A great way to bring up health behaviour topics at playgroup: a qualitative evaluation of the Healthy Conversations @ Playgroup program.

BACKGROUND: The early years is a critical stage to establish optimal nutrition and movement behaviours. Community playgroups are a relaxed environment for parents with a focus on social connection and supporting parents in their role as 'First Teachers'. Playgroups are therefore an opportunistic setting to promote health behaviours in the early years. To support parents with young children around healthy lifestyle behaviours, the Healthy Conversations @ Playgroup program was delivered in urban and regional areas, across three Australian jurisdictions between 2021-2023. OBJECTIVE: This qualitative evaluation aimed to understand how the Healthy Conversations @ Playgroup program was experienced by parents, playgroup coordinators and peer facilitators. DESIGN: Semi-structured virtual interviews and focus groups were conducted with parents, playgroup coordinators (i.e., person responsible for coordinating the playgroup) and peer facilitators (i.e., trained facilitator for the program) that participated in the Healthy Conversations @ Playgroup study. Transcripts were analysed following a thematic analysis approach. RESULTS: Twenty-eight playgroup parents, coordinators or peer facilitators participated in one of 8 focus groups or 5 interviews. Four themes were developed: Program strengths and challenges; Setting strengths and challenges; Factors that impact program delivery; Participant's suggestions for future program delivery. CONCLUSIONS: The Healthy Conversations @ Playgroup program was valued by parents, providing validation and normalisation of parenting practices, and fostering a shared experience of parenting. Playgroups are a convenient setting for families to attend. The dynamic and distracting nature of the playgroup setting were carefully considered when designing the program. Strategies to further enhance program engagement could include use of coordinator or parent champions, tailored delivery, and extending the reach to other family members. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12621000055808, registered 22 January 2021, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380890.

A translational application of music for preschool cognitive development: RCT evidence for improved executive function, self-regulation, and school readiness.

The benefits of active music participation and training for cognitive development have been evidenced in multiple studies, with this link leveraged in music therapy approaches with clinical populations. Although music, rhythm, and movement activities are widely integrated into children's play and early education, few studies have systematically translated music therapy-based approaches to a nonclinical population to support early cognitive development. This study reports the follow-up effects of the Rhythm and Movement for Self Regulation (RAMSR) program delivered by generalist preschool teachers in low socioeconomic communities. This randomized control trial (RCT) involved 213 children across eight preschools in disadvantaged communities in Queensland, Australia. The intervention group received 16-20 sessions of RAMSR over 8 weeks, while the control group undertook usual preschool programs. Primary outcome measures included executive function (child assessment of shifting, working memory, and inhibition) and self-regulation (teacher report), with secondary outcomes of school readiness and visual-motor integration. Data were collected pre- and post-intervention, and again 6 months later once children had transitioned into school. Results demonstrated significant intervention effects across the three time points for school readiness (p = 0.038, ηp 2  = 0.09), self-regulation (p < 0.001, ηp 2  = 0.08), and inhibition (p = 0.002 ηp 2  = 0.23). Additionally, the feasibility of building capacity in teachers without any music background to successfully deliver the program was evidenced. These findings are important given that children from low socioeconomic backgrounds are more likely to need support for cognitive development yet have inequitable access to quality music and movement programs. RESEARCH HIGHLIGHTS: Initial effects of self-regulation from a rhythm and movement program were sustained following transition into school for children from disadvantaged backgrounds. Delayed effects of inhibition and school readiness from a rhythm and movement program appeared 6 months post-intervention as children entered school. Generalist teachers can successfully implement a rhythm and movement program, which boosts critical developmental cognitive skills.

Child Maltreatment and Long-Term Physical and Mental Health Outcomes: An Exploration of Biopsychosocial Determinants and Implications for Prevention.

Child maltreatment rates remain unacceptably high and rates are likely to escalate as COVID-related economic problems continue. A comprehensive and evidence-building approach is needed to prevent, detect and intervene where child maltreatment occurs. This review identifies key challenges in definitions, overviews the latest data on prevalence rates, reviews risk and protective factors, and examines common long-term mental health outcomes for children who experience maltreatment. The review takes a systems approach to child maltreatment outcomes through its focus on the overall burden of disease, gene-environment interactions, neurobiological mechanisms and social ecologies linking maltreatment to mental ill-health. Five recommendations relating to the accurate measurement of trends, research on brain structures and processes, improving the reach and impact of teleservices for detecting, preventing and treating child maladjustment, community-based approaches, and building population-focused multidisciplinary alliances and think tanks are presented.

