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There is a significant variability in the prevalence of psychotropic medication use among young autistic persons worldwide and this is under-studied in Australia. Apart from risperidone, approved by the Therapeutic Goods Administration to manage challenging behaviour, the appropriateness of other psychotropic medications prescribed to young autistic persons warrants scrutiny. This retrospective study aims to gain initial insight into the magnitude, types and indications of psychotropic medication use in autistic children and adolescents in Western Australia. We analysed de-identified data from 239 autistic children and adolescents ([less than or equal to] 21 years) who participated in the Western Australian Autism Biological Registry between 2011 and 2015 and who completed a questionnaire regarding medication use. One-quarter (n = 66, 28%) of young autistic people reported using a total of 137 medications. Most (n = 46, 70%) of those medicated were under 12 years of age; half (n = 33) were 6-12 years and a fifth (n = 13) were under 6 years. The most used medications were stimulants (n = 35, 53.0%), followed by antidepressants (n = 24, 36.4%), antiepileptics (n = 21, 31.8%), sedatives (n = 15, 22.7%) and antipsychotics (n = 14, 21.2%). These medications were mainly to manage attention deficit hyperactivity disorder, challenging behaviours, seizures, insomnia, undefined anxiety, depression and mood instability. While most autistic young people in the Western Australian Autism Biological Registry did not report using psychotropic medication, over a quarter were prescribed medications, primarily stimulants, to manage symptoms of attention deficit hyperactivity disorder. Various medications, including risperidone, were used to help manage challenging behaviours. Medication use should be studied more comprehensively in a larger cohort of autistic persons to confirm our current preliminary observations. Further, future studies should monitor the effectiveness and safety outcomes of such medications due to a limited understanding of their effectiveness in managing the atypical presentation of co-occurring disorders in young autistic persons.

Communication and interaction in neurotypical environments can be challenging for autistic individuals, potentially disrupting the parent-child relationship. In Relationship Development Intervention (RDI) that facilitates improved interactions between autistic children and their parents, RDI Consultants play key roles in enabling parents to develop skills that support the parent-child relationship. Parents follow the guidance of the Consultants to build their capacities to model reciprocal communications with their autistic children. Given the significant role played by the Consultant, their perspectives should be explored. Two research questions were explored: 1) What are the lived experiences of RDI Consultants in delivering RDI to autistic children and their families? 2) What are RDI Consultants' perspectives regarding the outcomes of engaging in RDI for autistic children and their families? Eleven RDI Consultants participated in semi-structured interviews to explore their experiences in using RDI. Interviews were conducted via Zoom. All interviews were transcribed verbatim and thematically analysed. Three main themes were produced: 1) RDI helps autistic children reach their potential; 2) Parents learn to embrace parenthood through RDI; and 3) Consultants form a team with parents. Overall, RDI was perceived to be beneficial in improving autistic children's social engagement, such as parent-child interactions, as well as enhancing parenting experiences. The results add to and extend the existing evidence of RDI, which may provide families of autistic children and those professionals who are working with these families more therapeutic choices to consider. Future research implications for parents and health professionals involved in therapies are discussed.

Objectives: Increasing childhood health literacy (HL) is a crucial means of improving health outcomes and reducing preventable deaths globally. Understanding how to best support children's HL development in schools is essential. However, identifying pedagogical strategies that develop children's HL relies on a fit-for-purpose measure. Currently, no universally accepted approach for measuring HL among children exists. The purpose of this paper was to propose and discuss how a curricular approach to assessing children's HL could provide a means to overcoming the challenges with existing children HL measures. Design/Methods: The discussion is framed by the key components of assessment -- outcome of interest, and collection, analysis and interpretation of data -- and is underpinned by contemporary HL and educational research. Setting: The Australian Curriculum is used to discuss the approach in practice. Results: A curricular approach to HL assessment suggests that HL assessment may work best when it is relevant to the child and their context, is integrated with other areas of the curriculum, allows children to demonstrate a wide range of HL skills and contains an element of open-endedness. Measurement could be guided by a rubric (underpinned by a taxonomy), and interpretation of scores consistently aligned with the learning intentions outlined in the curriculum. Conclusion: A curricular approach provides a contextually adaptive framework from which HL assessment tools for children can be developed

This study aimed to assess differences in emotion and elaboration quality between clinical and community child cohorts in both past reminiscing and future worry conversations. We analyzed 54 Australian parents (46 mothers, 8 fathers) and their 8- to 12-year-old children (M = 9.63, SD = 1.29; 28 boys, 26 girls) in reminiscing interactions. Dyads were recruited from local schools (community cohort, n = 26) or a children's psychology clinic waitlist (clinical cohort, n = 28). Clinical cohort children engaged in less emotion exploration in both past and future conversations, as did parents for future conversations. Elaboration quality did not differ. Parent-son dyads differed in the clinical cohort, exhibiting significantly lower emotion resolution than the community cohort, or parent-daughter dyads when discussing past events. These findings suggest that discussing anticipated negative events may be a relevant point of family-based intervention for anxious children. Additionally, this study highlights the importance of parent-son emotional discussion.

Research suggests that challenges associated with raising a child with an Autism Spectrum Disorder (ASD) can increase parents' risk for diminished parenting self-efficacy (PSE) and psychological wellbeing. The present study aimed to explore interrelationships between noteworthy predictors of PSE and parental psychological distress, including parental mastery beliefs and the co-parenting relationship amongst 122 Australian parents of children with autism. Results indicated that greater mastery beliefs and more favourable co-parenting relationships predicted greater PSE, and higher PSE predicted less psychological distress. PSE significantly mediated relationships between mastery beliefs and psychological distress, and between the co-parenting relationship and psychological distress. Findings have implications that can aid professionals to more effectively support parents raising children on the autism spectrum.

Playgroups are a unique form of early childhood provision involving parents and their children attending together. Parents' attendance at playgroups provides opportunities for involvement in play. However, little is known about parents' practices of co-play in playgroups and the potential for these practices to enhance children's play experiences in early childhood. Drawing on practice architectures theory, this paper identifies parents' practices of co-play in a community playgroup, and the enablers and constraints on those practices. Data were collected through ethnographic methods, which included participant observation and informal individual interviews. The findings show that parents' practices of co-play consider the child's needs and interests in ways that support development and enhance children's play in the community playgroup. This research contributes new knowledge about the range of co-play practices engaged in by parents with children in community playgroups.

