South Wales Child Research Articles

Constantly changing, constantly adapting: Lives and life-course data of children and childhood social care

ObjectivesChildhood social care can lead to lifelong problems affecting health, educational attainment and other areas of a person’s life. Improving outcomes for children are therefore key policy objectives in many nations. The aim of this workshop was to inspire and drive forward life-course research on childhood social care internationally. ApproachThe workshop included presentations on the themes of the data jigsaw across the family life-course and data sovereignty and engagement. Presentations under each theme were followed by group activities and discussions. ResultsAdministrative data collections that include longitudinal details on childhood social care, developmental, health and other outcomes are becoming increasingly available for researcher purposes. Examples include the BEBOLD platform and the New South Wales Child E-Cohort in Australia, ECHILD in England and the Welsh SAIL Databank. First nations data sovereignty and engagement of childhood social care recipients has become a norm in many nations and led to improvements in research, including in methodology and interpretation of results. Together, improved access to data and meaningful stakeholder engagement can inform policy and practice to improve outcomes for children and young people. ConclusionsBarriers exist to understanding the family and home environments, such as very limited or no information about the fathers and other household members. Capturing populations who move between jurisdictions, e.g. migrants, is limited as administrative data is difficult to share across devolved nations/federated states. In some cases, a mismatch exists between expectations of meaningful engagement and institutional/research culture, resource and skill availability.

Contact with child protection services and subsequent rates of first police contact as a person of interest, victim or witness in early life

PurposeChild maltreatment is known to be associated with risk of later offending and victimisation in adolescence and adulthood, but only a few studies have examined justice system contact in childhood and none have focused on police contact. This study investigated the time to first contact with police in childhood (aged 13 years and younger) among children with prior child protection services contact. MethodsUsing administrative data for 91,631 children from the New South Wales Child Development Study, Cox proportional hazards regression analyses were used to investigate the time to first contact with the police (for any reason, and specifically as a ‘person of interest’, ‘victim’ or ‘witness’) associated with prior child protection contact, during the observation period from birth to age 13 years. Multivariate models controlled for sex, Aboriginal and/or Torres Strait Islander background, and socioeconomic disadvantage. Subgroup analyses were also conducted for boys and girls separately. ResultsAmong the 14,323 children with any police contact by age 13 years, around half (52.3 %) had prior contact with the child protection system. Higher rates of police contact for any reason (HR = 4.45 [95 % CI = 4.08–4.86]), and as a person of interest (HR = 9.57 [95 % CI = 6.85–13.38]), victim (HR = 4.49 [95 % CI = 4.18–5.05]), or witness (HR = 9.56 [95 % CI = 7.19–12.69]) were associated with child protection services contact. Effect sizes were similar for boys and girls. ConclusionsEarly interventions that specifically aim to prevent early contact with the justice system among vulnerable children and their families involved with child protection services are required.

Cohort Profile Update: The New South Wales Child Development Study (NSW-CDS) - Wave 3 (child age ∼18 years).

Cohort Profile Update: The New South Wales Child Development Study (NSW-CDS) - Wave 3 (child age ∼18 years).

Levels of Involvement with Child Protection Services Associated with Early Adolescent Police Contact as a Victim and Person of Interest.

The relationship between childhood maltreatment and subsequent offending/victimization is well established. However, the magnitude of this relationship for different levels of child protection services (CPS) involvement is poorly understood, due to measurement issues, lack of longitudinal data, and reliance on reports of substantiated maltreatment, which can underestimate the impact of maltreatment. This study examined associations between CPS involvement during childhood (ages 0 to <11 years) and police services contact (as a victim and/or a person of interest) for criminal incidents in early adolescence (11 to ~14 years), differentiated according to levels of CPS involvement (i.e., no risk of significant harm [non-ROSH], unsubstantiated ROSH, substantiated ROSH, and out-of-home care; each examined relative to no CPS contact). Data for 71,465 children were drawn from the New South Wales Child Development Study, an intergenerational, longitudinal investigation that uses administrative records from CPS and police alongside other health, justice, and education data. Multinomial regression analyses were conducted to determine associations between increasing levels of CPS involvement and police contact as a victim only, a person of interest only, and as both victim and person of interest while accounting for covariates (i.e., child's sex, Aboriginal, and/or Torres Strait Islander background, socioeconomic status, maternal age at child's birth, and parental offending history). Children exposed to any of the four levels of CPS involvement had higher odds of police contact, relative to children with no CPS involvement. Odds ratios were higher for contact with police as both a victim and a person of interest, compared to police contact as a victim or a person of interest only. These findings highlight that children with even unsubstantiated CPS reports (i.e., non-ROSH and unsubstantiated ROSH reports) are at heightened risk of police contact compared to children who are unknown to CPS, underlining the need to support all families in contact with CPS.

