Search

Experiences of family conflict are common in young people's accounts of homelessness, yet in‐depth explorations and conceptualisations of these experiences remain sparse. Drawing on focus group discussions with 29 participants, this article explores the accounts of young people and carers and parents about the dynamics, interactions and characteristics of family conflict. Findings highlight the primacy of verbal insults, criticisms or threats, as well as acts of aggression and violence in young people's and parent's understandings of family conflict. Feelings of mistrust, instability and a lack of safety also pervade family conflict and are considered its most impactful elements. We contend that these impacts are best understood via the concept of ontological (in)security, whereby young people's sense of self, belonging and stability are undermined by family conflict. This provides important insights for developing practice in this space, where working to remove long‐term patterns of family conflict, restoring young people's sense of self and belonging within their family, and supporting the stability and trust within a family may prove beneficial. [ABSTRACT FROM AUTHOR]

Aim: To assess parental awareness of respiratory syncytial virus (RSV) and the level of acceptance of future RSV prevention strategies. Methods: A cross‐sectional online survey was implemented targeting "future" and "current" parents of children aged ≤5 years in Australia. Results: From 1992 eligible participants, two non‐mutually exclusive subgroups were formed: "current" parents (N = 1931) and "pregnant/planning" parents (N = 464: 403 also "current" parents and 61 "future" parents). Participants were predominantly (86.6%) aged 25–39 years and 68.5% with university education. The majority (89.6% current; 78.7% future) had heard of RSV. Of those, 64.2% (current) and 50.0% (future) were aware that pneumonia is associated with RSV; 71.8% (current) and 52.1% (future) were aware that bronchiolitis is associated with RSV. In multivariable logistic regression analyses, Australian‐born parents (aOR = 2.47 [95% CI: 1.48–4.12]), living in the eastern states (e.g., New South Wales: aOR = 6.15 [95% CI:2.10–18.04]), with a university‐level education (aOR = 2.61 [95% CI:1.38–4.94]) and being a current parent (aOR = 12.26 [95% CI:2.82–53.28]) were associated with higher RSV awareness. There was a high level of acceptance for maternal vaccines (future: 79.3%) and infant immunisation (all: 81.7%). Conclusion: While RSV awareness and immunisation acceptance were high, there was limited knowledge of severity of RSV, especially in future parents. Education campaigns need to be developed to increase RSV knowledge. [ABSTRACT FROM AUTHOR]

Background: Developmental language disorder (DLD) is one of the most common neurodevelopmental conditions. Due to variable rates of language growth in children under 5 years, the early identification of children with DLD is challenging. Early indicators are often outlined by speech pathology regulatory bodies and other developmental services as evidence to empower caregivers in the early identification of DLD. Aims: To test the predictive relationship between parent‐reported early indicators and the likelihood of children meeting diagnostic criteria for DLD at 10 years of age as determined by standardized assessment measures in a population‐based sample. Methods: Data were leveraged from the prospective Raine Study (n = 1626 second‐generation children: n = 104 with DLD; n = 1522 without DLD). These data were transformed into 11 predictor variables that reflect well‐established early indicators of DLD from birth to 3 years, including if the child does not smile or interact with others, does not babble, makes only a few sounds, does not understand what others say, says only a few words, says words that are not easily understood, and does not combine words or put words together to make sentences. Family history (mother and father) of speech and language difficulties were also included as variables. Regression analyses were planned to explore the predictive relationship between this set of early indicator variables and likelihood of meeting DLD diagnostic criteria at 10 years. Results: No single parent‐reported indicator uniquely accounted for a significant proportion of children with DLD at 10 years of age. Further analyses, including bivariate analyses testing the predictive power of a cumulative risk index of combined predictors (odds ratio (OR) = 0.95, confidence interval (CI) = 0.85–1.09, p = 0.447) and the moderating effect of sex (OR = 0.89, CI = 0.59–1.32, p = 0.563) were also non‐significant. Conclusions: Parent reports of early indicators of DLD are well‐intentioned and widely used. However, data from the Raine Study cohort suggest potential retrospective reporting bias in previous studies. We note that missing data for some indicators may have influenced the results. Implications for the impact of using early indicators as evidence to inform early identification of DLD are discussed. WHAT THIS PAPER ADDS: What is already known on the subject: DLD is a relatively common childhood condition; however, children with DLD are under‐identified and under‐served. Individual variability in early childhood makes identification of children at risk of DLD challenging. A range of 'red flags' in communication development are promoted through speech pathology regulatory bodies and developmental services to assist parents to identify if their child should access services. What this paper adds to the existing knowledge: No one parent‐reported early indicator, family history or a cumulation of indicators predicted DLD at 10 years in the Raine study. Sex (specifically, being male) did not moderate an increased risk of DLD at 10 years in the Raine study. Previous studies reporting on clinical samples may be at risk of retrospective reporting bias. What are the potential or actual clinical implications of this work?: The broad dissemination and use of 'red flags' is well‐intentioned; however, demonstrating 'red flags' alone may not reliably identify those who are at later risk of DLD. Findings from the literature suggest that parent concern may be complemented with assessment of linguistic behaviours to increase the likelihood of identifying those who at risk of DLD. Approaches to identification and assessment should be considered alongside evaluation of functional impact to inform participation‐based interventions. [ABSTRACT FROM AUTHOR]

Introduction: Many Australian Defence Force (ADF) and Veteran families are affected by the stressors of Defence family life, including frequent and prolonged parental deployments, and frequent relocations. Objective: To address a gap in information about Defence and Veteran (hereafter Defence) parents' knowledge, confidence and resources to support their young children's well‐being and build their resilience. Design: This study used a mixed methods design to explore Defence parent's perceptions of their young children's (aged 2–8 years) social and emotional well‐being and understanding of their children's responses to unique stressors as well as their confidence in providing support. Data from 41 parents were available. Findings: Overall, parents reported positive well‐being evaluation of their children. However, just over a third of parents also reported that their children rarely cope well on two indicators combined (adapting to new situations and sharing negative emotions with others). Significantly, more than half of the parents (61%) were only partially confident in their ability to assist their children to cope with unique stressors in military families. Qualitative data provided further insights into children's struggle with relocations and parental absence and the challenges parents face in supporting them. Parents reported having limited access to effective age‐ and culturally appropriate resources to support their young children. Discussion: In a first‐of‐its kind study, we found that Australian Defence parents reported their young children were coping on most of the key well‐being indicators. However, awareness of currently available supports for children remains a barrier as well as access to contextualised, age‐ and culturally appropriate resources are lacking. Conclusion: There is a need for access to free, quality, online, research‐based Australian resources to support young children from Defence families, especially for those living in regional and rural locations and are less likely to have access to mental health and other specialist supports. [ABSTRACT FROM AUTHOR]

Background: Parents are frequently used to recall events of exposure and disease as a proxy for their children in observational health research. Aim: To assess the validity of parental recall of children's utilisation of dental services. Design: Parents in the Longitudinal Study of Australian Children (LSAC) were asked to recall their children's overall dental service use in the previous year and whether the study child had received fillings or extractions due to decay in the previous 2 years. True positives were identified through parents who correctly recalled child dental service utilisation with actual dental treatment received in a linked dataset. Results: Of the 10 090 participants from the LSAC, 1290 study children had linked dental treatment data eligible for inclusion in this study. The absolute true‐positive rate for parental recall of dental service use in the previous year was 82% (n = 1263). Overall true‐positive percentages were lower for recall of fillings (40%) and extractions (7%) in the previous 2 years. Increasing number of recall days was associated with the rate of true‐positive recall adjusted for other factors in all three models. Conclusion: Accuracy of parental recall for tooth fillings and extractions was low. The use of parental recall for specific dental treatment over a time span of 2 years in further research is not recommended. [ABSTRACT FROM AUTHOR]

