it requires immediate and widespread action from policy makers to ensure the health of Australia's next generation. IMPLICATIONS FOR PUBLIC HEALTH: The scale of the problem has now been identified; next steps rely on a public health approach to address this issue. This might include awareness raising campaigns and targeted interventions towards at-risk groups.

Basic epidemiology of wellbeing among children and adolescents: A cross-sectional population level study.

Wellbeing and mental health are fundamental rights of children and adolescents essential for sustainable development. Understanding the epidemiology of child and adolescent wellbeing is essential to informing population health approaches to improving wellbeing and preventing mental illness. The present study estimated the prevalence of wellbeing and how wellbeing indicators were distributed across social and economic groups. This study used data from the 2019 Wellbeing and Engagement Collection; an annual census conducted in South Australian schools that measures self-reported wellbeing in students aged 8-18 years (n = 75,966). We estimated the prevalence (n, %) of low, medium and high wellbeing across five outcomes: life satisfaction, optimism, sadness, worries and happiness, overall and stratified by gender, age, language background, socio-economic position and geographical remoteness. The prevalence of low wellbeing on each indicator was: happiness 13%, optimism 16%, life satisfaction 22%, sadness 16% and worries 25%. The prevalence of low wellbeing increased with age, particularly for females. For example, 22.5% of females aged 8-10 years had high levels of worries compared to 43.6% of 15 to 18-year old females. Socioeconomic inequality in wellbeing was evident on all indicators, with 19.5% of children in the most disadvantaged communities having high levels of sadness compared to 12.5% of children in the most advantaged communities. Many children and adolescents experience low wellbeing on one or more indicators (40.7%). The scale of this problem warrants a population-level preventative health response, in addition to a clinical, individual-level responses to acute mental health needs. Universal school-based programs that support social and emotional wellbeing have a role to play in this response but need to be supported by universal and targeted responses from outside of the education system.

Inequalities in child development at school entry: A repeated cross-sectional analysis of the Australian Early Development Census 2009-2018.

BACKGROUND: Australia is the only developed country to consistently undertake a developmental census of its children nationwide. The repeated collection of the Australian Early Development Census (AEDC) has provided an unprecedented opportunity to examine the prevalence of developmental vulnerability across Australia's states and territories, the socio-economic distribution of developmental vulnerability across jurisdictions, and how these distributions might have changed over time. METHODS: This study employed multivariable logistic regressions to estimate the probability of developmental vulnerability within each jurisdiction and AEDC collection year (2009 to 2018), adjusting for jurisdictional differences in socio-demographic characteristics. To explore socio-economic inequalities in child development, adjusted slope index of inequality (SII) models were utilised. FINDINGS: The results of this study found reductions in the adjusted prevalence of developmental vulnerability over time in Western Australia (26% to 20%) and Queensland (30% to 25%), with an increase observed in the Australian Capital Territory (27% to 30%). Analysis also indicated an increase in socio-economic inequalities over time in the Northern Territory (+12%), the Australian Capital Territory (+6%) and Tasmania (+4%). Sensitivity analysis found these effects to be robust with an alternative measure of socio-economic position. INTERPRETATION: There is considerable variation in the prevalence and socio-economic inequalities in developmental vulnerability across Australia's jurisdictions. Future research should explore the policy drivers in early childhood education and health contributing to the findings of this study, with a particular focus on jurisdictions where there have been notable changes in developmental vulnerability and socio-economic inequality over time. FUNDING: Analyses were funded under research contract by the Department of Education, Skills and Employment. Prof Brinkman is supported by a National Health and Medical Research Council fellowship, APP1160185.

Measuring early child development in low and middle income countries: Investigating the validity of the early Human Capability Index.