Cumulative comorbidity between neurodevelopmental, internalising, and externalising disorders in childhood: a network approach

Cumulative comorbidity of mental disorders is common, but the extent and patterns of comorbid psychopathology in childhood are not well established. The current study aimed to elucidate the emergent patterns of cumulative mental disorder comorbidity in children using network analysis of diagnoses recorded between birth and age 12 years. Participants were 90,269 children (mean age 12.7 years; 51.8% male) within the New South Wales Child Development Study (NSW-CDS)—a longitudinal record-linkage cohort study of Australian children born in NSW between 2002 and 2005. Binary indicators for eight types of mental disorder were derived from administrative health records. Patterns of conditional association between mental disorders were assessed utilising network analysis. Of 90,269 children, 2268 (2.5%) had at least one mental disorder by age 12 years; of the 2268 children who had at least one mental disorder by age 12 years, 461 (20.3%) were diagnosed with two or more different disorders out of the eight disorder types included in analyses. All disorders were either directly or indirectly interconnected, with childhood affective and emotional disorders and developmental disorders being most central to the network overall. Mental disorder nodes aggregated weakly (modularity = 0.185) into two communities, representative of internalising and externalising disorders, and neurodevelopmental and sleep disorders. Considerable sex differences in the structure of the mental disorder comorbidity networks were also observed. Developmental and childhood affective and emotional disorders appear to be key to mental disorder comorbidity in childhood, potentially reflecting that these disorders share symptoms in common with many other disorders.

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).

Parental mental disorders and offspring schizotypy in middle childhood: an intergenerational record linkage study

PurposeTo investigate relationships between distinct schizotypy risk profiles in childhood and the full spectrum of parental mental disorders.MethodsParticipants were 22,137 children drawn from the New South Wales Child Development Study, for whom profiles of risk for schizophrenia-spectrum disorders in middle childhood (age ~ 11 years) were derived in a previous study. A series of multinomial logistic regression analyses examined the likelihood of child membership in one of three schizotypy profiles (true schizotypy, introverted schizotypy, and affective schizotypy) relative to the children showing no risk, according to maternal and paternal diagnoses of seven types of mental disorders.ResultsAll types of parental mental disorders were associated with membership in all childhood schizotypy profiles. Children in the true schizotypy group were more than twice as likely as children in the no risk group to have a parent with any type of mental disorder (unadjusted odds ratio [OR] = 2.27, 95% confidence intervals [CI] = 2.01–2.56); those in the affective (OR = 1.54, 95% CI = 1.42–1.67) and introverted schizotypy profiles (OR = 1.39, 95% CI = 1.29–1.51) were also more likely to have been exposed to any parental mental disorder, relative to children showing no risk.ConclusionChildhood schizotypy risk profiles appear not to be related specifically to familial liability for schizophrenia-spectrum disorders; this is consistent with a model where liability for psychopathology is largely general rather than specific to particular diagnostic categories.

Out-of-home care characteristics associated with childhood educational underachievement, mental disorder, and police contacts in an Australian population sample

BackgroundChildren in out-of-home care (OOHC) are generally at increased risk of health and social adversities compared to their peers. However, the experiences of children in OOHC are not uniform and their associated health and social indices may vary in relation to characteristics of OOHC placements and child protection contact. ObjectiveTo examine associations between a range of characteristics of OOHC placements and child protection contact (e.g., number, type, and age of placement) with educational underachievement, mental disorder, and police contact (as a victim, witness, or person of interest) in childhood. Participants and settingParticipants were Australian children drawn from the New South Wales Child Development Study cohort who had been placed in OOHC at least once between the ages of 0–13 years (n = 2082). MethodsLogistic regression was used to examine prospective associations of OOHC placement and child protection contact characteristics (type of carer, placement instability, duration and frequency of maltreatment, and amount of time in care) with educational underachievement, mental disorder diagnosis and any type of police contact. ResultsPlacements with foster carers, greater placement instability, longer and more frequent exposure to maltreatment, and longer time spent in care were each associated with greater likelihood of consequences in all domains of functioning. ConclusionsChildren with certain placement characteristics are at higher risk of adverse consequences and should be prioritised for support services. The magnitude of relationships was not uniform across different health and social indices, highlighting the need for holistic, multiagency approaches to support children placed in care.

