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Early Childhood Education and Care (ECEC) services are critical points of intervention for children impacted by trauma. Intervention Mapping was utilised to develop an initiative for trauma-informed organisational change in ECEC. This paper describes how the research team understood the need and opportunity for the program using Intervention Mapping Step 1. This included: (i) convening a planning group, (ii) conducting needs assessment, (iii) describing the context for intervention, and (iv) establishing program goals. Benefits, challenges, and recommendations on using Intervention Mapping for program development in ECEC settings are discussed.

Purpose: This article examines the educational decision-making of hearing parents for their deaf children born during a period (1970-1990s) before the introduction of new-born hearing screening in New South Wales, where the study was conducted, and prior to the now near-universal adoption of cochlear implants in Australia. Design/methodology/approach: We present findings from an oral history study in which parents were invited to recall how they planned for the education of their deaf children. Findings: We propose that these oral histories shed light on how the concept, early intervention--a child development principle that became axiomatic from about the 1960s--significantly shaped the conduct of parents of deaf children, constituting both hope and burden, and intensifying a focus on early decision-making. They also illustrate ways in which parenting was shaped by two key structural shifts, one, being the increasing enrolment of deaf children in mainstream rather than separate classrooms and the other being the transformation of deafness itself by developments in hearing assistance technology. Originality/value: The paper contributes to a sociological/historical literature of "parenting for education" that almost entirely lacks deaf perspectives and a specialist literature of parental decision-making for deaf children that is almost entirely focussed on the post cochlear implant generation. The paper is distinctive in its treatment of the concept of "early intervention" as a historical phenomenon rather than a "common sense" truth, and proposes that parents of deaf children were at the leading edge of late-20th and early-21st century parenting intensification.

The role of early childhood education and care (ECEC) is to support the learning and development of children in collaboration with families. The notion of inclusion in ECEC provides children with a sense of agency in becoming a learner able to participate fully and actively in their community. This paper illustrates how ECEC assessment approaches risk labelling young children in 'deficit' terms. The paper through a case study critically reflects on the implementation of a new assessment tool in kindergartens in the south-eastern region of Melbourne, Australia (low-middle income). Interviews were conducted with managers about the new tool, and documents (checklists and observations) were collected from the teachers. Findings show that the children were positioned as vulnerable with the introduction of the new assessment tool, leading to a diagnosis of 'at risk' for many children and a subsequent referral to education consultants, and health professionals. We explore the tensions of labelling young children, 'at risk' against the notion of 'becoming' that frames the Early Years Learning Framework for Australia (Department of Education and Training 2019) and professional understandings of 'inclusion'. The work of Nancy Fraser on 'social justice' augments the examination of this tension.

School communities face challenges in responding effectively to the rising incidence of student self-harm. Evidence-informed guidelines may provide a platform for schools to provide better responses and improve the outcomes of students who engage in self-harm. This paper critically reviews policies published in English targeted for schools or education settings on effective early identification and intervention for children and adolescent self-harm. A grey literature search was conducted using "Start Page" web search engine with a documentary analysis approach applied to review polices that met criteria. The review identified 16 policies that aim to help school and education staff to identify and respond to student self-harm. The key themes include identification and risk assessment, intervention, roles and responsibilities, as well as addressing issues surrounding evidence-based psychological education and intervention. An evidence-informed policy that addresses multiple aspects of responding to and reducing student self-harm may be a vital foundation of a school's response to this growing public health issue. This paper outlines key points that will help inform the development of evidence-informed guidelines for schools to respond to student self-harm and presents an exemplar policy framework for use by schools.

International evidence indicates there may be little or no academic benefit for children who are retained, and the possibility of negative long term socio-emotional outcomes for these children. Drawing on data from the nationally representative Longitudinal Study of Australian Children (n = 4464), this paper provides an Australian perspective on the practice of grade retention, specifically investigating repeating the Kindergarten year. Our results indicated that nearly half of grade retention occurring by Year 6 occurs in the Kindergarten year, the main reasons being related to learning and behavioural difficulties. The analyses identified a number of child and family factors associated with grade retention, the strongest predictors being maternal mental health and parental receptive language concern, with school readiness, receptive language skills, and child hyperactivity also relevant factors. The paper considers implications for early intervention to support children's academic trajectories through school.

This paper presents current prevalence rates for bullying and victimisation across grades, genders and bullying types. It also explores mean differences in emotional intelligence (EI), aggression and resilience for bullies, victims and bully/victims. A series of one-way analyses were conducted with EI, aggression and resilience as the dependent variables to identify target areas for intervention and prevention. Early intervention is required to reduce the effect of bullying. Of the 704 primary school students who completed this study, 2.6% reported that they bullied others, 53.7% were victims and 35.9% bully/victims. Prevalence differences across bullying types are discussed. As expected, bully/victims displayed lower scores on EI and resilience and were quick to anger. The pattern of results for victims contradicted expectations. Further investigation on target areas for bullies is required in larger samples. Implications for the development of intervention and prevention programs are discussed.

This scoping review was prompted by the introduction of the National Disability Insurance Scheme (NDIS) in Australia, with a focus on young children with disabilities. The review began by investigating individualized outcomes measures used within Early Intervention (EI). The Canadian Occupational Performance Measure (COPM) was chosen as it is a widely used goal identification and outcome measurement tool. This paper explores how the COPM is used with young children with disabilities alongside other developmental assessments, what it contributes to the goal identification and outcome measurement process and the formulation of possible recommendations for early intervention (EI) services and the NDIS. This review highlighted that the COPM is currently used across several countries, with children aged birth-seven years with a range of disabilities. The COPM is being utilized to support the identification of functional goals and accurately track parent's satisfaction and their perception of their child's performance. This review indicated that the COPM builds in key elements of family-centered practice and would be a valuable tool to trial in the NDIS and to implement more broadly in early intervention internationally.