Study protocol for Healthy Conversations @ Playgroup: a multi-site cluster randomized controlled trial of an intervention to promote healthy lifestyle behaviours in young children attending community playgroups.

BACKGROUND: Early childhood is a critical window for preventing obesity and chronic disease. Yet, 1 in 4 Australian children aged 5 years and under are affected by overweight or obesity; and significant proportions of children under 5 years fail to meet guidelines for diet quality, physical activity (PA), screen time, and sleep. Consequently, effective interventions to promote healthy lifestyle behaviors and prevent obesity during early childhood are needed. Community playgroups provide an opportunity for parents, carers, and children to meet in a safe and relaxed environment to play and share information. The structure, low cost and reach of playgroups provide a unique platform to engage parents in a scalable program to promote healthful lifestyle behaviors and prevent childhood obesity. However, the evidence base for the effectiveness of health promotion programs delivered in community playgroup settings is limited and lacking credible evidence from rigorously conducted randomized controlled trials. METHODS: The Healthy Conversations @ Playgroup randomized controlled trial (RCT) aims to address the underlying behavioral risk factors for obesity by helping parents take effective steps to improve their child's dietary, PA, screen time, and sleep behaviors. The intervention program comprises 10 "healthy conversations" led by a trained peer facilitator, designed to increase parents' behavioral capability and self-efficacy to implement autonomy-supportive parenting practices. The program will be delivered biweekly during regularly scheduled playgroup sessions over 10-weeks. Effectiveness will be tested in a 2-arm cluster RCT involving 60 community playgroups in three states across Australia. After baseline assessments, participating playgroups will be randomly allocated to either intervention or wait-list control conditions. Primary outcomes (vegetable intake, discretionary foods, daily PA, screen time, sleep duration, and body mass index [BMI] z-score) will be assessed at baseline, immediately post-intervention (10-weeks; T2) and 6-months post-intervention (T3). Outcomes will be assessed for differential change at T2 and T3. DISCUSSION: The Healthy Conversations @ Playgroup trial will rigorously evaluate a novel peer-led intervention program to promote healthful lifestyle behaviors and prevent obesity in children and families attending community playgroups. If effective, the program could be immediately scaled-up and delivered in community playgroups across Australia. TRIAL REGISTRATION: Trial registered 22nd January 2021 with the Australian and New Zealand Clinical Trials Registry ( ACTRN12621000055808 ).

Proximal and distal predictors of self-regulatory change in children aged 4 to 7 years.

BACKGROUND: Growth in early self-regulation skills has been linked to positive health, wellbeing, and achievement trajectories across the lifespan. While individual studies have documented specific influences on self-regulation competencies in early childhood, few have modelled a comprehensive range of predictors of self-regulation change across health, development, and environment simultaneously. This study aimed to examine the concurrent associations among a range of proximal and distal influences on change in children's self-regulation skills over 2 years from age 4-5 years. METHODS: Data from the Longitudinal Study of Australian Children (N = 4983) were used in a structural equation model, predicting a multi-source composite measure of self-regulation at each of 4-5 years and 6-7 years. By controlling for earlier self-regulation and covariates, the model examined the relative contributions of a comprehensive range of variables to self-regulation change including health, development, educational, home environment, time-use, and neighbourhood characteristics. RESULTS: The significant predictors of children's self-regulation growth across 4 to 7 years were fewer behavioural sleep problems, higher gross motor and pre-academic skills, lower levels of maternal and paternal angry parenting, and lower levels of financial hardship. There were also marginal effects for high-quality home learning environments and child-educator relationships. CONCLUSION: Findings suggest that if we are to successfully foster children's self-regulation skills, interventionists would do well to operate not only on children's current capacities but also key aspects of their surrounding context.

The relative contribution of shape and colour to object memory.