Purpose: The aim of this research note is to introduce a new appraisal form, the Classroom Communication and Collaboration (C3) Appraisal, designed to evaluate communication and collaboration within classroom settings. Method: A comprehensive synthesis of the key skills from a broad range of publications on successful communication and collaboration in the classroom was conducted. The resulting appraisal comprises 39 items across six scales: crafting clear messages, appropriateness of communication exchange, active listening, pragmatics and discourse, communication breakdown, and collaboration. To demonstrate its application, an exemplar usage of the C3 Appraisal involving a hearing child and a child with hearing loss engaged in a collaborative learning task is presented. Results: The C3 Appraisal allowed for the quality and successfulness of the collaborative learning task between the two children to be assessed and quantified across the six scales. Conclusions: These findings highlight the utility of the C3 Appraisal as a valuable tool for evaluating communication and collaboration in classroom environments. Next steps are to test the reliability and validity of the C3 Appraisal on a large data set.

Data from 83,423 parent reports of temperament (surgency, negative affectivity, and regulatory capacity) in infants, toddlers, and children from 341 samples gathered in 59 countries were used to investigate the relations among culture, gender, and temperament. Between-nation differences in temperament were larger than those obtained in similar studies of adult personality, and most pronounced for negative affectivity. Nation-level patterns of negative affectivity were consistent across infancy, toddlerhood, and childhood, and patterns of regulatory capacity were consistent between infancy and toddlerhood. Nations that previously reported high extraversion, high conscientiousness, and low neuroticism in adults were found to demonstrate high surgency in infants and children, and countries reporting low adult openness and high adult neuroticism reported high temperamental negative affectivity. Negative affectivity was high in Southern Asia, Western Asia, and South America and low in Northern and Western Europe. Countries in which children were rated as high in negative affectivity had cultural orientations reflecting collectivism, high power distance, and short-term orientation. Surgency was high in Southeastern and Southern Asia and Southern Europe and low in Eastern Asian countries characterized by philosophies of long-term orientation. Low personal income was associated with high negative affectivity. Gender differences in temperament were largely consistent in direction with prior studies, revealing higher regulatory capacity in females than males and higher surgency in males than females, with these differences becoming more pronounced at later ages. [This article was written with 486 additional partners in the Global Temperament Project.]

Although individuals are exposed to a variety of pro-environmental influences in childhood, it is unclear which has the biggest impact on adult beliefs and behaviour. The aim of the current study therefore examined how formal sustainability education and childhood caregiver pro-environmental motivations, beliefs and behaviour, influence motivations and behaviours in adulthood. An Australian adult sample (n = 230) completed a survey measuring pro-environmental motivation, anthropogenic climate change beliefs and pro-environmental behaviour. Recollections of childhood caregivers' anthropogenic climate change beliefs and pro-environmental behaviours, and formal completion of sustainability education were obtained. Hierarchical multiple regression analysis found childhood caregiver pro-environmental behaviour significantly and uniquely predicted pro-environmental behaviour. Moderation analysis found no influence from formal sustainability education on this relationship. Caregiver and individual climate change belief were associated, but caregiver belief was not associated with pro-environmental motivation. No differences in adult pro-environmental behaviour were noted when considering childhood sustainability education. Results suggest transmission of anthropogenic climate change belief and pro-environmental behaviour occurs from childhood caregivers. Comparatively, formal childhood sustainability education was not significant in establishing ongoing pro-environmental behaviour patterns. This research adds to limited existing literature demonstrating caregiver impact on sustained pro-environmental behaviour and provides possible future direction for promoting sustainable behaviour.

The use of ethnographic approaches to study social settings has been steadily increasing over the last several decades. However, relatively few studies have been conducted with children, particularly in physical activity settings. This dearth of research may be due to the reported challenges of trying to 'fit in' in the world of children. This autoethnographic study provides insight into the approach utilised to conduct an ethnographic study with children and to become a 'friendly adult' in their world. The original six-month project focused on examining a cohort of 5--8year-old children to try and understand their engagement and relationship with physical culture. The project, conducted at a school in Victoria, utilised a range of ethnographic and child-centred methods to examine children's engagement in PE and on the playground. This autoethnographic exploration provided the primary author the ability to reflect on and unpack his ethnographic approach to gain a deeper insight into his role in the project. This study investigates the challenges and opportunities that the primary author faced in trying to study the lives of these children. These challenges and opportunities included, embracing and engaging with past experiences; balancing roles as a former teacher; and maintaining a 'friendly adult' role. Being accepted into the world of the children required navigating these challenges and using them as opportunities to engage with the children as the gatekeepers of the research. Exploring these challenges and opportunities provided significant insight into how to engage with children in ethnographic research and build trust and rapport. Unpacking this approach through autoethnography provides a guide for future researchers working with children.

Background: Many governments worldwide have established guidelines regarding children's physical activity and sedentary behaviors linked to positive health outcomes. While research has established low adherence to these guideline levels, it is unclear whether parents' knowledge, perceptions, and support around these behaviors might be barriers to adherence. Aims: This study examines parents' knowledge and agreement with guideline levels of physical activity, screen time, and sleep time, as well as their support for these behaviors. Methods: Parents of 5-12-year-old children who presented to a regional general practitioner (GP) office in New South Wales (NSW) responded to a survey regarding their child's physical activity, screen, and sleep time, as well as what they believed to be guideline levels, their perceived ideal levels, and the levels of support they provide for each of these behaviors. Results: Parents' perceived ideal levels for their child's physical activity and screen time were more ambitious than government levels and were consistent with sleep time guidelines. There were, however, few associations between parent support levels and children's actual or perceived ideal levels of these behaviors. Discussion: The findings suggest that parents' perceptions of ideal levels of physical activity and sedentary behavior may not hinder adherence to government guidelines. However, inconsistent, or ineffective support strategies can constrain adherence and thus be a viable intervention target.

Parents of dyslexic children often take on additional parental responsibilities as they seek to ensure fair and equitable access to education for their children. Often framed as advocacy, this paper explores the ways in which the term allyship may be well placed to represent the complex primary adjacent and vicarious disability experiences parents of dyslexic children have within schools. Drawing on interviews with 10 Australian parents, this study found that parents of dyslexic children felt they took on additional responsibilities to support their children within the school context and externally. This paper contributes a conceptual lens for viewing these activities as a form of allyship, rather than traditional understandings of advocacy. Findings highlight the need for greater recognition and understanding of the extensive responsibilities assumed by parents of dyslexic children and the ways in which their allyship roles within school settings can impact them.