The provision of information is generally not a technical activity, but rather a contextualized social action. Previous research about informed-choice and decision-making for parents of children who are deaf or hard-of-hearing (POCDHH) has demonstrated this, highlighting the close relationship between contextual factors and the nature of information parents are provided with to support decision-making on behalf of their children. Such contextual factors involve human elements such as attitudes, values and beliefs of individuals involved in the transfer of information, as well as broader contextual factors such as changing information technology and changing markets. This paper reviews literature from a range of fields relating directly and indirectly to issues of informed decision-making for POCDHH. These studies provide an overview of issues such as current understandings of what type of information does (or does not) support decision-making, as well as highlighting the importance of considering how information is presented. Approaches used in other fields to address issues of reliability of information are also discussed. To complement this literature review, the article includes an auto-ethnographic component documenting my own attempts as a POCDHH to garner reliable information on behalf of my daughter within a discursive environment where the material often appeared inconsistent with best practice informed-choice and decision-making principles.

Over the last 20 years, the authors have utilised Bronfenbrenner's ecological and bioecological models as a basis for their work investigating children's transition to school, including the place of mathematics learning in this transition. The later bioecological model gave increased emphasis to the role of the individual within contexts, the processes that characterised interactions within and across contexts (proximal processes), and the influence of time. This bioecological model outlined four elements--person, process, context and time--which, together, were described as influencing the development of individuals. While the mathematical learning of young children influences, and is influenced by, all four elements of the model, the critical role of proximal processes in this learning is highlighted in this paper. Our aim is to identify how the four elements of the bioecological model, particularly proximal processes, provide a framework to analyse the experiences of the adults--early childhood educators and parents--involved in an early childhood mathematics education intervention designed to promote engagement with mathematics in playful situations. Data are drawn from 35 early childhood educators and 37 parents over 2 consecutive years (2013, 2014) with generally different participants in each year.

Harmful sexual behaviour (HSB) carried out by children and young people can include sexual abuse of younger children or adults, or sexual assault in dating or peer relationships. The aim of this paper is to capture the "practice wisdom" of practitioners and applied researchers about clusters of risk factors associated with HSB onset, as well as possibilities for earlier intervention. Participants included practitioners and applied researchers in the HSB field. Data was collected in 2020 through individual interviews with eight key expert informants, and two group interviews – the first with two applied researchers and the second with three practitioners. Data analysis revealed risk factor clusterings around five key childhood experiences: being sexually curious; having a sexual interest in children; living with childhood trauma; living with contextual violence; and using pornography. These clusters are discussed in relation to early intervention. PRACTICE IMPACT STATEMENT Harmful sexual behaviour (HSB) is preventable but the early intervention agenda is underdeveloped. In this paper, five risk clusters are identified: being sexually curious; having a sexual interest in children; living with childhood trauma; living with contextual violence; and using pornography. The identification of these risk clusters present opportunities for early intervention that could enhance the prevention agenda to address HSB in Australia and internationally. [ABSTRACT FROM AUTHOR]

Secondary prevention efforts, which target risk and protective factors associated with harmful sexual behaviour (HSB) and seek to intervene early in the trajectory of HSB, are underdeveloped in Australia. This study explored design considerations for an online early intervention service for children and young people worried about their sexual thoughts and behaviours. A trauma-informed child right's framework underpinned the study, which involved 10 individual interviews with international experts in HSB, and one group interview (n = 3) with Australian practitioners. Analysis was carried out using thematic analysis. Results reflect design considerations in relation to: theoretical approaches; practice frameworks; service delivery components; and helpseeking challenges. Key tensions emerging from the results are discussed, including the need to move beyond binary constructions of victims and perpetrators. PRACTICE IMPACT STATEMENT: This paper has significant potential to influence practice in the field of harmful sexual behaviour prevention and response. The paper sets out the components of an early intervention online service for children and young people worried about their sexual thoughts and behaviours. The online service could be built and trialed for impact and efficacy in supporting children and young people not to sexually harm. It would be the first service of its kind in Australia and fill a gap in the current service delivery landscape. [ABSTRACT FROM AUTHOR]

Objectives: This paper describes the rationale for and development of an innovative mental health service for people aged over 65 years living in Northern and Eastern Melbourne, Victoria, Australia. Conclusion: The Healthy Ageing Service (HAS) was established in July 2020 to provide care for people aged over 65 years experiencing mild-to-moderate mental health concerns. It embraces a prevention and early intervention model of care. It provides primary consultation and brief intervention, secondary consultation, and capacity building to the primary healthcare sector. This innovative service is a Commonwealth-funded partnership between two tertiary mental health service providers that incorporates the recommendations from two major Royal Commissions. It demonstrates a service that acts as a bridge between primary and specialist mental health care, thereby extending mental health services to target the 'missing middle' and is potentially a model for mental health service provision throughout Victoria and Australia. [ABSTRACT FROM AUTHOR]

Aim: The provision and implementation of early intervention for psychosis services (early intervention services [EIS]) has received increasing attention over recent years. Maximizing engagement with EIS is of clinical and economic importance, and exploring the experiences of those who access EIS is vital. Although research has been conducted exploring the experiences of engaging with EIS from both a service user and carer/family member point of view, these data have not been systematically collated to generate new understanding. The primary aim of this study is to review, critically appraise and synthesize qualitative findings relating to the experiences of service users and/or carers and family members engaging with EIS. Methods: Four databases were systematically searched. Studies were analysed using an inductive thematic analysis approach, within a critical realist epistemological framework. Studies were critically appraised using the critical appraisal skills programme tool. Results: Fourteen papers were identified for inclusion. Three main themes were identified: the importance of a personal relationship with an EIS staff member, the impact of this relationship and consideration of life after EIS. The importance of a strong relationship with EIS staff was the most prominent theme throughout the papers reviewed. Conclusions: The quality of the therapeutic relationship with at least one EIS staff member was the single most important factor in determining whether the experience of accessing EIS was a positive or negative one. The majority of the studies reviewed were conducted in the United Kingdom or Australia. Therefore, more research across countries is needed to understand transferability of findings. [ABSTRACT FROM AUTHOR]

