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The COVID-19 pandemic has profoundly affected children's care and education worldwide. This article reports on patterns of participation in early childhood education and care (ECEC) across Australia as influenced by the COVID-19 pandemic and national policies. Using ECEC data from Xplor -- a software platform used across Australian childcare centres (2019: n = 229,349; 2020: n = 229,468), patterns of attendance rates were examined nationally in 2019 and 2020 by service-level and family-level characteristics. The average attended hours per week of ECEC nationally in 2020 (18.32 hours) was less than that in 2019 (21.26 hours). Attendance rates at ECEC in 2020 declined rapidly from 66% to 26.2% at the onset of the COVID-19 outbreak. Fee-free subsidy from Australian governments did not substantially increase attendance or reduce disparities in attendance for vulnerable families. Low ECEC attendance rates for prolonged periods could have significant implications for child development, particularly for children from vulnerable backgrounds.

Aim: To identify the barriers associated with inadequate antenatal attendance by disadvantaged women in Australia and to further explore how these barriers are experienced by this population group. Design: A qualitative descriptive study utilizing semi‐structured interviews and thematic analysis. Methods: Interviews were conducted with 11 pregnant women who self‐identified as experiencing disadvantage, purposively sampled from a local government area of Victoria, Australia, characterized by socio‐economic disadvantage. Data were collected from February to July 2019. Results: Study participants reported a range of barriers to receiving timely and adequate antenatal care (ANC). For several women, a combination of personal (e.g., emotions, knowledge), health service provision (e.g., limited access to continuity of care provider and continuity of information, inflexible scheduling, difficulty travelling, staff attitudes), and broader social‐contextual factors (e.g., financial situation, language, cultural norms) were ultimately insurmountable. Whereas some barriers were experienced as hassles or annoyances, others were unacceptable, overwhelming, or humiliating. Conclusion: Women experiencing disadvantage in Australia value ANC but face multiple and complex barriers that undermine timely and regular access. Implications for the Profession and/Patient Care: A wide range of strategies targeting barriers across multiple levels of the social‐ecological environment are required if ANC attendance rates are to improve and ultimately redress existing health disparities. Various continuity of care models are well‐placed to address many of the identified barriers and should be made more accessible to women, and particularly those women experiencing disadvantage. Impact: Antenatal care appointments promote the health of women and their babies during pregnancy, but for many women, particularly those experiencing disadvantage, access is delayed or inadequate. ANC providers play a critical role in facilitating timely and adequate care. Health service practitioners and management, and health services policymakers need to understand the complexity of the barriers women encounter. These stakeholders can utilize the findings reported herein to develop more effective strategies for overcoming multiple and multi‐level barriers. Reporting Method: The study is reported in accordance with the relevant EQUATOR guidelines: the standards for reporting qualitative research (SRQR) and consolidated criteria for reporting qualitative research (COREQ). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To systematically evaluate published experimental studies of sustained nurse home visiting (SNHV) programs. This review summarizes the evidence and identifies gaps in the literature to inform practice, policy, and future research. Design: Restricted systematic review with narrative summary. Data Sources: Databases searched were Medline, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials. Year of publication was originally restricted from 2008 to the date of search (13 February 2018, with supplementary searches conducted to identify more recent publications (up to 2019). Several reputable evidence clearinghouses were also searched. Review Methods: Studies were included if they used a randomized or cluster‐randomized controlled trial to evaluate a home visiting program that: (a) targeted disadvantaged mothers; (b) commenced during pregnancy or prior to the child's first birthday; (c) had an intended duration of at least 12 months from the time of enrolment; and (d) was substantively delivered by nurses or midwives. Meta‐analyses and reviews of studies meeting these criteria were also included. A quality appraisal was conducted for all studies. Results: Of 1,393 total articles, 30 met inclusion criteria. Seven specific SNHV programs were identified. Each demonstrated evidence of a positive statistical effect on at least one child or maternal outcome. Conclusion: Sustained nurse home visiting programs benefit disadvantaged families, though effects vary across outcomes and subgroups. Further research is needed to discern the critical components of effective programs. Impact: As SNHV programs have gained policy appeal, the need to evaluate the evidence‐base supporting such interventions has become imperative. The findings of this review will assist policy‐makers and practitioners in high‐income countries to make evidence‐informed decisions about which programs are best suited to addressing specific maternal and child outcomes for disadvantaged families. This should in turn ameliorate some of the inequalities in child development that have significant social and economic costs. [ABSTRACT FROM AUTHOR]