Background: Australia has limited supports to help families where Fetal Alcohol Spectrum Disorder (FASD) impacts children and young people. National Organisation for Fetal Alcohol Spectrum Disorder Australia (NOFASD), in conjunction with the University of Otago, New Zealand, piloted and established a 7-week online program to assist caregivers to develop strategies and supports to help their families live well in a disabling society. Method: The online program, Families Linking with Families (FLWF), was delivered to 88 caregivers. They participated in the weekly 90-minute online program of talks, activities, and interactive conversations. A brief evaluation was undertaken. Results: Participants reported high levels of satisfaction with the content and helpfulness of FLWF. FLWF helped caregivers increase their knowledge of, and skills in, parenting children with FASD, and equipped caregivers to nurture positive peer-to-peer relationships. Conclusions: Specialist FASD caregiver education and support programs are beneficial for caregivers who care for children and youth with FASD. Further research through a randomised control trial could establish the efficacy of the program.

Students in East Asian locations often obtain high academic results in international high-stakes testing, but lower results on affective aspects of their schooling, such as sense of belonging. These findings indicate the need for more holistic research into children's lifeworlds, including their experiences of school. In this article, we draw on a survey with 627 Year 4 students in three global cities in the Asia Pacific (Hong Kong, Singapore, and Melbourne), exploring dimensions of their perceptions of school. Responses from students were generally positive in terms of sense of school belonging and student identity. Students who responded positively in terms of belonging and student identity were more likely to want academic activities to occur more often. The article adds to the existing literature by offering an exploratory consideration of the relationships between sense of belonging, student identity, and school activity preferences of Year 4 students in Hong Kong, Singapore and Melbourne. It is argued that all of these are essential factors that need to be considered and incorporated in policy planning and curriculum development.

Background: Early identification and intervention for hearing loss is important for supporting language development. Despite this, parents are required to overcome barriers to access hearing assessments for their children. Aims: To identify the enablers and barriers to accessing hearing assessments for Australian children identified by their parents, and to compare between metropolitan, regional and rural areas. Methods & Procedures: This sequential, explanatory mixed-methods study was undertaken online and included participants in metropolitan, regional and rural area of Queensland, New South Wales, Victoria, South Australia, Western Australia and the Northern Territory. A total of 56 participants participated in the surveys, and 10 participated in semi-structured interviews. Outcomes & Results: Participants in metropolitan areas were more likely to have services in their area; however, access to hearing assessment was related more to individual circumstances (including health literacy skills) rather than geographical location. Many participants experienced long wait times, reduced flexibility, and a lack of audiologists experienced in working with children. Conclusions & Implications: Barriers to hearing assessments (which assist with early identification and intervention for hearing loss) should be addressed so that children have access to clear auditory information to assist with their speech and language development.

Practitioners who work with children and young people such as educators, psychologists, and social workers, are required to understand and respond to various sexual behaviours in children and young people. However, there is a dearth of training programmes dealing with sexual development. To reduce over- and under-reporting of risk, which can have serious adverse outcomes, it is essential to educate practitioners in understanding and responding appropriately to sexual behaviours. This study evaluated Traffic Lights® professional development training programme -- a one-day programme offered across Queensland, Australia, with the goal of educating practitioners and promoting safe and respectful sexual health among children and young people. Thirty postgraduate psychology students working with/interested in working with children and young people received Traffic Lights® training, and accuracy of understanding and responding to sexual behaviours presented in scenarios was assessed pre- and post-training. Participant responses were scored using criteria developed by a local sexual health organisation's research specialists. Findings revealed no significant improvement in understanding and responding to sexual behaviours in children and young people. Implications of this study include recommendations for small-scale evaluations with sexual health experts and follow-up research, which is critical given the need for evidence-based practice in this area.

Little is currently known about the autism spectrum disorder (ASD)-related difficulties of females narrowly below the ASD diagnostic threshold and whether the disorder conceptualisation should be broadened to capture their presentations. We extracted fine-grained information from the assessment reports of 222 children who were either diagnosed with ASD (n = 156) or not diagnosed despite many ASD traits (n = 78). Females were less likely than males to meet Criterion B3 (restricted interests), and this was especially the case for subclinical (non-ASD) females. Non-ASD females lacked sufficient atypicality for diagnosis in several key domains, particularly Criterion A1 (social-emotional reciprocity). Evidence of sex/gender-specific restricted interests and stereotypical behaviours was found. Many behaviours differed in the extent to which they predicted the ASD diagnostic result for males and females, perhaps suggesting that sex/gender influences how ASD-related behaviours are perceived. We discuss these findings in the context of underdiagnosis of ASD in females and propose adjustments to assessment protocols.

'The Children's Sensorium -- art, play and mindfulness for post-pandemic recovery' was an exhibition that brought together sensory-based art installations featuring First Nations Connection to Country with mindfulness and embodiment strategies to enhance well-being for children (ages 4-11). As the COVID-19 pandemic slowly moves from the centre of public attention, we are starting to gauge the impact of the world's longest lockdown in Melbourne, Australia, on children's well-being and resilience. 'The Children's Sensorium' exhibition was created with children and their well-being in mind. In this article, we focus on insights from the exhibition evaluation and address the ways artistic and sensory-based mindful engagement can support children's well-being and resilience. Evaluation of The Sensorium exhibition provides a view into the potential of sensory-based artworks to create a stimulating environment, positive emotions, mindful awareness of their senses and the environment and a sense of playful agency for children. The Sensorium provoked a fresh way of thinking about art exhibitions for children: one that centred a child-friendly, strength-based artistic space where children felt agency to be creative and explore the complexity of their emotions, hopes and fears in the wake of the global pandemic.

Routinely collected data help estimate the prevalence of autism spectrum disorder (ASD) in jurisdictions without active autism surveillance. We created a population-based cohort of 1,211,834 children born in 2002-2015 in New South Wales, Australia using data linkage. Children with ASD were identified in three datasets -- disability services, hospital admissions, and ambulatory mental health data. The prevalence of ASD in the cohort was 1.3% by age 12 and prevalence at age 6 increased an average of 4.1% per year (95% Confidence Interval, 3.3%, 4.8%). Most children with ASD were identified in disability services data (87%), although data linkage identified 1,711 additional cases that were more likely female, older at first contact, and living in major cities and less disadvantaged areas.