Eating disorders (EDs) are serious, deadly disorders that emerge in adolescence and early adulthood. Further, reported incidences of EDs are increasing worldwide. As such, accessible, affordable, and effective early intervention and prevention efforts are critical. The Body Project is a well-established ED prevention program with demonstrated success at reducing ED symptom severity and the risk of onset of EDs in young females. However, it has not yet been formally evaluated in an Australian population, nor have the benefits of the treatment for young people of all genders been thoroughly investigated. This protocol paper outlines the design for a study which aims to investigate the outcomes and feasibility of the Body Project as a brief ED prevention program within an Australian youth mental health service: headspace Camperdown. This pragmatic trial will compare outcomes between a Body Project treatment group and a Treatment-as-usual control group. Primary outcomes include body image concerns, ED symptomatology and general psychological distress, measured pre- and post-treatment, and at one-month follow-up. All young people attending headspace Camperdown for care are eligible for participation in the trial. The Body Project program is comprised of four group-based 1.5 h sessions run over 4 consecutive weeks. Overall, a trial of the Body Project as an ED prevention program is warranted to investigate the outcomes of the intervention in this sample and will provide valuable information about the feasibility for widespread implementation of the treatment as part of a stepped-care approach to intervention for EDs at youth mental health service locations across Australia. ANZCTR Trial Registration Number: ACTRN12623000695606 (registered 29 June 2023). [ABSTRACT FROM AUTHOR]

Purpose: This article examines the educational decision-making of hearing parents for their deaf children born during a period (1970–1990s) before the introduction of new-born hearing screening in New South Wales, where the study was conducted, and prior to the now near-universal adoption of cochlear implants in Australia. Design/methodology/approach: We present findings from an oral history study in which parents were invited to recall how they planned for the education of their deaf children. Findings: We propose that these oral histories shed light on how the concept, early intervention – a child development principle that became axiomatic from about the 1960s – significantly shaped the conduct of parents of deaf children, constituting both hope and burden, and intensifying a focus on early decision-making. They also illustrate ways in which parenting was shaped by two key structural shifts, one, being the increasing enrolment of deaf children in mainstream rather than separate classrooms and the other being the transformation of deafness itself by developments in hearing assistance technology. Originality/value: The paper contributes to a sociological/historical literature of "parenting for education" that almost entirely lacks deaf perspectives and a specialist literature of parental decision-making for deaf children that is almost entirely focussed on the post cochlear implant generation. The paper is distinctive in its treatment of the concept of "early intervention" as a historical phenomenon rather than a "common sense" truth, and proposes that parents of deaf children were at the leading edge of late-20th and early-21st century parenting intensification. [ABSTRACT FROM AUTHOR]

Young people with severe and complex depression experience substantial social connectedness difficulties. The aim of this qualitative study was to evaluate the role of social connectedness in a novel group therapy (Relate) for youth living with severe and complex depression from clinicians' perspectives. Semi-structured interviews were conducted with 11 clinicians practicing at Orygen's Youth Mood Clinic in Melbourne. Eight of the 11 clinicians were female, with the sample aged 30–42 years (M = 34 years, SD = 3.6 years) and having an average 4.5 years clinical experience at Orygen. Four key themes were identified by codebook thematic analysis. The first theme pertained to clients' difficulties with social engagement, which impacted their attendance of Relate, but were addressed by the intervention. In the second theme, clinicians identified Relate as providing a safe space. In the third theme, clinicians identified opportunities for positive relational experiences. In the fourth theme, clinicians observed social and clinical improvements in Relate clients, but marked recovery did not always occur after attending. Findings provide initial support for the continuation of Relate. Recommendations for future iterations of Relate include refining the intake criteria for referring clients to Relate and potentially lengthening the program's duration. What is already known about this topic: Group interpersonal therapy is an effective intervention for depression and interpersonal functioning in young people. Few studies have evaluated treatments for young people with severe and complex depression and high suicide risk. Few studies have evaluated group programs within early intervention services. What this paper adds: A relationally-focussed group therapy could improve social connectedness and interpersonal functioning for youth living with severe and complex depression. The Relate group emphasises a safe environment for sharing and social risk-taking, providing opportunities for positive relational experiences with similar others which might be particularly useful for youth with complex social difficulties. Identified issues with engagement suggest clients could benefit from an explicit rationale for how their participation in the group benefits their depression treatment. [ABSTRACT FROM AUTHOR]

Many fields of medicine have benefitted from the formation of clinical trials networks, whereby researchers come together on a large scale to identify high-priority questions and implement coordinated clinical trials. Clinical trials networks in the field of mental health, however, have been rare and largely absent from the Australian context. Here, we present an overview of the newly formed Growing Minds Australia Clinical Trials Network, which represents the first comprehensive clinical trials network in child and youth mental health in Australia. The 60 principal members of the Growing Minds Australia Clinical Trials Network represent teams across 19 diverse areas related to specific forms of psychopathology (e.g. internalising, externalising, neurodevelopmental disorders, early psychosis, substance use), specific research methods and processes (e.g. health economics, eHealth, implementation science) and specialised areas of practice (e.g. school-based systems, parenting interventions, Indigenous mental health, refugee families). Core functions of the Growing Minds Australia Clinical Trials Network include collaborative trial protocol development; peer review, prioritisation and endorsement of proposed trials; training; development of clinical guidelines; and consumer representation. The research by the clinical trials network will encompass the populations typically accessing youth mental health services, while placing a key emphasis on the early periods of life, and the role of parents and caregivers as critical partners in the co-design of research and the delivery of intervention and prevention strategies. The structures and processes built into the network are designed to coordinate collaboration between diverse stakeholders and ensure that provisions for translation are integrated into research from the outset. In this paper, we examine the potential for a dedicated clinical trials network to initiate fundamental improvement in child and youth mental health systems, and discuss the unique and complex challenges associated with establishing such an initiative. [ABSTRACT FROM AUTHOR]