Measurement Invariance Across Sex and Language Background of a Self-Report Social-Emotional Learning Questionnaire for Middle Childhood

This study investigates the measurement invariance of a brief self-report measure of childhood social-emotional competencies, the Middle Childhood Survey: Social-Emotional Learning (MCS-SEL), across demographic subgroups. Invariance was tested simultaneously among subgroups of children aged 11–12 years that were differentiated by sex (male, female) and main language spoken at home (English, not English). Multi-group confirmatory factor analysis evaluated structural and item-level invariance using two random, independent samples of 2,000 students (500 per demographic strata) selected by disproportionate sampling from the New South Wales Child Development Study (NSW-CDS) population cohort. The measure achieved full configural, metric, scalar, and residual invariance across all demographic subgroups, validating its utility for assessing middle childhood social-emotional competencies at a population-level.

Relationships between parental mental illness and/or offending and offspring contact with the police in childhood: Findings from a longitudinal record-linkage study.

Parental offending and mental illness are associated with an increased risk of criminal behaviour in offspring during adolescence and adulthood, but the impact of such problems on younger children, including children's experiences of victimisation, is less well known. To investigate the associations between parental offending and mental illness recorded prior to their offspring's age of 5years and their offspring's contact with police as a 'person of interest', 'victim' or 'witness' between ages 5 and 13years. Our sample consisted of 72,771 children and their parents drawn from the New South Wales Child Development Study, an Australian longitudinal population-based record linkage study. Logistic regression analyses were conducted to examine associations between parental factors and offspring's police contact. Separate models examined the relationships between maternal or paternal offending and mental illness, as well as the combination among either or both parents, as the independent variables, and their child's police contact as the dependent variable. Parental offending and mental illness were each individually associated with indices of police contact among offspring. Stronger associations were observed when both offending and mental illness were present together (in either parent, or when one parent had both exposures). Stronger associations were evident for mothers with both factors across all offspring police contact types, relative to fathers with both factors, in fully adjusted models; that is, children of mothers with both factors were over four times as likely to have contact with police as a 'person of interest' (OR=4.29; 95% CI=3.75-4.92) and over three times as likely to have contact as a victim (OR=3.35; 95% CI=3.01-3.74) or witness (OR=3.58; 95% CI=3.03-4.24), than children whose mothers had no history of offending or mental illness. Children with a parental history of offending and mental illness in early life are at an increased likelihood of early police contact as young as 5-13years of age; it is vital that this is taken as a signal to help them and their affected families according to need.

Early childhood developmental vulnerability associated with parental mental disorder comorbidity.

Parental mental health has a profound influence on the mental health and well-being of their offspring. With comorbid mental disorders generally the rule rather than the exception, increased knowledge of the impact of parental mental disorder comorbidity on early child development may facilitate improved targeting and delivery of early intervention for vulnerable offspring. Participants were 66,154 children and their parents in the New South Wales Child Development Study - a prospective, longitudinal, record-linkage study of a population cohort of children born in NSW between 2002 and 2004. Early childhood developmental vulnerability was assessed at age ~5 years using the Australian Early Development Census, and information on parental mental disorders was obtained from administrative health records. Binomial and multinomial logistic regression were used to assess the relationship between parental mental disorders and early childhood developmental vulnerability on emotional and behavioural domains, as well as membership of latent developmental risk classes reflecting particular classes of vulnerability. Multiple diagnoses of mental disorders in mothers and fathers were associated with an increased likelihood of early childhood emotional and behavioural developmental vulnerability in offspring, relative to parents without mental disorder. The likelihood of offspring vulnerability increased with the number of parental comorbidities, particularly maternal comorbidities. Early childhood developmental vulnerability was strongly associated with parental mental ill-health, with the strength of associations increasing in line with a greater number of mental disorder diagnoses among mothers and fathers. New and expectant parents diagnosed with multiple mental disorders should be prioritised for intervention, including attention to the developmental well-being of their offspring.

