New South Wales Child Research Articles

Regional mapping of early childhood risk for mental disorders in an Australian population sample.

Population-level profiles of risk for later childhood mental disorders have been identified in patterns of early developmental vulnerabilities using Australian Early Developmental Census. We sought to demonstrate the geographical distribution of these early childhood risk profiles for mental illness, to inform policy decisions for place-sensitive provision of health and allied services. Using geographic information system techniques, we mapped the regional percentage of children at highest risk for mental disorders across the state of New South Wales (NSW), according to Local Government Areas, for 82 891 children in the NSW Child Development Study. A high proportion (>10%) of children at risk of later mental disorders were located in regional and socioeconomically disadvantaged areas, with a few metropolitan regions showing similarly high proportions of the population at risk. These findings highlight the potential to identify place-sensitive needs for early intervention and prevention programs for emerging mental health problems in children.

'One hundred dollars is a big help, but to continue, it's a challenge': A qualitative study exploring correlates and barriers to Active Kids voucher uptake in western Sydney.

The Active Kids voucher is a universal, state-wide voucher program, provided by the New South Wales (NSW) Government, Office of Sport. All school-aged children in NSW are eligible to receive a voucher to reduce registration costs of structured physical activity programs. This study explores reasons behind lower uptake among children who are overweight or obese, from cultural and linguistically diverse families and those living in low socio-economic areas. Participants were recruited through a convenience sample of parent/carers who participated in the NSW Health Go4Fun program. Qualitative data were collected using focus groups. The Framework method was adapted for the analysis, taking an interpretive phenomenological approach. Study participants (n=54) were all parents of children who were overweight or obese from both low and high socio-economic status (SES). Most reported speaking a primary language other than English at home (65%). Parents were mostly aware of the Active Kids program (91%) and reported that the voucher had a positive impact on their children's participation in structured physical activity. A range of socio-ecological factors, in addition to activity cost, influenced whether parents were able to use an Active Kids voucher and participate in structured physical activity. The Active Kids voucher does not alleviate all barriers, particularly for families living in low socio-economic areas. Engagement of this population in structured physical activities using the Active Kids vouchers could be strengthened through the implementation of effective interventions which comprehensively address the remaining barriers, such as access and flexibility of programs with local stakeholders and activity providers.

Early Life Predictors of Suspensions from Primary School: Cross-Agency Indicators of Risk for School Exclusion in An NSW Population Cohort

IntroductionExcluding students from school via out-of-school suspensions and expulsions is a controversial practice in Australia and internationally, yet forms a key component of school welfare and discipline policies. There is growing concern that increasing exclusion at earlier grades and an over-representation of particular groups of disadvantaged students may intensify inequalities in educational, justice, health and welfare outcomes for excluded students relative to their non-excluded peers. Previous studies have focused predominantly on secondary school exclusions and on sociodemographic predictors.
 Objectives and ApproachThis study aimed to identify early life predictors of primary school suspensions using multi-agency data from the New South Wales (NSW) Child Development Study. Participants were 34,855 NSW children and their parents with linked records from education, health, child protection, and criminal justice spanning birth to the 6 th - grade (~12 years). Multinormal logistic regression examined the associations of sociodemographic, pre/perinatal, early developmental vulnerability, and parent factors with any later suspension during the 3 rd - to 6 th -grades.
 ResultsIn a multivariable model, many factors had significant independent associations with any suspension. The largest effects (odds ratios ≥4.0) were observed for male gender and child maltreatment reports, with moderate effects (odds ratios 1.5 to <4.0) for Indigenous ethnicity, socio-economic disadvantage, exposure to smoking in utero, any parental criminal offending, aggressive behaviour, school-based responsibility and respect, and sub-threshold notifications to child protection services. Small effects (odds ratios >1.0 to <1.5) were revealed for young maternal age at birth (<26 years), any parental mental illness, language and cognitive skills, any emotional or behavioural problem, hyperactivity-inattention, and any emergency department presentation for physical injury.
 Conclusion / ImplicationsBy facilitating the identification of students at risk of early (primary school) exclusion using multi-sector information available at the time of entry to school, these findings may assist educators to deliver targeted preventative interventions for at-risk students

Physical Activity Behaviors of Children Who Register for the Universal, State-Wide Active Kids Voucher: Who Did the Voucher Program Reach?