Purpose Child and family health (CAFH) services in Australia initially provide at least one nurse-home-visit following the birth of a child. Planning and referral then commences for the on-going provision of appropriate services to families. Unfortunately, services in rural and regional communities in Australia can be fragmented and poorly resourced. Little is known about CAFH nurses’ experiences of working with families in these communities. The purpose of this paper is to examine the way CAFH nurses work within a universal health service model that may be compromised by isolation, discontinuity and fragmentation.Design/methodology/approach Focus groups with 26 CAFH nurses from five rural, two regional and one urban community in New South Wales (NSW), Australia were conducted. A secondary, thematic analysis of the qualitative data were undertaken to reflect on change and continuity in the field of universal CAFH services. Analysis was driven by two key research questions: How do CAFH nurses experience their role in universal home-based CAFH services within rural and regional areas of Australia and, what unique factors are present in rural and regional areas that impact on their CAFH nursing role?Findings The experience of the CAFH nurses as presented by these data revealed a role that was family centred and concerned for the welfare of the family, yet compromised by the need to meet the disproportionately complex needs of families in the absence of a strong network of services. The opportunity to present the findings provides insight into the way in which families engage with available services in isolated communities. CAFH nurses in the study attempted to maintain service integrity by adapting to the unique context of their work.Originality/value It is important to understand the mechanisms through which CAFH nurses operate to work effectively with families referred to their service. This paper describes the way in which CAFH nurses work with families not meeting the threshold for more intensive and targeted home-visiting service delivery in rural and regional communities of NSW, Australia. [ABSTRACT FROM AUTHOR]

In July 2013, the Australian State of Queensland established the first fixated threat assessment service outside Europe to specifically assess and manage lone, fixated persons. The Queensland Fixated Threat Assessment Centre (QFTAC) is a collaboration between the Intelligence, Counter-Terrorism and Major Events Command of the Queensland Police Service and Queensland Health’s Forensic Mental Health Service. It has been modelled on the original Fixated Threat Assessment Centre (FTAC) which has been operating in the United Kingdom since 2006, with modifications to reflect local needs and differing mental health and legal practices. This paper describes the background to the development of these services, the rationale for their expansion to the Asia Pacific region, and outcome data for QFTAC’s first 12 months of operations. These findings support the efficacy of proactive FTAC-style approaches to managing the threat posed by fixated individuals to public figures and the wider community. [ABSTRACT FROM PUBLISHER]

Issue Addressed: Dental caries is highly prevalent in very young Australian and New Zealand children. Health professionals other than registered dental professionals can help prevent early childhood caries, promoting oral health to assist families establish preventative oral health habits at a child's early age. This review identifies oral health promotion (OHP) delivered by nondental health professionals in Australia and New Zealand involving very young children. Methods: Databases (MEDLINE, CINAHL, Embase, Emcare, Web of Science, Scopus, ProQuest, Google Scholar, TROVE) and digital libraries were searched between 2001 and 2021 for eligible studies and grey literature. Studies with a focus on preventative oral health strategies in a primary health care context were included. Results: The review identified 76 studies. Seven met the inclusion criteria, and were conducted in Australia across metropolitan, rural, and remote settings. Studies that successfully engaged nondental health professionals to promote oral health to families reported a positive change in oral health practices among very young children. Delivering OHP during a child's early life stage positively influenced their oral health outcomes. Conclusions: Integration of dental and primary health care increased access to oral health care and advanced positive oral health outcomes for children. With adequate training, resources, and support mechanisms, nondental health professionals can deliver oral health strategies that facilitate behaviour change in parents to improve children's oral health. So What? Health promotion generates enabling conditions that support and empower families to improve and maintain their oral health. Nondental health professionals can play a crucial role promoting oral health for very young children and improving equitable access to preventative oral health care. [ABSTRACT FROM AUTHOR]

Young people living in regional and rural areas of Australia are at an increased risk of suicide and have unique barriers and facilitators to seeking mental health support. As such, specific mental health and suicide prevention programmes that are tailored to young people within their communities are required. Despite this, peer-reviewed literature on such interventions is scant. In this commentary, we outline an existing rural place-based programme; Live4Life, created in 2009 in the Macedon Ranges, Victoria, and now running in nine Australian regional communities. We demonstrate that Live4Life shows promise in building the capacity of whole communities to support young people to recognise and seek help for mental health concerns. As such, we argue the need for further evaluation comparing Live4Life communities with matched control communities to assess the long-term impact of the programme and to support the upscaling of Live4Life across Australian regional and rural communities. What is already known about this topic: Young people face the highest burden of mental ill-health in Australia, with adolescent mental health challenges having long-lasting impacts on functioning and quality of life. Regional and rural Australians are particularly at risk, experiencing increased suicide rates and additional barriers to accessing mental health services. Place-based approaches to suicide prevention, which engage local communities have been identified as a need for regional and rural communities. What this topic adds: We outline the community-led programme Live4Life, which aims to increase community knowledge of youth mental health and encourage help-seeking behaviour in young people. We discuss the existing evidence demonstrating the potential impact of the Live4Life model on the communities in which it is implemented. We offer suggestions for future research evaluating the efficacy of the programme by comparing communities with Live4Life implemented to matched control communities. [ABSTRACT FROM AUTHOR]

Personality disorders have received limited recognition as a public health priority, despite the publication of treatment guidelines and reviews showing effective treatments are available. Inclusive approaches to understanding and servicing personality disorder are required that integrate different service providers. This viewpoint paper identifies pertinent issues surrounding early intervention, treatment needs, consumer and carer experiences, and the need for accurate and representative data collection in personality disorder as starting points in mental health care reform. [ABSTRACT FROM AUTHOR]

Objectives: Australia is piloting a stand-alone early intervention programme for psychosis, based on the Early Psychosis Prevention and Intervention Centre (EPPIC) model that was developed within mainstream Victorian State Government psychiatric services. The Australian early intervention programme is located in primary care, and badged as ' headspace Early Psychosis Youth Services'. There are currently six metropolitan early intervention services with two further services planned for the 2023 Financial Year. We discuss key findings from an external evaluation of the first six services, released by the Australian Government Department of Health under a Freedom of Information request. Conclusions: headspace Early Psychosis Youth Services received high ratings for patient satisfaction and engagement, which was associated with symptomatic improvement and functional recovery. However, governance was complicated, costs were relatively high, and caseload targets were not met. The cost for an additional year of good quality life was estimated at AUD 318,954, which exceeds the usual thresholds for defining a 'good buy'. Integrated models should be investigated, as they seem in principle to offer efficiencies and improved continuity of care. [ABSTRACT FROM AUTHOR]

