1
|
Draidi Areed W, Price A, Arnett K, Mengersen K, Thompson H. Where are the vulnerable children? Identification and comparison of clusters of young children with health and developmental vulnerabilities across Queensland. PLoS One 2024; 19:e0298532. [PMID: 38489278 PMCID: PMC10942074 DOI: 10.1371/journal.pone.0298532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 01/25/2024] [Indexed: 03/17/2024] Open
Abstract
This study aimed to better understand the vulnerability of children in their first year of school, aged between 5 years 5 months and 6 years 6 months, based on five health and development domains. Identification of subgroups of children within these domains can lead to more targeted policies to reduce these vulnerabilities. The focus of this study was to determine clusters of geographical regions with high and low proportions of vulnerable children in Queensland, Australia. This was achieved by carrying out a K-means analysis on data from the Australian Early Development Census and the Australian Bureau of Statistics. The clusters were then compared with respect to their geographic locations and risk factor profiles. The results are made publicly available via an interactive dashboard application developed in R Shiny.
Collapse
Affiliation(s)
- Wala Draidi Areed
- School of Mathematical Science, Centre for Data Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Aiden Price
- School of Mathematical Science, Centre for Data Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kathryn Arnett
- Children’s Health Queensland, Brisbane, Queensland, Australia
| | - Kerrie Mengersen
- School of Mathematical Science, Centre for Data Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Helen Thompson
- School of Mathematical Science, Centre for Data Science, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
2
|
Dadi AF, He V, Nutton G, Su JY, Guthridge S. Predicting child development and school readiness, at age 5, for Aboriginal and non-Aboriginal children in Australia's Northern Territory. PLoS One 2023; 18:e0296051. [PMID: 38117820 PMCID: PMC10732444 DOI: 10.1371/journal.pone.0296051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/05/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND Positive early development is critical in shaping children's lifelong health and wellbeing. Identifying children at risk of poor development is important in targeting early interventions to children and families most in need of support. We aimed to develop a predictive model that could inform early support for vulnerable children. METHODS We analysed linked administrative records for a birth cohort of 2,380 Northern Territory children (including 1,222 Aboriginal children) who were in their first year of school in 2015 and had a completed record from the Australian Early Development Census (AEDC). The AEDC measures early child development (school readiness) across five domains of development. We fitted prediction models, for AEDC weighted summary scores, using a Partial Least Square Structural Equation Model (PLS-SEM) considering four groups of factors-pre-pregnancy, pregnancy, known at birth, and child-related factors. We first assessed the models' internal validity and then the out-of-sample predictive power (external validity) using the PLSpredict procedure. RESULT We identified separate predictive models, with a good fit, for Aboriginal and non-Aboriginal children. For Aboriginal children, a significant pre-pregnancy predictor of better outcomes was higher socioeconomic status (direct, β = 0.22 and indirect, β = 0.16). Pregnancy factors (gestational diabetes and maternal smoking (indirect, β = -0.09) and child-related factors (English as a second language and not attending preschool (direct, β = -0.28) predicted poorer outcomes. Further, pregnancy and child-related factors partially mediated the effects of pre-pregnancy factors; and child-related factors fully mediated the effects of pregnancy factors on AEDC weighted scores. For non-Aboriginal children, pre-pregnancy factors (increasing maternal age, socioeconomic status, parity, and occupation of the primary carer) directly predicted better outcomes (β = 0.29). A technical observation was that variance in AEDC weighted scores was not equally captured across all five AEDC domains; for Aboriginal children results were based on only three domains (emotional maturity; social competence, and language and cognitive skills (school-based)) and for non-Aboriginal children, on a single domain (language and cognitive skills (school-based)). CONCLUSION The models give insight into the interplay of multiple factors at different stages of a child's development and inform service and policy responses. Recruiting children and their families for early support programs should consider both the direct effects of the predictors and their interactions. The content and application of the AEDC measurement need to be strengthened to ensure all domains of a child's development are captured equally.