Cumulative environmental risk in early life is associated with mental disorders in childhood.

No single environmental factor is a necessary or sufficient cause of mental disorder; multifactorial and transdiagnostic approaches are needed to understand the impact of the environment on the development of mental disorders across the life course. Using linked multi-agency administrative data for 71 932 children from the New South Wales Child Developmental Study, using logistic regression, we examined associations between 16 environmental risk factors in early life (prenatal period to <6 years of age) and later diagnoses of mental disorder recorded in health service data (from age 6 to 13 years), both individually and summed as an environmental risk score (ERS). The ERS was associated with all types of mental disorder diagnoses in a dose-response fashion, such that 2.8% of children with no exposure to any of the environmental factors (ERS = 0), compared to 18.3% of children with an ERS of 8 or more indicating exposure to 8 or more environmental factors (ERS ⩾ 8), had been diagnosed with any type of mental disorder up to age 13-14 years. Thirteen of the 16 environmental factors measured (including prenatal factors, neighbourhood characteristics and more proximal experiences of trauma or neglect) were positively associated with at least one category of mental disorder. Exposure to cumulative environmental risk factors in early life is associated with an increased likelihood of presenting to health services in childhood for any kind of mental disorder. In many instances, these factors are preventable or capable of mitigation by appropriate public policy settings.

COVID-19 in New South Wales children during 2021: severity and clinical spectrum.

Objectives: To describe the severity and clinical spectrum of coronavirus disease 2019 (COVID‐19) in children during the 2021 New South Wales outbreak of the Delta variant of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Design, setting: Prospective cohort study in three metropolitan Sydney local health districts, 1 June – 31 October 2021. Participants: Children under 16 years of age with positive SARS‐CoV‐2 nucleic acid test results admitted to hospital or managed by the Sydney Children’s Hospital Network (SCHN) virtual care team. Main outcome measures: Age‐specific SARS‐CoV‐2 infection frequency, overall and separately for SCHN virtual and hospital patients; rates of medical and social reason admissions, intensive care admissions, and paediatric inflammatory multisystem syndrome temporally associated with SARS‐CoV‐2 per 100 SARS‐CoV‐2 infections; demographic and clinical factors that influenced likelihood of hospital admission. Results: A total of 17 474 SARS‐CoV‐2 infections in children under 16 were recorded in NSW, of whom 11 985 (68.6%) received SCHN‐coordinated care, including 459 admitted to SCHN hospitals: 165 for medical reasons (1.38 [95% CI, 1.17–1.59] per 100 infections), including 15 admitted to intensive care, and 294 (under 18 years of age) for social reasons (2.45 [95% CI, 2.18–2.73] per 100 infections). In an analysis that included all children admitted to hospital and a random sample of those managed by the virtual team, having another medical condition (adjusted odds ratio [aOR], 7.42; 95% CI, 3.08–19.3) was associated with increased likelihood of medical admission; in univariate analyses, non‐asthmatic chronic respiratory disease was associated with greater (OR, 9.21; 95% CI, 1.61–174) and asthma/viral induced wheeze with lower likelihood of admission (OR, 0.38; 95% CI, 0.18–0.78). The likelihood of admission for medical reasons declined from infancy to 5–11 years, but rose again for those aged 12–15 years. Sex and Indigenous status did not influence the likelihood of admission. Conclusion: Most SARS‐CoV‐2 infections (Delta variant) in children were asymptomatic or associated with mild disease. Hospitalisation was relatively infrequent, and most common for infants, adolescents, and children with other medical conditions. More children were hospitalised for social than for medical reasons.

Self-reported mental health of children known to child protection services: an Australian population-based record linkage study.