The current studies examined the relative contribution of shape and colour in object representations in memory. A great deal of evidence points to the significance of shape in object recognition, with the role of colour being instrumental under certain circumstances. A key but yet unanswered question concerns the contribution of colour relative to shape in mediating retrieval of object representations from memory. Two experiments (N=80) used a new method to probe episodic memory for objects and revealed the relative contribution of colour and shape in recognition memory. Participants viewed pictures of objects from different categories, presented one at a time. During a practice phase, participants performed yes/no recognition with some of the studied objects and their distractors. Unpractised objects shared shape only (Rp-Shape), colour only (Rp-Colour), shape and colour (Rp-Both), or neither shape nor colour (Rp-Neither), with the practised objects. Interference effects in memory between practised and unpractised items were revealed in the forgetting of related unpractised items - retrieval-induced forgetting. Retrieval-induced forgetting was consistently significant for Rp-Shape and Rp-Colour objects. These findings provide converging evidence that colour is an automatically encoded object property, and present new evidence that both shape and colour act simultaneously and effectively to drive retrieval of objects from long-term memory.

Bidirectional associations between mothers' feeding practices and child eating behaviours.

BACKGROUND: This study examined bidirectional relationships between maternal feeding practices and child food responsiveness and satiety responsiveness from 2 to 5 years. METHODS: Mothers (N = 207) reported their own feeding practices and child eating behaviours using validated questionnaires at child ages 2, 3.7, and 5 years. Cross-lagged analyses were conducted to test for bidirectional effects, adjusting for child BMI z-score (based on measured weight and height) at 14 months. RESULTS: Eating behaviours and feeding practices showed strong continuity across the three time points. Maternal feeding practices (higher reward for behaviour [ß = 0.12, p = 0.025] and lower covert restriction [ß = -0.14, p = 0.008]) were prospectively associated with higher food responsiveness. Conversely, increased child satiety responsiveness was primarily prospectively associated with mothers' feeding practices (increased structured meal timing [ß = 0.11, p = 0.038], overt [ß = 0.14, p = 0.010] and covert restriction [ß = 0.11, p = 0.022]). The only exception was family meal setting, which was prospectively negatively associated with satiety responsiveness (ß = -0.11, p = 0.035). CONCLUSION: While maternal feeding practices and child satiety and food responsiveness show strong continuity between child age 2 and 5 years, maternal feeding practices appear to be associated with child food responsiveness over time. Conversely, child satiety responsiveness, but not food responsiveness, may also be associated with maternal feeding practices over time. These results are consistent with interventions that provide feeding advice to parents on how to respond appropriately to individual child eating behaviour phenotype. TRIAL REGISTRATION: ACTRN12608000056392 . Registered 29 January 2008.

A Developmental Cascade Model of Behavioral Sleep Problems and Emotional and Attentional Self-Regulation Across Early Childhood.

This article documents the longitudinal and reciprocal relations among behavioral sleep problems and emotional and attentional self-regulation in a population sample of 4,109 children participating in Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC)-Infant Cohort. Maternal reports of children's sleep problems and self-regulation were collected at five time-points from infancy to 8-9 years of age. Longitudinal structural equation modeling supported a developmental cascade model in which sleep problems have a persistent negative effect on emotional regulation, which in turn contributes to ongoing sleep problems and poorer attentional regulation in children over time. Findings suggest that sleep behaviors are a key target for interventions that aim to improve children's self-regulatory capacities.

The Feeding Practices and Structure Questionnaire (FPSQ-28): A parsimonious version validated for longitudinal use from 2 to 5 years.

Prospective studies and intervention evaluations that examine change over time assume that measurement tools measure the same construct at each occasion. In the area of parent-child feeding practices, longitudinal measurement properties of the questionnaires used are rarely verified. To ascertain that measured change in feeding practices reflects true change rather than change in the assessment, structure, or conceptualisation of the constructs over time, this study examined longitudinal measurement invariance of the Feeding Practices and Structure Questionnaire (FPSQ) subscales (9 constructs; 40 items) across 3 time points. Mothers participating in the NOURISH trial reported their feeding practices when children were aged 2, 3.7, and 5 years (N = 404). Confirmatory Factor Analysis (CFA) within a structural equation modelling framework was used. Comparisons of initial cross-sectional models followed by longitudinal modelling of subscales, resulted in the removal of 12 items, including two redundant or poorly performing subscales. The resulting 28-item FPSQ-28 comprised 7 multi-item subscales: Reward for Behaviour, Reward for Eating, Persuasive Feeding, Overt Restriction, Covert Restriction, Structured Meal Setting and Structured Meal Timing. All subscales showed good fit over 3 time points and each displayed at least partial scalar (thresholds equal) longitudinal measurement invariance. We recommend the use of a separate single item indicator to assess the family meal setting. This is the first study to examine longitudinal measurement invariance in a feeding practices questionnaire. Invariance was established, indicating that the subscales of the shortened FPSQ-28 can be used with mothers to validly assess change in 7 feeding constructs in samples of children aged 2-5 years of age.