There is considerable evidence that parents/guardians play an important role in their children's education. The supportive behaviours of parents have important implications for children's learning. However, most research in this area has focused primarily on the perspectives of school leaders, teachers and parents. One area that thus remains relatively under‐studied is student perspectives on what constitutes beneficial parental supports. This research explores two case studies: one with primary school students, the other with secondary students. Both studies interviewed students from former‐refugee and non‐English speaking backgrounds who had recently settled with their families in Australia. The students were asked to reflect on supportive behaviours of their parents/guardians relating to their education. Findings suggest that despite many barriers, parents demonstrated high levels of support for their children's education. By foregrounding student voice, this study identifies several types of parental behaviours that students find most helpful for effective learning. These include: affirmation, role‐modelling, backup supports, conversations and discussions, encouragement and advice, and decision‐making and problem‐solving. Students' responses suggest that slightly different sets of behaviours may be required at primary and secondary levels. This study highlights the types of supportive parental behaviours which schools could encourage, to help parents maximise the impacts of their supports for students, so these students are enabled to achieve effective learning and—more broadly—educational and career aspirations. [ABSTRACT FROM AUTHOR]

Background: The aim of this project was to identify the top 10 priorities for childhood chronic conditions and disability (CCD) research from the perspectives of children and young people with lived experience, their parents and caregivers and the professionals who work with them. Methods: We conducted a three‐stage study based on the James Lind Alliance priority‐setting partnership methods. It comprised two online surveys (n = 200; n = 201) and a consensus workshop (n = 21) with these three stakeholder groups in Australia. Results: In the first stage, 456 responses were submitted, which were coded and collapsed into 40 overarching themes. In the second stage, 20 themes were shortlisted, which were further refined in stage 3, before the top 10 priorities being selected. Of these, the top three priorities were improving awareness and inclusion in all aspects of their life (school, work and social relationships), improving access to treatments and support and improving the process of diagnosis. Conclusions: The top 10 priorities identified reflect the need to focus on the individual, health systems and social aspects of the CCD experience when conducting research in this area. Patient or Public Contribution: This study was guided by three Advisory Groups, comprising (1) young people living with CCD; (2) parents and caregivers of a child or young person with CCD and (3) professionals working with children and young people with CCD. These groups met several times across the course of the project and provided input into study aims, materials, methods and data interpretation and reporting. Additionally, the lead author and seven members of the author group have lived and experienced CCD. [ABSTRACT FROM AUTHOR]

Background: Persistent enteral tube feeding beyond the point of medical and/or physical necessity provides important nutrition to a child but may have implications for their development, gastrointestinal tract and quality of life. Tube dependency can affect parent–child relationships and sibling and family dynamics and place additional medical demands upon parents. It is therefore important to transition children from tube to oral eating and drinking as soon as is medically safe to do so. Tube weaning requires a skilled team to support the transition to oral intake; however, access to experienced teams is inconsistent. Without transparent discussions with their treating teams, many parents are left to navigate tube weaning options independently. Methods: Fourteen parents were interviewed using semi‐structured interviews. We explored the experiences of parents across their child's progression towards oral feeding, from the decision‐making process to undertaking an intensive multi‐disciplinary tube weaning programme. Thematic analysis of the parents' stories shaped the development of seven themes. Results: Parents were unaware that tube weaning would be required and how that would be facilitated. They expressed a strong belief that their child could learn to eat—if afforded an opportunity. Furthermore, parents are prepared to disengage from current services if they feel they are not respected members of their child's therapeutic team. Three key learnings were identified relating to the need for tube exit plans, parents as key team members and parents as change agents. Conclusions: Parenting a tube‐fed child, initiating and engaging in tube weaning, is a stressful and emotional journey. However, by establishing care partnerships, parents are willing to put trust in a process if provided with options and afforded autonomy, empowerment, acknowledgement and relevant support. [ABSTRACT FROM AUTHOR]

Background: Parents' beliefs and behaviours affect children's nutrition, eating behaviours, and health outcomes; however, little is known about parents' experiences and perspectives on establishing a healthy diet with young children. Methods: A community‐recruited sample of 391 parents of young children (under age 5) completed an anonymous cross‐sectional online survey assessing the degree to which their children met recommendations outlined in Australian nutrition guidelines, perceived barriers to establishing a healthy diet with their child, and interest in receiving tips/information about establishing healthy eating habits with their children. Descriptive statistics illustrated proportions of children adhering to recommendations. Thematic analysis was used to analyse qualitative data. Results: Adherence to recommended nutrition guidelines varied across age groups. Most children across all age groups had water as their main drink, routinely consumed a variety of fruit, and consumed sweet drinks or fast foods only rarely. In contrast, less than half of 2‐ and 3‐year‐olds regularly consumed a variety of vegetables. The proportion of children consuming discretionary "treat" foods increased sharply over the first 2 years of life, and two thirds of 2‐, 3‐, and 4‐year‐olds consumed treat foods a few days per week or more. Parent‐reported barriers to establishing a healthy diet with young children included child behavioural factors (e.g., dislike of vegetables), parental influences (e.g., lack of time), family dynamics (e.g., influence of extended family) and external influences (e.g., external environment). Parents were most often interested in ways to modify child behaviour and information about child nutrition. Conclusions: Parents cite child behavioural issues as a major barrier to establishing a healthy diet with young children. Behavioural interventions that provide parents with information and support on how to establish a healthy diet with young children, as opposed to educational interventions focusing mainly on what children should be eating, may better meet families' needs. [ABSTRACT FROM AUTHOR]

Limited research has directly sought the input of parents involved in the child protection system during pregnancy and with their infants. As the focus of these policies and practices, parents have a unique and important insight not available to others, so it is vital to obtain their input. As part of a larger Australian study, qualitative interviews were undertaken with 13 parents asking about their views and experiences. Parents predominantly became involved with child protection services during pregnancy through a prenatal report. Parents who previously had their newborn removed from their care described it as sudden and unexpected, leaving them distressed and unsupported post‐removal, with a growing list of requirements for them to see their baby or for restoration to be considered. Domestic violence was a particular issue of concern for some mothers who expressed distress that their partners, perpetrators of violence, were allowed access to their infant with fewer requirements than for them. Improvements recommended by the parents included greater communication and preparation for the removal, better recognition of improvements in their situations and increased supports to be provided to parents both pre‐ and post‐removal. Parental experiences provide an important guide to improving child protection practice with these families. [ABSTRACT FROM AUTHOR]

Background: The Immunisation Register of Australia reports that childhood vaccination rates in some regional areas are below herd immunity levels. This is a concern for the health and well‐being of society, as regions with low vaccination rates have an increased risk of disease outbreaks. Objective: This study explored psychological motivators as predictors of anti‐vaccination attitudes amongst parents living on the Sunshine Coast (Queensland), Australia. Methods: A cross‐sectional survey design explored anti‐vaccination attitudes, conspiratorial thinking, psychological reactance, trust in government and magical beliefs about health in 1050 parents (968 mothers). Results: The predictor variables significantly accounted for 42% of the variance in parental anti‐vaccination attitudes. The strongest predictor of anti‐vaccination attitudes was lower levels of trust in government. Conclusion: The findings contribute to understanding of psychological factors motivating anti‐vaccine attitudes in Australian parents. The findings may help inform health communication campaign effectiveness in their alignment with individual underlying motivations. [ABSTRACT FROM AUTHOR]