Maltreated children are vulnerable to adverse mental health outcomes. Information about how children's mental health needs vary according to different levels of child protection contact (potentiallyculminating in out-of-home care [OOHC]) is valuable for the effective provision of services. This study aimed to examine associations between different levels of contact with child protection services before the age of 10years and self-reported mental health difficulties at age 11years. Participants (n = 26,960) were drawn from the New South Wales Child Development Study, a multiagency, multigenerational, longitudinal record linkage study that combines administrative records with cross-sectional survey data. We examined associations between four levels of child protection response (non-threshold reports, unsubstantiated reports, substantiated reports, OOHC; each relative to no report) and six domains of self-reported mental health difficulties (including internalising and externalising symptoms, and psychotic-like experiences). All levels of contact with child protection services were associated with increased odds of mental health difficulties in all domains. Children who had been placedin OOHC and children with substantiated reports had the highest odds of reporting clinical levels of mental health difficulties; 48.1% of children with an OOHC placementand 45.6% of those with substantiated child protection reports showed clinical levels of mental health difficulties in at least one domain. Children with child protection reports that were unsubstantiated, or determined not to meet the threshold for risk-of-significant harm, were also at increased risk of mental health difficulties in middle childhood. These findings underscore the importance of early detection and intervention for all children at risk of maltreatment.

Incidence of Early Police Contact Among Children With Emerging Mental Health Problems in Australia

In adulthood and adolescence, mental health vulnerability is known to be associated with risk of criminal justice system contact as both a perpetrator and survivor of crime, but whether this association is apparent early in child development is unknown. Prevention of poor outcomes, including repeated contact with the criminal justice system, relies on the identification of vulnerability early in life and at the start of such contact. To ascertain whether children with emotional or behavioral problems and general developmental vulnerabilities are at an increased risk of subsequent contact with police as a person of interest, a survivor of crime, or a witness. This cohort study used routinely collected data from the New South Wales Child Development Study in Australia. The cohort was composed of children who entered full-time schooling in New South Wales in 2009, had complete data for the emotional maturity domain of the Australian Early Development Census, and had no police contact before January 1, 2009. The children in the cohort were followed up until the age of 13 years. Data were analyzed from October 17, 2019, to May 13, 2020. Emotional or behavioral problems and developmental risk profiles derived from the teacher-rated Australian Early Development Census. Incidence rates of police contact (as a person of interest, survivor of crime, or witness) were derived from the New South Wales Police Force Computerised Operational Policing System. A total of 79 801 children (40 584 boys [50.9%]; 2009 mean [SD] age, 5.2 [0.37] years) were included. Children with teacher-identified emotional or behavioral problems at school entry had an incidence rate of police contact (for any reason) that was twice that of children without such problems (unadjusted hazard ratio [HR], 2.14; 95% CI, 1.94-2.37). Contact with police as a survivor of crime was most commonly recorded (7350 [9.2%]), but the strength of the association was greatest between emotional or behavioral problems and police contact as a person of interest (unadjusted HR, 4.75; 95% CI, 3.64-6.19). Incidence of police contact as a person of interest was high for children with a pervasive developmental risk profile (unadjusted HR, 13.80; 95% CI, 9.79-19.45). This study found an association of emerging emotional or behavioral problems and developmental vulnerabilities with increased risk of police contact for any reason among young children, suggesting that this well-known association in adults and adolescents can be identified at an earlier developmental stage. These findings support primary and secondary interventions to prevent police contact early in life and to target the earliest contacts with the criminal justice and educational systems.

Quantifying the ossification of the carpus: Radiographic standards for age estimation in a New South Wales paediatric population

Age estimation from radiographs is common when age is not documented, such as in forensic, refugee and asylum seeker cases. The methods currently used are outdated and not applicable to all human groups due to variations between populations and secular changes in growth. This study aims to use the ossification of the carpus in a modern sample of New South Wales children to produce an age estimation formula that can be applied to cases of undocumented age. Hand radiographs (n = 400; 194 left and 206 right) from the Sydney children’s hospital, aged from birth to 17 years (256 males and 144 females) were analysed. Bone area (BO) and carpal area (CA) were measured, and a carpus ossification ratio (BO/CA) was calculated for each individual. Linear regression analysis was used to produce a formula for age estimation. Analysis demonstrated no significant difference in the ossification ratio (95% CI) between wrists of left and right sides and a regression formula for age was determined to be [−0.972 + 1.403 g + 21.758 (BO/CA)] ± 1.40 (g is 1 for males and 0 for females). This regression formula accounted for 88% of total variance. The median of the absolute values of residual (MAR) and the standard error of estimate (SEE) were −0.03 years, 1.40 years respectively. Using the ossification ratio of the carpus, an age estimation formula with a relatively high degree of reliability and accuracy was generated for a modern sample of New South Wales Children.

Parent engagement with the New South Wales child health home-based record: A cross-sectional survey and a retrospective chart review.