Item response theory analysis of self-reported social-emotional learning competencies in an Australian population cohort aged 11 years.

Childhood social and emotional competencies are recognized as teachable skills affecting well-being and developmental outcomes across the life span. This study sought to develop and validate a brief self-report measure of social-emotional competencies in middle childhood. The study used items from the 2015 Middle Childhood Survey, administered to a representative subsample of the New South Wales Child Development Study cohort, comprising sixth grade students (n = 26,837; aged 11-12 years) attending primary school in New South Wales, Australia. Exploratory and confirmatory factor analyses assessed the latent structure of social-emotional competencies, and item response theory and construct validity analyses evaluated the reliability, validity, and psychometric properties of the derived measure. A correlated five-factor model outperformed other latent structures (one-factor, higher order, and bifactor models) and was consistent with the framework developed by the Collaborative for Academic, Social, and Emotional Learning that informs the Australian school-based social-emotional learning curriculum, incorporating the following: Self-Awareness; Self-Management; Social Awareness; Relationship Skills; and Responsible Decision-Making. This brief (20-item), psychometrically sound, self-report measure of social-emotional competencies in middle childhood provides capacity for exploration of these skills as mediators and moderators of developmental outcomes across the life span. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The effectiveness of a short-term group music therapy intervention for parents who have a child with a disability.

BACKGROUND: The positive relationship between parent-child interactions and optimal child development is well established. Families of children with disabilities may face unique challenges in establishing positive parent-child relationships; yet, there are few studies examining the effectiveness of music therapy interventions to address these issues. In particular, these studies have been limited by small sample size and the use of measures of limited reliability and validity. OBJECTIVE: This study examined the effectiveness of a short-term group music therapy intervention for parents of children with disabilities and explored factors associated with better outcomes for participating families. METHODS: Participants were 201 mother-child dyads, where the child had a disability. Pre- and post-intervention parental questionnaires and clinician observation measures were completed to examine outcomes of parental wellbeing, parenting behaviors, and child development. Descriptive data, t-tests for repeated measures and a predictive model tested via logistic regression are presented. RESULTS: Significant improvements pre to post intervention were found for parent mental health, child communication and social skills, parenting sensitivity, parental engagement with child and acceptance of child, child responsiveness to parent, and child interest and participation in program activities. There was also evidence for high parental satisfaction and that the program brought social benefits to families. Reliable change on six or more indicators of parent or child functioning was predicted by attendance and parent education. CONCLUSIONS: This study provides positive evidence for the effectiveness of group music therapy in promoting improved parental mental health, positive parenting and key child developmental areas.

Academic resilience from school entry to third grade: Child, parenting, and school factors associated with closing competency gaps.

There is substantial evidence confirming that children who begin school with strong developmental skills tend to maintain positive academic trajectories across the elementary school years. Much less is known about children who begin school with poorer developmental competencies yet go on to achieve academically on par with, or above, their initially more competent peers, demonstrating academic resilience. This study used a large population dataset, the Longitudinal Study of Australian Children (n = 2,118) to identify children who demonstrated academic resilience between school entry and third grade, and the child, parenting, and school characteristics associated with this resilience. Findings show that two in five children who were initially identified as academically vulnerable on a school entry measure of language and cognitive skills were classified as academically resilient by Grade 3. In multivariate analysis, higher attentional regulation and receptive vocabulary skills were key factors associated with academic resilience in reading and numeracy, along with paternal consistency (for reading resilience) and fewer sleep problems (for numeracy resilience). Bivariate relations (ANOVAs) showed that resilient children, when compared to children who remained vulnerable, also showed fewer peer problems, fewer behavioral sleep problems, higher levels of parenting consistency and lower levels of parenting anger by mothers and fathers, higher levels of parental engagement in children's school, and higher levels of teacher self-efficacy. Supporting resilient pathways for children who are identified as vulnerable at school entry should include a particular focus on vocabulary development and attentional regulation, along with social skills and peer relationships, school-based parental engagement, and positive parenting support.

A review of Australian Government funding of parenting intervention research.