Issue addressed: In Australia, one in four (24.9%) children live with overweight or obesity (OW/OB). Identifying infants at risk of developing childhood OW/OB is a potential preventive pathway, but its acceptability is yet to be investigated in Australia. This study aimed to (1) investigate the acceptability of predicting childhood OW/OB with parents of infants (aged 0‐2 years) and clinicians and (2) explore key language to address stigma and maximise the acceptability of predicting childhood OW/OB in practice. Methods: This was a cross‐sectional and qualitative design, comprising individual semi‐structured interviews. Participants were multidisciplinary paediatric clinicians (n = 18) and parents (n = 13) recruited across public hospitals and health services in Queensland, Australia. Data were analysed under the Framework Method using an inductive, thematic approach. Results: Five main themes were identified: (1) Optimism for prevention and childhood obesity prediction, (2) parent dedication to child's health, (3) adverse parent response to risk for childhood obesity, (4) language and phrasing for discussing weight and risk and (5) clinical delivery. Most participants were supportive of using a childhood OW/OB prediction tool in practice. Parents expressed dedication to their child's health that superseded potential feelings of judgement or blame. When discussing weight in a clinical setting, the use of sensitive (ie, "overweight", "above average", "growth" versus "obesity") and positive, health‐focused language was mostly supported. Conclusions: Multidisciplinary paediatric clinicians and parents generally accept the concept of predicting childhood OW/OB in practice in Queensland, Australia. So what?: Clinicians, public health and health promotion professionals and policymakers can act now to implement sensitive communication strategies concerning weight and obesity risk. [ABSTRACT FROM AUTHOR]

Aims: The primary aim of the review was to provide an overall assessment of residential parenting services in Australia, by describing the characteristics of infants and parents using residential parenting services, their prior service use and reasons for admission, referral pathways for access and parenting and infant outcomes. The secondary aims were to explore parent and staff perception of the programmes. Design: An integrative literature review. Methods: A systematic and comprehensive search of health and social sciences databases was conducted for studies related to residential parenting services (published between 1st January 1990–31st December 2019). Six hundred and eleven peer‐reviewed papers were identified, after which 301 duplicates were removed and an additional 256 papers excluded after titles/abstracts were read. Of the remaining 54 abstracts/papers, a further 14 were omitted as not relevant. Forty papers were independently reviewed by four authors. ENTREQ and MOOSE checklists were applied. Results: Thirty studies were quantitative, nine were qualitative, and one was mixed methods. All studies originated from in Australia. Women and babies admitted to residential parenting services were found more likely to be: older, Australian born, from higher socio‐economic groups, and first‐time mothers, and having labour and birth interventions and a history of mental health disorders. The babies were more likely to be twins, male and admitted with sleep disorders and dysregulated behaviour. Studies reporting postintervention outcomes demonstrated improvements to maternal mental health, breastfeeding, parenting confidence and sleep quality, and infant sleeping and behaviour. [ABSTRACT FROM AUTHOR]

We examined Australian parents' opinions of primary school food and nutrition education (FNE) via a cross‐sectional survey that collected quantitative and qualitative data. Most parents agreed that primary schools should teach FNE, starting at either the first or the second year of primary school and delivered weekly or fortnightly for approximately 1–2 h. The majority of parents believed that FNE could be incorporated into several school subjects. Many believed that FNE should be taught to ensure equity and to promote healthy eating among children. Consideration of parents' opinions about school FNE programmes could help design and deliver more effective FNE programmes. [ABSTRACT FROM AUTHOR]

Introduction: As a result of COVID‐19 and associated lockdown restrictions, children may have been exposed to more home‐based alcohol consumption and parents' drinking practices. This paper explores Australian parents' perceptions of their children's awareness of drinking and their reflections on the impact of COVID‐19 on children's exposure and acquisition of alcohol‐related knowledge. Methods: In‐depth interviews were undertaken with 30 parents and carers of children aged four to 12 years from across Australia. Participants described their family lives, the role of alcohol, any changes in alcohol and family dynamics experienced because of COVID‐19 and their children's exposure and knowledge of alcohol before and during their experience of COVID‐19. Using social learning theory as a guiding framework, transcripts were analysed to identify relevant themes. Results: Pre‐COVID‐19 children were commonly thought to be aware of behavioural changes owing to alcohol consumption, made associations between people, beverages and activities and recognised boundaries around consumption. COVID‐19 was suggested to have impacted the environments in which children were exposed and the types of modelling and practices they were exposed to. It was more common for participants to describe COVID‐19 affecting other children's learning and knowledge of alcohol, rather than their own. Discussion and Conclusions: Participants were mindful of children's knowledge and the role they played in modelling consumption practices prior to and during the COVID‐19 lockdowns. There may be scope to use the insights provided here to support parents in modelling approaches and engaging with children about alcohol in ways that challenge or disrupt its prominence or acceptability. [ABSTRACT FROM AUTHOR]

The role of parental expectations in determining children's higher education participation is important in understanding both participation and potential policy responses. Using a nationally representative longitudinal survey of Australian households, providing repeat observations on expectations for individual children, this study extends the literature in several respects. First, it examines the adaptation of parental expectations over a 4‐year time frame. Second, it looks at how parental expectations for school children are associated with actual higher education outcomes in the future. Third, the longitudinal aspect of the dataset permits more robust analyses of factors that shape parental expectations. The findings indicate that parental expectations of their children's attendance at university are generally stable across time. Perceptions of children's academic achievement at school are shown to be the key influence in shaping parents' expectations, and behavioural issues at school adversely affect expectations. Australian parents from non‐English‐speaking backgrounds were more likely to form positive expectations of university participation by their children, consistent with studies from other countries. A more nuanced picture of the formation of expectations for sole‐parent mothers is also presented. Positive effects of parental education and children's enrolment in a private school on parents' expectations, over and above any effect on school achievement, highlight these socioeconomic factors as potential causal channels for the intergenerational transmission of socioeconomic outcomes. [ABSTRACT FROM AUTHOR]

Background: Adherence to medication for attention‐deficit hyperactivity disorder (ADHD) is less than optimal. Previous studies have primarily focused on qualitative assessment of factors that influence medication adherence. Objective: This study aimed to quantify the factors that influence patient and parent preferences for continuing ADHD medication. Method: A discrete‐choice experiment was conducted to investigate preferences. Adults, and parents of children, with ADHD were presented with eight hypothetical choice tasks of three options (Medication A, Medication B, No Medication) described by six attributes related to medication outcomes. Preferences were estimated using a mixed multinomial logit model. Results: Overall, respondents' preferences (n = 216) for continuing medication were negative (mean [β] = −1.426, p <.001); however, a significant heterogeneity in preferences was observed amongst respondents (standard deviation = 0.805, p <.001). Improvements in education, aggressive behaviour, social behaviour and family functioning, and side effects and stigma, influenced respondents' decision to continue taking medication. The respondents were willing to continue medication if they experienced positive effects, but side effects (even moderate) were the strongest concern for not continuing medication. While side effects were the most important factor for both adult patients and parents of children with ADHD, improvement in education was relatively more important for adults and improvement in aggressive behaviour, social behaviour and family functioning was relatively more important for parents of children with ADHD. Parents were more likely to not continue a medication with severe side effects even at the highest level of improvement in education. Conclusions: Side effects are the most important factor that influenced preferences for continuing medication for both adults with ADHD, as well as parents of children with ADHD. While overall the respondents preferred not to take/give medication, discrete‐choice experiment showed that the relative importance of factors that influenced continuation of medications was different for the two groups. Patient and Public Involvement: Adults, and parents of children, with ADHD participated in this study by completing the online questionnaire. The questionnaire was based on findings of research in the literature, as well as earlier focus groups conducted with adults, and parents of children, with ADHD. The face validity of the questionnaire was determined by asking parents of children, and adults, with ADHD (n = 3) to complete the survey and participate in a short discussion on their understanding of the questions and their recommendations on improving the clarity of the survey. [ABSTRACT FROM AUTHOR]