In 2018, World Health Organization endorsed universal use of home-based records to improve care for mothers, pregnant women, newborns and children. New South Wales (NSW), Australia has had universal use of a child health home-based record since 1988, with the first major update in 2013. Since the update, limitedbelief is sufficient for constituting evidence has been collected about factors influencing parent use of the record. This study aims to examine parent engagement with the record and whether it is influenced by child's first-born status and Parent Evaluation of Development Status (PEDS) outcome. A survey of 202 parent-child pairs and a review of 20 record books were conducted in NSW, Australia. Odds ratio (OR) at 95% confidence interval (CI) and .05 level of significance, bivariate and multivariate logistic regressions were conducted to examine the influence of first-born status, child's PEDS outcome and other parent-child characteristics on parent engagement with the record. Parents engaged with the home-based record by taking it for routine checks (80.7%), writing (74.8%) or reading (75.8%) information. Parents of first-born children were more than three times likely to take the record book for routine checks compared with parent of later-born children (adjusted OR [AOR] = 3.70, 95% CI 1.12-12.20). Similarly, parents of children with low PEDS level of risk were significantly less likely to read information in the record book compared with parents of children with high risk (AOR = 0.28, 95% CI 0.08-0.98). Parent record input through direct observation significantly decreased from 85% at 1-month to 60% at 12-month postnatal. Data about at least one vaccination event were recorded in all the record books examined, while 85% had all recommended vaccinations recorded. Parents valued/engaged regularly with a child health home-based record, and the record may be a useful tool for early detection and monitoring of child developmental concerns. Therefore, continued promotion of the use of child health home-based record appears to play an important role in improving child health and development.

Child protection services for children with special healthcare needs: A population record linkage study

AbstractChildren with disabilities are known to have high rates of contact with child protection services. However, little is known about child protection contacts for a broader group of children with special healthcare needs (SHCN; i.e., special needs or other impairments of concern that affect learning). This study examined the characteristics of contact with child protection services (prior to the age of 6 years) for children with SHCN identified at school entry using the 2009 Australian Early Development Census, using administrative data from more than 65,000 children in the New South Wales Child Development Study. Child protection contacts prior to age 6 years were more prevalent among children with SHCN compared with those without; in particular, children with SHCN had higher odds of a history of exposure to neglect and physical abuse, and higher odds of being placed in out‐of‐home care, compared with their typically developing peers. Understanding the characteristics of child protection contacts among children with SHCN, with consideration of factors that may influence their patterns of contact with these and other human services agencies, will inform the development of appropriate social policy initiatives to fulfil Australia’s obligations under the United Nations Convention on the Rights of the Child.

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.&#x0D; 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.&#x0D; 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 &lt;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 &gt;1.0 to &lt;1.5) were revealed for young maternal age at birth (&lt;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.&#x0D; 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

Healthy Lifestyle Behaviours Are Associated with Children's Psychological Health: A Cross-Sectional Study.

Protecting children’s mental health is important and studies have shown that diet and exercise can have a positive impact. There are limited data available, however, from representative populations of children on the relationship between regular healthy lifestyle behaviours and psychological health. Data were obtained from the New South Wales Child Population Health Survey, 2013–2014. Parents were asked about diet, physical activity and screen time behaviours and completed the Strengths and Difficulties Questionnaire (SDQ) for one child aged 5–15. Higher SDQ scores indicate poorer psychological health and risk for mental health problems. Multivariable linear and logistic regression examined the relationships among dietary consumption, physical activity, screen time and SDQ scores, adjusting for potential confounding. Meeting screen time recommendations was most strongly associated with a lower SDQ total difficulties score (5–10 years: −1.56 (−2.68, −0.44); 11–15 years: −2.12 (−3.11, −1.12)). Children and adolescents who met screen time recommendations were also significantly less likely to have any score in the at-risk range. Children and adolescents meeting vegetable intake guidelines had significantly lower total difficulties scores (5–10 years: −1.54 (−3.03, −0.05); 11–15 years: −1.19 (−3.60, −0.39)), as did adolescents meeting discretionary food guidelines (−1.16 (−2.14, −0.18)) and children consuming the recommended fruit intake (−1.26 (−2.42, −0.10)). Our findings indicate that more effective interventions to increase the proportion of young Australians who meet the guidelines for diet and screen time would contribute to protecting their mental health.