Background: The rate of transition to psychotic disorder in ultra high risk (UHR) patients has declined in recent cohorts. The reasons for this are unclear, but may include a lead-time bias, earlier intervention, a change in clinical characteristics of cohorts, and treatment changes.Aims: In this paper we examined the two possibilities related to reduction in duration of symptoms prior to clinic entry, i.e., lead-time bias and earlier intervention.Method: The sample consisted of all UHR research participants seen at the PACE clinic, Melbourne between 1993 and 2006 (N=416), followed for a mean of 7.5years (the 'PACE 400' cohort). Duration of symptoms was analysed by four baseline year time periods. Analysis of transition rate by duration of symptoms was restricted to more homogenous sub-samples (pre-1998 and pre-2001) in order to minimize confounding effects of change in patient characteristics or treatments. These cohorts were divided into those with a short and long duration of symptoms using a cut-point approach.Results: Duration of symptoms prior to entry did not reduce significantly between 1993 and 2006 (p=0.10). The group with a short duration of symptoms showed lower transition rates and did not catch up in transition rate compared to the long duration of symptoms group.Discussion: These data suggest that, while earlier intervention or lead-time bias do not fully account for the declining transition rate in UHR cohorts, it appears that earlier intervention may have exerted a stronger influence on this decline than length of follow-up period (lead-time bias). [ABSTRACT FROM AUTHOR]

In search of Kipling's six honest serving men in upper limb rehabilitation after stroke, we sought to investigate clinicians' perspective of when and where to begin therapy, how much and what therapy to provide, and who and why (or not) to provide therapy. Materials & methods: Within-participant case cross-over experiments were nested within an anonymous web-based questionnaire (21 questions, three cases). Graph theory-based voting to produce ranked ordered lists and mixed-effect logistic regression were performed. In total, 225 Australian stroke clinicians responded: 53% occupational therapists, 61% working in acute/inpatient stroke setting. Most respondents indicated they did not have a protocol/expectation regarding when (62%), how much (84%) or what (60%) therapy to provide in their setting. Respondents ranked 24-h to 7-days post-stroke as the optimal time to commence therapy, and 30- to 60-min per day as the optimal dose to provide. Within-participant experiments demonstrated that greater motor recovery as time progressed increased the odds of offering therapy, while lack of motor recovery, shoulder pain, neurological decline and sole therapist reduced the odds. We need to develop an evidence base concerning Kipling's six honest serving men and equip clinicians with clinical decision-making skills aligned with this focus. Most clinicians did not have access to a protocol / clinical pathway which defines when, how much and what upper limb therapy to provide after stroke, which may be improved by providing individual clinicians with organisational support to make therapy decisions. To improve the personalisation of upper limb rehabilitation in clinical practice, we need to understand when and where after stroke to begin therapy, how much and what therapy to provide, as well as who and why (clinical decision-making) to provide therapy. Clinicians perceive clinical trials as successful if the therapy can demonstrate recovery that is greater than a minimal clinical important difference (MCID). [ABSTRACT FROM AUTHOR]

Background: The effects of problem gambling are wide-ranging, affecting many aspects of health and negatively impacting the person who gambles, their family and friends, and their community. People experiencing problem gambling have low rates of help-seeking and perceive many barriers to treatment, although evidence suggests that encouragement and support from friends and family can increase rates of help-seeking. Mental Health First Aid Australia's Conversations About Gambling course aims to teach members of the public evidence-based strategies for recognising and responding to signs of problem gambling in a person they know. Methods: This research evaluated the effects of the Conversations About Gambling course on participants' knowledge, confidence, stigmatising attitudes, intended helping behaviour and actual helping behaviour towards a person experiencing problem gambling. Participants from Australia completed surveys before the course, immediately after the course and six months later. Changes over time (pre-course to post-course, and pre-course to 6-month follow-up) were assessed with linear mixed models. Descriptive statistics and content analyses of open-ended questions pertaining to participants' satisfaction with the course were also produced. Results: Between 2018 and 2020, 166 participants were recruited into this study. At 6-month follow-up 87 participants (52.4%) provided data. Participants' knowledge about gambling and gambling problems, confidence, desire for social distance and intentions to help a person experiencing problem gambling significantly improved from pre-course to post-course, and from pre-course to 6-month follow-up. The quality of some actions taken to support a person they knew who was experiencing problem gambling also improved from pre-course to 6-month follow-up, in line with the teachings of the course. Participants perceived the course to be highly acceptable. Conclusions: The results of this initial evaluation of Mental Health First Aid Australia's Conversations About Gambling course suggest that it is an effective and acceptable educational intervention for those who wish to support a person experiencing problem gambling. [ABSTRACT FROM AUTHOR]

Aim: Two integrated headspace Early Intervention Teams (hEITs) were established in 2017 to bridge gaps between headspace, the national primary care youth mental health programme in Australia, and the state funded secondary and tertiary mental health services. This study aims to describe functioning and outcomes of patients referred to hEIT over a 6‐month period. Methods: A retrospective file audit was conducted for all patients accepted into the service over a 6‐month period in 2018. Measures of distress, functioning and client satisfaction were collected and analysed. Exemplar vignettes were created to construct hypothetical examples and illustrate research findings. Results: At admission, the three most common presentations were depression/anxiety, trauma and stress related, and psychotic disorders. During their time in the service, young people displayed a statistically significant improvement in functioning, reduction in self‐harm in those 18 years and under, and a trend to reduction in distress scores. hEIT delivered a broad range of services covering social, occupational, educational, medical and mental health care, and the service was experienced positively by the patient cohort. Conclusions: hEIT appears to meet the needs of young people requiring greater care than primary care services can deliver. The integrated, wrap‐around care coordination facilitates treatments across social, educational and health domains. Further exploration of young people who disengage from care, improved outcome data reporting and economic evaluation are indicated. [ABSTRACT FROM AUTHOR]