Objective: We report the development and validation of a comprehensive Parenting and Child Tooth brushing Assessment (PACTA) questionnaire. Methods: This cross‐sectional study was conducted with community‐recruited Australian parents (N = 450) of children aged 2‐8 years. Parents completed an online survey including the newly developed PACTA (comprising four scales assessing children's tooth brushing behaviours, parenting strategies, attitudes and knowledge) and established scales assessing parenting behaviours, attitudes and self‐efficacy. Results: Exploratory factor analyses revealed two‐factor structures for scales assessing child behaviour ('noncompliance' and 'avoidance behaviour'), parenting strategies ('effective strategies' and 'ineffective strategies') and attitudes ('emotional reactions' and 'lack of concern'), whereas the knowledge scale was unidimensional. Internal consistencies were satisfactory (>0.7) for all except the knowledge scale. There was good evidence of convergent and predictive validity. All subscales predicted children's parent‐reported tooth brushing frequency; children were more likely to brush at least twice per day when parents reported fewer tooth brushing behavioural problems, using effective parenting strategies, and having better attitudes and knowledge. Poorer scores on the 'lack of concern' subscale of the attitudes scale were the strongest unique predictor of twice‐daily brushing (OR, 95% CI: 1.51, 1.36‐1.67). Conclusions: PACTA demonstrates satisfactory validity and reliability. Further research assessing sensitivity to change following intervention is warranted. [ABSTRACT FROM AUTHOR]

Background: Public health advocates have highlighted internalising problems as a leading cause of global burden of disease. Internalising problems (anxiety/depression) affect up to 20% of school‐age children and can impact peer relations, school engagement and later employment and mortality. This translational trial aimed to determine whether a selective/indicated parenting group programme to prevent internalising distress in shy/inhibited preschool children had sustained effects in middle childhood. Translational design aspects were a brief parent‐report screening tool for child inhibition offered universally across the population via preschools in the year before school, followed by an invitation to parents of all inhibited children to attend the parenting programme at venues in their local community. Methods: Design of the study was a randomised controlled trial. The setting was 307 preschool services across eight socioeconomically diverse government areas in Melbourne, Australia. Participants were 545 parents of inhibited four‐year‐old children of which 456 (84%) were retained during middle childhood (age of seven to 10 years). Early intervention was the Cool Little Kids parenting group programme, and control was 'usual care' access to available support services in the community. Primary outcomes were child anxiety and depression symptoms (parent and child report) and DSM‐IV anxiety disorders (assessor masked). Secondary outcomes were parenting practices and parent mental health. Results: There was no significant difference in anxiety disorders between the intervention and control group during the three annual follow‐ups of the cohort in middle childhood (2015 43% vs. 41%, 2016 40% vs. 36%, 2017 27% vs. 30%, respectively; p's >.05). There were also no significant differences in child anxiety or depression symptoms (by child or parent report), parenting practices or parent mental health, between the intervention and control group during middle childhood. However, a priori interaction tests suggested that for children with anxious parents, early intervention attenuated risk for middle childhood internalising problems. Conclusions: An issue for population translation is low levels of parent engagement in preventive interventions. Initial effects of the Cool Little Kids parenting group programme in reducing shy/inhibited preschool children's internalising distress at school entry dissipated over time, perhaps due to low engagement. Future translational research on early prevention of internalising problems could benefit from screening preschool children in the population at higher risk (combining temperamental inhibition and parent distress) and incorporating motivational techniques to facilitate family engagement. Trial registration ISRCTN30996662 http://www.isrctn.com/ISRCTN30996662. [ABSTRACT FROM AUTHOR]

Background: Despite emerging evidence of validity and reliability, speech and language therapists' (SLT) uptake of telehealth has been limited and barriers remain to the effective and confident use of this service model. The COVID‐19 pandemic has caused significant disruption to essential health services, including speech and language therapy assessment and intervention, meaning that telehealth must now be considered as part of the suite of service delivery options for all clinicians. Aims: To explore the perceived barriers and facilitators of telehealth among community paediatric SLTs before and after their use of a telehealth platform with an embedded standardised assessment tool. Methods & Procedures: Mixed‐methods questionnaires were developed for this study and completed by SLTs before and after the 3‐month trial of the telehealth platform. A total of 38 SLTs completed the pre‐trial questionnaire and training in the use of telehealth platform (Coviu), including instruction in using a standardised, norm referenced language test as an integrated tool within the Coviu platform. A total of 27 SLTs went on to use the telehealth platform, and 25 of these completed the post‐trial questionnaire on which subsequent qualitative and quantitative analysis was completed. Outcomes & Results: Prior to using the platform, perceived barriers included technology issues, limited clinician experience and concerns around parent acceptance of the service. Potential facilitators included access to appropriate platforms, tools and resources as well as increased clinician confidence with telehealth. Following the trial, barriers to telehealth use continued to include technology barriers, particularly internet stability, and client issues, including suitability for telehealth services. Facilitators for future telehealth use included access to appropriate platforms for telehealth, stable and appropriate internet connectivity, and more extensive telehealth resources for both assessment and intervention for this mode of service delivery. Conclusions & Implications: This study provides insights into the perceptions of the barriers and facilitating factors for telehealth use among community‐based SLTs. This information will be useful in developing strategies to promote uptake and effective and confident use of telehealth as a mode of service delivery beyond the pandemic. What this paper adds: What is already known on the subject: Research about telehealth has shown that it is a reliable and valid way of delivering speech pathology services, yet many clinicians have been wary of its use and uptake of telehealth prior to COVID‐19 had been limited. We wanted to know what SLTs thought about using telehealth before and after participating in a 3‐month trial of a telehealth platform with an embedded formal language assessment. What this study adds to existing knowledge: This study indicates that technology issues including internet stability are a barrier to effective telehealth services, but that appropriate telehealth platforms, resources and experience are facilitators of uptake and successful use of telehealth. What are the potential or actual clinical implications of this work?: This information will be useful in developing strategies to promote uptake and effective and confident use of telehealth as a mode of service delivery for children during and beyond the pandemic, including those isolated by geographical or transport barriers. [ABSTRACT FROM AUTHOR]

Issued addressed: There is increasing evidence that exposure to traffic‐related air pollution is related to childhood respiratory symptoms. This study demonstrated the effectiveness of an anti‐idling behavioural intervention targeting parents at primary schools. Methods: Based on two focus group discussions with parents, a low‐intensity 4‐week anti‐idling intervention was developed, comprising onsite signage, four newsletters, and two fact sheets. Exposure to selected air pollutants was assessed during pick‐up and drop‐off times pre‐ and postintervention at 12 randomly selected independent schools (10 intervention and 2 control) across the Perth metropolitan area. Results: The study results showed that a low‐intensity behavioural intervention can be an effective strategy to affect parents' attitude towards vehicle idling. This was demonstrated by the reduced number of idling vehicles observed in 8 of the 10 intervention schools and decreased overall particulate matter concentration after the anti‐idling intervention. Conclusion: Anti‐idling education can be effective in promoting clean travel behaviours and has potential health benefits for school children. So what?: This intervention study provides insights on the significant effect of anti‐idling education on parents' behaviour towards air quality and children's health. These promising findings warrant further rigorous actions on anti‐idling education and enforcement. [ABSTRACT FROM AUTHOR]