Inclusion of early child development in the United Nations Sustainable Development Agenda raises issues of how this goal should be monitored, particularly in low resource settings. The aim of this paper was to explore the validity of the early Human Capability Index (eHCI); a population measure designed to capture the holistic development of children aged 3-5 years. Convergent, divergent, discriminant and concurrent validity were examined by exploring the associations between eHCI domains and child (sex, age, stunting status, preschool attendance) and family (maternal education, home learning environment) characteristics. Analyses were repeated using data from seven low and middle income countries: Brazil (n = 1810), China (n = 11421), Kiribati (n = 8339), Lao PDR (n = 7493), Samoa (n = 12191), Tonga (n = 6214), and Tuvalu (n = 549). Correlations and linear regressions provide evidence that within these country samples, the tool is capturing the aspects of early child development that it was designed to measure. Although the tool was intended to measure development of children aged 3-5 years, results suggest it can be validly applied to children aged 2-6 years. The eHCI is free, requires minimal implementation resources, captures development across domains and abilities, and is designed to allow cultural and contextual concepts to be included. The eHCI appears psychometrically robust in diverse country contexts and could enable evaluation of early years policies and programs, as well as monitoring of children's development to track progress towards the Sustainable Development Agenda.

Reading and numeracy attainment of children reported to child protection services: A population record linkage study controlling for other adversities.

BACKGROUND: Maltreated children are at risk of poor educational outcomes, but also experience greater individual, family, and neighbourhood adversities that may obscure an understanding of relationships between child protection involvement and educational attainment. OBJECTIVE: To examine associations between child protection involvement and 3rd- and 5th-grade reading and numeracy attainment, while controlling multiple other adversities. PARTICIPANTS AND SETTING: Participants were 56,860 Australian children and their parents from the New South Wales Child Development Study with linked multi-agency records. METHODS: Multinomial logistic regressions examined associations between level of child protection involvement (Out-Of-Home Care [OOHC] placement; substantiated Risk Of Significant Harm [ROSH]; unsubstantiated ROSH; non-ROSH; and no child protection report) and standardised tests of 3rd- and 5th-grade reading and numeracy. Fully adjusted models controlled demographic, pregnancy, birth, and parental factors, and early (kindergarten) developmental vulnerabilities on literacy and numeracy, and other developmental domains (social, emotional, physical, communication). RESULTS: All children with child protection reports were more likely to attain below average, and less likely to attain above average, 3rd- and 5th-grade reading and numeracy, including children with reports below the ROSH threshold. Children with substantiated ROSH reports who were not removed into care demonstrated the worst educational attainment, with some evidence of protective effects for children in OOHC. CONCLUSIONS: A cross-agency response to supporting educational attainment for all children reported to child protection services is required, including targeted services for children in OOHC or with substantiated ROSH reports, and referral of vulnerable families (unsubstantiated and non-ROSH cases) to secondary service organisations (intermediate intervention).

The 2015 Middle Childhood Survey (MCS) of mental health and well-being at age 11 years in an Australian population cohort.

PURPOSE: The Middle Childhood Survey (MCS) was designed as a computerised self-report assessment of children's mental health and well-being at approximately 11 years of age, conducted with a population cohort of 87 026 children being studied longitudinally within the New South Wales (NSW) Child Development Study. PARTICIPANTS: School Principals provided written consent for teachers to administer the MCS in class to year 6 students at 829 NSW schools (35.0% of eligible schools). Parent or child opt-outs from participation were received for 4.3% of children, and MCS data obtained from 27 808 children (mean age 11.5 years, SD 0.5; 49.5% female), representing 85.9% of students at participating schools. FINDINGS TO DATE: Demographic characteristics of participating schools and children are representative of the NSW population. Children completed items measuring Social Integration, Prosocial Behaviour, Peer Relationship Problems, Supportive Relationships (at Home, School and in the Community), Empathy, Emotional Symptoms, Conduct Problems, Aggression, Attention, Inhibitory Control, Hyperactivity-Inattention, Total Difficulties (internalising and externalising psychopathology), Perceptual Sensitivity, Psychotic-Like Experiences, Personality, Self-esteem, Daytime Sleepiness and Connection to Nature. Distributions of responses on each item and construct demarcate competencies and vulnerabilities within the population: most children report mental health and well-being, but the population distribution spanned the full range of possible scores on every construct. FUTURE PLANS: Multiagency, intergenerational linkage of the MCS data with health, education, child protection, justice and early childhood development records took place late in 2016. Linked data were used to elucidate patterns of risk and protection across early and middle child development, and these data will provide a foundation for future record linkages in the cohort that will track mental and physical health, social and educational/occupational outcomes into adolescence and early adulthood.