Can a teacher-reported indicator be used for population monitoring of oral language skills at school entry?

PURPOSE: Monitoring oral language skills at the population level would provide valuable data to inform policy decisions to better support children's oral language skills in schools. The Australian Early Development Census (AEDC) is a teacher-rated population measure of early child development that includes a rating of children's oral communication in the classroom (OCC). METHOD: This study evaluates the validity of the OCC indicator for population monitoring of children's oral language skills, capitalising on data from two datasets: the 2012 AEDC cohort (n = 289 973) and a subsample of children from the Longitudinal Study of Australian Children for whom AEDC data were also collected (n = 720). RESULT: Construct validity was demonstrated by showing significant differences in OCC ratings between subpopulations of children who would be expected to differ in terms of oral language skills at school entry (e.g. children with a diagnosed speech-language impairment compared to those with no impairment). OCC ratings were associated with externally validated measures of language, suggesting convergent validity. No relationship was found between OCC ratings and physical health scores, indicating divergent validity. CONCLUSION: The findings support the use and interpretation of the OCC indicator as a tool for population-level monitoring of oral language in Australian school entrants.

Epidemiology of positive mental health in a national census of children at school entry.

BACKGROUND: Until now, child mental health promotion efforts have focused primarily on reducing the prevalence and severity of problems; yet the absence of mental health problems does not necessarily imply the presence of healthy psychosocial functioning. We aimed to investigate the epidemiology of child mental health competence in a full national population of school entrants. METHODS: The data source was the 2012 Australian Early Development Index, a national census of early childhood development completed for school entrants by teachers across Australia (n=275 800). The mental health competence outcome measure was derived from constructs that focused on children's social and emotional strengths. Children with mental health competence scores in the top quintile were compared with the standard population across individual and community characteristics. RESULTS: Average age at assessment was 5 years 7 months. Higher odds of mental health competence were observed for children who lived in more advantaged areas (OR 1.62; 99% CI 1.49 to 1.75), had attended preschool (1.38; 1.25 to 1.51) and demonstrated effective oral communication skills in the classroom (19.01; 15.62 to 23.13). Indigenous children had lower odds compared with non-Indigenous children (0.59; 0.54 to 0.64). Children in disadvantaged areas who attended preschool did not 'catch up' with their more advantaged peers. CONCLUSIONS: Mental health competence is unequally distributed across the Australian child population at school entry and is strongly predicted by measures and correlates of disadvantage. Effective oral communication and attendance at preschool warrant further investigation as potentially modifiable factors that may support mental health competence in new school entrants.

Child and Family Antecedents of Pain During the Transition to Adolescence: A Longitudinal Population-Based Study.

Pediatric persistent pain is associated with poorer physical and psychosocial functioning in children, as well as immediate and long-term societal costs. Onset typically occurs in early adolescence, suggesting that late childhood is a key window for identifying potential intervention targets before pain symptoms become entrenched. This study used population-based data from the Longitudinal Study of Australian Children (n = 3,812) and adopted a biopsychosocial and ecological systems approach to investigate child, family, and sociodemographic factors associated with pain problems in children transitioning to adolescence. The prevalence of at least weekly parent-reported pain in the study sample was approximately 5% at 10 to 11 years of age, and pain continued at 12 to 13 years of age for 40% of these children. Key factors at 10 to 11 years that uniquely predicted parent-reported pain problems at 12 to 13 years were frequency of previous pain (1-3 times weekly: odds ratio [OR] = 7.49; 95% confidence interval [CI], 4.3-13.0; 4-7 times weekly: OR = 17.8; 95% CI, 8.7-36.5) and sleep difficulties (OR = 1.86; 95% CI, 1.16-2.97). This study highlights the importance of early intervention for persistent pain in childhood, because pain complaints in late childhood tend to persist into early adolescence. PERSPECTIVE: This article used a biopsychosocial and ecological systems approach to understanding predictors of pain problems during the transition to adolescence within a nationally representative community-based cohort. Sleep difficulties at 10 to 11 years uniquely predicted pain at ages 12 to 13 years, suggesting that early intervention using sleep interventions may be a promising direction for future research.

A review of factors associated with mental health in siblings of children with chronic illness.