Collapse
Affiliation(s)
- Abel Fekadu Dadi
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Vincent He
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Georgina Nutton
- College of Indigenous Futures, Education and the Arts, Charles Darwin University, Darwin Northern Territory, Australia
| | - Jiunn-Yih Su
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Steven Guthridge
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| |
Collapse
|
3
|
McKean C, Reilly S. Creating the conditions for robust early language development for all: Part two: Evidence informed public health framework for child language in the early years. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:2242-2264. [PMID: 37431980 DOI: 10.1111/1460-6984.12927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/14/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND One of the most significant developmental accomplishments is the emergence of language in early childhood. Whilst this process is effortless for most children, others can face significant hurdles. Identifying, in the early years, which children will go on to have developmental language disorder is, however, fraught with several well-documented challenges. In the preceding paper we described and linked new research evidence about factors that influence language development in the early years, noting that exposure to some may be time sensitive and that these influences cluster together and can accumulate over time. We demonstrated that risk profiles were associated with and characterised low language trajectories, and we considered how this information could be integrated into a concept that moves beyond screening at single time points in the early years. We argue that this evidence might be used to build an improved early years framework for language thereby creating a more equitable surveillance system that does not leave children living in less advantageous circumstances behind. Underpinning this thinking was a bioecological framework that incorporates the social, environmental and family factors in the child's ecosystem known to influence language development in the early years. AIMS To develop a proposal for the design and implementation of an early language public health framework based on current best evidence METHODS: We synthesised the findings from the companion paper (Reilly & McKean 2023) regarding early language trajectories, inequalities and clustering of risks with key public health concepts, relevant intervention evidence and implementation theories to develop a new framework for language surveillance and preventative interventions in the early years. MAIN CONTRIBUTION An evidence informed early language public health framework is presented. Describing in turn (1) essential components; (2) relevant interventions; (3) essential qualities for implementation ((i) probabilistic, (ii) proportionate, (iii) developmental and sustained and (iv) codesigned); (4) system-level structures and (5) processes required to adopt and embed an early language public health framework in an existing Local Government Area's child health surveillance and early prevention-intervention systems. CONCLUSIONS Children's language development influences their life chances across the life course and language difficulties are unfairly distributed across society. Current evidence points to the need for whole systems approaches to early child language and enables a blueprint for such a framework to be described. WHAT THIS PAPER ADDS What is already known on the subject Early child language development sets the stage for a child's life chances and language difficulties can have profound long-term consequences. Such difficulties are unfairly distributed across society and the reach of preventative services is not universal or equitable. WHAT THIS STUDY ADDS Several effective primary and secondary preventative interventions exist but their successful implementation is not straightforward. An early language public health framework of surveillance and intervention is described to provide equitable and effective early interventions to children from 0-4 years. We detail the essential components, interventions and qualities of that framework and describe system-level structures and processes required to adopt and embed an early language public health framework in a given locality. WHAT ARE THE CLINICAL IMPLICATIONS OF THIS WORK?: A whole systems approach to early child language is required and should be co-designed through local collaboration with family, community and children's services stakeholders. A public health speech and language therapist role could catalyse the implementation of such approaches and support continuous improvement.
Collapse
Affiliation(s)
| | - Sheena Reilly
- Griffith University, Gold Coast Campus, Southport, Australia
| |
Collapse
|
4
|
Areed WD, Price A, Arnett K, Thompson H, Malseed R, Mengersen K. Assessing the spatial structure of the association between attendance at preschool and children's developmental vulnerabilities in Queensland, Australia. PLoS One 2023; 18:e0285409. [PMID: 37556459 PMCID: PMC10411799 DOI: 10.1371/journal.pone.0285409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 04/22/2023] [Indexed: 08/11/2023] Open
Abstract
Demographic and educational factors are essential, influential factors of early childhood development. This study aimed to investigate spatial patterns in the association between attendance at preschool and children's developmental vulnerabilities in one or more domain(s) in their first year of full-time school at a small area level in Queensland, Australia. This was achieved by applying geographically weighted regression (GWR) followed by K-means clustering of the regression coefficients. Three distinct geographical clusters were found in Queensland using the GWR coefficients. The first cluster covered more than half of the state of Queensland, including the Greater Brisbane region, and displays a strong negative association between developmental vulnerabilities and attendance at preschool. That is, areas with high proportions of preschool attendance tended to have lower proportions of children with at least one developmental vulnerability in the first year of full-time school. Clusters two and three were characterized by stronger negative associations between developmental vulnerabilities, English as the mother language, and geographic remoteness, respectively. This research provides evidence of the need for collaboration between health and education sectors in specific regions of Queensland to update current service provision policies and to ensure holistic and appropriate care is available to support children with developmental vulnerabilities.
