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Background: Early childhood interventions are critical for reducing child health and development inequities. While most research focuses on the efficacy of single interventions, combining multiple evidence-based strategies over the early years of a child's life may yield greater impact. This study examined the association between exposure to a combination of five evidence-based services from 0 to 5 years on children's reading at 8-9 years., Methods: Data from the nationally representative birth cohort (n=5107) of the Longitudinal Study of Australian Children were utilised. Risk and exposure measures across five services from 0 to 5 years were assessed: antenatal care, nurse home-visiting, early childhood education and care, parenting programme and the early years of school. Children's reading at 8-9 years was measured using a standardised direct assessment. Linear regression analyses examined the cumulative effect of five services on reading. Interaction terms were examined to determine if the relationship differed as a function of level of disadvantage., Results: A cumulative benefit effect of participation in more services and a cumulative risk effect when exposed to more risks was found. Each additional service that the child attended was associated with an increase in reading scores (b=9.16, 95% CI=5.58 to 12.75). Conversely, each additional risk that the child was exposed to was associated with a decrease in reading skills (b=-14.03, 95% CI=-16.61 to -11.44). Effects were similar for disadvantaged and non-disadvantaged children., Conclusion: This study supports the potential value of 'stacking' early interventions across the early years of a child's life to maximise impacts on child outcomes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To examine the child and parental outcomes at school age of a randomized controlled trial of a home-based early preventative care program for infants born very preterm and their caregivers., Methods: At term-equivalent age, 120 infants born at a gestational age of <30 weeks were randomly allocated to intervention (n = 61) or standard care (n = 59) groups. The intervention included 9 home visits over the first year of life focusing on infant development, parental mental health, and the parent-infant relationship. At 8 years' corrected age, children's cognitive, behavioral, and motor functioning and parental mental health were assessed. Analysis was by intention to treat., Results: One hundred children, including 13 sets of twins, attended follow-up (85% follow-up of survivors). Children in the intervention group were less likely to have mathematics difficulties (odds ratio, 0.42; 95% confidence interval [CI], 0.18 to 0.98; P = .045) than children in the standard care group, but there was no evidence of an effect on other developmental outcomes. Parents in the intervention group reported fewer symptoms of depression (mean difference, -2.7; 95% CI, -4.0 to -1.4; P < .001) and had reduced odds for mild to severe depression (odds ratio, 0.14; 95% CI, 0.03 to 0.68; P = .0152) than parents in the standard care group., Conclusions: An early preventive care program for very preterm infants and their parents had minimal long-term effects on child neurodevelopmental outcomes at the 8-year follow-up, whereas primary caregivers in the intervention group reported less depression., (Copyright © 2016 by the American Academy of Pediatrics.)

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

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