The need for a new measure of social-emotional wellbeing for children 6--12 years emerged in our collaboration with schools and community agencies in a disadvantaged region of Brisbane, Australia. Our search for an age-appropriate medium led us to develop "Clowning Around", a computer game generating data which was assessed for validity and reliability in Study 1 (N = 3,461), revealing four wellbeing factors with satisfactory properties. The imperative to support autonomous use at scale led to development of the "Rumble's Quest" user management system and game app, incorporating a slightly modified version of the measure. Reassessment of the factor structure (Study 2: N = 4,333) supported Study 1 results but extended factors to five: School Attachment, Social Wellbeing, Emotional Wellbeing, Family Support, and Behavioral Conformity. The measure exhibits sound convergent and concurrent validity and is a reliable and practical tool for data-guided service planning and evaluation, and for monitoring child wellbeing trends.

Research documenting the effects of trauma in early childhood describes the profound and long-term consequences of child abuse and neglect on the developing brain and the subsequent deficits in critical cognitive and social development. While educators have increasingly endeavoured to understand this impact and become more 'trauma-informed' in their classrooms, little is understood about the process or what it requires of the teacher. This study explores the experiences of six teachers in regional Victoria, Australia, who sought to apply their neuroscientific understandings in their classrooms, and identifies the many personal and professional challenges they confronted. Critical reflection was employed both to deeply explore their collective experiences and to support them in this complex work. Findings describe the nuanced and interpersonal nature of trauma-informed education and imply the need for critical reflection in teacher practice as an important element in the process.

Compelling international evidence illustrates the potential of reading for pleasure for enhancing student reading achievement along with other learning and wellbeing outcomes. Yet profound challenges exist for nations seeking to encompass attention to students' volitional reading. In this paper we critically review the growing research evidence in this area by drawing systematically on cognitive psychological studies of reading attainment and motivation, educational studies of classroom practice, and the work of literary scholars and medical professionals. We consider and critique the methodologies deployed and read between the lines, exposing contradictions and complexities across this interdisciplinary field before considering the demands of operationalising this agenda in education. Through a dual focus on England and Australia, where, exemplifying international trends, young people's voluntary reading continues to decline, we examine difficulties and dilemmas which play out in policy and practice contexts. Our points of commonality and comparison surface key issues for consideration in countries working to reconcile the push and pull of performativity and reading for pleasure agendas in order to nurture children's volitional reading. To conclude, we examine ways forward for research, policy and practice which deserve increased global attention, and offer future-focused recommendations to advance this significant social justice agenda.

Remote Education Tutors (RETs) enact crucial roles in Australian distance schooling, by living with families who reside in geographically isolated locations and supporting their school age children's learning. As part of a larger research project, this paper presents a study of four RETs derived from semi-structured interviews conducted in their respective home schoolrooms. Informed conceptually by Bronfenbrenner's socio-ecological systems theory (1979, 1986), the thematic analysis generated four substantive themes related to the participants' lives and work: pedagogical competencies; healthy relational dynamics; optimism with a solution focus; and substantive occupation. More broadly, the RETs contribute indispensably to the educational success and the lifestyle sustainability of the school age children with whom they work, yet currently there is no formal recognition of that contribution, just as there is no viable career pathway for RETs seeking to become qualified teachers. Accordingly, they are as occupationally invisible as the remote living families whom they serve.

Executive function (EF) is critical to students' academic behaviors and well-being. Environmental influences, particularly teacher-student interaction (TSI), play a key role in enhancing EF development. Previous studies have linked TSI quality to children's EF, yet the relationships between subdimensions of TSI--such as closeness, conflict, dependency, emotional support, classroom management, and instructional support--and EF outcomes remain unclear. Moreover, it is unclear whether these relations hold true across different cultural contexts. From an initial pool of 14,915 articles, in this meta-analysis, we considered 84 empirical studies across 18 cultural regions, revealing that TSI subdimensions are consistently related to EF with small-to-medium effect sizes. The analysis also identified statistically significant moderating factors, such as individualism, power distance, EF type, EF instrument, and socioeconomic status. Notably, stronger TSI-EF correlations were found among children from cultures with low-individualism and high-power-distance, as well as among children from higher socioeconomic backgrounds. These patterns were particularly pronounced in studies measuring hot EF through adult-reported data. This comprehensive meta-analysis bridges knowledge gaps in TSI-EF dynamics, and supporting theories, such as attachment theory, social learning theory, and socio-cultural theory within educational settings. Crucially, it provides cross-cultural perspectives showing how cultural and contextual factors may intertwine with TSI-EF interactions.

Interoceptive awareness refers to the way in which we perceive and interpret our body signals. It has links to sensory processing and how we understand and respond to emotion. Current research lacks evidence as to whether gender influences interoceptive awareness in children. In occupational therapy practice, clinicians use a family-centered approach to understand both child and parent perspectives to support participation, yet there is a gap in the literature that speaks to any differences in child- and parent-reports of child interoceptive awareness. This exploratory study investigated comparisons of gender and child- and parent-reported child interoceptive awareness. Twenty-seven pairs of typically developing school-aged Australian children, and one of their parents participated in the study by completing the Multidimensional Assessment of Interoceptive Awareness - Youth (MAIA-y). Independent-samples t-tests revealed no statistically significant differences in child interoceptive awareness between boys and girls. Comparing child-report (M = 3.837, SD = 0.509) and parent-report (M = 3.326, SD = 0.785) of child interoceptive awareness elicited one statistically significant difference on the MAIA-y "Emotional Awareness" subscale (t(52) = -2.840, p = 0.006). This exploratory study provides preliminary evidence relating to gender differences regarding interoceptive awareness in children and for using both a child- and family-centered practice approach in pediatric occupational therapy practice.

This article reports on the findings of a qualitative case study exploring the auditory skill "deficits" of a twice-exceptional male student who had multiple exceptionalities, including deficits in auditory processing skills, which contributed to learning issues and social connection difficulties in unique ways. Auditory skill deficits are an under-researched area in the field of gifted education, yet these are requisite skills necessary for learning in school. For this case study, auditory deficits were related to phonological processing, auditory sequential memory, lowered auditory recall abilities, and weaknesses in auditory analysis skills. The role that these auditory skill deficits played in the educational experiences of this young person is explored. Findings suggest that the presentation and impact of auditory processing deficits is very individual.