Active Kids is a government-led, universal voucher program that aims to reduce the cost of participation in structured physical activity for all school-enrolled children in New South Wales (NSW), Australia. As part of the Active Kids program evaluation, this cross-sectional study examined the Active Kids’ program’s reach to children in NSW and their physical activity behaviors, before voucher use. Demographic registration data from all children (4.5–18 years old) who registered for an Active Kids voucher in 2018 (n = 671,375) were compared with Census data. Binary and multinomial regression models assessed which correlates were associated with meeting physical activity guidelines and participation in the sessions of structured physical activity. The Active Kids program attracted more than half (53%) of all eligible children in NSW. Children who spoke a primary language other than English at home, were aged 15–18 years old, lived in the most disadvantaged areas, and girls, were less likely to register. Of the registered children, 70% had attended structured physical activity sessions at least once a week during the previous 12 months, whilst 19% achieved physical activity guidelines. Active Kids achieved substantial population reach and has the potential to improve children’s physical activity behaviors.

Implementation of an Early Childhood Healthy Eating and Physical Activity Program in New South Wales, Australia: Munch & Move.

Background: Childhood obesity is an important public health issue. Approximately 20% of 2–4 year olds are overweight or obese, meaning 1 in 5 Australian children start school above a healthy weight. In the state of New South Wales (NSW) the combined prevalence of childhood overweight and obesity is significantly higher among children from low socioeconomic status backgrounds and children from regional, rural and remote areas. This paper describes implementation of a healthy eating and active play program (Munch & Move) for center-based early childhood education and care (ECEC) services aimed at influencing healthy behaviors in young children in NSW, Australia. It shows changes over time including a focus on disadvantaged, Aboriginal and remote communities. It also discusses the challenges and future opportunities for the program.Methods: Routine data in relation to service delivery (reach) and implementation indicators are collected by Local Health District staff. Fifteen implementation indicators (known as practices) were introduced to monitor the implementation of Munch & Move (six related to promoting and encouraging healthy eating, four related to improving physical activity, two related to small screen recreation; and three related to quality of service delivery).Results: As of 30 June 2017, 88.4% of ECEC services have staff trained in Munch & Move. Of the 15 practices related to promoting and encouraging healthy eating, increasing physical activity and improving the quality of service delivery 13 practices saw significant improvements between 2012 and 2017. This was consistent for services with a high proportion of Aboriginal children and for services in disadvantaged and remote communities. There has been a statistically significant increase in the proportion (37.6–81.0%, p < 0.0001) and type of ECEC services (preschools 36.1–81.3%, p < 0.0001, long day care 38.6–81.0%, p < 0.0001, and occasional care 34.0–74.6%, p < 0.0001) that have implemented the program since 2012 as well as in services with a high proportion of Aboriginal children (33.6–85.2% p < 0.0001), services in disadvantaged communities (37.4–83.3% p < 0.001), and services in remote communities (27.8–59.4% p < 0.0139).Discussion: This paper demonstrates that Munch & Move has seen large improvements in the delivery of training, practice achievements and program adoption in ECEC services across NSW including services in disadvantaged and remote communities and that have a higher proportion of Aboriginal children.

Children overdue for immunisation: a question of coverage or reporting? An audit of the Australian Immunisation Register

ObjectiveVaccinations in Australia are reportable to the Australian Immunisation Register (AIR). Following major immunisation policy initiatives, the New South Wales (NSW) Public Health Network undertook an audit to estimate true immunisation coverage of NSW children at one year of age, and explore reasons associated with under‐reporting. MethodsCross‐sectional survey examining AIR immunisation records of a stratified random sample of 491 NSW children aged 12≤15 months at 30 September 2017 who were >30 days overdue for immunisation. Survey data were analysed using population weights. ResultsEstimated true coverage of fully vaccinated one‐year‐old children in NSW is 96.2% (CI:95.9‐96.4), 2.1% higher than AIR reported coverage of 94.1%. Of the children reported as overdue on AIR, 34.9% (CI:30.9‐38.9) were actually fully vaccinated. No significant association was found between under‐reporting and socioeconomic status, rurality or reported local coverage level. Data errors in AIR uploading (at provider level) and duplicate records contributed to incorrect AIR coverage recording. ConclusionsDespite incentives to record childhood vaccinations on AIR, under‐reporting continues to be an important contributor to underestimation of true coverage in NSW. Implications for public healthMore reliable transmission of encounters to AIR at provider level and removal of duplicates would improve accuracy of reported coverage.