Collapse
Affiliation(s)
- Wala Draidi Areed
- School of Mathematical Science, Center for Data Science, Queensland University of Technology, Queensland, Australia
| | - Aiden Price
- School of Mathematical Science, Center for Data Science, Queensland University of Technology, Queensland, Australia
| | | | - Helen Thompson
- School of Mathematical Science, Center for Data Science, Queensland University of Technology, Queensland, Australia
| | - Reid Malseed
- Children’s Health Queensland, Queensland, Australia
| | - Kerrie Mengersen
- School of Mathematical Science, Center for Data Science, Queensland University of Technology, Queensland, Australia
| |
Collapse
|
5
|
Jaworski M, Janvier A, Bourque CJ, Mai-Vo TA, Pearce R, Synnes AR, Luu TM. Parental perspective on important health outcomes of extremely preterm infants. Arch Dis Child Fetal Neonatal Ed 2022; 107:495-500. [PMID: 34815239 PMCID: PMC9411910 DOI: 10.1136/archdischild-2021-322711] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/03/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE Neonatal outcome research and clinical follow-up principally focus on neurodevelopmental impairment (NDI) after extremely preterm birth, as defined by the scientific community, without parental input. This survey aimed to investigate parental perspectives about the health and development of their preterm children. METHODS Parents of children aged 18 months to 7 years born <29 weeks' gestational age presenting at a neonatal follow-up clinic over a 1-year period were asked to evaluate their children's health and development. They were also asked the following question: 'if you could improve two things about your child, what would they be?' Responses were analysed using mixed methods. Logistic regressions were done to compare parental responses. RESULTS 248 parents of 213 children (mean gestational age 26.6±1.6 weeks, 20% with severe NDI) were recruited. Parents evaluated their children's health at a median of 9/10. Parental priorities for health improvements were (1) development, mainly behaviour, emotional health and language/communication (55%); (2) respiratory heath and overall medical fragility (25%); and (3) feeding/growth issues (14%). Nineteen per cent explicitly mentioned 'no improvements'. Parents were more likely to state 'no improvements' if child had no versus severe NDI OR 4.33 (95% CI 1.47 to 12.75)) or if parents had no versus at least a high school diploma (OR 4.01 (95% 1.99 to 8.10)). CONCLUSIONS Parents evaluate the health of their preterm children as being very good, with positive perspectives. Parental concerns outside the developmental sphere should also be addressed both in clinical follow-up and research.
Collapse
Affiliation(s)
- Magdalena Jaworski
- Department of pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Québec, Canada,Clinical Ethics Unit, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Québec, Canada
| | - Annie Janvier
- Department of pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Québec, Canada,Clinical Ethics Unit, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Québec, Canada,Clinical Ethics and Family Partnership Research Unit, CHU Sainte-Justine Centre de Recherche, Montreal, Québec, Canada,Palliative care unit, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Québec, Canada,Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, Québec, Canada,Bureau du partenariat patients-familles-soignants, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Québec, Canada,Bureau de l'éthique clinique, Université de Montréal, Montreal, Québec, Canada
| | - Claude Julie Bourque
- Clinical Ethics Unit, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Québec, Canada,Clinical Ethics and Family Partnership Research Unit, CHU Sainte-Justine Centre de Recherche, Montreal, Québec, Canada,Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, Québec, Canada
| | - Thuy-An Mai-Vo
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, Québec, Canada
| | - Rebecca Pearce
- Bureau du partenariat patients-familles-soignants, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Québec, Canada
| | - Anne R Synnes
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Thuy Mai Luu
- Department of pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Québec, Canada .,Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, Québec, Canada
| |
Collapse
|
6
|
Russell J, Grant CC, Morton S, Denny S, Paine (Tūhoe) SJ. Prevalence and predictors of developmental health difficulties within New Zealand preschool-aged children: a latent profile analysis. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2083188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Jin Russell
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Developmental Paediatrics, Neuroservices, Starship Children’s Health, Auckland, New Zealand
| | - Cameron C. Grant
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand
- General Paediatrics, Starship Children’s Health, Auckland, New Zealand
| | - Susan Morton
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Simon Denny
- Mater Research, Health Services Research Group, South Brisbane, Australia
| | | |
Collapse
|
7
|