This paper presents the provocation that 'unmediatised liveness', or experiences not filtered through digital technology, is vital to performances that promote recovery, resistance, and survival among young people in response to the climate crisis. Our provocation draws from interviews conducted with youth theatre and performance practitioners in Australia whose work addresses the climate crisis holistically across disaster preparedness, first response, disaster recovery, and climate activism. We argue that while mediatised interactions remain a critical element of contemporary youth culture and performance, unmediatised co-presence, artistic collaboration, community action, and activism are crucial in the high-stakes context of Australia's climate crisis.

Playwork is a recognised profession in the United Kingdom (UK) and is currently a growing area of interest internationally. However, debates about the nature and purpose of playwork have raged in the playwork field since the profession was invented in the early adventure playgrounds. This study is the first to capture data about what the now international playwork workforce understands to be the purpose of playwork. The International Playwork Census (IPC) was an online survey which asked participants from 19 different countries about their knowledge and experience of playwork. This paper reports on one question from the IPC: what is the purpose of playwork? A thematic analysis was undertaken from 193 responses on what was considered "the purpose of playwork" and three themes emerged: Facilitate and Provide for children's play; Support and Advocate. This paper describes how these three themes reflect both the historical change in understandings of the purpose of playwork and how different understandings of playwork are developed through the experience of practitioners working in range of different contexts.

This repeated-measures study examined the effects of a hybrid of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) with other therapeutic approaches at a community-based clinic in Perth Western Australia among a sample of children and young people overwhelmingly experiencing multiple forms of maltreatment and with complex family situations (i.e., family and domestic violence, parental mental health, parental substance abuse). Drawing on 1713 individual client records from between 2017 and 2020, the researchers identified 113 children and young people with viable pre-post treatment assessments including 78 on the TSCC, 36 on the TSCYC, and 12 on the CBCL. Significant improvements on most clinical scales were identified on the TSCC and TSCYC. Sub-analysis of the TSCC results found no differences across gender, age, care status, therapy funding source, and the presence of sexual abuse in the rate of improvement on trauma symptoms. Overall, the study highlights that integrating different therapy approaches for populations with multiple and complex trauma symptoms accessing community-based services can be useful for supporting the delivery of TF-CBT for difficult to treat populations. [ABSTRACT FROM AUTHOR]

Children and adolescents (henceforth "children") with both attention-deficit/hyperactivity disorder (ADHD) and anxiety experience greater difficulties than children with either alone, though qualitative methodologies are yet to be used to understand the challenges this population experiences. We aimed to explore parent-reported daily impacts of co-occurring anxiety in children with ADHD (ages 8–13 years). Participants were enrolled in an Australian trial evaluating an adapted anxiety intervention and were eligible if their child met diagnostic criteria for ADHD plus separation, social, and/or generalized anxiety disorder. A baseline measure of life impacts associated with child anxiety captured situations parents reported were difficult, due to their child's anxiety. Reflexive thematic analysis of free-text responses (N = 203) facilitated new insights via inductively generating key themes. Three overarching themes highlighted (1) child difficulties with everyday situations and processes due to their anxiety; (2) the nature of the child's anxiety being pervasive and unrelenting; and (3) the strain placed on the child's family system. This study enhances understanding of daily impacts associated with co-occurring anxiety and ADHD and may contribute to an improved understanding of support needs. Results reiterate the need to identify co-occurring difficulties in children with ADHD and support both children and their families. [ABSTRACT FROM AUTHOR]

Objective: Describe the ear and hearing outcomes in Aboriginal infants in an Australian urban area. Design: Aboriginal infants enrolled in the Djaalinj Waakinj prospective cohort study had ear health screenings at ages 2-4, 6-8 and 12-18 months and audiological assessment at ∼12 months of age. Sociodemographic, environmental characteristics, otoscopy, otoacoustic emissions, tympanometry and visual reinforcement audiometry data were collected. Study Sample: 125 infants were enrolled in the study; 67 completed audiological assessment, 62, 54, and 58 of whom attended ear screenings at 2-4, 6-8 and 12-18 months. Results: Of the children that attended the audiological assessment, 36.5%, 50% and 64.3% of infants had otitis media (OM) at 2-4, 6-8 and 12-18 months. Using a 10 dB correction factor, 44.8% of infants had hearing loss (HL) (≥ 25 dB HL) at ∼ 12 months of age. More males (X2=5.4 (1df, p = 0.02)) and infants with OM at audiological assessment (X2=5.8 (1df, p = 0.02)) had HL. More infants that used a pacifier at 12-18 months of age had HL (X2=4.7 (1df, p = 0.03)). Conclusion: Aboriginal infants in an urban area have high rates of HL and OM, which requires early surveillance and timely treatment to reduce the medical and developmental impacts of OM and HL. [ABSTRACT FROM AUTHOR]

The association of air pollution and greenspace with respiratory pathogen acquisition and respiratory health was investigated in a community-based birth-cohort of 158 Australian children. Weekly nasal swabs and daily symptom-diaries were collected for 2-years, with annual reviews from ages 3-7-years. Annual exposure to fine-particulate-matter (PM2.5), nitrogen-dioxide (NO2), and normalised-difference-vegetation-index (NDVI) was estimated for pregnancy and the first 2-years-of-life. We examined rhinovirus, any respiratory virus, Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae detections in the first 3-months-of-life, age at initial pathogen detection, wheezing in the first 2-years, and asthma at ages 5-7-years. Our findings suggest that higher NDVI was associated with fewer viral and M. catarrhalis detections in the first 3-months, while increased PM2.5 and NO2 were linked to earlier symptomatic rhinovirus and H. influenzae detections, respectively. However, no associations were observed with wheezing or asthma. Early-life exposure to air pollution and greenspace may influence early-life respiratory pathogen acquisition and illness. [ABSTRACT FROM AUTHOR]