Aim: Pain associated with immunisations can result in distress and/or anxiety for children and parents. We assessed the feasibility and acceptability of two novel devices; Coolsense (cold) and Buzzy (vibration ± cooling pads) versus standard care to minimise pain during immunisations. We also evaluated compliance to the devices and parent's perception of the effectiveness of the devices/standard care for minimising pain during immunisation.Design: Open label, pilot, randomised controlled trial (RCT).Methods: Forty children aged 3.5 to 6 years attending an Immunisation Centre at The Royal Children's Hospital in Melbourne, Australia, were randomised (1:1:1:1) into four groups: (i) Coolsense plus standard care; (ii) Buzzy with cold plus standard care; (iii) Buzzy without cold plus standard care; and (iv) Standard care alone (distraction with bubbles).Results and Analysis: Recruitment was completed in 12 days. Seventy percent were compliant with Buzzy (±cold), 82% with Coolsense, and 60% with standard care. Buzzy (with cold) was identified as effective by 70% of parents, Coolsense by 64%, Buzzy without cold by 50% and standard care by 60%.Conclusions: This pilot study demonstrated feasibility. A larger RCT is needed to provide definitive evidence to inform best practice for minimising immunisation pain in young children. [ABSTRACT FROM AUTHOR]

Background: Early childhood is an important time to establish eating behaviours and taste preferences, and there is strong evidence of the association between the early introduction of sugar‐sweetened beverages and obesity and dental caries (tooth decay). Dental caries early in life predicts lifetime caries experience, and worldwide expenditure for dental caries is high. Methods: Questionnaire data from the Splash! longitudinal birth cohort study of young children in Victoria, Australia was used to examine beverage consumption and parental feeding behaviours of young children, aiming to provide contemporary dietary data and assess consistency with the Australian dietary guidelines. Results: From 12 months of age, the proportion of children drinking sugar‐sweetened beverages consistently increased with age (e.g. fruit juice consumed by 21.8% at 12 months and 76.7% at 4 years of age). However, the most common beverages for young children are milk and water, consistent with Australian dietary guidelines. In relation to other risk factors for dental caries, at 6 months of age children were sharing utensils, and at 12 months three quarters of carers tasted the child's food before feeding. Conclusions: The increasing consumption of sugar‐sweetened beverages and prevalence of other risk factors for dental caries and obesity through early childhood continues to be a problem despite efforts to raise awareness of these issues with parents. [ABSTRACT FROM AUTHOR]

Objective: To report satisfaction with services for children with hearing loss in urban and rural Australia. Design: Mixed‐method approach using surveys and semi‐structured interviews. Setting: Australian organisations that serve children with hearing loss. Participants: One hundred parents of children with hearing loss and 91 professionals that serve children with hearing loss completed surveys. Seven parents and eight professionals were interviewed. Main outcome measures: Comparison of satisfaction with services in rural and urban areas. Results: Timing of initial hearing services was similar in rural and urban areas. Children with hearing loss in rural areas had less satisfaction with services than children in urban areas. Parents of children with hearing loss in rural areas had higher costs, mainly linked to travel, than parents in urban areas. Parents and professionals were concerned that advantaged parents received more services for their child than disadvantaged parents. Parents and professionals in urban and rural areas were satisfied with mainstream education, but less satisfied with education for children with hearing loss and additional disability. Professional satisfaction was lower in rural areas than urban areas. Conclusions: This small‐scale study adds to research citing reduced services in rural areas. An exception is the newborn hearing screening program, with the limited data presented indicating the program is effectively overcoming the barrier of distance. However, children with hearing loss in rural areas have reduced access to ongoing services. [ABSTRACT FROM AUTHOR]

Using a sociocultural perspective and a case study design, this research examined how three migrant parents in Australia viewed and supported children's learning in digital spaces and the reasons behind these perspectives and practices. The study found that the participating parents mainly valued and actively supported technology‐based mechanical learning of print‐based literacy and numeracy basics and disregarded the development of digital literacies. The participants' views and practices were shaped by their desire for children's social mobility, driven by their migration status and high educational levels, and further reinforced by their interpretations of what was valued in the Australian education system. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the implementation of an intervention for parents to escalate care if concerned about their child's clinical condition. Design: Mixed‐methods health‐care improvement approach guided by the Theoretical Domains Framework. Methods: Implementation of the 'Calling for Help' (C4H) intervention was informed by previously identified barriers and facilitators. Evaluation involved audit, review of clinical deterioration incidents, interviews and focus groups. Setting: Australian specialist paediatric hospital. Participants: Convenience sample of 75 parents from inpatient areas during the audit, interviews with ten parents who had expressed concern about their child's clinical condition; five focus groups with 35 ward nurses. Main outcome measures: Parent awareness and utilization of C4H, parent and nurse views of factors influencing implementation. Results: Parent awareness of C4H improved to 35% (25/75). Parent concern was documented prior to 21/174 (12%) clinical deterioration events. All interviewed parents and nurses who participated in focus groups were positive about C4H. Parents preferred to be informed about C4H by nurses, but nurses described this as time‐consuming and selectively chose parents who they believed would benefit most. Parents and nurses described frustrations with and trepidation in escalating care. Nurses had used C4H to expedite urgent medical review. Conclusions: There was an improvement in the level of parent awareness of C4H, which was viewed positively by parents and nurses alike. To achieve a high level of parent awareness in a sustainable way, a multifaceted approach is required. Further strategies will be required for parents to feel confident enough to use C4H and to address interprofessional communication barriers. [ABSTRACT FROM AUTHOR]

Objective: Attention‐deficit/hyperactivity disorder (ADHD) is associated with increased eating disorder symptoms, yet little research examining this association has taken a diagnostic approach using a population‐based sample. This cross‐sectional study examined differences in DSM‐5 eating disorder symptoms and partial‐syndrome diagnoses at 14–15 years of age in adolescents with and without ADHD in a population‐based sample. Method: This study uses data from waves 1, 5 and 6 of the Longitudinal Study of Australian Children (N = 2,672). ADHD (6.9%) was defined at 12–13 years of age by both parent‐ and teacher‐reported hyperactivity‐inattention scores ≥90th percentile on the Strengths and Difficulties Questionnaire, parent‐reported ADHD diagnosis, and/or ADHD medication treatment. Adolescents reported eating disorder symptoms at 14–15 years of age via the Branched Eating Disorders Test. Results: Boys with ADHD had greater odds of regular objective binge eating than boys without ADHD (OR: 9.4; 95% CI: 1.7–52.8; p = .01). Groups did not differ in prevalence of any other eating disorder symptoms or partial‐syndrome diagnoses. Discussion: Boys with ADHD appear to be at a greater risk of regular binge eating classified by DSM‐5 criteria at 14–15 years of age. Overall, the risk for eating disorder symptoms and partial‐syndrome diagnoses in adolescents with ADHD does not appear to be high at 14–15 years of age when using DSM‐5 criteria with population‐based sampling. [ABSTRACT FROM AUTHOR]

Background: Children fluctuate in their risk for mental health‐related problems. While children have demonstrated consistent trajectories for various types of mental health problems, the existence of developmental trajectories of overall risk of mental health problems has not been explored. This study aimed to identify distinct trajectories of overall mental health risk among children from ages 4–12 years. A secondary objective was to identify predictors of the mental health risk trajectories. Method: Data from the first five waves of the Longitudinal Study of Australian Children (LSAC) were used to assess mental health risk and potential predictors. The primary parent (n = 3717) completed questionnaires, time‐use diaries, and face‐to‐face interviews over the five waves. Growth mixture modeling was used to identify distinct latent trajectories of mental health risk. Multinomial logistic regression was used to identify predictors of the trajectories. Results: Six distinct trajectories of mental health risk were identified: Low Difficulty (72.9%), Improvers (9.7%), Decliners (7.9%), Early Decliners/Late Improvers (4.7%), Early Improvers/Late Decliners (2.7%), and High Difficulty (2.2%). Child sex, sociability, parental warmth, sports participation, and household income were identified as significant predictors of mental health trajectories. Conclusions: There are distinct trajectories of overall risk for mental health problems during childhood. Research should focus on the High Difficulties group and the Early Improvers/Late Decliners group to address the predictors and improve access to early mental health services. Read the full Response to the Commentary on this article at doi: https://doi.org/10.1111/camh.12299 Read the full Commentary on this article at doi: https://doi.org/10.1111/camh.12290 [ABSTRACT FROM AUTHOR]