OBJECTIVES: Parenting is central to children's optimal development and accounts for a substantial proportion of the variance in child outcomes, including up to 40% of child mental health. Parenting is also one of the most modifiable, proximal, and direct factors for preventing and treating a range of children's problems and enhancing wellbeing. To determine the effectiveness of new approaches to parenting intervention, and to evaluate how to optimise reach and uptake, sufficient funding must be allocated for high quality research. METHOD: We reviewed funding awarded by the National Health and Medical Research Council (NHMRC) and Australian Research Council (ARC) for parenting intervention research during 2011-2020. RESULTS: Parenting intervention research received 0.25% of the NHMRC and ARC research budgets. CONCLUSIONS: There is a substantial mismatch between the funding of parenting intervention research and the impact of improved parenting on short- and long-term child outcomes. To rectify this, it is critical that Australian Government funding schemes include parenting interventions as priority areas for funding. IMPLICATIONS FOR PUBLIC HEALTH: Changes in allocation of funding to parenting research will support the establishment of evidence for the effective development, implementation and dissemination of parenting interventions to maximise health outcomes for children and their families.

Latent Profiles of Teacher-Reported Self-Regulation and Assessed Executive Function in Low-Income Community Preschools: Relations With Motor, Social, and School Readiness Outcomes.

This study contributes to understandings of early childhood self-regulation and executive function, and their components, through taking a person-centered approach to investigating how these skills cluster together in children aged 4-5years. A sample of children (N=206) from preschools in low socioeconomic communities were assessed through teacher report of self-regulation and three executive function tasks at the commencement of the preschool year. Outcome variables included teacher report of social skills and behavioral problems, and children's school readiness and visual motor integration skills were directly assessed. When the scores from this low-income sample were compared to available norms, over 70% of children scored below the 50th percentile in executive function measures, approximately 20% were below average in self-regulation skills, 48% were delayed in school readiness scores, 36% had above average levels of internalizing problems, and 25% were above average in externalizing problems. A series of four latent profile models each used different measurement approaches and combinations of self-regulation and executive function components. In three of the four models (two which combined self-regulation and executive function measures and one with teacher report of self-regulation only), a high skill and low skill profile were found with 31 to 42% of children in the low profile depending on the model. Children were very similarly classified across all three models. When three executive function scores were modeled alone, a more complex three-profile solution emerged (low, moderate, and high) with 52% in the low profile. Children identified in the low profiles across all models were at greater risk of poorer school readiness, visual motor integration and social skills, and increased behavioral problems. Taken together, the findings suggest that self-regulation and executive function skills tend to cluster together at this age and in this low-income sample. Composite scores of teacher report of self-regulation are somewhat sufficient in identifying children who also have poorer executive function skills and are at risk of poorer motor, social, and school readiness outcomes. These children are an important target group for additional supports prior to school entry.

National study of an early parenting intervention: implementation differences on parent and child outcomes: parenting program implementation.

Sing & Grow is a 10-week group music therapy intervention to promote positive parenting and child development for marginalized parents of birth to 3-year-old children. This paper examined whether changes from pre to post intervention varied according to implementation site, when the intervention was taken to scale nationally. Outcomes for 850 participants were compared for the site where the program was first established against three new locations; one site where implementation processes were more favorable relative to the other two sites. Overall, the findings provided only limited support for differential outcomes by site of implementation. Participants showed significant improvements in parent-reported parenting and child outcomes from pre to post that were similar across all sites. For clinician-reported outcomes, improvements over time were generally greater in the original site and the well-supported site compared to the sites where there were more implementation difficulties. These differences were partly accounted for by differences in the characteristics of participants receiving programs in different sites and differences in the clinicians' ratings of program quality and the levels of support and training provided. However, confounding by the source of measurement requires cautious interpretation of clinician data. This study further highlights the potential for music therapy as an early parenting intervention, and the need for more rigorous evaluations in this field.

Rhythm and Movement for Self-Regulation (RAMSR) intervention for preschool self-regulation development in disadvantaged communities: a clustered randomised controlled trial study protocol.