The age of the onset of menstruation, termed menarche, has been declining for decades worldwide. Approximately 12% of Australian girls reach menarche between eight to 11 years of age. Current health and physical education subject guidelines from the Australian Curriculum Assessment and Reporting Authority state that puberty education should be introduced to students between year levels five to six (ages 10–12) when many have already begun puberty. To explore how girls experiencing early menarche are currently supported in Australian primary schools, semi-structured telephone interviews were conducted with 15 primary school staff from separate schools, including teachers, principals, a school services officer, and a school counsellor. Thematic analysis identified three main themes, (1) the prevalence of deficit models of early menarche and children's capacity to know; (2) gendered gatekeeping of menstruation knowledge; and (3) systemic barriers and inconsistencies in menstruation education. Our analysis complements but extends recent calls for improvements to menstruation education in Australian schools. Affirmative menstrual support practices and facilities are needed in primary schools to normalise and encourage conversations with students about menarche and menstruation irrespective of age, gender, class or culture. [ABSTRACT FROM AUTHOR]

This study aimed to assess differences in emotion and elaboration quality between clinical and community child cohorts in both past reminiscing and future worry conversations. We analyzed 54 Australian parents (46 mothers, 8 fathers) and their 8- to 12-year-old children (M = 9.63, SD = 1.29; 28 boys, 26 girls) in reminiscing interactions. Dyads were recruited from local schools (community cohort, n = 26) or a children's psychology clinic waitlist (clinical cohort, n = 28). Clinical cohort children engaged in less emotion exploration in both past and future conversations, as did parents for future conversations. Elaboration quality did not differ. Parent-son dyads differed in the clinical cohort, exhibiting significantly lower emotion resolution than the community cohort, or parent-daughter dyads when discussing past events. These findings suggest that discussing anticipated negative events may be a relevant point of family-based intervention for anxious children. Additionally, this study highlights the importance of parent-son emotional discussion. [ABSTRACT FROM AUTHOR]

Children's mental health symptoms' development can be characterized by both continuity and discontinuity. However, existing studies ignore the potential discontinuity in children's internalizing symptoms' development. Hence, the current study examines continuous and discontinuous developmental trajectories using representative data from a sample of 2792 children (49.10% females) from the Growing Up in Australia cohort assessed seven times (ages 4, 6, 8, 10, 12, 14, 16). Longitudinal measurement invariance analyses revealed that internalizing symptoms were comparable over time. Linear, quadratic, and piecewise latent growth curve models were deployed to estimate the trajectory of internalizing symptoms from early childhood to late adolescence. The analyses showed that internalizing symptoms were characterized by a quadratic-quadratic piecewise growth curve comprising two distinct phases of upward concave growth. Internalizing scores reduced steadily between ages 4 and 8 years but exhibited a slight upward curvature between ages 8 and 10 years. By age 14 years, the trajectory remained relatively stable but spiked between age 14 and 16 years. The two phases of internalizing symptoms' development were largely unrelated. Overall, the study adds to the knowledge about the development of internalizing mental health from early childhood to late adolescence and highlights the need for additional support in late adolescence. [ABSTRACT FROM AUTHOR]

This paper explores the cultural conceptualisation of children's social identity and status through memorialisation, based on the study of children's grave markers and plots in five South Australian cemeteries (from colonisation to the present), with an age range from infant (including stillborn) to 20 years. The idea of childness, the differing conception of being or being labelled a child, was used as a measure to identify the degree of variation in child identity realised by child-only and family grave markers, showing both change and continuity in the representation of children through family choices of form, style, wording, motif, spatial arrangement and grave furniture. Archaeological evidence of childness was observed through representations of smallness, innocence, domesticity, play, temporality and the distinct emotional nature of the parent-child relationship. Notably in the latter period of study, within the context of lower child mortality, revised understandings of child identity and status were observed representing the social re-evaluation of prenatally deceased and stillborn children. [ABSTRACT FROM AUTHOR]

Background: Developmental Dysplasia of the Hip (DDH) describes a spectrum of abnormalities that impact the normal function of the joint. These abnormalities are detectable during infancy using physical assessment, universal ultrasound, or a combination of both. In Australia, child health nurses predominantly screen for this disease using physical assessment. The aim of this study was to determine if child health nurses can accurately screen for DDH using physical assessment. Methods: This Australian study estimated the accuracy and utility of child health nurses using physical assessment to screen for DDH by comparing it to a handheld ultrasound device. Results: This study (N = 44) concluded that using a point prevalence study design, child health nurses in Australia are unable to accurately assess for DDH in infants using physical assessment; overall, clinicians had 50.5% sensitivity (95% CI, 15.7 to 84.3), a specificity of 75.0% (95% CI, 57.8 to 87.9), and 71.3% accuracy (95% CI, 55.6 to 83.9). Conclusion: This study suggests that child health nurses cannot screen for DDH using physical assessment. Understanding education, experience and what assessments are used suggests that the utility of nurses performing DDH screening requires further investigation. [ABSTRACT FROM AUTHOR]

Background Intussusception is the primary cause of acute bowel obstruction in infants. The majority of cases <2 years of age are classed as idiopathic, with viral infection implicated as one of the causes. Coronavirus disease 2019 (COVID-19) public health measures led to significant decreases in communicable disease prevalence. During these times, reductions in intussusception frequency were greater than would be expected with our previous understanding of its infectious etiology. Methods We conducted a retrospective, multistate, ecological study over a 12-year period. Monthly case numbers of "intussusception"-coded admissions (code K56.1; International Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification) were acquired from state-wide admissions data sets from New South Wales, Victoria, and Queensland, representing 77.62% of the eligible Australian population. These counts within differing jurisdictional lockdowns were compared with non-lockdown periods in order to investigate a correlation between intussusception frequency and lockdown periods. Results We found a negative association between intussusception frequency and lockdown periods in both eligible states. The largest reductions were seen in the <2-year age groups, with Victoria experiencing a 62.7% reduction (rate ratio, 0.37; P <.001) and New South Wales a 40.1% reduction (0.599; P =.006) during lockdown times. Controls for variations in lockdown restrictions between both regional and metropolitan areas also showed expected decreases. Conclusions Our ecological study demonstrates significant decreases in the frequency of pediatric intussusception admissions during the COVID-19 lockdown periods. The unexpected magnitude of the reductions suggests that the true proportion of infectious disease-caused idiopathic intussusception is greatly underestimated. [ABSTRACT FROM AUTHOR]