Developmental vulnerability at age five among children who enter and progress through the child protection system in New South Wales, Australia: a cross-sectoral data linkage study

IntroductionA recent independent review of the child protection system in New South Wales (NSW), Australia, highlighted the need for whole-of-government reform to improve outcomes for children at risk of, or experiencing, maltreatment. Population-level evidence on outcomes of children who enter and progress through the child protection system is currently lacking.&#x0D; Objectives and ApproachWe aimed to quantify developmental vulnerability at age five among children who enter and progress through the child protection system during early childhood to demonstrate the value of cross-sectoral data linkage to inform and evaluate policy at a population-level. We used Australian Early Development Census (AEDC) data linked to cross-sectoral population datasets in NSW, including birth registrations, perinatal, and child protectionnotification and out-of-home care (OOHC) placement data. Linked AEDC data, collected in 2009 and 2012, areavailable for 153,670 NSW children. Socio-demographic and perinatal characteristics available in the linked data were used to characterise the population.&#x0D; Results21,179 (13.9%) children had ≥1 ‘screened in’ notification, 4927 (3.2%) had ≥1 substantiated abuse and neglect notification, and 2177 (1.4%) had ≥1 OOHC placement before their fifth birthday. Indicators of disadvantage and adverse birth outcomes were more common among children who progressed to higher levels of the child protection system. The proportion developmentally vulnerable on ≥1 domains of the AEDC increased for children who entered and progressed through the child protection system; from 21% of children with no contact with child protection before age five, to 39% of children with ≥1 ‘screened in’ notification, 50% with ≥1 substantiated notification, and 54% with ≥1 OOHC placement before their fifth birthday. Comparison of findings from other Australian jurisdictions with similar data will be discussed.&#x0D; Conclusion/ImplicationsThis study demonstrates there is scope to improve developmental outcomes through targeted interventions among children who become known to child protection during early childhood in NSW. Moreover, it illustrates that cross-sectoral data linkage can be used to inform and evaluate policy reforms to drive better outcomes for vulnerable children.

Vaccine-preventable child deaths in New South Wales from 2005 to 2014: How much is preventable?

To identify and describe potentially vaccine-preventable child deaths in New South Wales (NSW). Child deaths in NSW from 2005 to 2014 potentially preventable by vaccination were identified from the NSW Child Death Register (maintained by the NSW Ombudsman) and the Notifiable Conditions Information Management System (NSW Health). Medical and post-mortem records were reviewed. Cases were classified as vaccine-preventable based on the strength of evidence for the relevant infection causing death and likelihood that death was preventable through vaccination. A two-source capture-recapture method was used to estimate the true number of deaths. Age-specific mortality rate and number of deaths by disease, area of residence and comorbidity were analysed. Deaths were classified as preventable based on vaccine availability, eligibility under the National Immunisation Program, age and presence of any contraindications. Fifty-four deaths were identified as definitely or probably due to diseases for which a vaccine was available, with a total average annual mortality rate of 0.33 per 100 000 children and 2.1 per 100 000 infants. Two thirds of deaths occurred in children with no identified comorbidities. Twenty-three deaths were classified as preventable or potentially preventable by vaccination, with influenza (12 deaths) and meningococcal disease (five deaths) most common. An additional 15 deaths would be potentially preventable as of August 2016 due to immunisation recommendation changes including maternal vaccination. Maternal vaccination along with increased uptake of childhood influenza vaccination could reduce child deaths, particularly from influenza.

Closing the Aboriginal child injury gap: targets for injury prevention

ObjectiveTo describe the leading mechanisms of hospitalised unintentional injury in Australian Aboriginal children and identify the injury mechanisms with the largest inequalities between Aboriginal and non‐Aboriginal children. MethodsWe used linked hospital and mortality data to construct a whole of population birth cohort including 1,124,717 children (1,088,645 non‐Aboriginal and 35,749 Aboriginal) born in the state of New South Wales (NSW), Australia, between 1 July 2000 and 31 December 2012. Injury hospitalisation rates were calculated per person years at risk for injury mechanisms coded according to the ICD10‐AM classification. ResultsThe leading injury mechanisms in both groups of children were falls from playground equipment. For 66 of the 69 injury mechanisms studied, Aboriginal children had a higher rate of hospitalisation compared with non‐Aboriginal children. The largest relative inequalities were observed for injuries due to exposure to fire and flame, and the largest absolute inequalities for injuries due to falls from playground equipment. ConclusionAboriginal children in NSW experience a significant higher burden of unintentional injury compared with their non‐Aboriginal counterparts. Implications for Public HealthWe suggest the implementation of targeted injury prevention measures aimed at injury mechanism and age groups identified in this study.