Objective. The aim of this article is to describe the development of a novel evidence-based model of early intervention vocational rehabilitation (EIVR) for people with spinal cord injury (SCI). Methods. An extensive literature review and background study guided the collaboration of experienced practitioners and researchers in developing and evaluating the innovative Back2Work model of EIVR for people with SCI in Queensland, Australia. The program is undergoing longitudinal mixed-methods evaluation to the end of 2023. Results. The model is central to the successful implementation of the EIVR program, delivered by rehabilitation counsellors in the Queensland Spinal Injuries Unit. Back2Work includes a strong focus on maintaining and nurturing the pre-injury occupational bond between injured workers and employers, and aims to create a positive expectation for return to work (RTW) and increase the rate and timeliness of RTW after SCI. Conclusions. The Back2Work program has become an integrated component of the multidisciplinary rehabilitation team, with positive early results in RTW outcomes and additional benefits in participants' sense of well-being and hope. [ABSTRACT FROM AUTHOR]

The purpose of this study was to use psychological measures of pre-schoolers who stutter and their parents to inform causal theory development and influence clinical practices. This was done using data from a substantive clinical cohort of children who received early stuttering treatment. The cohort (N = 427) comprised parents and their children who were treated with the Lidcombe Program, the Westmead Program, and the Oakville Program. The study incorporated demographic information, stuttering severity, and child and parent psychological measures prior to treatment. The cohort revealed nothing unusual about behavioural and emotional functioning, or the temperaments, of pre-school children that would influence treatment, be targeted during treatment, or influence causal theory development. However, a third of parents were experiencing moderate to high life stressors at the time of seeking treatment, and half the parents failed first-stage screening for Anankastic Personality Disorder. The present results are consistent with a number of previous reports that showed that the population of pre-schoolers who stutter have no unusual psychological profiles. Hence, these results suggest that the association between mental health and stuttering later in life is a consequence of the disorder rather than being a part of its cause. The finding of the life stress of parents who seek stuttering treatment for pre-school children has potential clinical importance and warrants further investigation. Further psychological research is required about parents of pre-school children who stutter, because half the parents in the cohort failed the screener for Anankastic Personality Disorder. This is of interest because a previous study associated screening failure for another personality disorder (Impulsive Personality Disorder) with treatment dropout for early childhood stuttering. [ABSTRACT FROM AUTHOR]

Aim: The involvement of young people in the development, implementation and evaluation of youth mental health services, policy and research programs is essential to ensure they are appropriate and responsive to the needs of young people. Despite the increasingly central role that youth engagement and participation plays internationally, such activities are rarely described in detail. This article aims to provide a thorough description of the development and implementation of an organization‐wide, 3‐year Youth Engagement and Participation Strategy for Orygen, a national youth mental health organization in Australia. Methods: A descriptive account of the development and implementation of the Strategy, with detailed examples of programs and initiatives. Results: The Strategy was developed based on available evidence, focus groups with key stakeholders and best practice principles. The implementation of the Strategy resulted in a number of programs being delivered that involved a range of young people from across Australia. Despite being successful overall, a number of challenges were experienced. Ongoing considerations include ensuring diversity of partnerships, 'raising the bar' of youth participation and creating meaningful pathways. Conclusions: Youth participation and engagement within a youth mental health context is best seen as an evolving ambition that must remain flexible to the needs of all stakeholders. Despite some challenges and ongoing fine‐tuning, it is possible to successfully implement youth participation and engagement across all areas of youth mental health, including service design and delivery, research and translation, and policy. [ABSTRACT FROM AUTHOR]

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This study investigated maternal and child health (MCH) nurse family violence clinical practices, practice gaps and future family violence training needs. Descriptive analysis was conducted of routine data collected as part of a larger MCH nurse family violence training project conducted in 2018. A purposive sample of routine data (2017–18) was analysed from six Victorian metropolitan and four regional and rural areas that were experiencing high rates of violence, as indicated by police reports. Descriptive statistics and regression analyses were used to identify rates of nurse family violence screening, safety planning and referral, with practice differences analysed across locations. MCH nurses ask only one in two clients about family violence at the mandated 4-week postnatal clinic visit. Overall, metropolitan nurses screen for family violence at higher rates than rural nurses. Safety planning rates were low (1.3%), suggesting that screening is not translating to disclosure rates equivalent to state-wide prevalence (~14–17%) or police data. Nurse referrals are even lower (<1%), with practice differences noted across reporting systems. Despite data collection limitations, analysis of routine data shows significant gaps in nurse family violence screening and response practices. This evidence reinforces the need for systems changes to address family violence and other maternal health and social issues. MCH nurses have been conducting family violence screening since 2009, yet these practices are poorly researched and understood. Only half the women attending MCH services are screened at the 4-week recommended visit. Asking rates are lower in rural areas. Disclosures and referrals are low, indicating significant barriers for nurses to address and women to discuss abuse in this setting. If sustainable family violence practices are to be achieved, MCH nurses require additional system support including ongoing family violence training. [ABSTRACT FROM AUTHOR]

Purpose: Misconduct and deviance amongst police officers are substantial issues in policing around the world. This study aims to propose a prediction model for serious police misconduct by variation of the theory of planned behaviour. Design/methodology/approach: Using two data sets, one quantitative and one qualitative, provided by an Australian policing agency, a random forest analysis and a qualitative content analysis was performed. Results were used to inform and extend the framework of the theory of planned behaviour. The traditional and extended theory of planned behaviour models were then tested for predictive utility. Findings: Each model demonstrated noteworthy predictive power, however, the extended model performed particularly well. Prior instances of minor misconduct amongst officers appeared important in this rate of prediction, suggesting that remediation of problematic behaviour was a substantial issue amongst misconduct prone officers. Practical implications: It is an important implication for policing agencies that prior misconduct was predictive of further misconduct. A robust complaint investigation and remediation process are pivotal to anticipating, remediating and limiting police misconduct, however, early intervention models should not be viewed as the panacea for police misconduct. Originality/value: This research constitutes the first behavioural model for police misconduct produced in Australia. This research seeks to contribute to the field of behavioural prediction amongst deviant police officers, and offer an alternative methodology for understanding these behaviours. [ABSTRACT FROM AUTHOR]