Background: The alcohol consumption patterns of young adults are of concern. Critically, tertiary students consume greater quantities of alcohol, are at increased risk of injury/harm, and have higher rates of alcohol use disorders as compared to their nonuniversity enrolled peers. The Brief Young Adult Alcohol Consequences Questionnaire (BYAACQ) is one of several tools utilized to explore adverse alcohol‐related outcomes among tertiary students. Alcohol intake behavior, assessed via retrospective summary measures, has been linked to BYAACQ score. It is unclear, however, how drinking assessed in real time, in conjunction with variables such as age of drinking onset, might predict severity of adverse alcohol consequences as captured by the BYAACQ. Methods: The psychometric properties of the BYAACQ were explored using a large Australian sample of tertiary students (N = 893). A subsample (n = 504) provided alcohol intake information in real time (21 days; event and notification contingent) via a smartphone app (CNLab‐A) plus details related to age of drinking onset, drug use, parental alcohol/drug use, and anxiety/depression symptomology. Results: Average BYAACQ score was 7.53 (SD = 5.37). Classical and item response theory analyses revealed inconsistencies related to dimensionality, progressive item severity, and male/female differential item functioning. Current drinking—namely, frequency of intake and quantity per drinking occasion—plus age of drinking onset predicted BYAACQ score after controlling for age, other drug use, and depression symptomology. Conclusions: The BYAACQ is a sound tool for use with Australian samples. Information related to current drinking, age of drinking onset, and drug use is useful for predicting severity of alcohol use consequences. These markers might enable tertiary institutions to better target students who could benefit from prevention/intervention programs. [ABSTRACT FROM AUTHOR]

Couple conflict, which includes conflict over parenting practices, continues to be a topic of considerable interest to family therapists. Following parental separation, resolution or management of conflict over children has a special urgency. 'High‐conflict' cases present some of the most complex systemic and clinical challenges. In this first of two related articles in this issue of ANZJFT, we set out key ideas – some old, some new – about parental conflict from the divorce literature. We present Australian data on separated parents' reports, which found significant conflict at three different points in time after separation and consider the clinical implications. We suggest that while 'high conflict' has an intuitive feel as a descriptor for difficult post‐separation disputes, it has limited utility as a blanket term to inform research and practice. The article acts as a conceptual backdrop to an earlier paper (Smyth & Moloney, 2017), in which we consider the dynamics of enduring 'high conflict.' We suggest that these cases might be qualitatively different to those cases in which intensely felt disputes develop but then recede. We also suggest that amongst enduring 'high conflict' cases there are likely to be cases with especially challenging dynamics such as interparental hatred. [ABSTRACT FROM AUTHOR]

Gay men and lesbian women have a long history of jointly creating families and co‐parenting their children together. This qualitative study aims to explore the experiences of separation and post‐separation parenting within same‐sex parented families. This involved semi‐structured in‐depth interviews with 22 separated same‐sex parents in Adelaide, Melbourne, Sydney, Brisbane, and regional Victoria. An adaptive theory approach was used for the collection and analysis of the data. The paper explores data from a cohort of six participants who came from three different multi‐parent families who had experienced a separation – either their own, or that of other parents in their parenting group. The term 'co‐parenting families' was found to be confusing due to the different connotations within separation/divorce and same‐sex parent literature. Consequently, the term 'guild parented families' was created to describe these families. Participants from these multi‐parent families had very different experiences of family formation and separation compared to others within the wider separated same‐sex parent study. Separation of one or more of the parent couples within these families complicated their original plans and kinship ideals. Each of the families resolved this differently in their post‐separation arrangements. After separation, whole family narratives and/or the role of individual parents, were either questioned or revised as a way of resolving the complexity of their new kinship situation. Following separation, parents often relied on Western kinship norms that privilege biological kinship and the dual‐parent family to construct their post‐separation kinship arrangements. More awareness of families that begin with more than two parents is needed within separation research and amongst separation services and service providers. [ABSTRACT FROM AUTHOR]

Background: Carer mental health literacy and help seeking are areas that are not well researched in the intellectual disability field. This study aimed to explore the above including service utilization experiences of Australian parents with an offspring with an intellectual disability and a comorbid psychiatric disorder. Method: Forty‐one parents took part in an online survey assessing satisfaction and helpfulness ratings of received services. Twenty‐six parents also completed items to assess mental health literacy and attitudinal barriers to help seeking. Results: Parents showed good mental health literacy with depression and with challenging behaviour associated with autism and poorer literacy with mixed presentations. Few attitudinal barriers to help seeking were reported. Parents reported varied helpfulness and satisfaction ratings with disability and mental health services. Conclusions: Parents are capable of recognizing the need to seek professional help for their offspring. Implications for service coordination, provision and carer involvement are discussed. [ABSTRACT FROM AUTHOR]

Objective: To identify barriers and facilitators to implementing a parent escalation of care process: Calling for Help (C4H). Design: Audits, semi‐structured interviews and focus groups guided by the Theoretical Domains Framework. Setting: Australian paediatric hospital where a parent escalation of care process was introduced in the previous 6 months. Participants: Four children, 13 parents, 91 nurses and doctors including Medical Emergency Team (MET) members. Main outcome measures: Parent awareness and involvement in escalating care and factors impacting implementation of C4H. Results: Two audits identified low level of parent awareness (16/88, 19% and 5/85, 6%). Parent involvement in escalation of care was documented in 11/62 (18%) events. The main facilitators included uniformly positive views that C4H was in the child's best interest, acknowledgement that parents had skills to recognize deterioration and would take action. C4H was considered to add to patient safety and being reviewed by the MET was a patient benefit. Key barriers were the low level of awareness, doubt about parent capabilities, concern about parents' information overload, anticipated overuse of resources, staff unease about possible repercussions and anticipated difficulty for parents to question staff with potential negative effects on parent‐staff relationships. Overall C4H presents a challenge to traditional hospital hierarchy and culture. Conclusions: Although there was a low level of awareness about C4H in practice, there was in‐principle support for the concept. Initial strategies had primarily targeted policy change without taking into account the need for practice and organizational behaviour changes. Using a theoretical approach to identify key factors will enable a targeted approach to implementation. [ABSTRACT FROM AUTHOR]

Aim: One in seven Australian schoolchildren do not consume breakfast. School‐based breakfast programs assist at‐risk children to meet their nutritional requirements and provide cognitive and behavioural benefits, but may result in significant food costs and waste. The present study aimed to explore acceptability and perceived benefits of a novel free primary school‐based breakfast program utilising donated food. Methods: Process evaluation included quantification of amount of food donated, number of meals provided and nutritional analysis of some of the meal items. Impact evaluation was based on thematic analysis of focus groups held with students, parents and teachers to explore their perspectives about the program. Breakfast diaries and hunger rating visual analogue scales were used to evaluate students' breakfast habits at home over five consecutive days. Results: The program saved 14.4 t of food from landfill through conversion into 44 000 meals. One‐fifth of children interviewed arrived at school without having breakfast at least once per week while one‐third of students reported being hungry on arrival at school. Benefits of participation in the program included increased willingness to attend school, improved alertness and behaviour, as well as creation of an equitable, supportive environment beneficial for low income or food insecure families. Conclusions: This novel breakfast program based on donated food was widely accepted by students, teachers and parents, providing benefits beyond the mere provision of food. It provides a model for school‐based interventions to combine breakfast programs with sustainable food production approaches. [ABSTRACT FROM AUTHOR]