Neonatal Abstinence Syndrome and High School Performance

Little is known of the long-term, including school, outcomes of children diagnosed with Neonatal abstinence syndrome (NAS) (International Statistical Classification of Disease and Related Problems [10th Edition], Australian Modification, P96.1). Linked analysis of health and curriculum-based test data for all children born in the state of New South Wales (NSW), Australia, between 2000 and 2006. Children with NAS (n = 2234) were compared with a control group matched for gestation, socioeconomic status, and gender (n = 4330, control) and with other NSW children (n = 598 265, population) for results on the National Assessment Program: Literacy and Numeracy, in grades 3, 5, and 7. Mean test scores (range 0-1000) for children with NAS were significantly lower in grade 3 (359 vs control: 410 vs population: 421). The deficit was progressive. By grade 7, children with NAS scored lower than other children in grade 5. The risk of not meeting minimum standards was independently associated with NAS (adjusted odds ratio [aOR], 2.5; 95% confidence interval [CI], 2.2-2.7), indigenous status (aOR, 2.2; 95% CI, 2.2-2.3), male gender (aOR, 1.3; 95% CI, 1.3-1.4), and low parental education (aOR, 1.5; 95% CI, 1.1-1.6), with all Ps < .001. A neonatal diagnostic code of NAS is strongly associated with poor and deteriorating school performance. Parental education may decrease the risk of failure. Children with NAS and their families must be identified early and provided with support to minimize the consequences of poor educational outcomes.

Management of paediatric splenic injury in the New South Wales trauma system

Since the 1980’s, paediatric surgeons have increasingly managed blunt splenic injury (BSI) in children non-operatively. However, studies in North America have shown higher operation rates in non-paediatric centres and by adult surgeons. This association has not been examined elsewhere. ObjectiveTo investigate the management of BSI in New South Wales (NSW) children, to determine the patient and hospital factors related to the odds of operation. Secondarily, to investigate whether the likelihood of operation varied by year. MethodsChildren age 0–16 admitted to a NSW hospital between July 2000 and December 2011 with a diagnosis of BSI were identified in the NSW Admitted Patient Data Collection, and linked to deaths data from Registry of Births Deaths and Marriages, and Bureau of Statistics. The operation rate was calculated and compared between different hospital types. Univariable analysis was used to determine patient and hospital factors associated with operative management. The difference in the odds of operation between the oldest data (July 2000–December 2005) and most recent (January 2006–December 2011) was also examined. Multivariable logistic regression with stepwise elimination was then performed to determine likelihood of operative management according to hospital category and era, adjusting for potential confounders. Results955 cases were identified, with 101(10.6%) managed operatively. On multivariable analysis, factors associated with operation included age (OR 1.11, 95% CI 1.01–1.18, p<0.05), massive splenic disruption (OR 3.10, 95% CI 1.61–6.19, p<0.001), hollow viscus injury (OR 11.03, 95% CI 3.46–34.28, p<0.001) and transfusion (OR 7.70, 95% CI 4.54–13.16, p<0.001). Management outside a paediatric trauma centre remained significantly associated with operation, whether it be metropolitan adult trauma centre (OR 4.22 95% CI 1.70–10.52, p<0.01), rural trauma centre (OR 3.72 95% CI 1.83–7.83, p<0.001) or metropolitan local hospital (OR 5.23, 95% CI 1.22–18.93 p<0.05). Comparing the 2 eras, the overall operation rate fell, although not significantly, from 12.9% to 8.7% (OR 1.3, 95% CI 0.89–243 p=0.13) ConclusionWhile Paediatric Surgeons have wholeheartedly adopted non-operative management, away from paediatric centres, children in NSW are still being operated on for BSI unnecessarily. While the factors at play may be complex, further evaluation of the management and movement of injured children within the broad NSW trauma system is required.

Developing a Culture to Facilitate Research Capacity Building for Clinical Nurse Consultants in Generalist Paediatric Practice

This paper reports a research capacity building exercise with a group of CNCs practicing in the speciality of paediatrics in New South Wales (NSW), Australia. It explores the first step in building a research culture, through identifying the research priorities of members of the NSW Child Health Networks Paediatric Clinical Nurse Consultant group, and this forms the major focus of this paper. A nominal group technique (NGT) was utilised with sixteen members to identify research topics for investigation which were considered a priority for improving children's health care. The group reviewed and prioritised 43 research topics in children's health which were identified in the literature. As a result of conducting this research prioritisation exercise, the group chose two research topics to investigate: reasons for children representing to the Emergency Department and a comparison of the use of high-flow and low-flow nasal prongs in children with bronchiolitis. The research team will continue to mentor the nurses throughout their research projects which resulted from the NGT. One bridge to leadership development in enhancing patient care is translating knowledge to practice and policy development. This study leads the way for a group of CNCs in paediatric nursing to combine their research capacity and influence clinical knowledge.