Background: The climate crisis is a significant risk to the health and wellbeing of children, young people, and future generations. While there are calls for children and young people's engagement in climate decision making, current power structures limit their participation. This paper aimed to understand children's perspectives about the impact of the climate crisis on their futures, their ability to influence climate decisions, and strategies and mechanisms to facilitate their greater engagement in decisions made about the climate crisis. Methods: Online in-depth interviews were conducted with n = 28 children (aged 12–16 years) across Australia. Photo elicitation techniques were used to prompt discussion about how the climate crisis impacted their futures, their ability to influence climate decisions, and strategies and mechanisms to engage them in climate decision making. A reflexive approach to thematic analysis was used to construct three themes from data. Images were analysed for ascribed meanings. Results: First, participants stated that they and future generations will inherit the climate crisis from older generations, specifically decision makers. Second, they described a need to address a range of age-related barriers that limit children and young people's engagement in climate decision making, including perceptions about their capabilities. Finally, they discussed strategies and mechanisms to embed children and young people's perspectives within climate decision making, including at civic and political levels. Conclusions: Children and young people have the right to be involved in decisions made about the climate crisis which significantly impact their futures, including their health and wellbeing. They argue for structural changes to embed their views in climate decision making, and describe a range of engagement strategies and mechanisms to structure their perspectives and knowledge with decision making processes. Furthermore, genuine involvement of children and young people in climate discussions must avoid youthwashing and tokenistic participation. The public health community can help address barriers to youth participation in climate action and should actively engage and collaborate with children and young people to facilitate their political and democratic influence over the climate crisis. This involves making room and creating an accessible seat at the decision making table to ensure their perspectives are embedded in climate decisions. [ABSTRACT FROM AUTHOR]

Issue Addressed: Regular physical activity is important for children's health. Parkrun supports communities to deliver free, weekly, 5 km events in 22 countries around the world and is the largest physical activity model delivered at scale in the world. Junior parkrun aims to encourage children aged 4–14 years to be active outdoors through providing safe, cost‐free and non‐competitive weekly timed walk, run or jog over a 2‐km distance. The aim of this study is to evaluate the junior parkrun pilot in Australia. Methods: A process evaluation was conducted using routinely collected data of junior parkrun participants, as well as a self‐completed questionnaire. Results: A total of 1827 children had registered and participated in at least one junior parkrun over the course of the pilot period. Participants had, on average, attended 10% of the junior parkrun events including and subsequent to their first participation by the end of the study period. Majority of parents (61%) said that junior parkrun had increased their child's physical activity either a little or a lot, and most agreed or strongly agreed that junior parkrun was fun (90%), enjoyable (91%), energising (85%) and challenging (70%). Conclusion: The junior parkrun pilot appears to show promise in Australia for enabling children to engage in physical activity, in their local communities in a fun and inclusive way. So What: Parkrun junior can co‐exist with other organised sports programs; however, it can also specifically target those not participating in any sports, given the high levels of enjoyment in a non‐competitive, non‐team environment. [ABSTRACT FROM AUTHOR]

The profound development that occurs during the first five years of a child's life may contribute to military families with young children facing unique challenges during reintegration. Yet, little is known about the reintegration experiences of military families with young children, and less so from the perspectives of non-deployed parents and families outside of the US. In this qualitative study, we explored the reintegration experiences of Australian Defense Force (ADF) families with young children (five years and younger). Through written responses to open-ended prompts, ADF service members (n = 9) and their non-deployed spouses (n = 38) reflected on periods of reintegration and discussed their family's adaption during this time. Using thematic analysis, six themes representing the reintegration experiences of these families were generated from the data. Four themes were generated from the combined experiences of service members and non-deployed parents, while a further two themes were generated from the experiences of non-deployed parents only. Relational and parenting challenges were at the forefront of reintegration experiences. These findings offer meaningful implications for practice and research to improve the quality of parent-child relationships and enhance outcomes for military families with young children during reintegration. [ABSTRACT FROM AUTHOR]

Physical activity (PA) during childhood and adolescence is important for the accrual of maximal peak bone mass. The precise dose that benefits bone remains unclear as methods commonly used to analyze PA data are unsuitable for measuring bone‐relevant PA. Using improved accelerometry methods, this study identified the amount and intensity of PA most strongly associated with bone outcomes in 11–12‐year‐olds. Participants (n = 770; 382 boys) underwent tibial peripheral quantitative computed tomography to assess trabecular and cortical density, endosteal and periosteal circumference and polar stress‐strain index. Seven‐day wrist‐worn raw acceleration data averaged over 1‐s epochs was used to estimate time accumulated above incremental PA intensities (50 milli‐gravitational unit (mg) increments from 200 to 3000 mg). Associations between time spent above each 50 mg increment and bone outcomes were assessed using multiple linear regression, adjusted for age, sex, height, weight, maturity, socioeconomic position, muscle cross‐sectional area and PA below the intensity of interest. There was a gradual increase in mean R2 change across all bone‐related outcomes as the intensity increased in 50 mg increments from >200 to >700 mg. All outcomes became significant at >700 mg (R2 change = 0.6%–1.3% and p = 0.001–0.02). Any further increases in intensity led to a reduction in mean R2 change and associations became non‐significant for all outcomes >1500 mg. Using more appropriate accelerometry methods (1‐s epochs; no a priori application of traditional cut‐points) enabled us to identify that ∼10 min/day of PA >700 mg (equivalent to running ∼10 km/h) was positively associated with pQCT‐derived measures of bone density, geometry and strength in 11–12‐year‐olds. Highlights: Accelerometry methods that are commonly used to assess free‐living, bone‐relevant physical activity (PA) are not well suited to measuring bone‐specific characteristics of PA (short bursts of high‐impact activity).Processing raw acceleration data using much shorter epochs (1‐s) and using incremental 50 mg intensity thresholds (rather than traditional, broad intensity thresholds) enabled a bone‐specific, beneficial intensity to be identified.The methods outlined provide a means for more precisely assessing free‐living bone‐relevant PA and permit the transparent and reproducible analysis of raw accelerometry data, which will enhance our ability to quantify dose‐response associations in the future. [ABSTRACT FROM AUTHOR]