The aim of this scoping review was to identify initiatives focused on the secondary prevention and management of chronic pain in Australian primary care to understand options available to Primary Health Networks and to identify evidence gaps. The Medline, EMBASE, Cumulative Index to Nursing and Allied Health Literature and Cochrane databases, as well as relevant websites, were searched for eligible records published from 2007 to 2018. Initiative characteristics and outcomes evaluated were extracted and synthesised. In all, 84 initiatives from 167 published and grey literature records were identified, including: (1) consumer initiatives that aimed to improve access to multidisciplinary care, health literacy and care navigation (n = 56); (2) health professional capacity building initiatives that aimed to ensure health professionals are skilled and provide best-practice evidence-based care (n = 21); and (3) quality improvement and health system support initiatives (n = 7). Evidence gaps were found relating to initiatives addressing the secondary prevention of chronic pain, those targeting vulnerable and regional populations, health professional capacity building initiatives for all primary health care providers and quality improvement and system support initiatives. Addressing evidence gaps related to effectiveness, cost-effectiveness and implementation should be the focus for future chronic pain initiatives in primary care settings. Primary Health Networks (PHNs) are well positioned to improve access to integrated and coordinated multidisciplinary care to prevent and manage chronic pain in the primary care setting. This scoping review identifies the types of chronic pain initiatives in Australian primary care (and the supporting evidence) that can be implemented or commissioned by PHNs. Future commissioned services and other primary care initiatives should incorporate robust evaluations to help address the identified evidence gaps and allow for adaptation by other PHNs to address local health needs. [ABSTRACT FROM AUTHOR]

This study aimed to explore Australian parents' use of universally available well‐child health services. It used an online survey of 719 parents of children aged from birth to 5 years in all states and territories to examine patterns of service use and consumer preferences. In Australia, several health professional groups provide advice to pregnant women, infants, children, and parents, offering health promotion, developmental screening, parenting support, and referral to specialist health services if required. The survey examined parents' use of different child and family health providers, and their preferences for support with several common parenting issues. The study indicated that families with young children obtain primary healthcare from a range of service providers, often more than one, depending on children's ages and needs. Parents frequently visit general practitioners for immunisation and medical concerns. They attend dedicated child and family health nurses for parenting advice and well‐child checks and prefer them as an information source for many health issues. However, a substantial proportion of parents (44.1%) do not currently visit a child and family health nurse, often because they not only do not perceive a need but also sometimes because these services are unknown, inaccessible, or considered unsuitable. They may seek advice from less qualified sources. There is potential for increased collaboration between child and family health providers to ensure effective resource use and consistency of parenting information and advice. Nursing services may need to address accessibility and appropriateness of care. [ABSTRACT FROM AUTHOR]

Background: Screening young people for risk of mental health difficulties in schools is an effective method to facilitate monitoring and early intervention. This study is a preliminary report on the adaptation of the Youth RADAR screening instrument for primary school children. Specifically designed to be used in schools, the Child RADAR assesses a child's balance of risk and protective factors known to be associated with the development of mental health problems. Method: Three hundred and thirty‐nine children drawn from six primary schools across NSW, Australia, completed the alpha version of the Child RADAR in addition to an assessment of depression and anxiety symptoms and subjective well‐being. Results: Confirmatory factor analysis revealed the Child RADAR to have an acceptable factor structure. Reliability for the Total Child RADAR was satisfactory based on both internal consistency (α = .86) and test–retest reliability (r = .85). Convergent validity was demonstrated through significant associations with symptoms of anxiety and depression. Conclusions: The Child RADAR shows preliminary promise as a school‐based screener of mental health risk. Further evaluation is required to demonstrate the generalizability of the instrument across different populations. [ABSTRACT FROM AUTHOR]

This exploratory randomised controlled trial tested the effectiveness of a tablet-based information communication technology early intervention application to augment existing therapy with the aim of improving visual motor, imitation, language and social skills in young children with ASD who reside in regional areas. Fifty-nine participants were recruited and randomised to either a therapy-as-usual group or intervention group. With the exception of the expressive language subscale on the Mullen Scales of Early Learning, no significant between-group differences were recorded for visual motor, imitation, receptive language and social skills of participants between baseline and post-intervention. When all participants were pooled and measured over time, improvements were shown in receptive and pragmatic language and social skills; these gains were maintained, thus suggesting skill acquisition. [ABSTRACT FROM AUTHOR]

Younger mothers are categorised as an ‘at-risk’ group and targeted for early recognition and subsequent intervention to enhance children’s safety and well-being. However, younger mothers systematically endure stigma which can affect their willingness to engage with supportive services. This article reports on the findings from an Australian qualitative study of thirty-five interviews and two focus groups with younger mothers to explore their experiences of stigma and how this affects their engagement with services. We found that their interactions with services confirmed their feelings of being treated differently to other mothers. It led them to actively avoid supportive services because they had negative experiences or assumed that they would have a negative experience. This demonstrates the predictive power of stigma. Hearing from younger mothers about how these experiences play out in their lives and what they suggest would need to change for them to access services is critical for social workers and other practitioners to engage more effectively with this group of parents. We argue that the offer of early-intervention programmes may be more successful where there is capacity to establish a trusting relationship and where services convey an effective message to younger mothers that the special attention they receive at critical times is voluntary, normal and well deserved. [ABSTRACT FROM AUTHOR]

BackgroundWe investigated the context for translating evidence-based early intervention for autism spectrum disorders (ASD) into real world settings through a case study of a regional town characterised as disadvantaged. MethodsData were from interview surveys of five managers reporting on 15 services, and surveys from 19 practitioners and 15 mothers of young children with ASD. ResultsThe 15 services were multidisciplinary, offering diagnostic assessments (n = 2) and interventions delivered in the home and centres. Children were diagnosed at a mean age of 3 years; access to intervention was delayed and mostly limited to one session every two weeks. Some families travelled substantial distances to services, driving on average 50 minutes each way. Practitioners described intervention strategies in broad terms, rather than name interventions. ConclusionsServices available to young children with ASD in this town were far removed from good practice in terms of early diagnosis, and intervention frequency and intensity. [ABSTRACT FROM PUBLISHER]