Taylor CL, Christensen D, Venn AJ, Preen DB, Stafford J, Hansen E, Jose K, Zubrick SR. Use of administrative record linkage to examine patterns of universal early childhood health and education service use from birth to Kindergarten (age four years) and developmental vulnerability in the Preparatory Year (age five years) in Tasmania, Australia. Int J Popul Data Sci 2022; 6:1681. [PMID: 35136844 PMCID: PMC8780991 DOI: 10.23889/ijpds.v6i1.1681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In Australia, the health and education sectors provide universal early childhood services for the same population of children. Therefore, there is a strong imperative to view service use and outcomes through a cross-sectoral lens to better understand and address the service needs of young children and their families. OBJECTIVES To investigate patterns of health and education service use from birth through Kindergarten (age four years), the associations with cumulative risks, and developmental vulnerability in the first year of full-time school (age five years). METHODS A retrospective cohort study that used population-wide linkage of health and education administrative data records for 5,440 children with a Tasmanian 2015 Australian Early Development Census (AEDC) record who were born in Tasmania (2008-2010). RESULTS Four service use patterns were identified: Regular (46% of children), Declining (24%); Low (18%); and Selective service use (12%). Regular service use (aOR 0.8, 95% CI 0.7 to 0.9), adjusted for cumulative risks, was associated with decreased odds of developmental vulnerability, compared to the other service use groups. Low (OR 6.1, 95% CI 4.5 to 8.2) and Declining service use (OR 2.5 95% CI 1.9 to 3.4) were more likely for children with the highest levels of cumulative risks. Low and Declining service use, adjusted for cumulative risks were associated with increased odds of developmental vulnerability, compared to the Regular service use group. CONCLUSION This study provides a whole population view of the differential use of universal services and the complex risk circumstances that influence service use. The association between patterns of multiple risk and service use points to barriers to service use, and the varying level of developmental vulnerability within each service use group draws attention to children who may benefit from higher sustained participation in core health and education services across the whole of early childhood.
Collapse
Affiliation(s)
- Catherine L. Taylor
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia,Corresponding author: Catherine L. Taylor
| | - Daniel Christensen
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Alison J. Venn
- Menzies Institute for Medical Research, The University of Tasmania. Hobart, Tasmania, Australia
| | - David B. Preen
- School of Population and Global Health, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Joel Stafford
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Emily Hansen
- School of Social Sciences, University of Tasmania, Hobart, Tasmania
| | - Kim Jose
- Menzies Institute for Medical Research, The University of Tasmania. Hobart, Tasmania, Australia
| | - Stephen R. Zubrick
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| |
Collapse
|
8
|
Eadie P, Levickis P, McKean C, Westrupp E, Bavin EL, Ware RS, Gerner B, Reilly S. Developing Preschool Language Surveillance Models - Cumulative and Clustering Patterns of Early Life Factors in the Early Language in Victoria Study Cohort. Front Pediatr 2022; 10:826817. [PMID: 35186809 PMCID: PMC8854765 DOI: 10.3389/fped.2022.826817] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Screening and surveillance of development are integral to ensuring effective early identification and intervention strategies for children with vulnerabilities. However, not all developmental skills have reliable screening processes, such as early language ability. METHOD We describe how a set of early life factors used in a large, prospective community cohort from Australia are associated with language abilities across the preschool years, and determine if either an accumulation of risk factors or a clustering of risk factors provide a feasible approach to surveillance of language development in preschool children. RESULTS There were 1,208 children with a 7-year language outcome. The accumulation of early life factors increased the likelihood of children having low language skills at 7-years. Over a third of children with typical language skills (36.6%) had ≤ two risks and half of the children with low language (50%) had six or more risks. As the number of factors increases the risk of having low language at 7-years increases, for example, children with six or more risks had 17 times greater risk, compared to those with ≤ two risks. Data collected from 1,910 children at 8- to 12-months were used in the latent class modeling. Four profile classes (or groups) were identified. The largest group was developmentally enabled with a supportive home learning environment (56.2%, n = 1,073). The second group was vulnerable, both developmentally and in their home learning environment (31.2%, n = 596); the third group was socially disadvantaged with a vulnerable home learning environment (7.4%, n = 142); the final group featured maternal mental health problems and vulnerable child socio-emotional adjustment (5.2%, n = 99). Compared to developmentally enabled children, the risk of low language at 7-years was greater for children in the three other groups. CONCLUSION The cumulative and cluster risk analyses demonstrate the potential to use developmental surveillance to identify children within the first years of life who are at risk of language difficulties. Importantly, parent-child interaction and the home learning environment emerged as a consistent cluster. We recommend they be adopted as the common focus for early intervention and universal language promotion programs.
Collapse
Affiliation(s)
- Patricia Eadie
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia
| | - Penny Levickis
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia.,Genetics, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Cristina McKean
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Elizabeth Westrupp
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, VIC, Australia.,Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia
| | - Edith L Bavin
- Genetics, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,School of Psychology and Public Health La Trobe University, Melbourne, VIC, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Bibi Gerner
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia.,Genetics, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Sheena Reilly
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| |
Collapse
|