People living in residential aged care homes in Australia often have limited opportunities for meaningful social engagement. The present study aimed to characterize the state of intergenerational programs in residential aged care within a nationwide Australian sample. A total of 572 valid survey responses were received. A large number of aged care homes had existing programs, but only 18.2% had active programs; 44.4% reported their programs as temporarily suspended, predominantly due to COVID-19. The most common activities included singing (67.8%), games (56.8%), reading (51.1%) and craft (41.5%). Mental health and wellbeing, opportunity to socialize, and connection with the community were considered as the main benefits. There is consensus on the benefits of well-placed programming and engagement. Several barriers and challenges to engagement exist, including the COVID-19 pandemic. Aged care homes need adequate information and support to increase their ability to offer intergenerational programs between residents and community members. The survey provides insight into intergenerational programs in Australian aged care homes during the COVID-19 pandemic Staff completing the survey reported positive views of the benefits of the programs to both old and young participants The findings highlight the diversity of participants' ages, places, mode of delivery and types of activities – frequently singing, games, reading and craft, but also dancing and reminiscence, and even robotics. While COVID-19 posed significant challenges, there were creative solutions including written letters and shared journals, virtual interaction and simple strategies such as access to areas where residents could observe children at play or in passing. [ABSTRACT FROM AUTHOR]

Based on the socioecological conceptual model, the physical environment within the home, childcare and neighbourhood domains are key factors that influence preschool children's physical activity; however, the relative importance of each of these domains for preschool children's physical activity is unclear. We explored the physical environment characteristics within three latent profiles of 115 preschool children aged 2–5 years based on where they accumulated moderate-to-vigorous physical activity (MVPA) across five GPS-derived environmental domains. The three profiles were "Active at home" (n = 41), "Active except close to home" (n = 61), and "Active except in local neighbourhood" (n = 13). Compared to other profiles, "Active at home" had fewer parks and playgrounds within their 500–1600 m neighbourhood. Findings suggest preschool children's MVPA profiles are reflections of their physical environmental opportunities. [ABSTRACT FROM AUTHOR]

Quality early care and education (ECE) presents an unparalleled opportunity to avert disadvantage and promote children's development. Mealtimes are essential daily routines, yet are often overlooked in research on ECE quality. This paper crystallises a composite case study of ECE mealtimes in highly disadvantaged communities by combining Departing Radically in Academic Writing (DRAW) methodology with parent surveys, scorings of educator‐child interactions (inCLASS), and field notes. Poverty is perpetuated in these centres: children do not have enough food, and educator‐dictated feeding practices restrict children's opportunities to exercise their agency and learn. Systemic policy action is needed to address poverty in ECE. [ABSTRACT FROM AUTHOR]

Objective: This paper explores Australian military families' use of social media and digital communication to maintain and strengthen parent–child relationships during military deployments. Background: The physical and emotional well‐being of children and partners of military serving members is affected by service. Maintaining positive family relationships between military members and their children during periods of absence (including deployment) is important for parental relationships as well as the well‐being of the child. Method: A qualitative meta‐analysis is used to collate data from two previous studies of Australian Defence Force (ADF) families with children, in order to generate a new data set from which novel insights were drawn. Results: Families show a preference for social media and digital communication methods, and digital technologies affordances and practicalities are well suited for Defence families with children. There are a range of benefits; digital technologies are used to strengthen relationships between children and their deployed parent. The study highlights a range of challenges for deployed parents as well as points to the work required from the at‐home parent in facilitating these connections. Conclusion: Maintaining positive family relationships between military members and their children during times of absences is important for both relationships. This paper explores how ADF families use social and digital communication during military absences and outlines the role these technologies play as a medium for strengthening familial relationship. Implications. The findings of this paper highlight the importance of digital and social communication technologies for supporting families during absences. This has implications for the ADF, who might look to reduce members' access to such communication for security concerns. Reduced family well‐being may also have impacts on retention, a key issue for military organizations. Accordingly, the findings of this paper may be used to inform decisions about restricting internet and social media access for deployed military members. [ABSTRACT FROM AUTHOR]

Emphasis on continuous infant sleep overnight may be driven by parental concern of risk to child mental health outcomes. The Mercy Pregnancy and Emotional Wellbeing Study (MPEWS) examined whether infant sleep at 6 and 12 months postpartum predicts anxiety disorders at 2–4 years, and whether this is moderated by maternal depression, active physical comforting (APC) or maternal cognitions about infant sleep. Data included 349 women and infants. Infant sleep was measured using the Brief Infant Sleep Questionnaire and child anxiety disorders by the Preschool Age Psychiatric Assessment. The risk of developing generalised anxiety or social phobia disorders at 3–4 years was reduced by 42% (p = 0.001) and 31% (p = 0.001), respectively, for a one standard deviation increase in total sleep at 12 months. No other infant sleep outcomes were associated. Maternal depression, APC and cognitions about infant sleep did not significantly moderate these relationships. Focus may need to be on total infant sleep, rather than when sleep is achieved. Highlights: To assess whether infant sleep outcomes (i.e., frequency of nocturnal wakes; nocturnal wakefulness and total sleep per day) at 6 and 12 months predict early childhood anxiety disorders at 3–4 years of age.Maternally reported infant sleep outcomes were not associated with the risk of developing early childhood anxiety disorders at 3–4 years.It may be total infant sleep, irrespective of when sleep occurs or night waking and, independently, active physical comforting that requires further investigation. [ABSTRACT FROM AUTHOR]

Background: Achondroplasia, the most prevalent skeletal dysplasia, stems from a functional mutation in the fibroblast growth factor receptor 3 gene, leading to growth impairment. This condition presents multifaceted medical, functional and psychosocial challenges throughout childhood, adolescence and adulthood. Current management strategies aim to minimise medical complications, optimise functional capabilities and provide comprehensive supportive care. Vosoritide (trade name: VOXZOGO®, BioMarin Pharmaceuticals) is the first disease-modifying pharmaceutical treatment approved for the management of patients with achondroplasia and became available in Australia in May 2023. Methods: Standardised clinical guidelines for its optimal use are not yet widely available. To address this gap, a multidisciplinary Australian Vosoritide Working Group, comprising 12 experts with experience in achondroplasia management from across Australia, developed recommendations to guide the use of vosoritide in clinical practice. Results: The recommendations, which are expert opinions of the Australian Vosoritide Working Group, aim to (i) standardise the use of vosoritide across Australia, (ii) support the safe clinical rollout of vosoritide and (iii) support universal access. Conclusions: These recommendations have been developed for healthcare professionals and institutions that are engaged in using vosoritide in the management of achondroplasia and will be revised using a formal framework for clinical guideline development once more evidence is available. [ABSTRACT FROM AUTHOR]