Children born extremely preterm (EP, <28 weeks) and/or extremely low birth weight (ELBW, <1000 g) have more academic deficiencies than their term-born peers, which may be due to problems with visual processing. The aim of this study is to determine (1) if visual processing is related to poor academic outcomes in EP/ELBW adolescents, and (2) how much of the variance in academic achievement in EP/ELBW adolescents is explained by visual processing ability after controlling for perinatal risk factors and other known contributors to academic performance, particularly attention and working memory. A geographically determined cohort of 228 surviving EP/ELBW adolescents (mean age 17 years) was studied. The relationships between measures of visual processing (visual acuity, binocular stereopsis, eye convergence, and visual perception) and academic achievement were explored within the EP/ELBW group. Analyses were repeated controlling for perinatal and social risk, and measures of attention and working memory. It was found that visual acuity, convergence and visual perception are related to scores for academic achievement on univariable regression analyses. After controlling for potential confounds (perinatal and social risk, working memory and attention), visual acuity, convergence and visual perception remained associated with reading and math computation, but only convergence and visual perception are related to spelling. The additional variance explained by visual processing is up to 6.6% for reading, 2.7% for spelling, and 2.2% for math computation. None of the visual processing variables or visual motor integration are associated with handwriting on multivariable analysis. Working memory is generally a stronger predictor of reading, spelling, and math computation than visual processing. It was concluded that visual processing difficulties are significantly related to academic outcomes in EP/ELBW adolescents; therefore, specific attention should be paid to academic remediation strategies incorporating the management of working memory and visual processing in EP/ELBW children. [ABSTRACT FROM AUTHOR]

Background Severe retinopathy of prematurity ( ROP) is associated with an increased risk for ophthalmologic morbidity, but the long-term impact in other domains is less clear. The aim of the current study was to determine whether severe ROP was related to poorer visual, cognitive, and educational outcomes in a representative sample of EP adolescents, and whether this persisted after adjusting for confounding neonatal risk factors. Method One hundred and eighty extremely preterm ( EP; <28 weeks) adolescents (17-18 years) were assessed on a range of neurodevelopmental measures, including visual processing, IQ, visual learning, visual-motor integration, and academic achievement. EP adolescents were grouped according to ROP status, (1) severe ROP (stage 3 or greater) in the worse eye; or (2) no or mild ROP and were compared on each outcome. Longitudinal data were compared at 2, 5, 8, and 17-18 years for general cognitive outcome. Results The severe ROP group performed more poorly and had more impairments than the non-severe ROP group on measures of visual processing, visual-motor integration, visual learning, IQ, and some academic achievement tests at 17-18 years of age. Group differences diminished after controlling for perinatal risk factors (severe white matter injury, post-natal corticosteroid, and surgery in the neonatal period), and only visual acuity scores remained significantly different between the groups. IQ scores remained consistently lower in the severe ROP group over time, but the magnitude reduced after adjusting for perinatal risk factors. Conclusions Extremely preterm children with severe ROP are at increased risk for ongoing visual processing difficulties and lower IQ compared with EP peers without severe ROP. While severe ROP is a predictor of long-term impairments, this association is largely mediated by other neonatal risk factors. [ABSTRACT FROM AUTHOR]

Background: Adolescents born extremely preterm (EP; <28 weeks' gestation) and/or extremely low birthweight (ELBW; <1000 g) experience high rates of visual impairments, however the potential neural correlates of visual impairments in EP/ELBW adolescents require further investigation. This study aimed to: 1) compare optic radiation and primary visual cortical structure between EP/ELBW adolescents and normal birthweight controls; 2) investigate associations between perinatal factors and optic radiation and primary visual cortical structure in EP/ELBW adolescents; 3) investigate associations between optic radiation and primary visual cortical structure in EP/ELBW adolescents and the odds of impaired vision. Methods: 196 EP/ELBW adolescents and 143 controls underwent magnetic resonance imaging at a mean age of 18 years. Optic radiations were delineated using constrained spherical deconvolution based probabilistic tractography. Primary visual cortices were segmented using FreeSurfer software. Diffusion tensor variables and tract volume of the optic radiations, as well as volume, surface area and thickness of the primary visual cortices, were estimated. Results: Axial, radial and mean diffusivities within the optic radiations, and primary visual cortical thickness, were higher in the EP/ELBW adolescents than controls. Within EP/ELBW adolescents, postnatal corticosteroid exposure was associated with altered optic radiation diffusion values and lower tract volume, while decreasing gestational age at birth was associated with increased primary visual cortical volume, area and thickness. Furthermore, decreasing optic radiation fractional anisotropy and tract volume, and increasing optic radiation diffusivity in EP/ELBW adolescents were associated with increased odds of impaired vision, whereas primary visual cortical measures were not associated with the odds of impaired vision. Conclusions: Optic radiation and primary visual cortical structure are altered in EP/ELBW adolescents compared with controls, with the greatest alterations seen in those exposed to postnatal corticosteroids and those born earliest. Structural alterations to the optic radiations may increase the risk of impaired vision in EP/ELBW adolescents. [ABSTRACT FROM AUTHOR]

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