This article reviews the literature on modifiable factors associated with mental health in siblings of children with chronic illness. Three clinical databases were searched. A total of 17 studies met the inclusion criteria. Several key themes emerged from the review. Better sibling mental health was associated with camp attendance, perceived parent/peer support, illness education and enhancing control through cognitive coping strategies and routine. Parental and sibling psychoeducation interventions and social support may enhance children's mental health when their sibling has a chronic illness.

Predictors of mental health competence in a population cohort of Australian children.

BACKGROUND: The child mental health epidemiology literature focuses almost exclusively on reporting the prevalence and predictors of child mental disorders. However, there is growing recognition of positive mental health or mental health competence as an independent outcome that cannot be inferred from the absence of problems, and requires epidemiological investigation in its own right. METHODS: We developed a novel measure of child mental health competence within the framework of the Australian Early Development Index, a three-yearly national census of early child development. Predictors of this outcome were investigated by linking these census data at individual level to detailed background information collected by a large longitudinal cohort study. RESULTS: Predictors of competence were consistent with previously described theoretical and empirical models. Overall, boys were significantly less likely than girls to demonstrate a high level of competence (OR 0.60, 95% CI 0.39 to 0.91). Other strong predictors of competence were parent education and a relative absence of maternal psychological distress; these factors also appeared to attenuate the negative effect of family hardship on child competence. CONCLUSIONS: This measure of mental health competence shows promise as a population-level indicator with the potential benefit of informing and evaluating evidence-based public health intervention strategies that promote positive mental health.

Psychosocial predictors of 4-year BMI change in overweight and obese children in primary care.

OBJECTIVE: This study aimed to determine whether (1) initial and/or (2) changes in psychosocial functioning predict body mass index (BMI) z-score change over 4 years in overweight/mildly obese 5- to 9-year old children presenting to primary care. DESIGN AND METHODS: Eligible participants (n = 258) were overweight/mildly obese children (IOTF criteria) recruited into the LEAP2 trial (ISRCTN52511065) from 3,958 children visiting general practitioners in Melbourne, Australia from May 2005 to July 2006. Predictors were change scores calculated from repeated measures of parent- and child-reported child health-related quality of life (PedsQL) and self-esteem; child-reported desire to be thinner; and parent-reported child weight concern. Outcome was measured BMI z-score change from baseline to 4 years. RESULTS: The 189 respondents (61% female; 73% retention) showed little mean change in BMI z-score (-0.08) but wide variation (standard deviation 0.50, range -1.32 to 1.20). Only one baseline measure (better parent-reported PedsQL School Functioning) predicted improving BMI z-score. However, parents and children consistently reported that changes in psychosocial functioning (i.e., PedsQL Social and Global Self-esteem) were inversely related to BMI z-score change scores. The strongest predictors of decreases in BMI z-scores were changes in child-reported body-image variables, i.e., improvements in Physical Appearance Self-esteem (ß =0.40, 95% CI -0.98 to -0.15, P < 0.01) and declines in Desire to be Thinner (ß = 0.33, 95% CI 0.04 to 0.23, P < 0.01). CONCLUSIONS: At presentation to primary care, it seems unlikely that targeting the psychosocial factors measured in this study would influence BMI z-score change in overweight/mildly obese children. Subsequent change in psychosocial well-being covaries with BMI z-score change and may have important adolescent ramifications; the causal directions for these associations require further research.

Psychological predictors of adiposity: systematic review of longitudinal studies.

We aimed to systematically review current literature on temporal relationships between psychological factors and subsequent adiposity gain and obesity onset within childhood/adolescence. Databases were searched for longitudinal, population-based studies assessing psychological predictors and adiposity-related outcomes ≥ 1 year later. Study characteristics were synthesised into descriptive Tables and quality evaluated. Fifteen papers met inclusion criteria. Predictors broadly related to psychological symptoms or self-esteem. Evidence was mixed as to whether depressive symptoms and other negative emotional states may increase risk for adiposity gain and obesity onset within adolescence. There was some evidence for low self-esteem predicting obesity onset. Among obese adolescents, depressive symptoms exacerbated obesity, while physical appearance self-esteem exerted gender-specific adiposity changes. The literature had substantial limitations and inconsistencies. This review provides some support for psychological components in obesity prevention/intervention programs as part of a multifactorial approach to tackling childhood obesity. Further good-quality longitudinal research would strengthen the sparse literature and clarify inconsistencies.