Novel inpatient surveillance in tertiary paediatric hospitals in New South Wales illustrates impact of first‐wave pandemic influenza A H1N1 (2009) and informs future health service planning

To document the impact of pandemic influenza A H1N1 (2009) in New South Wales (NSW) children's hospitals. A novel surveillance system, Paediatric Active Enhanced Disease Surveillance (PAEDS), identified hospitalised children <15 years with laboratory-proven influenza (1 June-30 September 2009) in the three children's hospitals in NSW: Children's Hospital at Westmead (CHW), Sydney Children's Hospital, John Hunter Children's Hospital. Clinical characteristics, management and complications were documented, and at CHW comparison made with 2007 data. The 324 children identified represented 1802 hospital bed-days and 230 PICU bed-days. Most (73.1%) children had H1N1, one had an oseltamivir-resistant isolate. Median age was 2.5 years: 65% were <5 years. Although 80.9% had cough, 8.0% had no respiratory symptoms. Complications occurred in 34.6%, of whom 56% were previously healthy. Only 50% received antivirals. Forty children (12.3%) were admitted to PICU: one child with H1N1 died. At CHW, comparison between 2009 and 2007 showed nearly twice the total number of admissions (226 vs. 122) and PICU admissions (22 vs. 13), but no deaths either year. Vomiting was more frequent in 2009 than 2007 (38.5% vs. 13.1%; P = 0.0001) as were neurological complications (11.4% vs. 2.4%; P = 0.0027) but length of hospital and PICU stay were similar. PAEDS is a valuable surveillance tool that documented the impact of the H1N1 (2009) pandemic in NSW children's hospitals. High numbers of complications, often in previously well children, suggest an important role for early diagnosis, antiviral therapy and influenza vaccination. Observed regional differences identify areas potentially at greater risk in a subsequent wave.

Concordance of mental health impairment and service utilization among children in care

This paper describes caregiver-reported patterns of mental health service use for 347 pre-adolescent children in foster and kinship care in New South Wales (NSW), Australia. Children's mean time in care and mean time with their present caregivers were 4.3 and 3.3 years respectively. Forty-four percent of children received individual therapy or counselling, 45% received interventions in the form of clinical guidance for their caregivers, and 31% received both forms of service. Among children scoring in the clinical range on any CBCL sub-scale (N = 191), equivalent rates of mental health service use were 60%, 55% and 41% respectively. Although not directly comparable, these findings describe a higher rate of service use than that reported for children in care elsewhere. While children with more complex and severe difficulties had higher rates of service use, there was no evidence of variable access for treatment of different types of disorder. Predictors of service use are reported and contrasted with previous findings. The paper considers several features of the NSW child welfare, health and education systems that may account for the relatively high rate of service use.

Matching health needs of refugee children with services: how big is the gap?

To document the health needs of refugee children accessing comprehensive refugee health services in New South Wales (NSW), to match needs with available services and establish gaps in services. We collated clinical data on all children aged under 14 years attending the three refugee specific clinics seeing children in NSW in 2005. We compared these data to the number of refugee children settling in NSW in 2005. NSW received 1,557 refugee children (<14 years) in 2005. Around one in five (n=331) was seen in a refugee specific clinic. Most were asymptomatic. Of those tested, 25% had anaemia, 27% were serology positive for schistosomiasis, 16% had evidence of current or recent malaria, 25% were tuberculin skin test positive, 69% were hepatitis B non-immune and 20% had low vitamin D levels. Most children needed catch up immunisation. Other problems included chronic health, developmental and behavioural problems. Screening tests varied across sites. Follow up was problematic for most. A small proportion of refugee children arriving in NSW have access to comprehensive screening and assessment, in spite of significant health needs. There is variation in screening practices, and follow up is poor. There is a high pick up rate for diseases of personal and public health significance. There is a strong moral and public health imperative to provide appropriately resourced, culturally competent and comprehensive health care to optimise refugee children's wellbeing.