INTRODUCTION: Self-regulation (the ability to regulate emotion, attention, cognition and behaviour) is an integral part of early learning competence in the years prior to school. Self-regulation skills are critical to ongoing learning behaviours, achievement and well-being. Emerging neurological evidence suggests coordinated music and movement participation could support self-regulation development for all children. A pilot study in 2016 introduced a coordinated music and movement programme designed to boost self-regulation skills in children in disadvantaged communities, delivered by visiting specialists, with promising findings. The intervention is based on the neuroscience of beat synchronisation, rhythmic entrainment and the cognitive benefits of music therapy and music education-and is called Rhythm and Movement for Self-Regulation (RAMSR). This study builds on the pilot by training regular teachers to deliver RAMSR in their classrooms (rather than visiting specialists). The study aims to establish the effectiveness of RAMSR, which is designed to translate the cognitive benefits that accrue from rhythm participation to address self-regulation for children who do not typically access high-quality music programmes. METHODS AND ANALYSIS: We will recruit 237 children from up to eight kindergartens in low socioeconomic areas. INTERVENTION: teachers will be trained to deliver the RAMSR intervention during group time in kindergartens, daily for 8 weeks. CONTROL: usual practice kindergarten programme. FOLLOW-UP: end of intervention using child assessments and teacher report; 12 months postbaseline using school teacher reports following school transition. Primary outcomes: executive function and self-regulation. SECONDARY OUTCOMES: school readiness; visual-motor integration; teacher-reported behaviour problems, school transition and academic competency; teacher knowledge, confidence, practice and attitudes related to self-regulation, rhythm and movement; fidelity of intervention implementation. ETHICS AND DISSEMINATION: Queensland University of Technology Human Research Ethics Committee, approval 1900000566. Findings dissemination: in-field workshops to service providers, conference presentations, journal and professional publications. TRIAL REGISTRATION NUMBER: ACTRN12619001342101; Pre-results (30 September 2019).

Early Self-Regulation, Early Self-Regulatory Change, and Their Longitudinal Relations to Adolescents' Academic, Health, and Mental Well-Being Outcomes.

OBJECTIVE: To evaluate the extent to which early self-regulation and early changes in self-regulation are associated with adolescents' academic, health, and mental well-being outcomes. METHODS: Data were collected from 1 of the cohorts in a large dual-cohort cross-sequential study of Australian children. This cohort consisted of a nationally representative data set of 4983 Australian children assessed at 4 to 5 years of age, who were followed longitudinally to 14 to 15 years of age. Using regression within a path analysis framework, we first sought to investigate associations of early self-regulation (at 4-5 years and 6-7 years of age) with a broad range of academic, health, and mental well-being outcomes in adolescence (at 14-15 years). We next investigated the extent to which an early change in self-regulation (from 4 to 7 years of age) predicted these adolescents' outcomes. RESULTS: Early self-regulation predicted the full range of adolescents' outcomes considered such that a 1-SD increase in self-regulation problems was associated with a 1.5- to 2.5-times greater risk of more-negative outcomes. An early positive change in self-regulation was associated with a reduced risk of these negative outcomes for 11 of the 13 outcomes considered. CONCLUSION: These results suggest the potential of early self-regulation interventions, in particular, in influencing long-term academic, health, and well-being trajectories.

Early predictors of escalating internalizing problems across middle childhood.

The objective of this study is to examine the trajectory of internalizing problems across middle childhood among a population sample of Australian children, and to understand the timing of explanatory factors related to children's development of internalizing problems, by using multiple-indicator latent growth curve modeling. Participants were children, parents, and teachers in the Longitudinal Study of Australian Children (LSAC) Kindergarten (K) cohort (n = 3,153). Mothers reported on children's internalizing problems at 3 time points (6-7, 8-9, and 10-11 years). Explanatory factors included gender, emotional regulation skills, externalizing problems, peer relationships, parenting behaviors, socioeconomic status, and maternal mental health reported by mothers and teachers at 2 time points (4-5 years and 6-7 years). Growth modeling identified an increasing trajectory of internalizing problems over time. Initial levels were predicted by concurrent (6-7 years) emotional dysregulation, externalizing problems, angry parenting, and maternal mental health problems, as well as earlier (4-5 years) peer problems and maternal mental health. Escalation in internalizing problems was predicted by externalizing problems, peer problems, maternal mental health at 4-5 years, and emotional dysregulation and peer problems at 6-7 years. Girls had both higher initial levels and faster escalation of internalizing problems than boys. The findings provide ecological and developmental evidence and insights for effective intervention. Identifying and addressing early problems with peers may be particularly important to avoid the risk of escalating internalizing problems. Professional development sessions for educators to promote and support children's emotional regulation and peer interaction skills are likely to have a positive impact on children's well-being. (PsycINFO Database Record

Bidirectional Associations Between Child Sleep Problems and Internalizing and Externalizing Difficulties From Preschool to Early Adolescence.