Background/aim: Parent proxy reports are well used in occupational therapy, yet historically parent report instruments of motor skill have not required parents to report on the same motor skills that their children are assessed on. The aim was to examine how well a parent report of children's fundamental movement skill (FMS) was associated with children's actual FMS. Method: A sample of 100 children aged 7–9 years from Melbourne, Australia, were recruited. Parents/guardians completed proxy report (parent version of the 'Pictorial Scale of Perceived Movement Skill Competence' (PMSC)) and children's actual motor skills were assessed ('Test of Gross Motor Development' 3rd edition (TGMD‐3)). Data were first analysed using Pearson's correlation coefficients and then hierarchical linear stepwise regression was conducted with actual skill as the outcome variable in each model. Results: The PMSC‐Parent (r = 0.36, P < 0.001) was moderately associated with children's actual skill. After age and sex adjustment, the PMSC‐Parent explained 11.4% of variance in total skills. Parent report of their children's object control scores (PMSC object control scale) was significantly associated with children's actual object control (B = 0.36, P < 0.001) and explained 11.3% of the variance. Parent report of children's locomotion scores (PMSC locomotion scale) was associated with children's actual locomotor skills (B = 0.27, P = 0.007) and explained 6.2% of the variance. Conclusion: Parents are able to report to some degree on their children's FMS competency, in particular, their object control competence. Parent proxy report of FMS may help inform occupational therapists to identify children with low FMS competency to develop interventions targeting FMS. [ABSTRACT FROM AUTHOR]

Abstract: Background: Many children in developed countries do not receive recommended vaccines on time. However, knowledge about factors related to timeliness remains limited. Quantifying the relative impact of parental attitudes compared with socio‐demographic factors for delayed immunization would inform policy responses. Methods: Participants in the nationally representative Longitudinal Study of Australian Children were matched with their vaccination histories in the Australian Childhood Immunisation Register (N = 4,121). Information about the children and their families were collected in face‐to‐face interviews in 2003–2004. We considered whether children had completed the primary course for each recommended antigen due by 6 months old. Children were categorized as either fully immunized, delayed, or totally non‐immunized. The outcome was examined using logistic regression. Population attributable fractions were estimated for key predictors. Results: Delayed immunization was significantly associated with indicators of social disadvantage as well as parental disagreement with immunization. Attributable fractions for delayed immunization included lone motherhood (3.8%; 95% confidence interval CI [0.8, 6.7]), larger family size (39.5%; 95% CI [31.2, 46.8]), residential mobility (3.3%; 95% CI [0.1, 6.5]), lack of private hospital insurance (9.4%; 95% CI [0.7, 17.3]), a medical condition in the child (2.0%; 95% CI [0.2, 3.9]), and parental disagreement with immunization (2.1%; 95% CI [0.3, 3.9]). Conclusions: Parental attitudes accounted for a relatively small percentage of delayed infant immunization. In contrast, many children who did not receive vaccines on time were characterized by social disadvantage, especially larger family size. Researchers and policy‐makers should consider how to make timely immunization easier for busy parents. [ABSTRACT FROM AUTHOR]

Abstract: Background: Infectious diseases cause considerable morbidity and mortality in children less than 5 years of age. Children attending childcare centres are at increased risk of contracting infections. It is of public health interest to understand what triggers and underpins parental decisions to send an unwell child to childcare, with the obvious attendant risks to other children and childcare staff as well as the affected child. This study aimed to examine parents' disease prevention health beliefs and practices with a particular focus on how these factors influence childcare attendance decisions. Methods: Semistructured, in‐depth interviews were conducted between June 2009 and May 2011 with parents who had at least one child under 5 years of age enrolled in a childcare centre. Six centres in the metropolitan area of Sydney, Australia, were selected to include parents from a range of demographic and socio‐economic backgrounds. Results: Forty‐two interviews were conducted, recorded, and transcribed. Themes emerging from the data included “vitamin dirt,” contagion, and contagion prevention and control. These interacted with parents' decision‐making about childcare attendance, and parents made choices in a complex context of obligations to their child, social contract obligations to others, peer expectations, and the need to work. Vaccination received only scant mention as a preventive health measure. Decision‐making by parents concerning childcare attendance was made without reference to any external guidelines. Conclusions: This study provides insights into parental disease prevention beliefs, behaviours, and decision‐making. It reveals a need for policies to support parents with unwell children. In addition, resources and educative efforts to raise awareness of vaccination as a preventive health measure, and awareness of infectious disease contagion more broadly, would assist in providing parents with a greater evidence base for making decisions about childcare attendance when their child is unwell. [ABSTRACT FROM AUTHOR]

Aim: Health-care providers are crucial in maintaining parental confidence in vaccination. Health-care providers are the most commonly accessed resource by parents for vaccine-related information and are highly trusted. We investigated paediatricians' (i) frequency of vaccine discussions; (ii) specific vaccine-related topics discussed; (iii) perceived role in childhood vaccination; (iv) challenges faced when having discussions; (v) confidence in vaccine-related knowledge and communication skills; and (vi) interest in online education and training.Methods: We invited members of the Australian Paediatric Research Network to complete an online Research Electronic Data Capture survey in 2015-2016.Results: Of 383 active Australian Paediatric Research Network members, 165 (43%) completed the online survey. A total of 61% reported 'frequently' or 'almost always' having vaccine-related discussions, with 15% 'rarely' having them. 'Lack of time' was the most commonly reported barrier to having vaccine discussions (54%). Vaccine necessity was most commonly discussed (33%), followed by vaccine safety (24%), general vaccine concerns (23%) and catch-up schedules (23%). While only 25% of paediatricians lacked confidence in their vaccine-related knowledge and 11% in their communication skills, most expressed interest in online training to address vaccine knowledge (62%) and communication skills (53%).Conclusion: Paediatricians play a key role in maintaining public confidence in vaccination. However, opportunities to address concerns are not being maximised by Australian paediatricians. There is a need and desire for training and resources to increase vaccine knowledge and communication skills for paediatricians, to optimise the frequency and effectiveness of vaccine discussions with parents and to ensure ongoing high immunisation coverage rates in Australia. [ABSTRACT FROM AUTHOR]

Background Requests for assistance in menstrual management and menstrual suppression are a common, emotive and sometimes controversial aspect of adolescent disability care. Aims To review the uptake and outcomes of menstrual suppression among adolescent patients with developmental delay. Methods A retrospective review of the medical records of adolescent females with intellectual disability referred for menstrual management to the Paediatric and Adolescent Gynaecology Clinic, Children's Hospital at Westmead, Sydney, for the three-year period between January 1, 2010 and January 1, 2013. Results Eighty adolescent patients with developmental delay were identified. A third ( n = 28) of the patients were pre-menarcheal at first review with parent/caregivers seeking anticipatory advice. Of the post-menarcheal patients, the median age of menarche was 12 years (range 10-15 years). First and second line interventions were documented as were reasons for change where applicable. The combined oral contraceptive pill ( COCP) was the most frequently used therapy (67%), and 19 patients in total had a levonorgestrel releasing intrauterine system ( LNG- IUS) inserted (31%). Our study population differs from similar previously published groups in the marked absence of the use of depot medroxyprogesterone acetate or the subdermal etonogestrel releasing device. Conclusion As a paediatrician, it is important to address menstrual management issues and allay caregiver concerns with appropriate advice. Our study supports the use of the COCP as sound first line management in achieving menstrual suppression. The LNG- IUS appears to be a favourable second line option. Further investigation into longer-term outcomes and potential complications of device insertion is recommended. [ABSTRACT FROM AUTHOR]