Area socioeconomic status and childhood injury morbidity in New South Wales, Australia

. Poulos R., Hayen A., Finch C. &amp; Zwi A. ( 2007 ) , 13 , 322 – 327 . DOI: 10.1136/ip.2007.015693. Objective To explore the relationship between child injury morbidity and socioeconomic status.Design A cross‐sectional analysis of routinely collected hospital separation data for unintentional injury for the period 1999/2000–2004/2005.Setting All statistical local areas of New South Wales (NSW), Australia.Subjects 110 549 unintentional injury‐related hospital separations for NSW children aged 0–14 years.Main outcome measure Adjusted incidence rate ratios (IRRs) for hospital separations for unintentional injury (for all injury and by individual injury mechanisms) by quintile of socioeconomic disadvantage for children aged 0–14 years.Results There was no clear relationship between socioeconomic status and injury when all injury mechanisms were combined. However, children in the more disadvantaged quintiles were more likely to be hospitalized than children in the least disadvantaged quintile for the following injury mechanisms: motor cycle (point estimates for IRRs across the socioeconomic status quintiles ranged from 2.95 to 4.02 relative to the least disadvantaged quintile), motor‐vehicle occupant (IRR range 1.33–2.27), pedestrian (IRR range 1.43–2.54 for ages 0–4 years), pedal cyclist (IRR range 1.30–1.50), fire and burns (IRR range 1.37–2.00), and poisoning (IRR range 1.32–1.91). Similarly, hospital separation rates for foreign body, other transport, and pedestrian (aged 5–9 years) injuries were also greater, but the differences were not statistically significant across all quintiles. These injury mechanisms accounted for about 25% of the hospital separations.Conclusions The relationship between relative socioeconomic disadvantage and injury risk in NSW children is strongest for transport‐related injuries, fires and burns, and poisoning. Interventions that address these specific injury mechanisms may help to reduce the disparity between high and lower socioeconomic groups.

Area socioeconomic status and childhood injury morbidity in New South Wales, Australia

Objective:To explore the relationship between child injury morbidity and socioeconomic status.Design:A cross-sectional analysis of routinely collected hospital separation data for unintentional injury for the period 1999/2000–2004/2005.Setting:All statistical local areas of...

Domestic violence and child protection: issues in safety planning

AbstractThere is strong evidence for the link between domestic violence and child abuse. Agencies' policies regarding domestic violence and child protection are critical in determining the dimensions of practitioner intervention, including safety planning for women and children. This paper explores the issues identified in research around safety planning where there are domestic violence and child protection concerns which was conducted with practitioners in New South Wales (NSW), Australia, in 2001. In particular, the paper focuses on three of the factors that influence practitioner intervention with women and children. These are: definitional understandings of domestic violence and child abuse; child protection legislative changes, including mandatory reporting and domestic violence as a child‐at‐risk category; and the NSW child protection statutory authority's response to domestic violence. The interplay between these factors results in complexities of practice for practitioners as they attempt to maximize women's strengths and minimize risks to children's safety. The resultant inconsistent response to domestic violence and child protection by government and non‐ government agencies suggests the need for domestic violence interagency guidelines. Copyright © 2002 John Wiley &amp; Sons, Ltd.

THE PROBLEM OF MENTALLY DEFECTIVE CHILDREN IN NEW SOUTH WALES FROM THE EDUCATIONAL AND VOCATIONAL POINTS OF VIEW

Medical Journal of AustraliaVolume 1, Issue 11 p. 370-376 Original Article THE PROBLEM OF MENTALLY DEFECTIVE CHILDREN IN NEW SOUTH WALES FROM THE EDUCATIONAL AND VOCATIONAL POINTS OF VIEW† A. E. Machin M.B. (Sydney), A. E. Machin M.B. (Sydney) Principal Medical Officer Department of Education, New South WalesSearch for more papers by this author A. E. Machin M.B. (Sydney), A. E. Machin M.B. (Sydney) Principal Medical Officer Department of Education, New South WalesSearch for more papers by this author First published: 01 March 1934 https://doi.org/10.5694/j.1326-5377.1934.tb42585.x †Read at a meeting of the Section of Neurology and Psychiatry of the New South Wales Branch of the British Medical Association on November 21, 1933. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume1, Issue11March 1934Pages 370-376 RelatedInformation

STATE CHILDREN IN NEW SOUTH WALES

Medical Journal of AustraliaVolume 1, Issue 3 p. 65-67 Public Health STATE CHILDREN IN NEW SOUTH WALES First published: 01 January 1915 https://doi.org/10.5694/j.1326-5377.1915.tb52152.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume1, Issue3January 1915Pages 65-67 RelatedInformation