Importance: Although multiple cross-sectional and longitudinal studies have established that sleep problems and behavioral difficulties are associated in children, the directionality of this association and whether sleep problems are differentially associated with different types of childhood behavioral difficulties are unclear. Understanding these associations will inform the focus and timing of interventions. Objective: To determine whether longitudinal and reciprocal associations exist between child sleep problems and externalizing, internalizing, or both behavioral difficulties. Design, Setting, and Participants: Prospective cohort study using nationally representative data from the first 5 waves (2004, 2006, 2008, 2010, and 2012) of the kindergarten cohort (4983 children aged 4-5 years in 2004) collected for the Longitudinal Study of Australian Children. Associations were evaluated using cross-lagged structural equation model analyses performed from May 25, 2016, to September 20, 2017. Main Outcomes and Measures: Child sleep problems and internalizing and externalizing behavioral difficulties. Sleep problems were defined using parent-reported child sleep problem severity and specific difficulties (ie, difficulty getting to sleep at night, not happy sleeping alone, waking during the night, and restless sleep) on 4 or more nights of the week. Child behavioral difficulties were defined using the parent-reported Strengths and Difficulties Questionnaire for externalizing difficulties (conduct problems and hyperactivity/inattention subscales) and internalizing difficulties (emotional problems subscale). Results: The 4983 children enrolled in 2004 had a mean (SD) age of 4.7 (0.2) years and comprised a similar percentage of boys (2536 [50.9%]) and girls. In 2012, 3956 children (79.4%) aged 12 to 13 years were retained. Significant bidirectional associations were detected between sleep problems and externalizing difficulties during the elementary school transition period, with greater sleep problems associated with later externalizing behavior and vice versa (cross-lagged path coefficient, 0.04 [95% CI, 0.01-0.08] to 0.09 [95% CI, 0.06-0.13]). Although sleep was a significant driver of later internalizing difficulties (coefficient, 0.10 [95% CI, 0.07-0.14] to 0.16 [95% CI, 0.12-0.19]), the reverse association was not significant. In the final model that included all 3 constructs, the associations were attenuated but remained significant over time. Conclusions and Relevance: These results suggest that future studies should investigate whether implementing sleep problem intervention decreases the occurrence of both externalizing and internalizing difficulties. Interventions targeting externalizing, but not internalizing, difficulties may benefit childhood sleep.

Executive Function in Adolescence: Associations with Child and Family Risk Factors and Self-Regulation in Early Childhood.

Executive functions are important higher-order cognitive skills for goal-directed thought and action. These capacities contribute to successful school achievement and lifelong wellbeing. The importance of executive functions to children's education begins in early childhood and continues throughout development. This study explores contributions of child and family factors in early childhood to the development of executive function in adolescence. Analyses draw on data from the nationally representative study, Growing up in Australia: The Longitudinal Study of Australian Children. Participants are 4819 children in the Kindergarten Cohort who were recruited at age 4-5 years. Path analyses were employed to examine contributions of early childhood factors, including family socio-economic position (SEP), parenting behaviors, maternal mental health, and a child behavioral risk index, to the development of executive function in adolescence. The influence of children's early self-regulatory behaviors (attentional regulation at 4-5 years and approaches to learning at 6-7 years) were also taken into account. A composite score for the outcome measure of executive function was constructed from scores on three Cogstate computerized tasks for assessing cognition and measured visual attention, visual working memory, and spatial problem-solving. Covariates included child gender, age at assessment of executive function, Aboriginal and Torres Strait Islander status, speaking a language other than English at home, and child's receptive vocabulary skills. There were significant indirect effects involving child and family risk factors measured at 4-5 years on executive function at age 14-15 years, mediated by measures of self-regulatory behavior. Child behavioral risk, family SEP and parenting behaviors (anger, warmth, and consistency) were associated with attentional regulation at 4-5 years which, in turn, was significantly associated with approaches to learning at 6-7 years. Both attentional regulation and approaches to learning were directly associated with executive functioning at 14-15 years. These findings suggest that children's early self-regulatory capacities are the basis for later development of executive function in adolescence when capabilities for planning and problem-solving are important to achieving educational goals.