Aim: To examine socio-demographic factors associated with maternal help-seeking for child developmental concerns in a longitudinal birth cohort study. An understanding of these factors is critical to improving uptake of services to maximise early identification and intervention for developmental concerns.Methods: A birth cohort was recruited from the post-natal wards of two teaching hospitals and through community nurses in South Western Sydney, Australia, between November 2011 and April 2013. Of the 4047 mothers approached, 2025 consented to participate (response rate = 50%). Socio-demographic and service use information was collected after the child's birth and when the child was 18 months of age. Sources of help were divided into three categories (formal health services, other formal services and informal supports) and compound variables were created by summing the number of different sources identified by mothers.Results: Significantly more sources of help were intended to be used and/or actually accessed by mothers born in Australia, whose primary language was English, with higher levels of education and annual household income, and among mothers of first-born children.Conclusions: Developmental concerns are known to increase with increased psychosocial adversity. Our findings of reduced intent to access and use of services by socio-economically disadvantaged families and those from culturally and linguistically diverse backgrounds suggests that an inverse care effect is in operation whereby those children with the greatest health needs may have the least access to services. Possible explanations for this, and recommendations for improving service accessibility for these populations through targeted and culturally appropriate services, are discussed. [ABSTRACT FROM AUTHOR]

In Australia cochlear implantation of profoundly deaf infants, babies, and young children is approaching 100% saturation. Why do parents choose to implant rather than learn Auslan? What is the Deaf community’s reaction to this and how will it change Sign as a living language? In this article, the author is a Deaf parent who chose to implant her Deaf child. When she initially published in a news outlet on this topic the reaction was quite heated: how terrible a parent you must be if you are denying your child Sign! This article explains the reasoning behind that decision to implant, taking issue with the notion that giving a child an ‘extra ability’ of speech means that you do not love them as they are. Nothing is natural, but everything is acquired or augmented – in all children. [ABSTRACT FROM AUTHOR]

The article focuses on the applicability of relationship-based approaches in early childhood intervention under the National Disability Insurance Scheme (NDIS). Topics discussed include need of trans disciplinary, family centred, and key worker approaches for evidence-based practices; philosophical shift in pediatric occupational therapy practice; and importance of parent–child relationship.

Background Playgroups are a relatively unique form of family support programme that is common in Australia which has high community acceptance and significant government investment. However, limited evidence exists regarding the effectiveness of playgroups to achieve better outcomes for children and their parents. This study describes patterns of playgroup participation for Aboriginal and Torres Strait Islander families with young children and examines the extent to which participation from birth to three years is associated with subsequent child, parent and community outcomes. Methods This study uses three years of longitudinal data for 622 Aboriginal and Torres Strait Islander children who were participants in the Longitudinal Study of Indigenous Children (LSIC). Longitudinal associations between playgroup attendance when children were age 2 and 3 years and outcome measures for child vocabulary, motor skills, behaviour problems, prosocial development, parent home learning engagement, resilience, advice-seeking and health service use, and community trustworthiness were examined using path analysis. Results Rates of playgroup participation in this sample group were generally lower than for Australian children overall. Playgroup attendance when children were age 2 to 3 years was associated with higher parental engagement in home learning activities when children were aged 4 years which, in turn, was associated with stronger expressive vocabulary scores for children. Conclusion The findings from this study suggest that playgroup participation can enhance the home learning environments for Aboriginal and Torres Strait Islander children. Playgroups as a parent support programme hold strong potential to reach and engage families, particularly in areas of high geographic isolation, which can realize improved outcomes for children, parents and communities. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to explore the extent to which Australian child and family health nurses work with families with complex needs and how their practice responds to the needs of these families. Background Many families with young children face challenges to their parenting capacity, potentially placing their children at risk of poorer developmental outcomes. Nurses increasingly work with families with mental health problems, trauma histories and/or substance dependence. Universal child health services must respond effectively to these challenges, to address health inequalities and to promote the best outcomes for all children and families. Design The descriptive study used cross-sectional data from the first national survey of child and family health nurses in Australia, conducted during 2011. Methods Survey data reported how often, where and how child and family health nurses worked with families with complex needs and their confidence in nursing tasks. Findings Many, but not all, of the 679 respondents saw families with complex needs in their regular weekly caseload. Child and family health nurses with diverse and complex caseloads reported using varied approaches to support their clients. They often undertook additional professional development and leadership roles compared with nurses who reported less complex caseloads. Most respondents reported high levels of professional confidence. Conclusion For health services providing universal support and early intervention for families at risk, the findings underscore the importance of appropriate education, training and support for child and family health professionals. The findings can inform the organization and delivery of services for families in Australia and internationally. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this review is to report on recent developments in youth mental health incorporating all levels of severity of mental disorders encouraged by progress in the field of early intervention in psychotic disorders, research in deficiencies in the current system and social advocacy.Methods: The authors have briefly reviewed the relevant current state of knowledge, challenges and the service and research response across four countries (Australia, Ireland, the UK and Canada) currently active in the youth mental health field.Results: Here we present information on response to principal challenges associated with improving youth mental services in each country. Australia has developed a model comprised of a distinct front-line youth mental health service (Headspace) to be implemented across the country and initially stimulated by success in early intervention in psychosis; in Ireland, Headstrong has been driven primarily through advocacy and philanthropy resulting in front-line services (Jigsaw) which are being implemented across different jurisdictions; in the UK, a limited regional response has addressed mostly problems with transition from child-adolescent to adult mental health services; and in Canada, a national multi-site research initiative involving transformation of youth mental health services has been launched with public and philanthropic funding, with the expectation that results of this study will inform implementation of a transformed model of service across the country including indigenous peoples.Conclusions: There is evidence that several countries are now engaged in transformation of youth mental health services and in evaluation of these initiatives. [ABSTRACT FROM AUTHOR]