Background One of the strategies proven most successful in curbing rising rates of childhood obesity involves targeting parents as agents of change. Prior studies have focused on what messages to communicate, but few have investigated how they should be communicated. Objective To identify the channels most effective for communicating with parents of overweight and obese children and understand whether their use of parenting information sources differs from others in the community. Design/setting This study utilizes data from the Longitudinal Study of Australian Children ( LSAC). Families were included if weight and height information was available for parents and children at three data collection points: Waves 1, 2 and 4 (collected 2004, 2006 and 2010, respectively, n = 5107). Analysis A priori and a posteriori segmentation methods identified groups of parents that were similar in the sources used to obtain information about parenting, and examined whether some segments were more likely to have obese children. Results Four segments were identified that differed in their information source use: the 'personal networks', 'books', 'official sources' and 'mixed approach' segments. The 'official sources' and 'mixed approach' segments were most likely to have obese children, and they used doctors, government/community organizations and friends to obtain information on parenting. These segments were also less educated and had lower employment. Conclusions Messages are most likely to reach families with obese children if communicated through doctors, government publications and community organizations. Further, messages targeting social groupings of parents will leverage the power of advice from friends, which is another valuable information source for this group. [ABSTRACT FROM AUTHOR]

Aim: A fifth of children enter school with special health care needs (SHCN) impacting on their physical, psychosocial or educational development, including many with emerging SHCN who often do not qualify for additional supports. This study aimed to compare the perceptions of parents and teachers on children's emerging SHCN, and explore correlates of conflicting reports.Methods: The Longitudinal Study of Australian Children (LSAC) is a nationally representative study of Australian children, which includes the abbreviated Children with Special Health Care Needs Screener. Data were analysed from a subsample of n = 720 children from the LSAC Kindergarten cohort (n = 4983) for whom teachers also completed the Australian Early Development Index checklist, a measure of early childhood development that includes teacher reported SHCN.Results: Teachers (n = 120, 17.34%) identified more emerging SHCN than parents (n = 74, 10.74%), and reports were often discrepant. Children were more likely to have consistent reports of emerging SHCN when their parents had high levels of involvement at school (OR 4.86; 95% CI 1.08-21.80; P < 0.05), whereas children who came from disadvantaged family backgrounds were more likely to have teacher-only identified difficulties (OR 3.66; 95% CI 1.17-11.50; P < 0.05).Conclusion: Parents and teachers bring different perspectives to children's development and additional support needs, each of which is valuable. Greater attention should be given to ensuring that common understandings about a child's needs at school are established early in children's educational pathways. [ABSTRACT FROM AUTHOR]

Background Parents are increasingly recognized as important partners in children's health care. Despite their involvement in care, parental experiences of their child's hospitalization have received little research attention. In this study we explored parents' perceptions of what they found difficult, what they would like to be different and what they found to be helpful during their infant's hospitalization and surgery for the treatment of congenital heart disease. Methods Structured interviews were conducted with 154 parents (91 mothers, 63 fathers) whose infant underwent cardiac surgery (at <3 months of age) 1 month post discharge from hospital. Thematic and frequency analyses were performed. Results Parents reported a range of difficulties from dealing with their baby's unfolding illness, surgery and recovery to the structural and systemic issues associated with the broader context of their experiences. In an effort to be near their baby, parents struggled to obtain the necessities for daily living at the hospital and negotiate transitions between their hospital and home lives throughout the admission. Domains parents identified for change included the availability of facilities and resources and the quantity and quality of information and emotional support. Parents reported relationships with hospital staff as the most common source of support during this challenging time. Conclusions Opportunities to improve parents' experiences when their infant is in hospital exist at an organizational level as well as at the clinical level. The significance of parents' relationship with hospital staff indicates the potential for each professional to impact on families' experiences on a daily basis. The range of challenges indicates the scope and need for allied health services. [ABSTRACT FROM AUTHOR]

Background Very little research has examined the role of parenting in managing behavioural side-effects of cancer treatment. The purpose of this paper was to explore parent perceptions of (a) parenting in the context of childhood cancer; (b) the parenting strategies used in the context of managing child behavioural side-effects of cancer treatment; and (c) the perceived impact that cancer-specific parenting strategies have on child behaviour. Methods Participants were 15 mothers of children aged 2-6 years in the maintenance phase of treatment for acute lymphoblastic leukaemia at the Royal Children's Hospital Children's Cancer Centre, Melbourne, Australia. Mothers participated in a one-on-one semi-structured telephone interview using an interview guide which included questions on parenting in the context of childhood cancer, specifically in relation to behavioural side-effects (problems with behaviour, sleep and eating) and any perceived impact cancer-specific parenting may have on the ill child. Results Many parents reported that following their child's cancer diagnosis, they had to implement a suite of 'new' strategies that 'pre-diagnosis' were used only in moderation, if at all. The most salient theme that emerged was parents' perception that their parenting became more lax since their child's diagnosis. Parents further reported specific parenting strategies for each of the main child behavioural side-effects of cancer treatment. Conclusion Data from the current qualitative exploratory study highlight the role of specific parenting strategies in managing or assisting child behavioural side-effects of cancer treatment. Further quantitative research is needed to more fully examine the association between parenting and child behavioural outcomes in order to develop modifiable approaches to improving child behavioural side-effects in a paediatric oncology context. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the characteristics of Australian parents and intended parents and their attitudes towards surrogacy arrangements. It states that surrogacy is being used if a woman does not have the ability to carry pregnancy. It adds that most Australian intended parents uses overseas compensated surrogacy as the practice has been considered illegal in all Australian laws.

Aim The aim of this study was to determine if parent intentions to facilitate social interactions between their child and a peer, or parental perceptions of their child's peer social interaction intentions, differ according to the weight status of a child's peer. Methods During a telephone survey, 250 Australian parents of children 5-12 years were randomly assigned to listen to one of two descriptions of a hypothetical child differing by group in the description of child weight status ('quite overweight' or 'healthy weight'). Parents then completed the Social Interaction Intention Scale, which assessed how likely they or their child would engage in a number of behaviours that may facilitate social interaction with the child described in the profile. Results Means scores on the overall scale and the child sub-scale of the Child Social Interaction Intention Scale were significantly higher among participants allocated to the healthy weight child profile, indicating more positive social intentions. Conclusion The findings suggest that negative weight-based stereotypes hinder the development of peer friendships by obese children. [ABSTRACT FROM AUTHOR]

Background: An implantable cardioverter defibrillator (ICD) is a device used in the treatment of individuals with life-threatening cardiac conditions. These include genetic disorders such as long QT syndrome, hypertrophic cardiomyopathy, and Brugada syndrome, all of which have the propensity to cause sudden cardiac death. Adults with ICDs consistently report elevated levels of anxiety and depression, as well as negative lifestyle changes associated with the device. Compared to older ICD recipients, young patients face decades of life with the device and the long-term impact and implications are important to consider. This research explores the experiences of adolescents living with an ICD. Parents of these adolescents were also included to explore the impact on them as the primary caregivers. Methods: A qualitative approach was chosen to explore the lived experience; semistructured interviews with six adolescents and six parents were conducted from which a number of key themes emerged. Results: The experiences described by participants included the restrictions adolescents face, the ICD shock experience, and ongoing challenges post-ICD implantation. However, both adolescents and parents were able to adjust to life after receiving an ICD and described several benefits associated with having the device. Findings also emerged relating to communication between health professionals and adolescents, and the limitations adolescents impose on themselves post-ICD implantation. Conclusion: These findings have important implications for clinical practice and may help guide medical management for adolescents with ICDs and their families. (PACE 2012; 35:62-72) [ABSTRACT FROM AUTHOR]

This paper reviews the diversity in parenting values and practices amongst Aboriginal peoples and Torres Strait Islanders. First, issues arising from the historical traumatic disruption of families' attachments are discussed. Then the contribution Indigenous parenting makes to the development of healthy and vulnerable individuals becomes the central focus. Family therapists can draw from a broad understanding of the diversity of parenting values and practices in the context of a strength-based approach. [ABSTRACT FROM AUTHOR]